Feeling included and engaging in community life is an important aspect of health and well-being among older adults (Bourassa et al. Reference Bourassa, Memel, Woolverton and Sbarra2017; Clair et al. Reference Clair, Gordon, Kroon and Reilly2021) yet building and maintaining inclusive communities that support older adult wellbeing is a key social challenge (Hong et al., Reference Hong, Welch-Stockton, Kim, Canham, Greer and Sorweid2023; Wister & Kadowaki, Reference Wister and Kadowaki2021). In fact, promoting social inclusion and developing supports and services to reduce social isolation among the aging population continues to be a focus of Canadian aging recommendations (MacCourt, Reference MacCourt2016; National Seniors Council, 2014; Wister & Kadowaki, Reference Wister and Kadowaki2021). Older adults are disproportionately affected by social isolation; that is, an insufficient quantity of social contacts and quality of engagements and relationships with others (Wister et al., Reference Wister, Menec, Mugford, Raina, Wolfson, Kirkland and Griffith2018; Zavaleta et al., Reference Zavaleta, Samuel and Mills2017). Older adults who are socially isolated often experience loneliness, which can be defined as the emotional distress experienced when an individual’s social needs are not being met (Hawkley & Cacioppo, Reference Hawkley and Cacioppo2010; Wister et al., Reference Wister, Menec, Mugford, Raina, Wolfson, Kirkland and Griffith2018). In turn, social isolation and loneliness contribute to depression and decreased quality of life, life satisfaction, and wellbeing among older adults (Clair et al, Reference Clair, Gordon, Kroon and Reilly2021; Morrow-Howell et al., Reference Morrow-Howell, Galucia and Swinford2020). While many strategies targeting isolation and loneliness involve individual or small-group interventions (Gardiner et al., Reference Gardiner, Geldenhuys and Gott2018), approaches that promote the development of inclusive communities, that are “designed for, and by, older adults” (Parniak et al., Reference Parniak, DePaul, Frymire, DePaul and Donnelly2022, p.3) are recommended (Parniak et al., Reference Parniak, DePaul, Frymire, DePaul and Donnelly2022). Group-based, community interventions that are participatory in nature, involve older adults actively in design and delivery, and prioritize social participation and engagement contribute to the enhancement of social networks, build sense of community, and reduce loneliness and isolation among older adults (Hong et al., Reference Hong, Welch-Stockton, Kim, Canham, Greer and Sorweid2023). Interventions that prioritize older adults’ collective engagement in these ways are more likely to be successful and have sustained impacts (Hong et al., Reference Hong, Welch-Stockton, Kim, Canham, Greer and Sorweid2023; Stojanovic et al., Reference Stojanovic, Collamati, Mariusz, Onder, La Milia, Ricciardi and Poscia2017). This study explores a program offered in a naturally occurring retirement community (NORC) in London, Canada during the COVID-19 pandemic.
NORCs hold great potential to access potentially isolated older adults and enact supports and services to promote social connectedness and sense of community among them (DePaul et al., Reference De Paul, Parniak, Nguyen, Hand, Letts, McGrath and Donnelly2022; Parniak et al., Reference Parniak, DePaul, Frymire, DePaul and Donnelly2022). NORCs are places – communities, residential buildings, or neighbourhoods – where many older adults happen to live, despite an absence of that intention in construction or design (Hunt & Gunter-Hunt, Reference Hunt and Gunter-Hunt1986). One means of enacting supports within NORCs is through the provision of targeted, supportive service programs (NORC-SSPs) that involve working with older adult NORC residents to identify their needs and collaborating with local health and social service providers to ensure the needs are met (Bedney et al., Reference Bedney, Goldberg and Josephson2010; Xia et al., Reference Xia, Susilawati, Chen and Wang2022). By prioritizing the involvement of older adults, supporting engagement in shared activity, and strengthening community relationships, this “place-based” (Vladeck & Altman, Reference Vladeck and Altman2015, p.21) programming facilitates the development of supportive communities of older adults (Bedney et al., Reference Bedney, Goldberg and Josephson2010; Greenfield et al., Reference Greenfield, Pestine-Stevens and Scher2022). NORC-SSPs have also demonstrated benefits for older adult residents including a greater sense of community, increased social support, reduced social isolation, decreased depression, and improved quality of life (Bedney et al., Reference Bedney, Goldberg and Josephson2010; DePaul et al., Reference De Paul, Parniak, Nguyen, Hand, Letts, McGrath and Donnelly2022; E et al., Reference Xia, Susilawati, Chen and Wang2022; Parniak et al., Reference Parniak, DePaul, Frymire, DePaul and Donnelly2022). Despite these benefits, and a brief peak in NORC publications in 2010, NORC research has gained limited traction since Hunt and Gunter-Hunt’s conceptualization in 1986, with only three articles published on NORCs in the past five years. While most of the literature has focused on NORCs in the United States, information on NORC-SSPs is rarely made public (E et al., Reference Xia, Susilawati, Chen and Wang2022).
The Oasis Senior Supportive Living Inc. (2022; www.oasis-aging-in-place.com) is a unique NORC-SSP in Canada. Aligned with NORC-SSP ideals, Oasis is an older adult-driven model for aging in place that aims to support the health and wellbeing of older adults living in NORCs through the provision of programming that caters to the needs and interests of members (De Paul et al., Reference De Paul, Parniak, Nguyen, Hand, Letts, McGrath and Donnelly2022; Donnelly et al., Reference Donnelly, Mahoney, Hay, Parniak, Goes and DePaul2019). Originally developed in Kingston, Ontario (Oasis Senior Supportive Living, 2022), each Oasis site involves access to communal space and a paid on-site program coordinator who works with older adults to develop in-NORC programming based on the core Oasis principles of promoting social connection, physical activity, and nutritional wellness. All sites share these foundations; however, the types of programming vary across sites based on the capacities and preferences of the older adults, the space, and the local community services and resources available. The role of the program coordinator is not to provide formal health and social services to members, rather they provide informal support through program facilitation and can connect members to community organizations and services, as needed. In addition, all sites receive guidance and support through regular membership meetings, and some have a volunteer steering committee/board of directors. Fundamental to Oasis is the preservation of older adults’ autonomy; Oasis members collectively control the types and amount of programming offered, and their individual level of engagement can vary depending on what, and how often, they choose to participate. A critical part of Oasis is building community through doing occupations together, which are the everyday, meaningful activities that people do independently or with others (World Federation of Occupational Therapists [WFOT], 2022).
The site of the current research was established in early 2019 by Western University researchers in collaboration with researchers from Queen’s University, McMaster University, and the board of directors of the original Kingston Oasis site. It is supported by a steering committee made up of researchers, Oasis members, funders, and local community organizations that serve older adults.
Pandemic influences on older adults’ social connectedness
The COVID-19 pandemic both highlighted and exacerbated the issue of social isolation among older adults (Morrow-Howell et al., Reference Morrow-Howell, Galucia and Swinford2020; Smith et al., Reference Smith, Steinman and Casey2020). In an effort to control the spread of the virus as the population waited for vaccines to be developed and available, several mandates were enforced in Ontario and elsewhere, such as stay-at-home orders, closures and reduced capacities at public places, social distancing recommendations, and masking mandates (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021; Smith et al., Reference Smith, Steinman and Casey2020; Wister & Kadowaki, Reference Wister and Kadowaki2021). The highly contagious, airborne coronavirus had a disproportionately greater impact on the morbidity and mortality of older adults (Morrow-Howell et al., Reference Morrow-Howell, Galucia and Swinford2020; Smith et al., Reference Smith, Steinman and Casey2020). Pandemic guidelines and restrictions that “encouraged [older adults] to self-isolate while the rest of the population has been cautioned against in-person contact with them” (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021, p.1) magnified rates of social isolation and loneliness among older adults. Data from the Canadian Longitudinal Study on Aging showed that since the pandemic, there was a 67% increase in loneliness for women aged 65 to 74, 37% for those aged 75 to 84; and 45% and 33% increase (respectively) for men of the same age distributions (Wister et al., Reference Wister, Menec, Mugford, Raina, Wolfson, Kirkland and Griffith2018; Wister & Kadowaki, Reference Wister and Kadowaki2021). Even for those who did not contract the virus, restrictions, heightened awareness of risk, as well as fear and concern for their health and safety, have shaped how older adults engage in individual and collective occupations (WFOT, 2020). Older adults were forced to change and adapt to their daily occupations, habits, and routines due to the disruptions caused by the pandemic (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Rotenburg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021). Throughout the pandemic older adults were unable to access many of the supports, services, programs, and “chosen” (Sweeney & Zorotovich, Reference Sweeney and Zorotovich2021, p. 262) activities that they relied on to have their “physical, emotional, and social needs met” (Morrow-Howell et al., Reference Morrow-Howell, Galucia and Swinford2020, p.528). The pandemic also created barriers to accessing socially supportive public places, including senior, fitness, and community centres, libraries, museums, coffee shops, restaurants, and places of worship (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021; Wister & Kadowaki, Reference Wister and Kadowaki2021). Having limited access to the people and places that provided meaning and purpose in their lives (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021; Smith et al., Reference Smith, Steinman and Casey2020) challenged many older adults’ abilities, processes, and choices regarding those occupations they “need to, want to, and are expected to do” (WFOT, 2022, para.2).
In response to the local public health restrictions, many community-based programs were cancelled and gathering places closed; however, there were also promising programs and practices that emerged to reduce isolation and promote social connection among older adults while remaining physically distanced (Smith et al., Reference Smith, Steinman and Casey2020; Wister & Kadowaki, Reference Wister and Kadowaki2021). In some instances, various programs during the pandemic were offered virtually (telephone or online video conferencing) or in hybrid environments (some combination of in-person and telephone/online participation) (Morrow-Howell et al., Reference Morrow-Howell, Galucia and Swinford2020; Wister & Kadowaki, Reference Wister and Kadowaki2021). Many of these programs focused on promoting and maintaining older adults’ physical health, ranging from telemedicine and health professional check-ins to online fitness and nutrition programs (Wister & Kadowaki, Reference Wister and Kadowaki2021). While some programs provided individualized and practical support, like telephone befriending programs, grocery shopping, and meal delivery, others involved group and social discussion, like those offered through Senior Centres Without Walls (Wister & Kadowaki, Reference Wister and Kadowaki2021). At an Oasis NORC-SSP in Hamilton, Ontario, all regular, in-person programming was replaced only by program coordinator telephone calls to members and monthly care package delivery (Garcia Diaz et al., Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022). While these efforts were supportive for older adults’ wellbeing, Garcia Diaz et al. (Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022) found that the physical distancing within the first 6 months of the pandemic had negative impacts on the older adults’ social networks.
NORC-SSPs like Oasis hold strong potential to support older adults during a pandemic. Although some research is beginning to emerge on older adults’ experiences with the pandemic, very few studies have examined the role of living in a NORC or how NORC-SSPs were impacted or helped support older adults throughout the pandemic (Garcia Diaz et al., Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022). Thus, the aim of this paper is to discuss how a community of older adults living in a NORC with an Oasis program sought to build and maintain a sense of community during a global pandemic, by finding new ways of being together and engaging in occupation together.
Methods
Study setting: the NORC-SSP program
Programming at the London Oasis was suspended in March 2020 due to pandemic restrictions and resumed in a modified format in November 2020. From November 2020 to July 2021, the program coordinator, with direction from the members, organized 92 virtual activities for the 37 members, with attendance at these events totalling 384. During this period, about 9-15 group virtual events were offered each month, including educational and informative guest speakers, movie showings, live music, craft workshops, virtual tours, at-home exercises, storytelling sessions, and holiday celebrations. At the time of interviews, some events were beginning to happen in-person, such as a walking group. Although most of the activities changed each month depending on the interest of the members, virtual coffee hours were a regular occurrence, and 40 took place in this 9-month period. Trivia began as an occasional monthly activity, but quickly gained popularity and developed into a weekly activity with a cumulative total of 68 people attending 21 sessions. London Oasis also provided two hot, catered meals that members picked up. Members were informed about the various activities through monthly newsletters and calendars delivered door-to-door by member volunteers as well as via email. Newsletters and calendars also contained other information about upcoming holidays, events, research updates, and additional activities for members to do at home. The program coordinator supported at-home activities through the provision of board games, puzzles, craft supplies, and books. London Oasis attempted to support members’ virtual engagement through the purchase and provision of two tablets for those who expressed interest, with the program coordinator providing instructional and troubleshooting support over the phone. Oasis members provided input into the program at monthly member meetings held via Zoom and regular individual telephone and email check-ins with the program coordinator. Despite the challenges posed by the pandemic, London Oasis facilitated older adult engagement online, over the phone, and in their own homes in an attempt to maintain meaningful connections between members. See Table 1 for an example of how London Oasis activities and member attendance compared before and during the pandemic.
Table 1. June Oasis activities comparison
Study design
Methods of qualitative inquiry are designed to capture individuals’ perspectives, including understanding how people make sense and meaning of their experiences and rationalize their behaviour (Teti et al., Reference Teti, Schatz and Liebenberg2020). Researchers recommend qualitative inquiry for investigating what makes interventions successful, particularly in the context of a socially disruptive event like the COVID-19 pandemic (Gardiner et al. Reference Gardiner, Geldenhuys and Gott2018; Teti et al., Reference Teti, Schatz and Liebenberg2020). According to Sandelowski (Reference Sandelowski2000), “qualitative descriptive studies offer a comprehensive summary of an event in the everyday terms of those events” (p.336). Qualitative description uses naturalistic inquiry, purposive sampling, and data collected through interviews or focus groups to better understand “the who, what, and where of events or experiences and gain insights from informants regarding a poorly understood phenomenon” (Kim et al., Reference Kim, Sefcik and Bradway2017, p.23). Grounded in a constructivist paradigm that emphasizes the importance of understanding individuals’ lived experiences from their own perspectives (Ponterotto, Reference Ponterotto2005), this qualitative descriptive study utilized semi-structured interviews to explore older adult NORC-SSP members’ experiences with Oasis during the COVID-19 pandemic.
Sampling, recruitment, data collection, and analysis
A member of the research team invited Oasis members to participate in the research by email and telephone. Consenting members participated in either a telephone or Zoom video-conferencing interview. Although participation was open to any London Oasis member who volunteered, we employed purposive sampling to achieve maximum variation in the sample. We recruited participants with varying attendance levels, length of experience with the program, and gender, based on program records. All participants that we were able to reach, agreed to participate in the study (see Table 2). We contacted 13 Oasis members, 11 women and two men, out of a possible 37 people, all of whom agreed to participate. While most participants (n=11) had been Oasis members since its inception in 2018, two participants had just moved to the site and joined Oasis within the year. Attendance levels among participants varied, with four frequent, regular attenders (i.e. at least once per week); five who often or occasionally attended programming (i.e. 1–3 times per month), and four who rarely attended events or activities, but received the newsletters and attended large events like meals.
Table 2. Sample characteristics
Interviews with Oasis members were conducted from the end of May 2021 through to July 2021, 14 months after the first government-mandated lockdown and social distancing restrictions began. Interviews were semi-structured, with questions focusing on participants’ experiences with Oasis over the past year. Given that the Oasis model aims to promote well-being, a sense of community, and shared occupations, these were key concepts addressed in the interviews. Participants were asked about their participation in and contributions to the programs and activities both in-person and online. They were also asked to elaborate on any perceived benefits, challenges, suggested improvements, and opinions regarding the sense of community in the building. The semi-structured interview guide is available in Appendix A. The first author conducted individual interviews with participants which ranged from 22 to 78 minutes in length. The interviews were transcribed verbatim using NVivo transcription software, after which audio files and transcripts (162 pages) were reviewed for consistency, and any errors were revised. The names of participants as well as the names of those mentioned in interviews, were removed and replaced with an alphanumeric code.
The first author, in consultation with the second author, conducted qualitative content analysis (Kim et al., Reference Kim, Sefcik and Bradway2017; Sandelowski, Reference Sandelowski2000) of the interview transcripts. To begin, these researchers read and re-read transcripts multiple times to become familiar with the data, then followed a combined strategy (Schreier, Reference Schreier2012), where researchers determined concept-driven categories based on the interview guide, like benefits and challenges of Oasis, and additional data-driven categories, like participants’ connection to the coordinator. We further attended to ways in which participants lost, maintained, and re-imagined Oasis-related occupations and activities, considering both individual and more social occupations. Segments of text were structurally coded and subsequently ‘cut and pasted’ into their relevant categories in Microsoft Excel. Through the process of subsumption (Schreier, Reference Schreier2012), we reviewed the meaningful units of text within each category, developing subcategories that described the changes to the program, participants perceptions of the program, and the role of occupation in older adults’ attempts to build and maintain the sense of community during the pandemic. Additional authors reviewed and contributed ideas to the developing themes.
Throughout the study, the first and second authors met regularly to discuss on-going data collection and analysis, sharing findings with the broader research team, and engaging in a process of collective reflexivity that enhanced the methodological integrity and rigour of the study (Levitt et al., Reference Levitt, Motulsky, Wertz, Morrow and Ponterotto2017; Tracy Reference Tracy2010). Ethical approval for the study was granted by the Western University Research Ethics Board.
Findings
Our analysis showed how changes in context prompted changes in the program and community, and how the Oasis members continued to seek to be together and do occupations together, often in creative ways that supported their sense of community. This section presents the findings according to the three major themes derived from the analysis of participant interviews, Oasis as a Lifesaver: A Positive During a Negative Time, Connections to Coordinator, and Finding New Ways of Being and Doing Together.
Oasis as a lifesaver: a positive during a negative time
Participants described the stay-at-home orders/lockdowns and social distancing measures associated with the pandemic as isolating, especially if they lived alone. The building common rooms were locked in March 2020, leaving Oasis members unable to access their “hub” (P2) for over 17 months. Even though some of the most well-attended activities prior to the pandemic (like weekly coffee hours and catered meals) were re-instated virtually in November 2020, not having access to their common room, a familiar and comfortable space for connection and the in-person Oasis activities that were held there, was discouraging to some, like one participant who commented, “this pandemic has just killed everything that we’re doing” (P12). After months of lockdowns and social distancing restrictions, participants reported feeling the isolating effects of the pandemic and missing their social connections. Participant 9 revealed, “I can hardly stand this anymore, this isolation thing not being around people, because I’m really, really very a people person, too. And social. I think it’s got to be hard for those of us who are like that.” That said, in-house virtual programming through Oasis served as a sort of refuge in a dark time. As one participant stated, “I’ve really, really enjoyed it, and I know if I didn’t have Oasis, I’m sure that I would be very depressed at this point in the lockdown” (P1). Participants felt participating in the adapted Oasis program helped them to avoid negative mental health outcomes of isolation, as one participant stated, “If I didn’t have [this program], [while] we’ve been shut in, you know what, I would’ve jumped off the balcony long ago…it’s been so depressing, but with all these activities” (P4) she knew she always had something fun, social, or informative to be involved in. Another participant expressed a similar sentiment, “I would have given up, certainly because of the of the pandemic I would have given up, I would probably sit on my sofa much too much and I wouldn’t know what to do” (P2). Being part of Oasis served a motivational purpose as well, “it keeps me motivated to have something like that. Like I say, a coach is always good, Oasis is a good coach” (P2). The pandemic was challenging for these older adults, and participants expressed how much they valued having opportunities presented to them, “this last couple of years, it’s not been so great. We are lucky to have them to do something for us” (P5). Oasis offered older adults not just “something to do” (P4) during an isolating time, but equally importantly “something to look forward to” (P1), much of which was due to the work of the program coordinator.
Connections to coordinator
Participants expressed their gratitude for the “thought and hard work” (P4) involved in facilitating Oasis programming in their building. Participants appreciated having a program coordinator who they not only got along with but who respected them and their voice. One participant went so far as to say, “you’ve got a coordinator who’s got the personality for it. She’s just the right person and she’s a hard worker, so that makes a difference… she doesn’t talk down to us… [which is] the most important” (P7). Her more regular individual check-ins with members via telephone and virtual methods, inquiring about their interests, hearing their feedback, and subsequently developing and facilitating activities and events for the older adults to do online, over the phone, and in their own homes, contributed to the relationship building between the coordinator and members as well as between one another through the facilitation of opportunities for connection. One participant revealed that, “it’s not that easy to connect with your neighbors in the apartment building” (P9), but that having programming “available and accessible” (P3) in their residence, helped them establish and maintain connections in their building. For participants, having attention paid to them, “having a program to try and do something for [them]” (P3), “for [their] benefit” (P4) – especially during a period marked by cancellations and closures – meant a lot to them as expressed through their interest and pleas for its continuation. As Participant 3 stated, “I was impressed…I not only accept it, but I really am thankful that it exists.”
Finding new ways of being and doing together
Being together, online --- Better than nothing
With pandemic-related social distancing restrictions closing the building common rooms and in-person programming, participants sought connection in the virtual social opportunities offered through Oasis. Most participants agreed that the online programs and activities offered through Oasis were “all valuable, because they’re all social” (P11), and “even when you’re on Zoom it’s a social benefit to have somebody else to talk to” (P1). Video conferencing helped older adults stay connected to each other through the in-house programming, but also to their families. As one participant mentioned, “I do Zoom. I like to be able to see people. It’s better than nothing when it comes to getting together” (P9). For participants who were willing and able to connect online, video calling was the next best option when in-person connection could not take place, as Participant 4 explained,
coffee on Zoom is better than nothing…but it will be nice when we can get back into the room and sit around the table or table or two and just see everybody and in person, you know, so but we do what we have to do for the circumstances. So it’s nice that we see them on Zoom, you know, and any new faces that we see.
Successes and challenges in the transition to a virtual environment. The importance of staying connected to older adults in the program was clear, but the pandemic left older adults having to adapt and create new ways of doing so. Participants learned to use new technological devices, with varying success, in an attempt to remain connected with their Oasis community. Participating in the online Oasis activities was some participants’ first introduction to video-conferencing. For some, connecting online was a welcomed new experience that provided a more enjoyable experience than the phone, like one participant who said, “it’s a great way to communicate in meetings…I think it was only once, twice tops that I went on the phone. But I, my preference is the Zoom" (P4). Another participant expressed a similar sentiment, stating, “I think it’s really important that, you know, if you could get on to Zoom instead of on the telephone to see people” (P1). After weeks of lockdowns and isolation, hopping onto virtual coffee hours was well received, acknowledging that it “was nice to see people face to face without a mask on” (P9). Some online activities like trivia were encouraged to remain virtual even as restrictions loosened since, as one participant noted, “there’s a lot more that come onto the Zoom than would go down to sit down at the table and play" (P1). Despite it being her first time using computers and the internet to connect in this way, this participant applied her newly acquired video-communication skills to help others in the building troubleshoot their technical difficulties, proudly stating “I have become your techie here” (P1). Determined to be independent and self-reliant, one participant reflected on the difficulties others were having with computers and the internet, saying “some people that aren’t really good on computers, so they miss out on a heck of a lot. So, I’m determined that as technology changes, I’m going to keep up with it” (P7).
The social distancing restrictions and shift to a virtual environment also carried challenges. Some participants experienced barriers to participation in virtual activities because of their mobility, vision, and other health conditions. Reflecting on these challenges, one participant mentioned, “I mean, at my age, my eye sight’s going, my hearing’s going… that’s another drawback, that I can’t always participate in anything” (P5). Similarly, Participant 2 stated, “well, he [my husband] can’t see, he is…legally blind…He’s very gracious about listening to me, to what I have to describe…[but] It’s very hard for him". Some participants recognized that others dealt with these challenges on top of technological difficulties, saying, “two or three neighbours who are in our building do not [join online sessions], because either they’re hard of hearing or no computer or I think they have a computer, but don’t know how to use it” (P2).
Participants recognized that the programming changed with the pandemic:
It’s been a little different. But [the program coordinator’s] worked her rear end off and made it interesting enough that we even get the people to phone in, even though they’re not on the Zoom…So I think it’s still, it’s still there, the interest is still there. (P7)
The program also attempted to provide tablets to ease some of the issues with connecting, but social distancing requirements made it difficult to teach residents how to use them, at a distance. One participant who was frustrated with connecting via telephone, tried for weeks to connect via Zoom, seeking new devices, doing telephone troubleshooting from program staff, and even in-person support from neighbours. Participant 1 described her experiences attempting to help this participant get online:
Before she wouldn’t let me come over [to help her with her computer, because of the pandemic restrictions]. So, I’m happy that she’s able to let me in and then…hopefully she’ll get on to the coffee time tomorrow. I’d love to have that happen for her.
The challenge to using new technology proved too large to overcome for some members, leaving them discouraged, with one participant describing it as “a big hassle, I think, a big hurdle" (P2). Members who were connecting online recognized the challenges it posed for others,
Some of them, as I say, in our wisdom years, we’re afraid to push buttons. And so they’re afraid of the technology. Not that I know a lot, but I at least have a little bit more confidence. And so that is a real deterrent. (P1)
Participants struggling with technological barriers appreciated the benefits of virtual programming for others, but the longing for a return to normal was clear. Participant 5 reflected, “I just hope they keep doing what they can do. It helps some of the people…It doesn’t help me a lot right now. But if we ever get back to normal, I’ll enjoy it again."
Participants did not fully articulate why the Zoom versions of their activities were “just not the same” (P1) as in-person, but their comments speak to a lack of physical “contact” (P1) or a feeling missing in video calls, making remarks like: “the in-person is, is always nicer” (P10), “I would feel happier…[to] be able to see them in person” (P4), “we’re waiting for the face to face….it just doesn’t have the same feeling as with the people" (P8). There seemed to be something inherent in physical, social connection that the virtual programming could not replicate, “there’s always that barrier that, you know, not in person” (P7). Despite the prolonged pandemic-imposed time apart, members still looked forward to Oasis gatherings with each other, as one participant noted, “I think once COVID is done and if you guys open up the social room then I’ll be down there, in a flash” (P13).
Doing together in creative ways, offline
Participants found creative ways to connect with each other and engage in occupations together, outside of, and alongside the online activities offered by the coordinator. As one participant stated, “[this pandemic] doesn’t prevent us from getting together” (P3). While they knew in some cases they could not gather indoors, participants found ways to connect, “as much as [they could]” (P6). Participant 6 went on to say that “with the lockdowns like we respected the guidelines before and we just kind of do balcony chats or phone calls” (P6). They came up with innovative ways to keep doing the activities they loved to do together, with safety precautions. For example, a couple of participants decided to lead their own impromptu balcony singalong during a special holiday for them:
One time we had oh, when was it, oh, Easter. We had an Easter parade on our balconies. Oh, we sang I have a piano and it’s close to the patio door, so. I called him, I called another neighbor on our side, on the west side, so she called her next neighbor and the four of us were singing…That was an activity we like to do, singing along with each other on our balconies. (P2)
Despite the social room being closed, participants found ways to make even seemingly solo activities collective. One participant started colouring and doing jigsaw puzzles, “I’ve done puzzles now, I never thought I could do a 1000 [piece] puzzle, I did!" (P2) and connected with the program coordinator to get more supplies as needed. For take-home crafts, Participant 6 described how she joined another member who had access to the instructions on the computer, “I generally go to a friend’s place and do it with her…It’s nice to have something like that to do” (P6). Despite not having participated in the craft herself, one participant described how delighted she was by the kindness extended by her neighbours during a tough time, “when I came home that day, I found this bag hanging on my door and it was a hug certificate…and just to express that, just how lovely that was to receive that hug package” (P9). Participants appreciated making things that were useful, for example creating decorations to hang on their apartment doors. These handmade paintings and crafts allowed the opportunity to display their new-found skills and connection to the Oasis community. One participant reflected, “[i]t’s just these simple little things and they all love it and they run upstairs with it and…I see it hanging on the walls of their apartments” (P6). In addition, although the social rooms were closed, Oasis provided occasional hot, catered meals that members were able to select and pick up in their building lobby, allowing an opportunity to engage briefly with the program coordinator. The intention was for participants to eat in their private dwellings, but some participants elected to “eat them in the hall” (P11) as another way to stay connected.
Volunteering with Oasis within the building also became an opportunity for connecting with others. Newsletters were delivered door-to-door by older adult residents from each building. Newsletter delivery served as an opportunity for older adults to check-in and speak with other residents during the pandemic, with one participant explaining, “[i]t’s like a little visit on the doorstep, with your mask on” (P2). Delivering newsletters also served as a way for older adults to meet new older adult residents. Participant 4 admitted that “to be honest with you, I wasn’t even aware that there were new members” as it was only when she received three extra packages to deliver that she found out more older adults had moved in and joined Oasis.
Sense of community: supporting and being there for one another
Participants have “gotten to know others” (P1) through Oasis programming over the years, one member stating, “nearly everybody I’ve met, or I know in the building…I met through Oasis, which I would not have normally” (P11). This sense of community persisted throughout the pandemic through acts of support between members. Participant 2 mentioned that “we phone each other. We do things for each other”, while Participant 11 explained, “I give her my paper. She takes down my blue box. We’ve got a little thing going on.” Checking in on neighbours was not uncommon among Oasis members, as one participant stated, “we look out for each other” (P1). Older adults recognized that other residents could use support and reached out to them, like Participant 6 who mentioned, “I have an old man beside me that I’m trying to look after, make sure he gets everything…Buy stuff for him when he needs it, things like that." Participants expressed their generosity and consideration for others through offers to do things for them, as Participant 4 explained,
a number of people…can’t get out. So, I get on the phone and if I’m heading out, phone a couple of the neighbours and just see, you know, can I pick stuff up or whatever… for there are a number of seniors in here that aren’t, aren’t just able to get out as easily.
For some, a sense of community was the most important thing about Oasis. As stated by two participants: “community…getting to know more people and interacting…I cannot sit in my little corner alone. I have to have community, have people that we can talk to, share interests, other interests besides our little world” (P3), and “[t]he main thing is that you’re with people and that you’re able to interact with people.” (P9). With Oasis in the building, Participant 9 continued, “I think it gives a person some reassurance that you can always connect with people if you’re feeling lonely, if you’re feeling isolated, that you can make a connection somehow.” Participants built and sustained this sense of community through leisure and social occupations and through providing support to one another, all supported and sustained by their involvement in the program and the program coordinator.
Discussion
The findings demonstrated how, despite disruptions to the program during the COVID-19 pandemic, older adult Oasis members continued to engage in their Oasis community, often through new or adapted occupations that: connected them with others, enabled social interaction, and contributed to the maintenance of a communal sense of belonging. Dealing with the abrupt occupational loss resulting from restricted access to familiar places and faces in their lives can be challenging for older adults (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Nizzero et al., Reference Nizzero, Cote and Cramm2017). Like Oasis members’ uptake of online, group trivia, many older adults were forced to find new activities to replace those social activities that could not be adapted during the COVID-19 pandemic (Luck et al., Reference Luck, Doucet and Luke2022; Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022). While the emerging literature demonstrates that many older adults were impacted and forced to independently adapt their lives in response to pandemic lockdowns and social distancing challenges (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021; Luck et al., Reference Luck, Doucet and Luke2022; Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021; Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022), the older adults in this study were supported through being members of Oasis, a NORC-SSP. The findings illustrated that older adults considered Oasis a lifesaver, they valued their connections to the coordinator, and with the support of the London Oasis program older adults were able to find new ways to be together online, do together creatively, offline, and be there for one another in ways that contributed to their sense of community.
The social component of Oasis – doing things together, interacting with others, and the sense of community that participation fostered – was important to Oasis members. The valued activities demonstrated a form of ‘collective occupation’, that is, occupations that can contribute to the social fabric of a community (Kantartzis & Molineux, Reference Kantartzis and Molineux2017). Consistent with the findings of others (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Garcia Diaz et al., Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022; Luck et al., Reference Luck, Doucet and Luke2022; Mills et al., Reference Mills, Parniak, Hand, McGrath, Rudman, Chislett and Donnelly2022; Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021) the types of occupations, that fulfilled older adults’ needs and were meaningful to them, involved engaging with others, fostered social connection, and promoted their sense of belonging. Despite abrupt and enduring barriers posed by the pandemic, the older adult Oasis members managed to maintain the social fabric of their community, by “coming together in collective occupation” (Kantartzis & Molineux, Reference Kantartzis and Molineux2017, p.171). They continued to be and do together through engagement in new and adapted activities.
Driven by the pandemic disruption, some older adults elected to “reconnect with [their] creativity” (Luck et al., Reference Luck, Doucet and Luke2022, p.359). While some of these activities, like puzzling and cooking, usually remained solitary for the older adults that Luck and colleagues encountered (Reference Luck, Doucet and Luke2022), the Oasis members were innovative in their attempts to stay connected with each other as they engaged in creative and arts activities. Whether they were reaching out to the Oasis coordinator to access new, challenging puzzles or supplies for colouring activities, coming together to do the monthly Oasis craft, or displaying their artworks on their front doors for others to see, there usually was some social, interactive component to their engagement. When restrictions prohibited their singalongs, Oasis members collectively connected with their love of music by attending virtual orchestras organized by the program coordinator or engaging in impromptu balcony singing sessions.
Kantartzis and Molineux (Reference Kantartzis and Molineux2017) state that collective occupation can be enacted through, “small acts of giving” (p.171), a pattern noted among current study participants. Many everyday, previously taken-for-granted interactions appeared to be ways that study participants could support and ‘give’ to each other. The brief, masked conversations in the lobby during meal pick up, greeting each other in the hallways or mailroom, and doing other things for each other like taking recycling bins down or picking up groceries, all contributed to Oasis members’ sense of community. In addition to weekly phone call check-ins from the Oasis coordinator, some older adults checked in with each other on the phone, or face-to-face on their doorsteps during newsletter and program calendar deliveries, demonstrating their care for each other. Other studies have shown a similar pattern, as Wenning et al. (Reference Wenning, Polidano, Mallen and Dikomitis2022) reported that older adults shared information with each other, such as about grocery delivery, that helped others and contributed to a communal sense of belonging during the pandemic.
Supportive role of Oasis NORC-SSP
Literature has shown that for older adults during the pandemic, finding, learning, and enacting new ways to meaningfully connect with others, required more motivation, time, resources, and effort than some could afford, especially those who lived alone or did not have support for such tasks (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Luck et al., Reference Luck, Doucet and Luke2022; Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022). In contrast, the older adults who were part of the London Oasis program appeared to have a different experience. The Oasis coordinator took on many tasks that might have been challenging for Oasis members, such as helping discover, curate, and schedule activities that best supported the Oasis member’s needs, potentially lessening the stress of having to reshape at least some aspects of their lives. Oasis members expressed the important motivational role that the Oasis coordinator played in their lives, acting like a coach and encouraging them to be involved, similar to Mills et al. (Reference Mills, Parniak, Hand, McGrath, Rudman, Chislett and Donnelly2022) who found that an Oasis coordinator at another site prompted members to “get up, get dressed, and proceed with the day when they otherwise may not have” (p. 6). Another author found that working with older adults to “maintain order or routine” (Nizzero et al., Reference Nizzero, Cote and Cramm2017, p.123) in a time of great disruption, promoted a sense of control, and feelings of self-worth, and facilitated a sense of normalcy in a changed environment. In addition, being able to maintain some consistency with respect to their pre-pandemic social routine through the support of the Oasis coordinator, helped strengthen bonds of friendship between members and resist some of the negative feelings associated with a sudden halt of social activities, as experienced by other older adults during the pandemic (Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021; Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022).
A key unique feature of Oasis, that was valued by participants, was their autonomy in choosing activities that would be delivered through the program. The literature shows that for many older adults, being able to choose the activities they participated in was more valuable than simply having things to do (Luck et al., Reference Luck, Doucet and Luke2022; Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021). While the pandemic limited the “autonomy and choice” (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021, p.13) of many older adults, Oasis continued to offer older adults not only the opportunity to contribute to their community through the shaping of the program but also a variety of personalized activities they could choose to participate in. In addition, through the pandemic, many older adults lost opportunities to contribute to their community through roles and activities that were meaningful to them like volunteering (Luck et al., Reference Luck, Doucet and Luke2022; Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021), but Oasis offered opportunities through steering committee participation, and newsletter and event calendar delivery that allowed at least some members to stay involved in this capacity. Participating in activities that are meaningful facilitates a sense of purpose and self-worth among older adults, especially those managing occupational disruption (Luck et al., Reference Luck, Doucet and Luke2022; Nizzero et al., Reference Nizzero, Cote and Cramm2017), and this appeared to be the case in the current study.
In their work exploring older adults’ experiences adapting to pandemic lockdown measures in England, Wenning et al. (Reference Wenning, Polidano, Mallen and Dikomitis2022) found that “belonging fosters resilience” (p.7). By working with older adults and supporting their efforts to remain connected and maintain their participation in meaningful, collective occupations, Oasis served as a strategy to support older adults in ways that “strengthen their sense of agency and belonging in a lockdown world” (Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022, p.7). Regardless of how often they participated or how much they contributed, Oasis members still appreciated having and being part of Oasis. Knowing that Oasis was there, available and welcoming to them, that “they could rely on the site coordinators for support, if needed” (Garcia Diaz et al., Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022, p.17), was important to older adults in this study and other Oasis sites. Maintaining Oasis group membership allowed older adults to retain their sense of belonging and connection despite pandemic disruptions, something Nizzero et al. (Reference Nizzero, Cote and Cramm2017) also recognized as important in effectively managing occupational disruption. Even when the places where these interactions typically occurred were no longer accessible, the connections between members remained. Older adults persevered, and with the support of the Oasis coordinator and other members, engaged in new activities, adapted to familiar occupations, and found ways to remain connected and do together. Even though older adults in the current and previous studies generally felt that face-to-face interactions were preferred over the virtual programming offered during the pandemic, (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Garcia Diaz et al., Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022; Luck et al., Reference Luck, Doucet and Luke2022), the participants in the current study remained willing to adapt and engage in the ways they could in order to remain connected – demonstrating their commitment to and resilience of their collective occupation.
Navigating technology
Like many other community-dwelling older adults (Carlsson et al., Reference Carlsson, Granbom, Fristedt, Jonsson, Hägg, Ericsson and Kylén2022; Garcia Diaz et al., Reference Garcia Diaz, Durocher, McAiney, Richardson and Letts2022; Luck et al., Reference Luck, Doucet and Luke2022; Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021; Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022), the participants in this study shifted much of their communication to telephone and video calling during the pandemic. While studies have shown that some older adults struggle with the loss of participation in meaningful social activities like coffee groups (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021), others transitioned to virtual pub nights or in our case weekly coffee hours to maintain their valued practice of conversation over ‘shared’ drinks (Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022). That said, navigating the technological transition was not without its challenges, especially for those with limited access to technological resources and support (Aybar-Damali et al., Reference Aybar-Damali, McGuire and Kleiber2021; Lopez et al., Reference Lopez, Tong, Whate and Boger2021).
The study findings also demonstrated the difficulties that can arise when using technology to offer programs. Morrison et al. (Reference Morrison, Nicholson, Wood and Briggs2023) found that the rapid pandemic-related digital changes highlighted and reinforced social and digital inequities among older adults. Having limited access to information and communication technology, whether due to inadequate or outdated devices, unstable internet connection, or low digital literacy, like several participants experienced in this study, can have offline implications for social inclusion and reduce access to health-promoting educational, financial and other services and resources (Morrison et al., Reference Morrison, Nicholson, Wood and Briggs2023; Lopez et al., Reference Lopez, Tong, Whate and Boger2021). To ameliorate barriers to participation due to inadequate technology, London Oasis offered tablets to members who expressed interest, but providing new devices to older adults required a wireless internet connection and the physical distancing requirements made training and troubleshooting difficult.
Many programs emerged during the pandemic that were specifically designed to support and guide older adults to use information and communication technology remotely (O’Connell et al., Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022; Weil et al., Reference Weil, Kamber, Glazebrook, Giorgi and Ziegler2021; Wenning et al., Reference Wenning, Polidano, Mallen and Dikomitis2022). Weil et al. (Reference Weil, Kamber, Glazebrook, Giorgi and Ziegler2021) used online learning programming (videoconferencing, webinars, workshops) to improve older adults’ agency in the “digital sphere” (p.644). O’Connell and colleagues (Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022) explored how a telephone-based, cognitive rehabilitation-rooted program administered by clinical psychology students and practitioners, helped train older adults to use videoconferencing as programming shifted to online during the pandemic. Both programs used specially designed, iterative training sessions that catered to older adult learning needs, individual digital devices and literacy, and involved delivery by specially trained instructors (O’Connell et al., Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022; Weil et al., Reference Weil, Kamber, Glazebrook, Giorgi and Ziegler2021). These programs, however, encountered similar challenges as London Oasis despite this specialized training.
Transitioning to virtual program delivery was easier for those Oasis members who had some experience using information and communication technology before, which was the case for many participants in other programs (Lopez et al., Reference Lopez, Tong, Whate and Boger2021; O’Connell et al., Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022; Weil et al., Reference Weil, Kamber, Glazebrook, Giorgi and Ziegler2021). As experienced with London Oasis, the greater challenges came with supporting those who arguably needed the support the most, those with low digital literacy, hearing and vision difficulties, and overall higher levels of digital deprivation (Morrison et al., Reference Morrison, Nicholson, Wood and Briggs2023; O’Connell et al., Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022). Like O’Connell and colleagues (Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022) found, the difference in devices and operating systems between members and trainers and not being able to see each other’s screen made it difficult to assist older adults, especially those with low digital literacy. O’Connell and colleagues (Reference O’Connell, Haase, Grewal, Panyavin, Kortzman, Flath and Peacock2022) found that providing one-on-one tech training for older adults with dual vision and hearing difficulties, like those reported in this study, using only the telephone created an “insurmountable barrier” (p.6) that required additional resources or skills to overcome, like utilizing videoconferencing and/or the support of another in-person individual. While the findings demonstrate how the program coordinator and older adult members worked together in an attempt to overcome technological barriers, given the challenges experienced, more needs to be done to promote the digital inclusion of older adults, ensuring they are not “turned away simply because of the devices they own…their levels of digital literacy” (Morrison et al., Reference Morrison, Nicholson, Wood and Briggs2023, p.11), or their vision and hearing abilities. As the reliance on technology for connection, leisure, and everyday activities continues to grow post-pandemic, finding ways to narrow the digital divide will be crucial for promoting the wellbeing and preventing the further isolation of older adults (Aybar-Damali et al., Reference Aybar-Damali, McGuire and Kleiber2021; Lopez et al., Reference Lopez, Tong, Whate and Boger2021).
Limitations
This paper explored how a NORC-SSP supported older adults in building and maintaining a sense of community by finding new ways of being together and engaging in occupation together during a global pandemic. As such, this study explored the experiences of just one NORC, situated in one mid-sized Canadian city, through interviews at one period, just over a year into the COVID-19 pandemic. Additionally, the majority of the 13 participants (n=11) were women. While this gender imbalance was commensurate with the total population of program members at this site, it may not be the case in all NORCs. Continued research exploring the perspectives and experiences of older adults’ engagement in collective occupation to build and maintain a sense of community in different contexts is recommended. While this study relied on telephone and Zoom interviews in line with pandemic guidelines for community-based research, exploring older adults’ experiences in physically closer ways, like through go-along interviews or observation, could provide a different, more immersive perspective into the everyday lives of older adults. As we enter an era of ‘living with’ COVID-19, it will be important to explore how older adults’ perspectives, needs, and interests change and adjust policies and programming accordingly.
Practical and policy implications
Highlighting older adults’ experiences coping with restrictive measures through the support of a NORC-SSP, can help inform policy, programming, and interventions that aim to promote aging in place and the overall quality of life of older adults. The study findings suggest that NORC-SSPs such as Oasis can be effective in supporting older adults’ well-being during a global pandemic, as well as in non-pandemic times. Ensuring older adults “have choices, places to go, people to engage with, and a range of activities within their homes and their surrounding communities” (Herron et al., Reference Herron, Newall, Lawrence, Ramsey, Waddell and Dauphinais2021, p.13) is essential to their wellbeing, and NORC-SSPs like Oasis are designed to do just that. Working with older adults to create policy based on their needs, experiences, and values is crucial to creating effective, successful, relevant programs that work for those they are intended to serve. NORC-SSPs like Oasis prioritize working with older adults, maintaining close, consistent communication resulting in a more comprehensive understanding of their needs so that they are better situated to implement programming, provide support, and facilitate connections that help resolve the social health and wellbeing paradox. Investing in NORC-SSPs, like Oasis, is one way to answer the call for government and community policy to “take the broad health needs of older adults into account” (Rotenberg et al., Reference Rotenberg, Oreper, Bar, Davids-Brumer, Arbel and Dawson2021, p.530), in ways that involve “those with lived experiences…[and] ensure their voices are heard” (Luck et al., Reference Luck, Doucet and Luke2022, p.364). Practitioners working with older adults can incorporate models that target NORCs and implement SSPs that involve the key components of Oasis, particularly a paid coordinator, a focus on senior-driven programming, and expanding opportunities for ‘doing together’.
Conclusions
NORC-SSPs, like Oasis, play an important role in supporting older adults’ capacity to build strong, resilient communities that support well-being. Despite the pandemic’s disruption of the places older adults had access to and its impact on the ways older adults engaged in their everyday lives, their need to interact with others, to maintain their sense of connection, belonging, and community remained. With the support of Oasis NORC-SSP, the older adults involved built and maintained their sense of community, by finding new ways of being together and doing meaningful activities together.
Supplementary material
The supplementary material for this article can be found at http://doi.org/10.1017/S0714980824000345.
