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Riding in the moment: an exploratory mixed methods case study of activity situations and quality of life of institutionalized adults with dementia




Fields, Beth E., author
Wood, Wendy, advisor
Bruemmer, Jason, committee member
Hooper, Barb, committee member
Gloeckner, Gene, committee member

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The number of adults with some form of dementia is growing, and growing remarkably fast (MBA Healthcare Management, 2017). As adults experience the progressive nature of dementia and consequently, lose functional abilities, many turn to long-term care (LTC) facilities for health care assistance. Unfortunately, LTC facilities experience challenges in providing activities to residents that allow them to participate fully and promote the use of their remaining abilities (Chung, 2004). This exploratory, mixed methods case study sought to investigate the influence of routine activity situations, in particular, an equine-assisted intervention, called Riding in the Moment (RM), on quality of life (QoL) for institutionalized adults with dementia. I used the Activity in Context and Time (Wood, 2005) to record behavioral observations of the institutionalized adults with dementia during routine activity situations at Seven Lakes Memory Care and Hearts and Horses Therapeutic Riding Center for eight weeks, four hours each day. Semi-structured interviews with five key informants from both study sites along with field notes were also gathered. First, I analyzed both data sets separately; for the quantitative data, I used nonparametric statistical testing and descriptive statistics and for the qualitative data, I employed a basic qualitative description approach. Next, I merged findings from both data sets together using a joint display method. This convergence allowed me to compare and contrast the prevalence of dementia-specific QoL indicators across routine activity situations as well as to investigate the impact of the unique activity situation, RM, on the QoL of residents with dementia. Results revealed that RM was the only activity situation that gave rise to all optimal QoL indicators captured. As suggested in this study, residents' involvement in activity situations, a unit of analysis, can provide a detailed understanding of their dementia-specific QoL. Moreover, RM may be an effective environmental intervention that allows institutionalized adults with dementia a means to return to nature. Overall, this study aligns with and further supports that nature constitutes an important basis for institutionalized adults with dementia to thrive and attain individual fulfillment.


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animal-assisted therapy
equine-assisted therapy
quality of life


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