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Freedom, flexibility, autonomy…good things right? To have a voice in how you manage your day and feel in control of your work. The need for autonomy is not just an ideal it’s a critical and key performance indicator. The freedom to choose, the flexibility to spend time on the things that are most important to us and the autonomy to approach things in your own way is a prerequisite for engagement.

This has been shown in many studies, one of my favourites was conducted in 1975 at Arden House, a nursing home in Connecticut by Ellen Langer and Judith Rodins and shows extraordinary results.

They wanted to understand the effects of enhanced personal influence on the wellbeing of elderly residents who were living virtually choice-free. At the time Arden House was a well-run large home with approximately 300 residents, the staff ensured every care was attended to. Langer and Rodin chose two floors to study, the second and the forth, because of the similarity in the residents physical and phycological health, length of stay and prior socio-economics status. Baseline health measurements were taken of the residents within the study and, whilst the subjects could not be randomly assigned to the experimental treatments, the treatments were randomly assigned between the two floors, giving rise to two groups:

1) The Responsibility-induced group

2) The Comparison group

First the groups were given a talk by a member of the nursing team to introduce the study. Group 1 were told that they had influence over many things at the home, like how they wanted their rooms arranged, when they wanted visitors, how to spend their time, that they were at liberty to offer up complaints and suggestions for change. In other words, ‘it’s your life and you can make of it whatever you want’. This group were also told that a film would be shown two nights a week and they had the choice to attend or not. Finally, they were given the option to choose a plant from a variety on offer and were told that it was their responsibility to care for the plant, as they wished.

The comparison group were told that their rooms had been laid out for them as nicely as the staff could do them, that a film would be shown twice a week and they would be told which day they were scheduled to see it, and, just like the other group, they’d be given a plant as a gift from Arden House, but their plant would be cared for by the nursing staff. The major difference between these two groups is the emphasis on their sense of influence, choice and control. The responsibility-induced group had a level of control over their environment while being in the care of staff, whereas the comparison group had minimal responsibility for themselves. There was, however, no difference in the amount of attention paid to the two groups.

The results were astonishing and went beyond Langer and Rodin’s expectations. In 93% of the responsibility group, providing them with a greater sense of control showed improvements in activity and self-reported happiness in as short a period as three weeks of the experiment, versus 71% of the comparison group, who were rated as more debilitated in the same period. More importantly, however, when Langer and Rodin returned to the home 18 months later, they found that twice as many of the comparison group had died in relation to the responsibility group.

The idea that just having a plant to look after or choosing when you want to see a film can extend life is extraordinary, almost unbelievable, but the experiment has been repeated since and yielded the same results.

Langer went on to study how giving greater control to hospitalised patients had a positive effect on their medication levels. Choice and a sense of control have a ripple effect. Greater choice helps keep self-esteem intact, deepens the motivation to connect to others and take part, and support a sense of purpose.