The Role of Sense of Purpose in the Psychological Wellbeing of Older People in Care Homes

  • Rebecca Owen

Student thesis: Doctor of Clinical Psychology


This thesis explored the relationship between sense of purpose and facets of psychological wellbeing in older people residing in care homes. The thesis consists of three papers: 1) a systematic literature review, 2) an empirical study and 3) a critical evaluation of the research process. The systematic review (Paper 1) presented a synthesis of the evidence pertaining to the nature and effectiveness of interventions that supported the oldest-old to engage in purposeful activity, with respect to improving wellbeing outcomes. Eight studies were included, spanning 14 years of aging research in five different countries and involving 241 participants, all of whom were care home residents. The review identified two main types of interventions: (1) interventions that supported participants to adopt a specific functional role whereby the purpose was to help others, such as, volunteering; (2) interventions that supported participants to learn and develop a new skill. With regard to improving psychological wellbeing and quality of life, the strongest evidence was for interventions that had supported participants to adopt a specific functional role. The benefits of supporting older people residing in care homes to step outside of their usual role as a passive recipient of care, and into a more active, purposeful role were discussed. Recommendations were made for residential care settings to consider the provision of structured volunteering opportunities for residents, in addition to the social and recreational activities typically offered in such settings. The empirical study (Paper 2) explored the views of older care home residents regarding sense of purpose, including the ways in which they maintain a sense of purpose, and the potential barriers to this. Semi-structured qualitative interviews were conducted with 15 older people from four residential care homes and a thematic analysis was used to understand the data. Participants maintained a sense of purpose by helping other residents, having a structured daily routine, and engaging in meaningful activities. Experiences such as bereavement, agerelated losses of valued social roles, feelings of dependence, and the physical limitations that accompany old age were identified as barriers to maintaining a sense of purpose. Clinical recommendations were made in relation to addressing the modifiable barriers to purpose and challenging care home cultures that reinforce narratives of dependence, in order to enhance feelings of purpose and improve the psychological wellbeing of older people in residential care. Paper 3 provides a critical appraisal of the research process. The strengths and limitations of the work, the challenges faced and contributions to the research field were considered. The researchers’ personal reflections on the research process were also presented.
Date of Award31 Dec 2020
Original languageEnglish
Awarding Institution
  • The University of Manchester
SupervisorKatherine Berry (Supervisor), Richard Brown (Supervisor) & Laura Brown (Supervisor)

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