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Interest May Be More Significant Than Function

Published August 24, 2011 12:23 PM by Brian Garavaglia

In a recent study presented to the Gerontological Society of America, results found that tailoring the activities of nursing home residents toward their interests rather than just their functional level may help in enhancing their daily involvement, forestalling a resident's functional decline, and possibly enhancing a resident's mood during post-activity socialization. 

The study, lead by Dr. Ann Kolanowski from Penn State University, found that structuring activities on the basis of particular interests to each individual helped to reduce passivity and improve the participation of the resident, as well as improve the resident's alertness and attention during the activity itself.

The results of this study often run counter to what is often found in most nursing care facilities. Frequently there is a standardized set of activities that are employed by the activity personnel, and these activities continue to be repetitively provided throughout the week. 

Furthermore, many nursing facilities often break their residents into different groups, based on the resident's functional ability. Therefore, although activity personnel often do take an inventory about resident's likes and interests, especially as part of the overall individual assessment, most activities nevertheless are organized on the basis of the functional status of the residents as a group. Subsequently, rather than personalizing or individualizing the activities more toward the level of interest for the resident, many activity sessions are attempts to homogenize the activities towards a "one size fits all" activity that places greater emphasize on the resident's function rather than interest.        

Some of this problem within the activities area continues to exist due to the nursing care facility continuing to be looked at first and foremost as a medical facility. Even though many long-term care facilities have attempted to "Edenize" their facilities, with an attempt to move away from the predominately based "medical model" that is found in most facilities, we cannot deny that the medical model continues to be the predominate model that guides life within these care centers. 

Within these systems of care we continue to see medical care and treatment being individualized. It would be preposterous to think that medical care should not be individualized and directed toward the specific needs of the resident. However, as we move away from the medical care area, why should our thinking deviate and why should we come to think that we can homogenize all other services, in particular activities, and fail to pay particular attention to the individualized interests of each person and how they can be satisfied and better cared for in these areas. 

Furthermore, as mentioned in the study conducted by Ann Kolanowski, helping to individualize activities can also provide beneficial effects for behavior and mood. Providing better interest and attention helps to focus many older adults that may have incipient cognitive issues outward, and allows them to have less time to focus and become preoccupied with thoughts that may influence their mood and behavior in a negative manner.      

It is critical that greater therapeutic emphasis is provided to the activity area.  Most often look toward this area as a department that is headed by fun people who like to engage older adults in fun activities. However, that is only part of the importance of activity personnel. It is important to have all nursing home personnel understand the therapeutic impact of activities, especially for enhancing the socially therapeutic care that older adults receive. 

Moreover, the activity personnel must be viewed as key players of the therapeutic team. Often, activity personnel are viewed in less regard by many within the nursing home environment, especially since they are viewed as not being part of the mainstream providers of healthcare. However, the socially therapeutic intervention that they can provide is often what humanizes many older adult's existence within long-term care facilities. 

In addition, the activities personnel also need to be aware of the importance of sound, clinical assessment of a resident's interests to establish an individualized plan of action toward each resident. This plan cannot just be part of the individualized activities care plan that is placed in the resident's chart and ignored thereafter.      

The study discussed in this article provides important emphasize for the therapeutic significance of activities as they relate to enhancing the lives of elderly nursing home residents that may present symptoms of dementia. However, it also asserts a need that most residents are currently not receiving: the need to receive much more individualized activities that are directed toward each resident's specific interests. 

Since this may also be difficult for many nursing care centers to introduce, especially since it may take more activities personnel to address the more specific activity needs that resident's have, probably many nursing care facilities strapped by budgetary constraints in this area will opt to continue to homogenize their activity programs as has continued to be the tradition. 

Until we truly start to move away from the exclusive emphasize on the medical model, and therefore emphasize greater socially therapeutic intervention, many older adults within the long-term care environment will continue to not achieve the optimal benefits from sound therapeutic activities that is often needed to address older adult's social needs, and subsequently provide an environment that is more humanizing and directed toward addressing each and every older adult's particular interests. 

Reference

McNamara, D. (2011).  Tailored activities cut dementia symptoms.  Caring for the Ages, 12(7), 10. 

posted by Brian Garavaglia

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About this Blog


    Brian Garavaglia, PhD
    Occupation: Long-term care administrator
    Setting: Sterling Heights, Mich.
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