Social Participation Before and After Long-Term Care Entry

To the Editor Lam and colleagues provide important insights on social and community participation in long-term care (LTC) settings (ie, nursing homes and assisted living). They found that residents’ social participation in clubs and religious services increased following LTC admission, yet going out for enjoyment declined.

The authors suggest social participation is a patient-centered outcome, but the role of patient-specific values in ensuring benefit of such participation warrants further examination. As clinician-researchers who work in LTC, we know that many residents attend activities not because they find that activity meaningful but because it may be the only activity offered.

For many residents, the activities they find truly meaningful require leaving their home (now the facility), such as eating with friends or going to the salon. After LTC admission, residents’ primary location of activities may move to the facility, but the activities they perhaps value most may not move with them.

Thus, despite increases in ostensibly meaningful clubs or religious services, we find it alarming that the going out for enjoyment activities declined so notably.