Coping with institutional life at the old people's therapeutic community

A research project at a Finnish old people's home was carried out in 1983-1989, its aim being to explore whether therapeutic community principles can be applied to the institutional care of the elderly. Some aged seemed to adapt better to the community than others. In 1987 the group "excellent coping in institution" (N = 14) was formulated for this study, on the basis of favorable outcome, good adaptation to aging, nonproblematic behavior and a high subjective satisfaction with life. Using logistic regression analysis, the properties of this group were compared with the group "problem coping in institution" (N = 32). The following variables discriminated the excellent coping group best: therapeutic community activity, current mental health, and a socio-economically deprived childhood. This result suggested that active and mentally strong elderly coped better with the "homelike" therapeutic community method executed between 1983-87, which focused only on a pleasant atmosphere in which the old people could live together. Therefore the treatment policy has been partially reorganized since 1987, so as to include special attention for passive and mentally fragile residents. The modified therapeutic community that was developed seems to help coping in geriatric institutions if its working methods permit 1) active participation, 2) passive rest and reminiscence, and 3) support, holding, and even psychiatric intervention.