The development and testing of the lively later life programme (3lp) for institutionalised elderly people in Malaysia

Abstract

Changes in demographic characteristics and modernisation in Malaysia have contributed to relocation of many elderly people to an elderly institution which is rapidly growing in number in Malaysia in spite of traditional cultural values and the personal beliefs towards elderly people. Living in elderly institutions is often associated with deterioration in well-being as a result of negative issues in institutions such as occupational injustice, loss of meaningful relationships, loss of autonomy and individuality which lead to psychological problems such as depression. Subsequently these issues affect several domains in life including future orientation towards ageing (ERA), general self-efficacy (GSE) and quality of life (QoL). Various lifestyle redesign programmes based on occupational therapy have been conducted to prevent such deterioration. However, such programmes are conducted in Western countries and were design for elderly people in the community. To date, there is no substantial work exploring the applicability of such programmes to elderly people in institutions and in different sets of cultures, values and beliefs such as in Malaysia. This provides justification for the need for such a study. The aim of this concurrent embedded experimental mixed methods study was to explore the effect, and identify the ideographic experience, of forty-six elderly people living in a public funded elderly people institution in Malaysia before and after participated in a new lifestyle redesign programme known as the Lively Later Life Programme (3LP) on ERA, GSE and QoL. Another thirty-six elderly people in a control group participated in an 'in-house' programme. After six months of taking part in the 3LP, there were statistical significant changes in the scores of the study measures for the participants in the experimental group. In addition, the participants provided ideographic experiences exemplified in various themes relating to the experience of taking part in the 3LP which supported and elaborated the changes in the scores of the study measures. Findings from this study contribute to evidence based practice in occupational therapy, validate and expand previous lifestyle redesign programmes. In addition, the findings demonstrate that a lifestyle redesign programme based on occupational therapy can be successfully transferred to a different setting, transcend cultural barriers and philosophies of life.