"The key issue to support resident thriving seems to be that
residents have a selection and variety in activities, and that the
activities are meaningful to the residents," said study author
Sabine Bjork of the University of Umea.
"If I was the daughter or spouse of a nursing home resident, I would
be more interested in to what extent the care was person-centered
and how staff work together with residents to facilitate social
engagement and activities despite their physical and/or cognitive
impairments,” Bjork added by email, “rather than the prevalence rate
of physical activities in the nursing home."
For the study, Bjork and colleagues surveyed staff from 172 Swedish
nursing homes with a total of 4,831 residents. They asked caregivers
to assess individual residents' cognitive and functional abilities,
engagement in activities and what's known as thriving - or quality
of life and wellbeing.
Residents in the study were 86 years old on average, though they
ranged from 47 to 107. Roughly two-thirds were female.
The most common everyday activities included receiving hugs and
physical touch, talking to friends and relatives, talking to staff
about issues unrelated to care and personal grooming, researchers
report in the Journal of Advanced Nursing.
Some of the least common daily activities included going to the
movies, participating in educational programs, visiting restaurants,
doing everyday chores and playing games with others.
While gender, age and physical and mental health explained some of
the variation in thriving among residents, some of the difference
could also be associated with what residents did during the day, the
study found.
Roughly 25 percent of the variation in thriving among residents
could be explained by opportunities to engage in an activity
program, dress nicely, spend time with someone the resident likes,
engage in a hobby, participate in religious activities, have
conversations with staff about topics unrelated to care, watch
television, get exercise, go outside, play games, participate in
celebrations and receive hugs or physical touch.
Out of all these things, engagement in activity programs appeared to
have the biggest influence on thriving, followed by dressing well
and spending time with someone the resident liked.
The study wasn't designed to prove how the availability of certain
activities might influence thriving among nursing home residents.
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Other limitations include the possibility that residents with
greater functionality and better quality of life or wellbeing were
able to participate in a wider variety of activities, the authors
note. This means thriving might make more activities possible,
rather than activities causing people to thrive.
Even so, the findings add to a body of research suggesting that
physical and social activities can lead to improved health outcomes
for nursing home residents, said Dr. XinQi Dong, associate director
of the Rush Institute for Healthy Aging at Rush University Medical
Center in Chicago.
"Physical and social activities can be a conduit for nursing home
residents to have a daily purpose to look forward to, potentially
reducing a sense of psychological distress, which can lead to
improved subjective wellbeing in their daily lives," Dong, who
wasn't involved in the study, said by email.
When patients and families are choosing a nursing home, they should
look at staffing levels and also ask how staff help residents engage
in activities, Dong added. This may not be one-size-fits-all because
residents can have a variety of health issues like dementia,
physical disabilities, mental illness or an inability to manage
self-care.
Ideally, families should look for nursing homes that track what
activities residents join and what they enjoy, Bjork said.
"I would choose a nursing home that rigorously and systematically
collects this type of information on their residents and actually
incorporates this in the care," Bjork added.
SOURCE: http://bit.ly/2m4efGR Journal of Advanced Nursing, online
February 23, 2017.
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