Living in a long-term care (LTC) facility does not mean that the joys and experiences of life have ended. The 1975 film Rooster Cogburn has a memorable scene in which U.S. Marshal Cogburn, played by John Wayne, is “celebrating” by tossing biscuits into the air and shooting at them. When an alarmed Eula Goodnight (Katharine Hepburn) asks him what he’s celebrating in this unusual manner, the drunken Cogburn joyously shouts, “Bein’ alive, sister. Bein’ alive!”
Although the movie is fictional, it represents part of the reality for activity directors in LTC communities. The days of simply keeping residents occupied are over, and the focus has turned squarely on making sure that meaningful, person-centered activities contribute to a life worth living—and celebrating. As always, LTC communities and their activity directors are rolling up their sleeves and taking the challenge to heart.
Percell Smith, vice president of resident loyalty at CHE/Trinity Senior Living Communities, says he believes strongly that there needs to be a transformative philosophy that moves away from the old paradigm of activity programs and toward life enrichment and facilitates a community life that embraces everyone within it. The Livonia, Mich.-based healthcare system includes skilled nursing, assisted living and independent living communities.
“We believe an activities program should be more than diversional,” Smith says. “It should be a vehicle for enriching the lives of all the residents within our communities. It should recognize and affirm them as a whole person.”
To successfully meet this goal, CHE/Trinity Senior Living Communities realized that it would need to incorporate more people into administering life-enrichment experiences at its communities. This realization led to an increased role for nursing assistants in activities.
“We recognized that, given the way most communities staff their activity departments, there was no way they were going to be able to cover enough ground to meet the interests of each and every resident,” Smith says. “So we made a decision that the regularly scheduled caregivers—the nursing assistants—were going to work with the activity director.”
As Smith explains, the activity director still does all the traditional tasks that he or she was doing, such as assessments and the creation of a calendar. But now the nursing assistants, who often are the individuals closest to the residents, can help arrange the community into “neighborhoods” of shared interests or even advise the activity director about specific one-on-one pursuits residents would like to enjoy.
“That’s a fundamental change we find quite exciting,” Smith says. “It has been exciting for the activity directors because now they don’t feel overwhelmed by having a small department that’s called to serve people with many interests, and it’s really enriching for the nursing assistants—who we now call care partners—because many of them learn things about the residents that transform them from a resident that they’re caring for into a person who has a life history and has intellectual interests and things they want to pursue.”
PROVIDE MEANINGFUL PURSUITS
Knowing your residents is the easiest way to meet their needs with activities, and the best way to know residents is to learn as much about them as possible when they enter your facility, says Kendra Howard, LPN, RACCT, Country Lane health coach at Evergreen Community of Johnson County, a 112-bed skilled nursing facility in Olathe, Kan.
“If you know what a resident’s profession was, what his or her hobbies were, what he or she enjoyed doing, you’re going to be able to meet that person’s needs activity-wise,” Howard says.
Although Howard believes that group activities are important because they bring people together, the most import aspect of activities is ensuring that people have a purpose. “We’ve really had good success by giving people the opportunity to do things they’re still capable of doing that gives them the sense of purpose they had their whole life,” Howard says.
She cites the example of a gentleman who had been a maintenance worker. “You could tell that when he got here, he just didn’t feel like he had a purpose,” Howard says. “He would walk around checking the handrails to make sure they were sturdy, checking chair legs, things like that. So we set him up with our maintenance department when they did their rounds in the morning. He’d be with them to make sure everything looked good and was working properly, and he’d go with the maintenance workers to storage to pick up supplies.”
An added bonus, according to Howard: The more engaged and more purposeful the residents are, the less likely they are to fall and be injured.
BLENDING FUN AND THERAPY
Terri Occhionero, ADC, activity director at Avon Oaks, an assisted living and skilled nursing facility in Avon, Ohio, agrees with Howard: The key is keeping residents involved in meaningful activities that they did at home and still enjoy doing now.
One activity that Occhionero is eager to share with others is Avon Oaks’ choir.
“Our music therapist discovered that one thing many people had done in the past was to have been part of a choir,” she says. “So we put together a choir, and it has been very popular. At any given time, we have between 20 and 30 residents participating.”
Occhionero notes that singing not only is enjoyable; it also helps residents breathe better.