Condi����es de Enfrentamento Psicol��gico de Trabalhadores Aeroportu��rios

Esse estudo teve por objetivos identificar sinais e sintomas de transtornos psiqui��tricos e descrever tipos de enfrentamento utilizados por trabalhadores aeroportu��rios. Participaram desse estudo 203 trabalhadores e utilizou-se uma Escala Modo de enfrentamento problemas EMEP e uma Escala de Medida de Sinais e Sintomas psiqui��tricos QMPA. Os resultados indicaram predom��nio de estrat��gias positivas : a) focalizadas no problema (3,78) que significam que h�� um esfor��o do indiv��duo no enfrentamento de situa����es estressantes procurando mudan��as na rela����o entre o indiv��duo e o ambiente causador de tens��o; b) busca de suporte social (3,13), denotando busca de apoio instrumental, emocional ou de car��ter informativo, ou seja, enquanto a maior parte da amostra apresentava estrat��gias mais positivas e integradoras tamb��m n��o apresentava sinais e sintomas psiqui��tricos. Houve, portanto indicativos de que os sujeitos que compuseram essa amostra apresentaram mais respostas positivas em seus esfor��os cognitivos ante as situa����es estressantes ao mesmo tempo em que eram n��o suspeitos de sintomas psiqui��tricos; acrescendo ao fato de que houve conson��ncia entre os instrumentos de medida utilizados no presente estudo. Por��m, uma pequena parte da amostra apresentou sinais e sintomas psiqui��tricos (23,2%), bem como maior utiliza����o de estrat��gias focalizadas na emo����o (2,50), ou seja, estrat��gias de enfrentamento negativas. Embora esse fosse um n��mero pequeno em rela����o �� amostra total, considera-se preocupante, dado ao fato de serem trabalhadores aeroportu��rios e exercerem importantes fun����es tanto em rela����o ao manejo e orienta����o de manobras de aeronaves no solo como em rela����o �� lida com pessoas; de modo que a associa����o entre sinais e sintomas com estrat��gias consideradas negativas implicam em transtornos que merecem acompanhamento pela equipe de sa��de e de recursos humanos na empresa. �� nesse sentido que aqui se sugere um trabalho de constante acompanhamento com trabalhadores em geral, a fim de verificar aqueles que necessitam de suporte psicol��gico e m��dico e aqueles que podem ser remanejados de suas fun����es dentro do aeroporto. O acompanhamento com instrumentais adequados, al��m de serem preventivos e promotores de sa��de psicol��gica, na medida em que facilitam a detec����o de sintomatologias mentais, tamb��m auxilia no planejamento de programas de sa��de e, por conseguinte, como benef��cio no trabalho e fator preditor de sa��de.(AU)

OS IMPACTOS DO BALAN��O EMOCIONAL, OTIMISMO E PERCEP����ES DE SUPORTES SOBRE BEM-ESTAR NO TRABALHO DE AGENTES COMUNIT��RIOS DE SA��DE

Nas d��cadas de 60 e 70, os olhares de muitos estudiosos se voltaram para os aspectos positivos da vida. Diversos autores ofereceram sustenta����o para fortalecer uma nova perspectiva de campo cient��fico, a Psicologia Positiva. Tendo como base te��rica o conhecimento de Psicologia Positiva e Psicologia da Sa��de, pesquisas est��o sendo desenvolvidas para investigar simultaneamente vari��veis oriundas destes dom��nios. Um dos temas colocado sob analise s��o as emo����es, investigadas em diferentes contextos e no ambiente organizacional. Importante salientar a exist��ncia de outras vari��veis no contexto organizacional que t��m sido investigadas �� luz da Psicologia Positiva, tais como otimismo, percep����es de suporte social no trabalho e percep����es de suporte organizacional, algumas delas reunidas para compor modelos preditivos de bem-estar no trabalho (BET), construto multidimensional composto por dois v��nculos afetivos positivos com o trabalho (satisfa����o no trabalho e envolvimento com o trabalho) e um com a organiza����o (comprometimento organizacional afetivo). O presente estudo teve como objetivo analisar a capacidade de predi����o do balan��o emocional (afetos positivos/negativos), do otimismo e de percep����es de suporte (social no trabalho e organizacional) sobre as tr��s dimens��es de BET. Participaram do estudo 110 agentes comunit��rios de sa��de (ACS), prestadores de servi��o de uma prefeitura municipal paulista, com idade m��dia de 38,84 anos, sendo o grupo constitu��do, em sua maioria, por mulheres e por pessoas casadas. Para a coleta de dados, foi aplicado um question��rio contendo sete escalas autoaplic��veis que aferiram as vari��veis do estudo. A an��lise dos dados, todos de natureza num��rica, foi desenvolvida utilizando-se subprogramas do SPSS, vers��o 17.0 para Windows, para c��lculos de estat��sticas descritivas (m��dias, desvios padr��o e correla����es) e estat��sticas multivariadas (an��lises de regress��o linear m��ltipla stepwise). Os resultados do estudo, no que concerne ao seu objetivo principal, que consistiu em submeter a an��lise um modelo preditivo para BET, demonstraram que os n��veis das tr��s dimens��es de BET poderiam variar sob o impacto de tr��s preditores: percep����o de suporte organizacional, afetos positivos e percep����o de suporte instrumental. Como an��lise geral dos tr��s modelos de regress��o calculados, seria poss��vel afirmar que o estado geral de bem-estar dos ACS no contexto de trabalho pode ser fortalecido ou enfraquecido pela atua����o de fatores cognitivos que se desenvolvem a partir de percep����es da din��mica social presente no ambiente de trabalho (percep����es de suporte social e organizacional) e de um fator de cunho estritamente pessoal contido na estrutura emocional do indiv��duo sob a forma de experi��ncias afetivas e aqui referidas com afetos positivos.(AU)

How do older people with sight loss manage their general health? A qualitative study

Purpose: Older people with sight loss experience a number of barriers to managing their health. The purpose of this qualitative study was to explore how older people with sight loss manage their general health and explore the techniques used and strategies employed for health management. Methods: Semi-structured face-to-face interviews were conducted with 30 participants. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Health management challenges experienced included: managing multiple health conditions; accessing information; engaging in health behaviours and maintaining wellbeing. Positive strategies included: joining support groups, clubs and societies; using low vision aids; seeking support from family and friends and accessing support through health and social care services. Conclusion: Healthcare professionals need to be more aware of the challenges faced by older people with sight loss. Improved promotion of group support and charity services which are best placed to share information, provide fora to learn about coping techniques and strategies, and give older people social support to prevent isolation is needed. Rehabilitation and support services and equipment can only be beneficial if patients know what is available and how to access them. Over-reliance on self-advocacy in current healthcare systems is not conducive to patient-centred care. Implications for Rehabilitation Sight loss in older people can impact on many factors including health management. This study identifies challenges to health management and highlights strategies used by older people with sight loss to manage their health. Access to support often relies on patients seeking information for themselves. However, self-advocacy is challenging due to information accessibility barriers. Informal groups and charities play an important role in educating patients about their condition and advising on available support to facilitate health management.

Are HRM practices related with patient mortality in NHS hospitals?:A study examining the underlying reasons for such an association

This thesis will report details of two studies conducted within the National Health Service in the UK that examined the association between HRM practices related to training and appraisal with health outcomes within NHS Trusts. Study one represents the organisational analysis of 61 NHS Trusts, and will report training and appraisal practices were significantly associated with lower patient mortality. Specifically, the research will show significantly lower patient mortality within NHS Trusts that: a) had achieved Investors in People accreditation; b) had a formal strategy document relating to training; c) had tailored training policy documents across occupational groups; d) had integrated training and appraisal practices; e) had a high percentage of staff receiving either an appraisal or updated personal development plan. There was also evidence of an additive effect where NHS Trusts that displayed more of these characteristics had significantly lower patient mortality. Study one in this thesis will also report significantly lower patient mortality within the NHS Trusts where there was broad level representation for the HR function. Study two will report details of a study conducted to examine the potential reasons why HR practices may be related to hospital performance. Details are given of the results of a staff attitudinal survey within five NHS Trusts. This study examined will show that a range of developmental activity, the favourability of the immediate work environment (in relation to social support and role stressors) and motivational outcomes are important antecedents to citizenship behaviours. Furthermore, the thesis will report that principles of the demand-control model were adopted to examine the relationship between workplace support and role stressors, and workplace support, influence, and an understanding of role expectation help mitigate against the negative effects of work demands upon motivational outcomes.

Work stressors, strains and hospital unit performance

Hospital employees who work in an environment with zero tolerance to error, face several stressors that may result in psychological, physiological, and behavioural strains, and subsequently, in suboptimal performance. This thesis includes two studies which investigate the stressor-to-strain-to-performance relationships in hospitals. The first study is a cross-sectional, multi-group investigation based on secondary data from 65,142 respondents in 172 acute/specialist UK NHS trusts. This model proposes that senior management leadership predicts social support and job design which, in turn, moderate stressors-to-strains across team structure. The results confirm the model's robustness. Regression analysis provides support for main effects and minimal support for moderation hypotheses. Therefore, based on its conclusions and inherent limitations, study one lays the framework for study two. The second study is a cross-sectional, multilevel investigation of the strain-reducing effects of social environment on externally-rated unit-level performance based on primary data from 1,137 employees in 136 units, in a hospital in Malta. The term "social environment" refers to the prediction of the moderator variables, which is to say, social support and decision latitude/control, by transformational leadership and team climate across hospital units. This study demonstrates that transformational leadership is positively associated with social support, whereas team climate is positively associated with both moderators. At the same time, it identifies a number of moderating effects which social support and decision latitude/control, both separately and together, had on specific stressor-to-strain relationships. The results show significant mediated stressor-to-strain-to-performance relationships. Furthermore, at the higher level, unit-level performance is positively associated with shared unit-level team climate and with unit-level vision, the latter being one of the five sub-dimension of transformational leadership. At the same time, performance is also positively related to both transformational leadership and team climate when the two constructs are tested together. Few studies have linked the buffering effects of the social environment in occupational stress with performance. Therefore, this research strives to make a significant contribution to the occupational stress and performance literature with a focus on hospital practice. Indeed, the study highlights the wide-ranging and far-reaching implications that these findings provide for theory, management, and practice.

The use of anticholinergic agents to treat excessive oropharyngeal and tracheal secretions in palliative care

Palliative care involves a multi-professional team approach to the provision of active, holistic care for patients and their families when the patient's disease is no longer responsive to curative treatment. Patient care encompasses medical and pharmacological intervention for symptom control, together with psychological, spiritual and social support for patients and families. Care is provided by teams in hospice, hospital or community environments. Although traditionally associated with providing care for cancer patients, palliative care services are increasingly providing for patients with non-malignant disease. Symptoms commonly associated with terminal phase of disease include pain, nausea, agitation, respiratory symptoms and general fatigue. During the last few days of life, patients may become weak, resulting in difficulty taking oral medication and have periods of unconsciousness. Some patients may require drug administration via subcutaneous infusion. A proportion of patients may develop difficulty clearing respiratory secretions causing a characteristic ���death rattle���, which although not generally considered to be distressing for the patient, is often treated with a variety of anticholinergic drugs in an attempt to reduce the ���noisy breathing��� for the benefit of relatives and others who may be closely associated with the patient.This study examined treatment of death rattle in two Hospices focusing on objective and subjective outcome measures in order to determine the efficacy of anticholinergic regimens in current use. Qualitative methods were employed to elicit attitudes of professionals and carers working closely with the patient. The number of patients recruited and monitored were small, many confounding factors were identified which questioned firstly the clinical rationale for administering anticholinergic drugs routinely to treat death rattle and secondly, the ethics of administering drug regimens to patients to treat death rattle with the primary aim of relieving distress for others. Ethnical issues, including those of consent are discussed in relation to their impact on the methodology of end of life studies in medicines management in palliative care.

Managing the human resource in Indian SMEs:The role of indigenous realities

This paper discusses how issues of people management are addressed in Indian small and medium enterprises (SMEs). It also highlights the indigenous approaches to human resource management (HRM) that have surfaced in the Indian SME context. The research formulation has been built on the mapping of people-management practices in two SME case studies, one of which is also a family-based organization. The analysis shows that indigenous realities in HRM in Indian SMEs relate mainly to the provision of financial, emotional and social support to the workforce; employee involvement (EI) practices; recruitment; skill development; managing employee relations; and managing vis-��-vis labor law framework. The paper argues that in the sphere of people management in SMEs, the willingness to innovate and formalize the HR systems is constrained by a kind of bounded rationality, i.e., the owners of SMEs mostly believe that they are already doing what is humanly possible in this regard. The analysis has an important message for concerned practitioners���in order to realize their full potential and to progress towards fulfilling their vision; SMEs eventually have to intertwine indigenization and formalization for their people management approaches.

Patient adherence to medication requirements for therapy of type 2 diabetes

Type 2 diabetes is a complex, progressive endocrine and metabolical disease that typically requires substantial lifestyle changes and multiple medications to lower blood glucose, reduce cardiovascular risk and address comorbidities. Despite an extensive range of available and effective treatments, <50% of patients achieve a glycaemical target of HbA <7.0% and about two-thirds die of premature cardiovascular disease. Adherence to prescribed therapies is an important factor in the management of type 2 diabetes that is often overlooked. Inadequate adherence to oral antidiabetes agents, defined as collecting <80% of prescribed medication, is variously estimated to apply to between 36% and 93% of patients. All studies affirm that a significant proportion of type 2 diabetes patients exhibit poor adherence that will contribute to less than desired control. Identified factors that impede adherence include complex dosing regimens, clinical inertia, safety concerns, socioeconomic issues, ethnicity, patient education and beliefs, social support and polypharmacy. This review explores these factors and potential strategies to improve adherence in patients with type 2 diabetes. �� 2011 Blackwell Publishing Ltd.

Do stressful times call for team-based working? A study of psychiatric nurses in UK mental healthcase

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

Stressful times call for team-based measures:psychiatric nursing in the UK National Health Service

Background: Team-based working is now an inherent part of effective health care delivery. Previous research has identified that team working is associated with positive mental health and well-being outcomes for individuals operating in an effective team environment. This is a particularly important topic in the health services context, although little empirical attention has been paid to mental-health services. Psychiatric nurses work on a day-to-day basis with a particularly stressful and demanding client group in an environment which is characterised by high demands, uncertainty, and limited resources. This paper specifically focuses on psychiatric nurses working in National Health Service (NHS) and casts some light on the ways in which effective team-based working can help to alleviate a number of occupational stressors and strains. Method: A questionnaire method (2005 NHS Staff Survey) was employed to collect data from 6655 psychiatric nurses from 64 different NHS Trusts. The hypotheses were concerned with four overall measures from the survey; effective team working, occupational stress, work pressure and social support. Hypothesis 1 stated that effective team working will have a significant negative relationship with occupational stress and work pressure. Further, Hypothesis 2 stated that social support from supervisors and co-workers will moderate this relationship. Findings: Data was treated with a series of regression analyses. For Hypothesis 1, working in a real team did have main effects on work pressure and accounted for 1.6 per cent of the variance. Using the Nagelkerke R square value, working in a real team also had main effects on occupational stress an accounted for approximately 2.8 per cent of the variance. Further, the Exp (B) value of 0.662 suggests that the odds of suffering from occupational stress are cut by 33.8 per cent when a psychiatric nurse works in a real team. Results failed to provide support for Hypothesis 2. The analysis then went on to adopt a unique approach for assessing the extent of real team-based working, distinguishing between real teams, and a number of pseudo team typologies, as well as the absence of teamwork all together. As was hypothesised, results demonstrated that psychiatric nurses working in real teams (ones with clear objectives, where-by team members work closely with one another to achieve team objectives and meet regularly to discuss team effectiveness and how it can be improved) experienced the lowest levels of stress and work pressure of the sample. However, contrary to prediction, results indicated that psychiatric nurses working in any type of pseudo team actually experienced significantly higher levels of stress and work pressure than those who did not report as working in a team at all. Discussion: These findings have serious implications for NHS Mental Health Trusts, which may not be implementing, structuring and managing their nursing teams adequately. Indeed, results suggest that poorly-structured team work may actually facilitate stress and pressure in the workplace. Conversely, well-structured real teams serve to reduce stress and work pressure, which in turn not only enhances the working lives and well-being of psychiatric nurses, but also greatly improves the service that the NHS provides to its users.

The relationship between expatriate job level and host country national categorization:an investigation in the UK

Using data from 493 host country nationals (HCNs) in the UK, we investigated relationships between expatriate gender, national origin, and job level, and HCN characteristics and willingness to help expatriates. Results showed that HCNs from the UK are likely to categorize expatriates as in-group or out-group members based on perceived values similarity, ethnocentrism, and collectivism. This categorization is also likely to affect HCN willingness to provide role information and social support to expatriates. Overall, our results suggest that HCNs would be more likely to provide role-related information to subordinates and peers than supervisors, and social support to male peers regardless of their nationality (i.e. USA vs. India). The analysis contributes to the fields of expatriate management, social categorization, and international human resource management. It also has key messages for multinational companies regarding the development of efficient expatriate management systems. �� 2011 Taylor & Francis.

The role of interpersonal functioning in the maintenance of eating psychopathology:a systematic review and testable model

This review aims to systematically evaluate the empirical literature relating to the interpersonal functioning of those with eating disorder psychopathology and presents a preliminary model to help the formulation of patients' problems. Following a thorough literature search, 35 papers were included in this systematic review. The vast majority of studies indicate a strong association between eating psychopathology and certain maladaptive personality traits. The origins of social anxiety and poor social support that have been described as maintaining eating disorders appear to differ according to diagnostic groups. Interpersonal difficulties in people with restrictive behaviors such as anorexia appear to be related to the avoidance of expressing feelings to others and to giving priority to other people's feeling over their own. While interpersonal difficulties in patients with bulimia nervosa appear to be more related to interpersonal distrust and negative interaction and conflict with others. These concepts are presented in a preliminary model of interpersonal functioning in the eating disorders. �� 2012 Elsevier Ltd.

Cortisol - ein geeigneter physiologischer Indikator f��r Belastungen am Arbeitsplatz?

Die vorliegende Studie pr��ft Zusammenh��nge zwischen Arbeitsintensit��t, T��tigkeitsspielraum, sozialer Arbeitsumgebung (Kooperation/Kommunikation, soziale Unterst��tzung, soziale Stressoren) und Stresserleben am Arbeitsplatz mit der basalen Cortisolsekretion im Speichel (Tagesprofil, Aufwachreaktion und Variation ��ber den Tag). Insgesamt 46 Erwerbst��tige aus dem Bankwesen sammelten an zwei aufeinander folgenden Arbeitstagen je vier Speichelproben (beim Aufwachen, 30 min nach dem Aufwachen, 14 Uhr und unmittelbar vor dem Zubettgehen), aus denen die individuelle Cortisolkonzentration (Mittelwert aus den jeweils zugeh��rigen Proben) bestimmt wurde. Die T��tigkeitsmerkmale wurden sowohl mittels Frageb��gen als auch objektiv, d.?h. unabh��ngig vom Arbeitsplatzinhaber, erhoben. Alter, Geschlecht, Rauchen, Body-Mass-Index, gesundheitliche Beeintr��chtigungen sowie eventuelle Abweichungen bei der Probensammlung wurden als m��gliche Drittvariablen ber��cksichtigt. Im Ergebnis zeigte sich, dass subjektiv erlebte, geringe soziale Unterst��tzung und hohe soziale Stressoren mit einer erh��hten Aufwachreaktion bzw. mit einer erh��hten Variation ��ber den Tag assoziiert waren. F��r die Arbeitsintensit��t, den T��tigkeitsspielraum sowie f��r die objektiv erhobene Kooperation/Kommunikation waren keine Effekte nachweisbar. Die Ergebnisse lassen vermuten, dass sowohl die Belastungs- als auch deren Erhebungsart f��r den Nachweis von Effekten im Hinblick auf die Cortisolsekretion bei Erwerbst��tigen von Bedeutung sind. The present study examines associations between job demands, job control, social work environment (cooperation/communication, social support, social stressors), and strain at work with basal salivary cortisol (day profiles, cortisol awakening reaction, diurnal variation). Forty-six employees collected four saliva samples (immediately after waking up, 30 min after waking up, at 2 p.m. and immediately before going to bed) each on two consecutive working days. We computed the mean across the two days for each of the four saliva samples per employee. Job characteristics were assessed by self-reports as well as by objective job analysis. Analyses were controlled for possible confounding effects of age, gender, smoking, body-mass index, health impairments, and non compliance with the cortisol protocol. Results show that subjectively experienced low social support and high social stressors at work were associated with elevated cortisol awakening reaction and elevated diurnal variation. We found no effects for job demands, job control or objectively assessed cooperation/communication. Our results suggest that both the type of job characteristic as well as the type of measurement of job characteristics have to be taken into account when relating them to employees��� cortisol secretion.

Foundations of an intervention package to improve communication in residential care settings:a mixed methods study

Background: The prevalence of hearing loss is considerably higher in individuals in residential care than in people within the community-dwelling population, and yet hearing aids and hearing services are relatively underused. Care staff have a key role in supporting access to services. Objectives: This study identifies staff perspectives on hearing loss and their views about potential hearing service improvements. Study design: A four-stage mixed methods study was used, made up of qualitative interviews, observation, a survey and a stakeholder involvement meeting. Results: The qualitative stages indicated that staff were concerned about their levels of interaction with residents. Staff considered maximizing communication as part of their professional role. The quantitative survey indicated that these views were widely held by staff, and the stakeholder stage identified the need for social support and dedicated staff training opportunities. Conclusion: Care home staff regard communication as a shared issue. Future interventions could enhance access to hearing services and provide care home staff with training in hearing loss and hearing aid management. �� 2013 Informa Healthcare.

Living well to the end:a phenomenological analysis of life in extra care housing

OBJECTIVES: To understand older adults' experiences of moving into extra care housing which offers enrichment activities alongside social and healthcare support. DESIGN: A longitudinal study was conducted which adopted a phenomenological approach to data generation and analysis. METHODS: Semi-structured interviews were conducted in the first 18 months of living in extra care housing. Interpretative phenomenological analysis was used because its commitment to idiography enabled an in-depth analysis of the subjective lived experience of moving into extra care housing. Themes generated inductively were examined against an existential-phenomenological theory of well-being. RESULTS: Learning to live in an extra care community showed negotiating new relationships was not straightforward; maintaining friendships outside the community became more difficult as capacity declined. In springboard for opportunity/confinement, living in extra care provided new opportunities for social engagement and a restored sense of self. Over time horizons began to shrink as incapacities grew. Seeking care illustrated reticence to seek care, due to embarrassment and a sense of duty to one's partner. Becoming aged presented an ontological challenge. Nevertheless, some showed a readiness for death, a sense of homecoming. CONCLUSIONS: An authentic later life was possible but residents required emotional and social support to live through the transition and challenges of becoming aged. Enhancement activities boosted residents' quality of life but the range of activities could be extended to cater better for quieter, smaller scale events within the community; volunteer activity facilitators could be used here. Peer mentoring may help build new relationships and opportunities for interactive stimulation. Acknowledging the importance of feeling-empathic imagination-in caregiving may help staff and residents relate better to each other, thus helping individuals to become ontologically secure and live well to the end.