Exploring Factors That Influence Peer-Relations among Older Adults Living in Residential Homes

Background:
An understanding of peer relationships whilst living in care homes, requires sensitivity to the complex breadth of factors that comprise the persons’ experiential and social contexts. This is necessary to ensure that academic and public perspectives on older people in care homes are not subsumed under homogenising discourses that prioritise victimhood and biological impairment. Research generally on older people is relatively sparse and even less is known about co-resident relationships. The analytical focus for this study is on the perspectives of residents living in UK care homes and of the factors that inform their relationships with other residents. It is hoped that this, in turn, will inform clinical psychology and service delivery in supporting the lives of people in assisted living settings. In short, the paper seeks to inform an agenda of ‘living well and dying well’ (Kewell, 2019:20).

Method: Semi-structured interviews were conducted with seven older people living in a UK care home. Thematic analysis of transcripts was undertaken and was informed by a critical realist epistemology.

Results: Four main themes emerged from the analysis: 1. Belonging and Connection: an integral need, 2. Self-esteem and Validation: maintaining a unique presence, 3. Freedom and Control: negotiating authorship of life, and 4. Occupation and Growth: a search for meaning.

Conclusions:
The types of co-resident relationships found to exist within the care home are consistent with previous studies: no-contact (common), companion (common), confidante (rare) and antagonist (rare). Departing from existing studies, is the finding that social discourse and institutional context fundamentally inform peer relations. Participants were actively engaging with multiple losses: community, self-identity, autonomy and meaningful pursuit; all reinforced by institutionalised approaches to death, dying and assisted living. This negotiation of loss informed the behaviours of peer-avoidance, peer-selection, withdrawal, and a prioritisation of non-peer relations. The implications of the findings at research, service, clinical and policy levels are discussed.