Exploring the applicability of selection, optimization, and compensation model to the personal goals of nursing home residents

Abstract

Selection, optimization, and compensation theory (SOC) is a major theoretical framework through which human development has been studied. It is a process-oriented model that provides accounts for how gains are maximized and losses minimized throughout the lifespan, and particularly in later life. This theory has been previously used to inform caregiving approaches, although the extent that the care recipient themselves use this SOC process has not been examined. The purpose of this dissertation was to learn more about the goals of nursing home residents and strategies for goal pursuit within the context of the nursing home. Eight cognitively-intact nursing home residents (mean age = 88.3 years; SD = 4.9) were interviewed for this mixed-methods study. Semi-structured interviews were conducted and three brief questionnaires were administered. Data were coded for goal identification and content, and also analyzed qualitatively in response to the large percentage of interview data unrelated to goals. Results of the study suggest that these nursing home residents were not primarily oriented towards explicit goal selection or pursuit; 63% denied having goals outright. Goal coding analysis revealed only a small portion of interview responses related to goal identification or pursuit. Qualitative analyses, however, revealed 11 emergent themes across the interviews. Taken together these results may suggest that residents are able to describe domains of meaning, such as how they spend their time and what was important to them, but are less focused on intentionally-defined, behaviorally-driven goals. Implications relating to SOC theory and person-centered care are discussed.