Investigating perceptions of disgust in older adult residential home residents

Objectives: As people become increasingly physically dependent as they make the transition into older age, they may lose the ability to control bodily functions. Problems with eating, voiding and washing can be linked with feelings of disgust and, given the necessity for some of being assisted with intimate care activities, it has been suggested that self-focused disgust and concerns over the disgust of others may become important preoccupations in older people, with the potential to further impair their quality of life. Method: In a mixed-methods study, feelings of disgust in 54 physically dependent older adults living in residential homes were investigated. Participants completed measures of disgust sensitivity, mood, and two new scales assessing feelings of self-disgust and perceived other-disgust related to intimate care activities. Six of the residents who reported high levels of self-disgust also participated in semi-structured interviews. Results: Results indicated that disgust was uncommon. Where present, self-disgust was related to perceptions of others' feelings of disgust and general disgust sensitivity. These results were benchmarked against 21 community-dwelling older adults, who reported believing they would feel significantly more disgusting if they were to start receiving assistance. A thematic analysis identified the importance of underlying protective factors, the use of strategies and carer characteristics in ameliorating feelings of disgust. Conclusion: The results are discussed with reference to the disgust literature, with recommendations being made for ways in which self-disgust can be minimised in those making the transition to residential homes.