A MIXED METHODS STUDY OF HOW NURSING HOME RESIDENTS VIEW THEIR SOCIAL RELATIONSHIPS AND INTERACTIONS

As part of a larger study of social cognition and social functioning in nursing home residents ( N =40) with and without cognitive impairment, participants responded to open-ended questions about their day-to-day interactions with staff and other residents, as well as their ongoing relationships with family and friends. Beginning with a content analysis of verbatim transcripts, themes were constructed inductively first within and then across participants’ responses to the interview questions. Next, data from measures of social cognition and cognitive status, as well as nursing staff’s ratings of their social behavior, were used in within-participant analyses to identify possible cognitive and behavioral correlates of residents’ self-assessments of interpersonal relationships and interactions. Finally, patterns of perceived change in the residents’ social functioning were characterized in cross-participant comparisons of these combined individual qualitative and quantitative results. Participants’ social experiences appeared to be determined not only by long-established habits and preferences and length of time at the nursing home, but also by their cognitive status and social cognition competencies. A common theme though, regardless of cognitive status, was the importance of managing ongoing relationships and day-to-day interactions so as to reduce one’s own stress as well as burden on others. For those with little or no cognitive impairment, maintaining a sense of self was also a priority, especially as they became frailer and as they witnessed cognitive decline in their peers. Examples will be given of how participants with moderate cognitive impairment but intact social cognition assess their relationships and interactions with others.