Psychosocial resilience, depression, and subjective well-being in long-term care

This prospective study focused on the correlates of adaptation to institutional long-term care in the first 90 days of admission. It examined the strength of the correlations among four independent variables conceptually related to resilience and adaptive functioning: Self-efficacy, mastery, purpose in life, and social support. The Mini-Mental State Examination (MMSE) was selected to provide a baseline measure for determining the cognitive capacity of 55 older adults, residing in four nursing homes in Washington, DC. Twenty-seven African American male and female residents participated in the study.; From a life-span development perspective with its emphasis on adaptive aging, self-efficacy was chosen as the theoretical framework linking the correlates of psychosocial resilience and adaptation in long-term care. A correlational design, using Pearson's r, examined the relationships between the dependent variables, depression and subjective well-being, with the above-referenced independent variables. With performance of activities of daily living (ADLs) as a background variable, it was predicted that high levels of self-efficacy, mastery, purpose in life, and social support would be associated with optimal adaptation to long-term care, as evidenced by the absence of depression and presence of high levels of life satisfaction, a proxy measure for subjective well-being. The study hypothesis was partially supported by the findings that social support mediates the adaptation of older adults to long-term care nursing homes by promoting mental health. The findings revealed a moderately strong, negative association between social support and depression (−.496, p ≤ .05), confirming that social support, as an external protective factor, is a salient characteristic of resilience in older adults in long-term care. The findings further confirmed a very strong, highly significant, negative association between ADL performance and depression (−.721, p ≤ .01).; The study data contribute empirical findings that support intuitive notions about ways to promote the quality of life for older adults in nursing homes. The social work profession is uniquely positioned to anticipate the individual strengths that newly admitted residents bring to nursing homes, proactively intervene to reduce any risks for poor adaptation, and skillfully promote psychosocial resilience in long-term care.