There is an old saying “If you don’t use it, you will lose it”. This concept rings true for our residents. Living in congregate or long-term care settings can decrease or give the perception of loss of the control the resident can exert over their daily life choices. Meals, activities, ADL assistance and something as simple as going to bed for the night may be determined by the facility to meet the facility’s needs more than the individual resident’s needs. Residents should be given active control over their own lives as much as possible. Allowing them to plan, organize and conduct activities will restore some control.
The WHY of resident engagement is to help older adults find meaning in their lives and stay connected to their purpose regardless of their interests or cognitive changes. Being active in social activities can help stave off isolation and loneliness- two issues people may face if they are not socially engaged. To achieve this goal, it is important that we collaborate with those we serve to fully understand what purposeful living means to them.
The FUTURE of resident engagement needs to be based on a holistic approach to care that prioritizes person-centered strategies and tools that make advancing wellness a priority. Many people think of wellness in terms of physical health only. We need to think of wellness as much more than physical health. Wellness is a full integration of physical, spiritual, and mental wellbeing that leads to quality of life. Wellness is a state of mind and a lifestyle. Simply put, what you do, think, feel, and believe has an impact on your health and wellbeing. When using the wellness model approach to resident programming, you will find that this approach focuses on humanistic concepts in which residents are seen as a whole person of mind, body, and spirit. The Wellness model approach includes activity programming in the following areas: Physical, Emotional, Creative, Cultural, Environmental, Social, Spiritual, and Cognition.
To determine what approach to programming is best for each resident, the activity professional would complete an activity assessment. This assessment is used to collect important information about the resident in regard to what the resident feels are important recreational and leisure interests they wish to pursue. This assessment paired with the wellness model approach provides a solid foundation for determining the type of activities the resident would enjoy and find purpose in engaging in. Once the assessment data is gathered, the activity professional will be able to identify the activity related problems the resident may experience as well as strengths and resources that can be used to help resolve the problems.
In research by the Centers for Medicare and Medicaid Services (CMS), residents have reported that independence and a positive self-image were central to their wellbeing. They want a choice in activities and activities that “amount to something”, such as those that produce or teach, activities using skills from former work, religious activities, and activities that contribute to the community home.
F-Tag 679 stipulates that the facility must provide, based on the comprehensive assessment and care plan and preferences of each resident, an ongoing program to support residents in their choice of activities, both facility-sponsored group and individual activities and independent activities, designed to meet the interests of and support the physical, mental, and psychosocial well-being of each resident, encouraging both independence and interaction in the community.
Enhancing control and autonomy has been a focus in the culture change and person-centered care movement. Increasing autonomy can lead to greater personal satisfaction. By providing residents with opportunities to exert a sense of control after moving into long term care facilities we are allowing them to maintain their dignity and individuality.
In planning activities, we must consider each resident’s lifestyle, ethnic background, religion, family interactions, interests, and mental and physical capabilities. Facilities have (thankfully) moved away from the traditional mainstays of an activity program-what is known as the “3 B’s”, Bingo, Bible study and Birthdays to a more enriched and purposeful engagement program. Here are a few suggestions to incorporate a variety of engagement opportunities for your residents beyond the “3-B’s”:
- Family and intergenerational experiences-Involve the resident’s family members in life at the facility; invite them to smaller and more intimate activities not just the big events where it is hard to create family connections!
- Become involved in local community activities and events- Most of your residents are native to the area the facility is in and have been active in the local community events for years, let’s help them to continue this!
- Maintain lifelong skills-give residents the opportunity to share their knowledge and skills with others!
- Religious affiliations- Ensure to reach out to local churches and synagogues to ask for clergy to conduct in-person services at your facility. Many clergy are covering services at several churches in neighboring towns and Sundays can be very full for them. Ask if they could provide another day for the service, or, if possible, on a Sunday evening, invite the clergy to facilitate the service and stay for supper with the residents in the dining room!
- Physical and mental activities- Let’s get moving to stay strong and keep our residents minds sharp!
- Lifelong learning- Introduce educational classes, lectures with local college students needing intern hours, visual presentations, and discussion groups!
What are the benefits of an engaging resident activity program for residents?
- Decreased dependency or feelings of helplessness.
- Decreased isolation.
- Increase in the use of their abilities and skills.
- Increased self-esteem.
- Provides purpose; a life worth LIVING!
What are the benefits of an engaging resident activity program for the facility?
- Decreased complaints from residents and family members.
- Increased occupancy.
- Increased staff morale and decreased staffing turnover.
- Meeting state and federal licensing requirements.
In summary, developing a comprehensive activity program begins with an understanding of the needs and interests of the residents and how activities can benefit them. Your engagement program is the backbone of the activity department and should effectively illustrate your strategy in meeting your resident’s needs and interests. Your role as the activity professional is not one of an entertainer who stands in front of a group of residents and entertains them several times a day. It is more of a CONNECTOR who fully understands the resident on an individual level, knowing what makes them tick and using that to create connections between peers with similar interests.
Scott Smith, “Purposeful Engagement: The Challenge, the Opportunity, the Example,” webinar; Pioneer Network, Culture Change in Action Series, October 2023
Ridgewater College, Activity Interventions and Engagement Techniques Course (2023)
Kim Mead, ADC, CDP, CMDCP, CAP
Director of Engagement, Gardant Management Solutions
NAAP Central Region Director