Abstract
The residents of long-term facilities are often content with the activity calendar or tend to isolate themselves in their rooms due to a lack of interest. This isolation and boredom tends to lead to further declines in socialization and interests. The goal of this study was to explore individuals’ interests, especially activities they may have done prior to living in the facility and may wish to actively engage in. Will engaging in purposeful activity increase the long-term resident’s quality of life?
Primary Author and Speaker: Shannon Strate
Additional Authors and Speakers: Carol Doehler
The occupational therapy workforce (30% OTAs and 55% OTRs) work in skilled nursing facilities (American Occupational Therapy Association (AOTA), 2015), the largest of most employed settings, creating a stage for practitioners to serve as a catalyst for culture change (Rafeedie, Metzler, & Lamb, 2018). The environment of a long-term care facility is becoming more patient centered and less facility driven. Too many residents living in long-term care, regardless of activities offered, continue to feel lonely & depressed, socially isolated & boredom.
The goal of this study was to determine whether engagement in purposeful activity increased the quality of life in long-term nursing home residents. This study explored the activity levels of residents and the effects of engagement when residents could choose activities based on personal preference. This study also assessed whether the engagement affected their perceived quality of life.
This quasi-experimental design consisted of 14 residents, 10 women and four men, from a long-term care facility. Their ages ranged from 64 to 100 years old with a mean age of 86.21. Residents met inclusion criteria if they were scheduled for a Minimum Data Set (MDS) assessment due during March and April 2019,and scored eight or greater on the Brief Interview for Mental Status (BIMS). Additionally, residence at the nursing facility for at least three months, capacity to attend to a task for 30 minutes, and communicate verbally. The exclusion criteria of this study was a score of seven or below on the BIMS. All residents volunteered to participate.
The participants of this study completed the World Health Organization Quality of Life-OLD module as a pre/post-test. An 8 week intervention was provided with individually chosen activities at least one time per week. The data was analyzed utilizing IBM SPSS Statistics program. The six facets were analyzed individually using paired samples t-test. Scores were calculated on the ten participants who completed the pre and post-test, as four residents chose not to complete the post-test. Results pre and post-test did not yield significant change, one can speculate that these participants were a group of well-adjusted long-term residents.
Important social validity findings were gained regarding residents’ perceptions of independence, socialization and engagement in purposeful activity as shown in the responses shared by the participants. The aim of this study was to measure whether engagement in purposeful activity would increase the resident’s QOL. The social participation facet had a mean score of 67% implying the importance placed in active participation by residents.
Life in a nursing home is less than optimal, and for the long-term resident, daily routines often lack autonomy, personal decision making, privacy and dignity (Ragsdale & McDougall, 2008). OT has much to offer in addressing these concerns. With a strong foundation in mental health and a holistic approach to our clients, as well as with a high percentage of OTs working in these settings, we have an ideal opportunity for greater success for our residents. The OT profession should expand its focus with long term residents in a nursing home, to include addressing any declines in socialization, increased signs of depression, or changes in mental status. Referrals for occupational engagement must be made to OT as they are best positioned to incorporate occupations into residential plans based on OT’s knowledge and skills, setting apart OT as a valued and often underutilized professional. OT’s can expand their goals to include leisure, as it is an important part of our OT Practice Framework III (AOTA, 2014), and therefore, provide the meaningful engagement in activity the resident may be craving.
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Ragsdale, V., & McDougall, G. J. (2008). The changing face of long-term care: Looking at the past decade. Issues in Mental Health Nursing, 29(9), 992–100. doi: 10.1080/01612840802274818.