A psychological needs-based intervention to facilitate adjustment and improve wellbeing in newly admitted aged care residents: three illustrative case studies

Objective: Moving into residential aged care (RAC) is recognised as a major life transition and is associated with adjustment difficulties and depression for many older adults. We developed the Programme to Enhance Adjustment to Residential Living (PEARL) to assist newly admitted residents to adjust to their new environment through the introduction of tailored strategies that meet their psychological needs for autonomy, relatedness, and competence. Method: The structure and content of PEARL is described. Clinical information via three cases are presented to illustrate how the programme facilitates the adjustment and psychological wellbeing of residents following their transition to RAC. Results: The cases highlight the potential benefit of individualised approaches to address the psychological needs of new residents and demonstrate how staff can be assisted to facilitate these needs through a simple, brief intervention. Conclusions: PEARL is a structured step by step programme that can be used by clinicians working in this field. While additional empirical data evaluating the efficacy and cost-effectiveness of this intervention is required, PEARL offers promise as a non-pharmacological approach to address the current high rates of distress and mental health disorders in RAC. KEY POINTS: What is already known about this topic: (1) Mental health concerns among older adults in permanent residential aged care are common, and many newly admitted residents find it difficult to adjust to an institutional environment. (2) Newly admitted residents should have the opportunity to receive adequate support to meet their psychological needs; however, currently, these needs are poorly met. (3) Previous research has identified factors that can contribute to better adjustment to residential aged care however, there are limited evidenced based programmes that support and assist residents during this transition. What this topic adds: (1) PEARL is a five session, structured, tailored intervention that enables clinicians to collaborate with admitted residents and facility staff in an attempt to meet residents’ psychological needs and assist in facilitating their adjustment to residential aged care. (2) Clinical information including the structure and content of PEARL is provided including case studies to illustrate the implementation of the programme. (3) While the clinical approach underpinning PEARL is simple, it represents a major departure from standard care that is potentially feasible for wide-spread use.