25 January 2026
Manufacturing Meaning
How do we create "meaningful lives" in aged care?
Photo by Benjamin Voros on Unsplash
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Article summary (by AI)
- Aged care struggles to support meaningful lives after autonomy, roles, and relationships are lost
- Meaning is often replaced with activities because systems restrict genuine choice
- Loneliness persists despite extensive programs; relationship quality matters more
- Meaning depends on real choice, dignity of risk, and genuine relationships
- Possible pathways: micro-communities; informed risk conversations; families shifting from visitors to community co-creators
NASA invites you to send your name to the moon. Sounds grand, doesn't it? Here's what actually happens: you type your name into a web form. NASA saves it to a memory card, I’m guessing sort of a USB drive. The memory card goes on a rocket. The rocket flies around the moon. Your name, now digital data among millions of other names on a storage device, circles the moon and comes back. You receive a digital certificate as proof of this monumental achievement.
As I’m writing this, two million people have already signed up.
This is participation theatre at full scale. The illusion of involvement, or the performance of meaning. And it works, because at some level we want to believe we're part of something bigger, even when that “something” is a marketing database launched into space.
Now consider aged care, which faces a version of the same challenge that actually matters.
Aged care providers are attempting to create meaningful lives for people whose life circumstances have stripped away the conditions that previously generated meaning organically. Moving into residential care, loss of autonomy, disrupted relationships, proximity to death—these factors remove the relationships, routines, and valued roles that gave life meaning before residential care.
We could draw something of a parallel here: both NASA and the aged care sector create feelings of participation and meaning in environments where real participation is difficult, expensive, or structurally impossible. But NASA's stakes are a press release. Aged care's stake is human dignity.
The difference is intent. Aged care providers aren't choosing manufactured meaning because it's easier or more profitable. They're working within funding models, regulatory frameworks, and workforce realities that make genuine autonomy and organic meaning-making difficult to achieve at scale.
How meaning gets manufactured
Lifestyle coordinators inherit an impossible brief, and I don’t envy them: create meaning, community, and purpose for groups of dozens of residents with different backgrounds, varying needs, limited budget, and regulatory requirements to ensure compliance. The result is often one-size-fits-all programming because personalisation at scale is genuinely difficult*.
Research by Moilanen et al. (2021) shows what autonomy looks like in residential care. Residents make decisions about what to wear, what to eat from the menu, how to decorate their room. These choices aren't trivial, but they exist within a system where the fundamental structure remains fixed. Routines, staffing schedules and patterns, risk management protocols etc. can’t change based on individual preference.
Person-centred care is our sector's quasi-mantra, embedded in quality standards and strategic plans. But research by Backman et al. (2024) identifies multi-level barriers that prevent implementation. The gap isn't due to lack of commitment, but rather it is structural. Funding models, workforce shortages, regulatory compliance, family expectations, and organisational constraints collide.
"Celebrate the Greek Independence Day by making loukoumades" isn't so different from "your name goes to the moon". Both are symbolic gestures offered when substantive participation isn't possible. Except one is manufacturing public interest to justify NASA's future funding requests, while the other represents genuine attempts by Australian aged care providers to create joy for older residents within limited resources.
The sector manufactures meaning because the structural context strips organic meaning away. And this must happen within budget constraints that rarely reflect the true cost of genuine person-centred care—unlike space agencies, which apparently have budgets big enough for publicity stunts.
However, there are inherent limitations that come with this "manufactured" meaning. Research demonstrates that loneliness persists in residential care despite extensive activity programs. Quality of relationships matters far more than quantity of connections or scheduled activities (Norlin et al., 2025), practically meaning that residents can be surrounded by scheduled uniform activities, engaged staff, and well-intentioned programs and still be profoundly alone.
What organic meaning requires
The research is consistent about what genuine autonomy and dignity require: substantive choice. This means decision-making power over things that matter to daily life, i.e. the ability to shape routines rather than fit into them. Various research shows residents want to maintain “continuation of self”, yet respondents often feel that they have to adjust and fit in so as not to disturb routines.
Furthermore (and perhaps not surprisingly), research on dignity of risk (Woolford et al., 2024) found that in practice, risk-reduction strategies are prioritised over promotion of independence. There is limited appreciation of the positive benefits of risk and no counter strategy for risk enhancement.
Organic meaning emerges from agency, relationships built on genuine connection, and the ability to contribute rather than consume manufactured experiences. The question is how to create space for organic meaning within systems designed for efficiency, safety, and scale.
Possible pathways
Some options require thinking beyond current frameworks.
Micro-communities within facilities. Rather than programming for large cohorts of residents, facilities could support smaller household models where 8-10 residents shape their shared life together. Evidence shows this enables organic routines, relationships, and meaning-making that more general programming cannot. This, of course, increases costs substantially in the short term, particularly during implementation, but research shows benefits over time. The model works because it allows residents to find each other—people who share interests, values, or simply enjoy each other's company. Think of Richard Osman's Thursday Murder Club: a fictional group of residents bonding over their shared passion for true crime, meeting because they want to, not because it's scheduled. That's organic meaning. You can't program it into existence, but you can create conditions where it emerges.
Redistributing risk and responsibility. Much manufactured meaning stems from risk-averse policies. Facilities could support genuine "dignity of risk" conversations, documenting residents' informed choices to take risks that matter to them, even when those choices conflict with safety protocols. What does this look like in practice? A resident who wants to tend a garden past daylight, and despite fall risk. Someone who prefers to skip their morning medication to avoid drowsiness when playing bridge. Calculated decisions by adults who understand the trade-offs.
Honest conversations with families about limits and partnership. Aged care providers can provide clinical care, safety, and programming. But they cannot manufacture meaningful community single-handedly, or sustained connection to the outside world, without help from the families who actually know their loved ones. This requires honest conversations about what residential care can and cannot provide alone. So, what if families shifted from visitors to community co-creators? Different families could lead monthly activities based on their skills. Families with children could bring them regularly for intergenerational projects, e.g. oral history recording or art collaborations. The shift is from "visit your loved one" to "contribute to the community your loved one lives in." This requires facilities to cede control and families to commit beyond occasional visits.
What can be done
Those 2 million people who sent their names to the moon participated in something that felt meaningful. Most will never think about it again. NASA achieved its goal—public engagement at scale with minimal actual commitment required from anyone.
But aged care isn't selling symbolic participation in someone else's journey. It's creating the conditions for people to live their final years with dignity, agency, and genuine connection. Unlike space exploration, our sector can't afford gestures that feel meaningful without being meaningful.
Providers already know this. Every lifestyle coordinator who struggles to create genuine engagement, every manager wrestling with the gap between person-centred rhetoric and institutional reality, every staff member who sees residents isolated despite full activity calendars—they understand the problem.
What we can do is name it clearly, redirect resources and reform structures to address it honestly, and pursue systemic change that enables what we know people need: genuine autonomy, authentic relationships, and the ability to shape lives that feel like their own.
_____________
* This seems to be the case for almost every industry except Facebook ads.
As I’m writing this, two million people have already signed up.
This is participation theatre at full scale. The illusion of involvement, or the performance of meaning. And it works, because at some level we want to believe we're part of something bigger, even when that “something” is a marketing database launched into space.
Now consider aged care, which faces a version of the same challenge that actually matters.
Aged care providers are attempting to create meaningful lives for people whose life circumstances have stripped away the conditions that previously generated meaning organically. Moving into residential care, loss of autonomy, disrupted relationships, proximity to death—these factors remove the relationships, routines, and valued roles that gave life meaning before residential care.
We could draw something of a parallel here: both NASA and the aged care sector create feelings of participation and meaning in environments where real participation is difficult, expensive, or structurally impossible. But NASA's stakes are a press release. Aged care's stake is human dignity.
The difference is intent. Aged care providers aren't choosing manufactured meaning because it's easier or more profitable. They're working within funding models, regulatory frameworks, and workforce realities that make genuine autonomy and organic meaning-making difficult to achieve at scale.
How meaning gets manufactured
Lifestyle coordinators inherit an impossible brief, and I don’t envy them: create meaning, community, and purpose for groups of dozens of residents with different backgrounds, varying needs, limited budget, and regulatory requirements to ensure compliance. The result is often one-size-fits-all programming because personalisation at scale is genuinely difficult*.
Research by Moilanen et al. (2021) shows what autonomy looks like in residential care. Residents make decisions about what to wear, what to eat from the menu, how to decorate their room. These choices aren't trivial, but they exist within a system where the fundamental structure remains fixed. Routines, staffing schedules and patterns, risk management protocols etc. can’t change based on individual preference.
Person-centred care is our sector's quasi-mantra, embedded in quality standards and strategic plans. But research by Backman et al. (2024) identifies multi-level barriers that prevent implementation. The gap isn't due to lack of commitment, but rather it is structural. Funding models, workforce shortages, regulatory compliance, family expectations, and organisational constraints collide.
"Celebrate the Greek Independence Day by making loukoumades" isn't so different from "your name goes to the moon". Both are symbolic gestures offered when substantive participation isn't possible. Except one is manufacturing public interest to justify NASA's future funding requests, while the other represents genuine attempts by Australian aged care providers to create joy for older residents within limited resources.
The sector manufactures meaning because the structural context strips organic meaning away. And this must happen within budget constraints that rarely reflect the true cost of genuine person-centred care—unlike space agencies, which apparently have budgets big enough for publicity stunts.
However, there are inherent limitations that come with this "manufactured" meaning. Research demonstrates that loneliness persists in residential care despite extensive activity programs. Quality of relationships matters far more than quantity of connections or scheduled activities (Norlin et al., 2025), practically meaning that residents can be surrounded by scheduled uniform activities, engaged staff, and well-intentioned programs and still be profoundly alone.
What organic meaning requires
The research is consistent about what genuine autonomy and dignity require: substantive choice. This means decision-making power over things that matter to daily life, i.e. the ability to shape routines rather than fit into them. Various research shows residents want to maintain “continuation of self”, yet respondents often feel that they have to adjust and fit in so as not to disturb routines.
Furthermore (and perhaps not surprisingly), research on dignity of risk (Woolford et al., 2024) found that in practice, risk-reduction strategies are prioritised over promotion of independence. There is limited appreciation of the positive benefits of risk and no counter strategy for risk enhancement.
Organic meaning emerges from agency, relationships built on genuine connection, and the ability to contribute rather than consume manufactured experiences. The question is how to create space for organic meaning within systems designed for efficiency, safety, and scale.
Possible pathways
Some options require thinking beyond current frameworks.
Micro-communities within facilities. Rather than programming for large cohorts of residents, facilities could support smaller household models where 8-10 residents shape their shared life together. Evidence shows this enables organic routines, relationships, and meaning-making that more general programming cannot. This, of course, increases costs substantially in the short term, particularly during implementation, but research shows benefits over time. The model works because it allows residents to find each other—people who share interests, values, or simply enjoy each other's company. Think of Richard Osman's Thursday Murder Club: a fictional group of residents bonding over their shared passion for true crime, meeting because they want to, not because it's scheduled. That's organic meaning. You can't program it into existence, but you can create conditions where it emerges.
Redistributing risk and responsibility. Much manufactured meaning stems from risk-averse policies. Facilities could support genuine "dignity of risk" conversations, documenting residents' informed choices to take risks that matter to them, even when those choices conflict with safety protocols. What does this look like in practice? A resident who wants to tend a garden past daylight, and despite fall risk. Someone who prefers to skip their morning medication to avoid drowsiness when playing bridge. Calculated decisions by adults who understand the trade-offs.
Honest conversations with families about limits and partnership. Aged care providers can provide clinical care, safety, and programming. But they cannot manufacture meaningful community single-handedly, or sustained connection to the outside world, without help from the families who actually know their loved ones. This requires honest conversations about what residential care can and cannot provide alone. So, what if families shifted from visitors to community co-creators? Different families could lead monthly activities based on their skills. Families with children could bring them regularly for intergenerational projects, e.g. oral history recording or art collaborations. The shift is from "visit your loved one" to "contribute to the community your loved one lives in." This requires facilities to cede control and families to commit beyond occasional visits.
What can be done
Those 2 million people who sent their names to the moon participated in something that felt meaningful. Most will never think about it again. NASA achieved its goal—public engagement at scale with minimal actual commitment required from anyone.
But aged care isn't selling symbolic participation in someone else's journey. It's creating the conditions for people to live their final years with dignity, agency, and genuine connection. Unlike space exploration, our sector can't afford gestures that feel meaningful without being meaningful.
Providers already know this. Every lifestyle coordinator who struggles to create genuine engagement, every manager wrestling with the gap between person-centred rhetoric and institutional reality, every staff member who sees residents isolated despite full activity calendars—they understand the problem.
What we can do is name it clearly, redirect resources and reform structures to address it honestly, and pursue systemic change that enables what we know people need: genuine autonomy, authentic relationships, and the ability to shape lives that feel like their own.
_____________
* This seems to be the case for almost every industry except Facebook ads.
Photo by Jsme Mila on Pexels
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Sources
- Backman, A., Sjögren, K., Lindkvist, M., Lövheim, H., & Edvardsson, D. (2024). Nursing home managers' descriptions of multi-level barriers to leading person-centred care: A content analysis. International Journal of Older People Nursing, 19(1), e12581. https://doi.org/10.1111/opn.12581
- Moilanen, T., Kangasniemi, M., Papinaho, O., Mynttinen, M., Siipi, H., Suominen, S., Suhonen, R. (2021). Older people's perceived autonomy in residential care: An integrative review. Nursing Ethics, 28(3), 414–434. https://doi.org/10.1177/0969733020948115
- Norlin, J., McKee, K. J., Lennartsson, C., & Dahlberg, L. (2025). Quantity and quality of social relationships and their associations with loneliness in older adults. Aging & Mental Health, 29(7), 1198-1208. https://doi.org/10.1080/13607863.2025.2460068
- Woolford, M. H., de Lacy-Vawdon, C., Bugeja, L., Weller, C., & Ibrahim, J. E. (2020). Applying dignity of risk principles to improve quality of life for vulnerable persons. International Journal of Geriatric Psychiatry, 35(1), 122–130. https://pubmed.ncbi.nlm.nih.gov/31647586/