Institute for Health & Ageing

PEARL Program to Enhance Adjustment to Residential Living

Program to Enhance Adjustment to Residential Living (PEARL)

The Gables - Aged care facility

Depression is common in aged care facilities, with half of all newly admitted residents experiencing substantial symptoms of depression. Many older adults and their families find the transition to aged care extremely difficult. Quality of life is poor among older adults in residential care compared to their peers in the community.

We have developed a simple intervention to help new residents, including those with dementia, to adjust to life in aged care. This Program to Enhance Adjustment to Residential Living (PEARL) focuses on key aspects of psychological wellbeing, and is designed for widespread use in aged care. We will evaluate the intervention to determine if it is superior to current care approaches in reducing depression and improving quality of life. New approaches to address the burden of depression are required, particularly targeting residents in their first six months of institutional care, which is known to be a period of critical risk.

Developmental theory and research by our team have identified that autonomy, environmental mastery and purpose in life are central to understanding depression in aged care and to assisting older adults to adjust to institutional care. We have developed an innovative psychological intervention to enhance these factors among newly admitted residents with depressive symptoms or disorders.This simple intervention is suitable for the majority of older people, including those with mild–moderate dementia. It involves collaboration with staff members to ensure that the care they provide meets residents’ psychological needs. This is the first early mental health intervention designed specifically for this setting, responding to evidence that early interventions can help to prevent intractable mental conditions. The program is brief and can be embedded within existing aged care procedures, recognising that interventions will prove feasible only if demands are kept manageable.