The influence of occupation on wellbeing, as perceived by the elderly: a systematic review protocol

Review objective/questions The objective of the current review is to identify the types of occupations that are important in improving overall wellbeing amongst the elderly population. It is assumed that conducting a systematic review with a qualitative approach will lead to a deeper understanding of how the independently‐living elderly enhance their wellbeing through participation in occupations. Such a review will contribute to the knowledge and practice within the health promotion framework with the healthy elderly population. Thus the review will be of use to occupational therapists and others working with elderly people in terms of both theory and practice, as the knowledge will be grounded in the reality of human experience. The specific question to be addressed in this review is: Which occupations do the independently‐living elderly consider to enhance their overall wellbeing? Background An important health goal for elderly people in western countries is to maintain their ability to live independently and to function well.1 In the fields of social science and gerontology, concepts such as ‘active aging’ and ‘successful aging’ imply that ‘doing’ activities is closely related to wellbeing.3 Being active is an important factor in managing life and coping with the challenges related to advanced age.2 Activities are defined by all that people need, want or are obligated to do such as self‐care, household tasks, leisure and social interactions with family and friends.4 When a person engages in and gives the activity a purpose, value or reason, the activity will become meaningful and can be defined as an occupation.5,6 Crepeau et al. stated that occupations “include the day‐to‐day activities that enable people to sustain themselves, to contribute to the life of their family and to participate in the broader society”. 7(p28) Thus, occupations are multifaceted phenomena as they provide meaning, identity and structure to a person's life.5 The one premise underpinning occupational therapy and occupational science is that the occupations in which people engage and their health are interrelated and this seems to be universal for the experience of wellbeing.8,9 The meaningfulness of the occupations in which a person engages throughout their lifespan changes over time.10 The occupations a young man at university may find meaningful will probably differ from those of an elderly man who is retiring from work. For the elderly, there are different factors influencing their engagement in occupations. Examples of these include the aging process, as well as the individual's history of occupations. Significant changes in external conditions, for example retirement, also have an impact on the occupations considered by an individual to be meaningful and in which they will subsequently engage.11 This complex interaction between external conditions of the individual's lifespan and the internal perceptions of those conditions,12 influences the way in which the individual perceives general wellbeing.10 Several studies indicate that engagement in social occupations seems to improve the wellbeing of the elderly.9,13‐16 However, a Danish study showed that the majority of the elderly in their sample found physical and solitary occupations as being the most important for maintaining health and wellbeing.17 Productive activities such as remaining active in work or volunteering has also been indicated to have a positive effect on wellbeing.13,18 It is important for society in general, as well as social and health services in particular, to enable and assist the elderly in improving their health and enhance their general wellbeing. Conducting a systematic literature review on elderly persons’ occupations from the perspective of the elderly will lead to a deeper understanding on how the elderly can maintain their well‐being.