Prioritizing Choice, Self-Expression, and Accessible Drumming- and Nature-Based Interventions in Adult Day Health Care: A Thematic Analysis of Rhythm and Nature Programming

Background:

People living with disabilities experience disproportionate risks for violence and trauma, across the lifespan and particularly in later life, owing to ableism and intersectional discrimination. Research on opportunities to enhance agency and opportunities for expression and prosocial behavior for this population are still emerging. As such, a Rhythm and Nature program was developed and piloted, entailing a modifiable drumming and garden-based intervention to promote opportunities for self-expression and confidence among older adults (ages 60 and older) living with disabilities. The eight sessions were recorded and transcribed, then analyzed.

Methods:

Eight Rhythm and Nature programming sessions occurred weekly in an adult day center, lasting approximately 30 to 45 minutes per drumming and nature-based therapeutic session each for a total of up to 90 minutes in duration, with a total of eight participants (n=8). Each of these eight sessions were video recorded. The transcripts from both the gardening and drumming components of the Rhythm and Nature programming were transcribed and thematically analyzed using a combination of in vivo, descriptive, and values coding, to learn about how participants experienced the Rhythm and Nature programming. Following these eight Rhythm and Nature programming sessions, four staff members at the adult day center participated in a focus group discussion, to share their observations during and after the eight Rhythm and Nature program sessions.

Results:

Following thematic analysis, six overarching themes were identified, including (a) community and active prosocial engagement; (b) safe spaces for sharing memories, processing, and reminiscing; (c) fun, laughter, and joy; (d) autonomy, voice, and creativity; (e) multisensory experiences and learning, and (f) skill development, affirmations, and confidence. The staff also reported that the participants were more engaged in Rhythm and Nature than in other programming at the adult day center, that the participants clearly enjoyed themselves, that they themselves as staff enjoyed Rhythm and Nature programming, and that the programming was desired both by participants and staff.

Conclusions:

The results highlight the unique benefits of Rhythm and Nature as a holistic non-pharmacological creative arts-based intervention, for older adults living with disabilities. This intervention is unique, in its regular engagement with staff at the adult day facility. The participants in this combined creative arts-based programming, and the staff who observed and participated in this programming, also shared that they enjoyed both the music and the nature-based activities, and that these activities were remarkably effective at promoting prosocial engagement. Thus, the findings also support emerging evidence that suggests nature-based approaches, and reflexive strategies may offer safe spaces to enhance and maintain individual and community wellness. Still, further research is needed on best practices for engaging adults with intellectual disabilities in research, and namely, on best practices for gathering data directly from individuals living with intellectual disabilities. Further implications will be discussed for social work practice and research with older adults living with disabilities.