Nursing Homes Activities

Special programs in nursing homes encompass a wide range of activities and services. Their purposes are:

To enable residents to react and interact with their environment;

To help them fight back, to shape their destinies, to find new and satisfying social relationships; and

To be able to be self-directing and spontaneous.

These programs are planned and carried out by the care team of staff, family, residents, and volunteers working together. The programs should meet the needs of the residents as the resident defines them. In other words, the programs are done with the residents, not for them.

The variety of programs available in any nursing home depends on the health and interests of the residents. The range of activities should meet the needs of all residents, from the disoriented to the wheelchair bound to the ambulatory. Possible programs to meet resident needs are described in this article as activities, religious services, and therapies. While the structure and delivery of programs varies from home to home, their availability is essential to the total nursing home community.

Activities

A broad range of programs is directed by the activities coordinator. A home certified for Medicare and Medicaid must have someone designated as an activities coordinator. The planning and implementation of activities comes from requests by residents, families, staff, and volunteers. The activities are usually posted on a calendar of events that is available to each resident and also posted in large print where a wheelchair-bound resident can easily see it. Examples of a few such activities are:

Monthly birthday parties to which all residents are invited. Families and friends may be invited to participate. Volunteers often help to bring residents to the party and join in the fun.
Celebrations of various holidays, both secular and religious. Holidays are particularly difficult times for those away from their own homes, families, and friends. Valentine's Day, Halloween, Christmas, Hannukah, Easter, and Memorial Day are a few examples.
Musical events can be enjoyed actively or passively depending on the abilities of the residents. Many homes have sing-alongs in which the residents request their favorite songs and sing along with a leader. Again, the involvement of volunteers, families, and friends is crucial to the success of such a program. Sometimes concerts are given by a church or school group or friend of the nursing home. Hopefully, the public is invited to attend, for this allows the residents to provide a source of pleasure to their community.
Games foster both one-to-one relationships and group activity. Bingo is a favorite for many, but bridge, chess, and other games for smaller groups usually are available. Volunteers and families often are the ones to stimulate resident interest in a game and they may be able to help arrange suitable opponents. Contests sometimes are run with work games, and tournaments are arranged for bridge or game players.
Outdoor activities include gardening, cookouts, or just enjoying time in the sun alone or with a friend. Often the staff does not have the time to take the immobile residents outside. Family and volunteers are relied upon to make this possible.
Trips and tours to community events. Some homes have a special resident fund from the sale of arts and crafts made and sold by the residents to finance transportation rentals and ticket purchases. Friends or volunteers may donate to the fund or sometimes the nursing home sets aside money. Transportation can be a problem for those in wheelchairs, but the activities coordinator usually can find volunteer drivers who are taught to cope with the special needs of disabled people. Some communities have special vans that transport residents in wheelchairs. Trips outside the home offer variety and mental stimulation.
Nursing home newsletter, especially if published by residents. This is an especially valuable method of expression and uses resident talent that otherwise may lie idle. Poetry, history, birthdays, and resident and staff personality profiles are all topics that can be included.
Resident discussion groups. Sometimes a resident is an expert on a particular subject and will be the group leader. Other times a volunteer may offer to lead a discussion group. Topics may include current events, literature, and religion. The residents choose the topics and those interested attend.
Exercise fun and physical fitness. Community leaders often volunteer to lead yoga or other exercise sessions. Even wheelchair-bound residents find satisfaction in exercising on a regular basis.
Books. Volunteers may run a book service, taking a cart of books to the room of immobile residents. There may be a central library or small bookcases on each floor. Talking books for the blind may be part of the service. Families, friends, and volunteers can buy, bring, and hand out books. Many people help with reading to those unable to see well.
Coffee or cocktail hours. Policies vary from home to home, but social hours provide a time of resident interaction. It is a particularly nice time for volunteers, family, and friends to join the residents.
Arts and crafts programs separate from occupational therapy frequently are offered by the activities coordinator. A volunteer, resident, or family member may lead this program.
Religious services. Every Medicare- and Medicaid-certified nursing home must, by federal regulation, provide the opportunity for residents to attend religious services of their preference. Many nursing homes welcome denominational groups to provide religious services in the home for those who wish to attend. Again, this often provides an opportunity for families and friends to join the resident in worship. The organization of such services is usually handled by the activities coordinator.

Therapies

Reality orientation therapy is a technique used to rehabilitate residents who suffer from moderate or severe disorientation. These people may no longer know who they are, where they are, or what hour, day, or year it is. The technique can be carried out by anyone who comes into contact with the resident. The nursing home offering such a program involves the entire staff, families, and friends in the process. One or two staff members in the home may be responsible for the program. This is a relearning process, individually and through short group sessions, of basic information such as name, place, age, and day. As these facts are learned more facts are added. It is the basis of more advanced remotivation techniques designed to help the resident function better.

Remotivation therapy is under the direction of a trained remotivation coordinator and carried out by her or someone she designates such as an RN, LPN, or nursing assistant. It is for those who are already oriented but who need to take a renewed interest in their surroundings by focusing their attention on simple, objective aspects of daily life.

Regular meetings are important for successful remotivation programs. The meeting site must promote a relaxed atmosphere and be devoid of other distractions. A topic of conversation is introduced by the leader; a short poem or a newspaper item is appropriate. Often, the residents are asked to read part of the poem or story. Next, the topic is developed through the use of a preplanned set of questions. Then the topic is related to each individual experience. Finally, the meeting is brought to a close and plans for the next meeting are made.

Occupational therapy is a service provided by a qualified occupational therapist to evaluate, diagnose, and treat problems that interfere with everyday living skills. Impairments may be due to physical illness, injury, emotional disorders, or the aging process. Therapists and patients together work toward the goals of optimal levels of independent living, prevention of disability, and maintenance of health.

Specific occupational therapy services include education and training to increase independence in activities of daily living such as dressing and eating; to improve eye-motor coordination, sensory integration, concentration and attention span, thought organization, and problem solving; and to correct impaired visual-spatial relationships.

Additional services also seek to prevent muscle atrophy, prevent or minimize deformity, and increase pain tolerance. For instance, someone who has weakness in an arm due to a stroke may benefit from an activity such as sanding wood that strengthens muscles. Or the occupational therapist may make a splint for the hand and arm to prevent the muscles from stretching or contracting.

Volunteer Services

Volunteers provide an important link between the community and the nursing home resident. Many are involved in the activity program because they have special talents and skills to contribute. Many others assist residents who have disabilities, to participate in activities. Friendly volunteer visitors provide one-to-one relationships for residents.

Regardless of their specific roles in the home, volunteers must be recruited, oriented, and supervised to be used effectively. A dedicated group of volunteers from the community is testimony to a concerned nursing home.

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