Occupational adaptation in place: Family caregiving in an assisted living center

The phenomenon of occupational adaptation emerges from complex interactions between person, context, and occupation. An appreciation of how these interactions influence the adaptation process over time is needed for an understanding of the process of occupational adaptation. In the science of occupation we have characteristically focused on the relationship between person and occupation as supported or constrained by the space in which occupational engagement occurs. Theories about place, particularly those from a phenomenological perspective, have important implications for occupational therapy and its science. The line of research described here attempted to extend knowledge about occupational adaptation by contextualizing this phenomenon as it occurs in a specific situation, based on theories of place. This research explored place and its influences on family caregivers' occupational adaptation during care provision in an assisted living center.; Family care provision in the midst of an assisted living center (ALC) is an apt situation for study of place's role in occupational adaptation because the dynamics of formal and informal caregiving at an ALC lead to a unique, complex situation. The findings are described in three papers that were submitted for publication. The first paper is a synthetic literature review of the relationship between occupational adaptation and place. This paper proposes that occupation and place are complementary, parallel concepts that integrate through experience into situations. Occupational adaptation is the process of making situations into what they ought to be. The second paper reports the findings of an ethnography of elders' experience of place while living at an ALC. It describes the situations experienced by residents and how they shaped those situations in the process of adapting to life in an ALC. The third paper reports the findings of a phenomenology of family caregivers' visiting experiences. It describes the family caregivers' visiting experiences, the significance of those experiences, and how engagement in visiting-related occupations and routines shaped and characterized family caregivers' occupational adaptation process.; The significance of this work to occupational therapy and its science lies in its claims about the role and function of place in occupational adaptation, about the importance of occupational forms as part of the temporal-occupational nature of place, and about the possible importance of personal projects as the culmination of person, place, and occupation in occupational adaptation. The findings of this research are significant to health and social service professionals who work with family caregivers in the midst of residential care settings because it identified challenges and adaptive efforts of family caregivers. Also, it described some often overlooked aspects of family caregivers' experiences, such as the joy and fulfillment they find in this part of their lives.