Long-term effects of a control-relevant Intervention with the Institutionalized Aged

Rodin. J., Langer, J. E.(1997) Journal of Personality and Social Psychology, Vol 35, No12, 897-902

This study looked at giving elderly nursing home residents increased feelings of choice and personal responsibility over daily events and the effect this has on health and well-being.

Many people who end up in nursing homes feel that they have lost control of their lives, and are often placed there against their wishes. Once in a residential home, they have little say on what they do, who they see and what they eat. This study looks at giving elderly folk a sense of responsibility and control over events in their lives and the effect that this has on health and longevity. This was done by designing an intervention which allowed nursing home residents to make a greater number of choices and was intended to determine whether the decline in health, alertness and activity that generally occurs in the aged in nursing home settings could be slowed or reversed.

91 subjects were split into three groups. The first group was given a speech by the director of the nursing home which emphasised that residents had a lot of responsibility for their own lives. The director went on to say that a movie would be shown on two nights the next week and that the residents should decide which night they wanted to attend. Finally, he gave each resident a gift of a house plant, emphasising that it was up to the residents to take care of it. The director gave a speech to the other (comparison) group, only this time all references of taking responsibility and making decisions for oneself were omitted. Participants in this group were assigned to a movie night, they were also given a plant, however, the difference was that they were told that a nurse would care for it. The final group had no speech or plant given to them.

Health, activity patterns, mood and sociability were measured. Health rating, mortality rating and behavioural measures were taken pre intervention, post intervention (3 weeks after speech, and plant) and at 18 month follow up. The manipulation did indeed produce strong effects that lasted as long as 18 months later.

The experiment involved giving elderly patients more control over their lives yet this small boost in control had a dramatic effect. Residents in the experimental group became happier and more active than residents in the comparison group. The most dramatic findings were that the intervention not only improved residents? health but reduced the likelihood that they would die in the next year and a half. After 18 months 15% of the experimental group had died compared to 30% in the comparison condition. The findings suggest that interventions, such as giving elderly people more responsibility and control over their lives and their environment, may slow down mental and physical decline. The authors are keen to point out that too much choice or control may have negative effects on both the person and the setting and that interventions which foster decision making should not be terminated at the end of the study period, as this may make salient the loss of control and thus have a detrimental effect on health and well-being.

In conclusion, giving elderly people more control over their lives and creating an atmosphere which maintains this sense of control over a period of time has positive effects on mortality rate and well-being.