Residents Perceptions of Friendship and Positive Social Networks Within a Nursing Home

Purpose of the Study: (i) To describe nursing home residents' perceptions of their friendship networks using social network analysis (SNA) and (ii) to contribute to theory regarding resident friendship schema, network structure, and connections between network ties and social support. Design and Methods: Cross-sectional interviews, standardized assessments, and observational data were collected in three care units, including a Dementia Specific Unit (DSU), of a 94-bed Sydney nursing home. Full participation consent was obtained for 36 residents aged 63-94 years. Able residents answered open-ended questions about friendship, identified friendship ties, and completed measures of nonfamily social support. Results: Residents retained clear concepts of friendship and reported small, sparse networks. Nonparametric pairwise comparisons indicated that DSU residents reported less perceived social support (median = 7) than residents from the other units (median = 17; U = 10.0, p = .034, r = -.51), (median = 14; U = 0.0, p = .003, r = -.82). Greater perceived social support was moderately associated with higher number of reciprocated ties [rho(25) = .49, p = .013]. Implications: Though some residents had friendships, many reported that nursing home social opportunities did not align with their expectations of friendship. Relationships with coresidents were associated with perceptions of social support. SNA's relational perspective elucidated network size, tie direction, and density, advancing understanding of the structure of residents' networks and flow of subjective social support through that structure. Understanding resident expectations and perceptions of their social networks is important for care providers wishing to improve quality of life in nursing homes.