Factors Associated With Low and High Social Engagement Among Older Nursing Home Residents in Korea

Objectives: With the increase in older adults receiving long-term care in facilities, the level of social engagement within nursing homes is a growing concern for improving the quality of life of residents. This study seeks to assess the level of social engagement and identify the factors associated with high and low engagement among older adults in Korean nursing homes. Design: Cross-sectional study. Setting and Participants: Data were obtained from a nationally representative sample of 1453 older residents in 92 long-term care facilities across Korea. Methods: Multilevel-multivariate analyses were carried out to identify individual- and institution-level risk factors of social engagement, as measured by the Revised Index of Social Engagement (RISE). Results: Three-fourths of older residents had a low level of social engagement, whereas only about one tenth showed a high level of social engagement. Being male, having severe functional impairments, having depression, and having no supportive family relationships were risk factors for low social engagement. Conversely, a high level of social engagement was significantly associated with being female, having no impairments, and a longer length of stay. Meeting staffing requirements for personal care assistants, an institution-level factor, was negatively associated with low social engagement and positively associated with high social engagement. Conclusions and Implications: Low social engagement is very common in Korean nursing homes and is concentrated among those with poor functional and social outcomes. Future efforts to improve longterm care will need to address the various factors associated with social engagement in designing social care for nursing home residents. (c) 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.