Practice question

How can I make activity for residents meaningful in my care home?

Activities are not always seen as integral in a person's overall care and are often arranged by care home staff and not by registered nurses.

Activities are not always seen as integral in a person's overall care and are often arranged by care home staff and not by registered nurses.

It was recognised two decades ago that lack of physical and mental activity and limited social stimulation have a negative effect on individuals (Phair and Good 1998). It is now referred to as deconditioning syndrome (Arora 2017) and is becoming better understood, and links activities with the role of the nurse.


Picture: Charles Milligan

The principles of person-centred care, described by Kitwood more than 20 years ago, should always be the starting point when considering meaningful activity (Kitwood 1997). Life history should be used to discover what a person enjoyed doing and why. For example, a person may have enjoyed camping which they can no longer do, but the fresh air, peace, tranquillity and being close to nature may be the reasons why they enjoyed it and this could be captured in activities.

Tailor-made meaningful activity

Meaningful activity is not simply filling the day with things to do. In a care home people risk being isolated, disengaged and feeling useless. What meaningful activity is will vary from person to person, but will have characteristics of belonging, purpose, enjoyment, fun, relaxation, engagement or satisfaction.

All staff working in a care home, regardless of role, can be part of the activity team. Enabling residents to assist with practical tasks around the home according to the residents’ abilities, will support a feeling of purpose and usefulness. Cleaning, table laying, gardening, vegetable preparation or serving drinks are examples of enabling people to feel useful.

Health and safety should be considered in the context of positive risk taking and assessment of reasonable risks (Department of Health 2010).

Culturally aware

Ensuring residents from diverse cultures have the opportunity to participate in festivals or family traditions is important and staff should ensure they learn and are aware of the importance of this. Equally, staff from overseas should be supported to learn and embrace the traditions, cultures and activities of the local indigenous population.

Overseas staff cannot be expected to understand local, regional or national festivals, celebrations, cultural activities or simple pastimes if they have not been taught about them. Something as simple as taking a resident blackberry picking may not be understood if blackberries are not a familiar fruit to the care worker.

Residents may consider a meaningful activity as being able to watch their favourite television programme in the privacy of their room while enjoying a much-loved drink. Staff should enable this to happen and record in the care plan the value of this to the person.

Having a sense of belonging is important and could be encouraged through group activities. Examples include fitness activities, games, singing or music as well as social meals, or trips to visit places of interest. Engagement by the care home in the local community could involve participation in local festivals, or celebrations, while the joy of simply chatting and laughing must never be underestimated.

Central to any group activity must be the involvement of residents and/or their families when deciding the plans. Changing the culture of passive acceptance (activity being done to a person) to collective decision making and engagement in planning requires a shift in culture of the staff who lead activity. The registered nurse should demonstrate leadership skills in facilitating this to happen.

References

Lynne Phair is an independent consultant nurse and expert witness 

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