Feature ArticleIs the experience of meaningful activities understood in nursing homes? A qualitative study
Introduction
The nursing home (NH) is the residents' home and place to live as well as being their social environment and the place where they receive necessary care.1 The recognition of the diversity of the residents' needs, such as their activities and how they spend their time within the NH, adds complexity to the issue of their care.
Occupation has been described as “involvement in life in a way that is personally significant” and “that which we seize for our own personal possession, and which engages our time, attention and environment.”2 Occupation should incorporate meaningful activities; these can be defined as enjoyable activities that engage the resident to the extent that they improve either their emotional wellbeing, cognitive status, or their physical function.3 The presence of meaningful activities is a quality indicator for NHs.4, 5
Lack of occupation can lead to boredom, apathy, disruptive behavior, lack of confidence, social exclusion and solitude.2 However, previous studies have demonstrated that residents spend less than 13% of their time performing meaningful activities,5, 6 and are inactive,7 bored and alone for a large part of the time.8 Nursing homes are characterized by a rapid and long-standing reduction in choices regarding meaningful occupational as well as decreased autonomy. Residents tend to find meaning in activities that address psychological and social needs, whereas the staff tends to give importance to activities that exercise physical abilities.3
Published research examining the meaning of activities in NH residents has commonly focused on residents with dementia.2 However, there is far less qualitative research examining meaningful activities in residents without dementia. The aim of the present study was to describe how Nursing Home residents experienced and made sense of meaningful activities.
Section snippets
Design
A qualitative phenomenological study was conducted,9 in order to analyze the experience of NH residents regarding meaningful activities. Qualitative phenomenological research is designed to explore the meaning of a phenomena, through the specific human experience, via rich descriptions in order to understand what it means to be in that life-world.10 The lived experience is based on exploring the subjective reflection of human beings when taking part in events in a specific geographical, social
Results
A total of 38 residents, 18 males and 20 females participated in the study, mean age was 81.68 years (±8.9 SD) and mean Barthel index score was 60.86 (±12.14 SD). No one withdrew from the study. Table 3 shows details of the socio-demographic data for the participants included in the study.
Three themes representing the experience of meaningful activity were identified from the results: Feeling the passage of time, Seeking an occupation, and Living with restrictions. Findings are followed by
Discussion
Our findings show how residents experience the passing of time as being very slow. Previous studies,7, 24, 25, 26 corroborate our results showing how residents are given little chance to organize their free time in a purposeful way. Harper Ice7 and Chang25 described how the passage of time within the residential home is experienced with boredom. Days feel long and endless, moreover time spent without doing anything is perceived as a form of daily suffering.8 The residents themselves worry about
Conclusions
This study shows how residents experiment time differently within the NH, and that the performance of meaningful activities helps residents to occupy their time and feel useful. On occasion, the performance of meaningful activities entails being supervised by the nurses as these activities are considered to be a risk. It is important to develop activity programs based on the residents' own preferences, needs and abilities. These results can be applied for the development of activity programs by
Acknowledgment
We would like to thank all the nursing home residents who participated in this study.
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The impact of Covid-19-related distancing on the well-being of nursing home residents and their family members: a qualitative study
2021, International Journal of Nursing Studies AdvancesCitation Excerpt :The FMs said that they and their loved ones had experienced anxiety, grief, and stress due to the social restrictions, which is in line with previous research findings (Nelson and Bergeman, 2021; Heid et al., 2021; Whitehead and Torossian, 2021). Loneliness and insufficient meaningful activity among nursing home residents was a concern before the pandemic (Palacios-Ceña et al., 2016; Pirhonen et al., 2018), but the distancing seems to have emphasized the pre-existing challenges and worries (see also Kehusmaa et al., 2021). In the current study, several FMs expressed concern that their loved ones might die, socially at least, because of the lack of social contact and activities (see Brannelly, 2011).
Quality of life of nursing home residents in mainland China: The role of children and family support
2019, Archives of Gerontology and GeriatricsCitation Excerpt :A study conducted among 1316 residents from 40 NHs in five American states demonstrated that meaningful activity had the lowest score among the 10 QOL domains (Kane et al., 2003). These results are congruent with previous studies that have found residents spent a small proportion of their time on meaningful activities and stayed in their rooms, sitting or alone for the most of their time (Cheng, Rosenberg, Wang, Yang, & Li, 2011; Palacios-Cena et al., 2016). To change the inactive, immobile, bored, and alone life, NHs must develop diverse and meaningful activity programs based on residents’ real needs and preferences.
Exploring gaps in positive solitude perceptions: Older adults vs. gerontology professionals
2021, International PsychogeriatricsExperiences of meaningful occupation among diverse populations–A qualitative meta-ethnography
2024, Scandinavian Journal of Occupational Therapy
Disclosure statement: No potential conflicts of interest were disclosed.