Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Related Sciences

First Advisor

Jodi L. Teitelman


Understanding volition and preferences for occupation is a critical underpinning of effective occupational therapy services that promote and preserve identity for persons with moderate dementia. Although it has been posited that this population has significant difficulty expressing volition for daily occupations, little research has examined the role of volition in guiding engagement in occupations. This phenomenological study provides an in-depth description and analysis of volition in eight persons with moderate dementia. Guiding questions related to understanding patterns of past life interests, outward demonstration of volition, volitional continuity. and the relationship of the social environment to volition and engagement in daily occupations, were used. Maximum variation sampling was used to recruit from one memory-support assisted living in a Midwestern continuing care retirement community. Participants were enrolled sequentially over an 11-month period. Participant observation and interviews of family and staff were the main data collection methods. The Volitional Questionnaire (VQ) was used to gain additional data about participants’ volition, and the Mini-Mental Status Exam (MMSE) provided a general indicator of cognitive impairment. Data analysis used van Manen’s phenomenological approach to uncover the phenomenon of volition. Three major themes emerged, and had a dynamic interaction: a) variation in volitional expression in the areas of interests, values, and personal causation, b) redefining meaningful occupation, reflected in four categories, and c) potency of the social environment, highlighting the pervasive influence of other people on participants’ volition. Participants’ lived experience of volition reflected the importance of the dynamic between the social environment and the person.The findings of this study support the importance of assessing volition for individuals in the context of their social world in order to maximize function and minimize excess disability. Further research is needed to address caregivers’ perceptions about volition, as well as examining the use of the VQ and specific intervention strategies that target volition.


Scanned, with permission from the author, from the original print version, which resides in University Archives.


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Date of Submission