Out-of-Home Participation Strategies and Reckoning With Risk for Older Adults With Cognitive Change

Aging in place contributes to increased independence and quality of life for community-dwelling older adults, but those with cognitive changes face challenges with necessary mobility and out-of-home engagement. The purpose of this research is to gain insight into the lived experience of navigating and participating in community settings despite cognitive changes. A qualitative exploratory study was conducted with 10 community-dwelling older adults living with cognitive changes using the go-along method (mapping, observation, and interviews). The study revealed three key strategies for maintaining and enhancing community participation (placed-based navigation strategies, relying on routines, and cultivating familiar spaces) despite cognitive change, and revealed ways that this population accepts or avoids risk in daily life. These findings inform interventions for out-of-home participation. Existing functional strategies can be identified and enhanced, and new strategies taught. Increased knowledge about how individuals consider, avoid, or accept risk is useful for therapists working with this population.