Beyond Attendance: Participation and Relational Work in Planned Group Recreational Activities in a Long-Term Care...

Person-centered care (PCC) has shaped dementia care reforms and informed innovative long-term care models such as care villages. Recreational activities are often seen as a site where PCC is enacted, yet little empirical work has examined how participation in structured activities is enabled, mediated, and constrained through everyday social, relational, and organizational dynamics. This study examines how participation in structured group activities was produced in a care village.

An ethnographic study was conducted in Canada's first publicly funded care village, drawing on 100 hours of participant observation, 12 staff interviews, and informal resident conversations. Data were analyzed using qualitative content analysis.

Participation varied across activity types and residents' fluctuating comfort, stamina, and readiness. For many residents, participation was not simply an individual decision, but was scaffolded through staff invitation, accessible information, relational familiarity, and individualized encouragement. It also depended on logistical and organizational conditions, including preparation, transportation, staffing coordination, and role boundaries. These findings show that participation was relationally and organizationally produced rather than simply a matter of resident preference or program design.

Structured activities can support meaningful engagement when sustained by relational, logistical, and organizational work. The findings clarify how PCC commitments such as choice, autonomy, and inclusion are enacted through activity systems, while highlighting the labor-intensive conditions required for more equitable participation. These insights have implications for staffing, coordination, and activity provision in care villages and long-term care settings.