It seems to me that we Activity Professionals have a unique vantage point on the condition of the world, quality of life, and human behavior in general. So, when I read about research in other fields, I get all excited about the obvious tie-ins to our work. A few months ago I wrote an article reviewing Jonathan Rauch’s “The Happiness Curve” as it relates to long-term care, especially critical staffing shortages. That article appeared in McKnight’s Long-Term Care News this spring. However, I couldn’t fit everything from Rauch’s book that applies to activities into the first article.
My activities tie-in is a bit heretical. I think that the “person-centered” movement is all well and good, but implementing the results of the meta-analyses being done in the field of human behavior might benefit our residents just as much. And combining the two approaches even more. For example:
Self-isolation. Hopelessness. Ukraine.
Rauch himself was looking for tie-ins from research on happiness, how people rate their own satisfaction with life (aka happiness) and how it affects their activity choices. As he describes it, our collective sense of satisfaction follows a predictable curve related to the age of the people being interviewed. No surprise but satisfaction with life tends to bottom out in middle age, even in the presence of great personal career/financial success. Then, later in life, our perspective starts changing and things get better. It’s a world-wide phenomenon. He also points out that age seriously affects our experience of time. Seniors often don’t think they have enough “time” for our activity programs, because … after all … they are hoarding the limited number of moments they feel they have left. Again, no surprise to you folks. Again, it’s a phenomenon seen in many cultures around the world. Meta-analysis, not person-centered data collection.
But Rauch had more numbers up his sleeve. That middle-age angst eventually begins to dissipate with age. Here we see seniors, sicker, more disabled and suffering more pain, but also happier, more mellow in general than they were 20 years ago. You know what I’m talking about. If I picture myself in the medical condition so many of our residents enjoy, I would picture myself as completely miserable, not mellow. And what about that sense of time being too limited to allow for out-of-room activities? It’s not set in concrete. There are examples that show we might be able to enlarge seniors’ sense of time in general with the right input. Applied meta-analysis, not derived from the MDS or an activity history.
How do we change our residents’ perception of time? Younger people assume they have time for going places, doing things, and meeting people (besides close friends and family). I’m wondering if we can convince our residents that there is enough time to do things besides wait in their rooms for family to visit. I’m not sure what the optimum time frame would be. Tomorrow? The next scheduled event? Christmas? A staff pregnancy or wedding? I’m thinking that we need to find some way to involve more residents in the preparations for the future. However, if staying in the room is part of the problem, asking for their suggestions on out-of-room activities is probably a waste of time. Resident council is supposed to elicit participation in the planning process, but if someone is coming out for resident council, they aren’t really the target for this intervention. Applied meta-analysis based on current level of participation/attendance, not on self-reported MDS answers or activity history.
I’m not above involving family members. One resident has been refusing activities she used to participate in happily. She only leaves her room for meals now, and only if staff really coaxes. By chance, I saw her heading to her room after a meal. She was right at the point where it was actually closer in time and distance to go to bingo than to go back to her own room. She let me assist her to bingo. When it was done, I asked if she had had fun. “Oh, yes,” she said, smiling broadly, “I had a good time.” Then she went back to her room, back to self-isolating. I saw her son the other day. I told him I had a job for him – he needs to talk to his mom about the future whenever he can, to try and get her thinking about the future.
So, here we are still dealing with the pandemic. We used to joke about PTSD at work. It’s no joke anymore. Many staff bailed since our major outbreak in 2020. Those of us who are left cringe when the office calls. We’ll be standing in the hallway and someone’s cellphone will ring and we look up and make eye contact with each other. News that another staff member tested positive. It just doesn’t end. Rauch had no way to know that the “happiness curve” would take such a hit so soon after he wrote his book. That was 2018. In 2019, my niece, in her late 30’s, took her own life. In 2021, a nephew in his late 30’s gave up on the future and took his own life. Both were heading into what probably looked to them like an unending downward slope. The drop in life satisfaction beginning in the 30’s and bottoming out in the 40’s and early 50’s is a real thing, and obviously the pandemic is not helping. In fact, the pandemic is probably also skewing our sense of time. When the future of the world as we know it seems problematic, all our personal plans for the future seem less relevant. Rauch had already figured out that while individual counseling could help people struggling with hopelessness, our society could do a better job of warning people what to expect. Maybe we’d feel less stigmatized and more inclined to get the help we need to wait it out. Maybe if you’ve just rolled into a long-term care facility and you wish your family would just let you die … maybe it would help to know there is still happiness to be had. Potentially life-saving meta-analysis.
You’re wondering why I mentioned Ukraine. Well, as I’ve pointed out, Rauch has data to show that the “happiness curve” is universal. In almost every country there is a self-reported drop in life satisfaction in middle age. There is also a universal rise in life satisfaction in later years. The problem is Russia. Their curve bottoms out lower and rises later. They are less happy in general and unlike the US, where we very gradually begin getting happier in our 50s, the Russians are barely starting to get happier in their 80s or 90s.
“… the curve there does not turn until the average person is dead” (80).