Elsevier

Geriatric Nursing

Volume 37, Issue 2, March–April 2016, Pages 110-115
Geriatric Nursing

Feature Article
Is the experience of meaningful activities understood in nursing homes? A qualitative study

https://doi.org/10.1016/j.gerinurse.2015.10.015Get rights and content

Highlights

  • Meaningful activities represent a part of the identity of the older people.

  • Residents encounter difficulties to perform meaningful activities.

  • Meaningful activities help residents to recover a sense of belonging and identity.

  • The nurse staff does not always accept the performance of meaningful activities.

  • These results should be used to design nursing occupational care programs.

Abstract

Lack of occupation can lead to boredom, apathy, social exclusion and solitude. Occupation should incorporate meaningful activities. The aim of this study is to describe how Spanish Nursing Home residents experienced and made sense of meaningful activities. A qualitative phenomenological approach was followed. Data were collected over an 18-month period between 2012 and 2014. Purposeful sampling was conducted with Spanish residents in nursing homes in Madrid. Data were collected using unstructured and semi-structured interviews. The data were analyzed using the Giorgi proposal. Thirty-eight residents (20 female and 18 male) participated. Three main themes describing the significance of meaningful activity in nursing homes emerged from the data: Feeling the passage of time, Seeking an occupation, and Living with restrictions. Nursing homes should strive to develop diverse and meaningful activity programs for residents in order to occupy their time and provide them with a greater sense of purpose.

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.

References (34)

  • A.P. Giorgi et al.

    The descriptive phenomenological psychological method

  • J. Green et al.

    Qualitative Methods for Health Research

    (2009)
  • A. Giorgi

    The phenomenological movement and research in the human sciences

    Nurs Sci Q

    (2005)
  • C. Teddlie et al.

    Mixed method sampling: a typology with examples

    J Mix Methods Res

    (2007)
  • A. Kuper et al.

    An introduction to reading and appraising qualitative research

    BMJ

    (2008)
  • R. Díaz-Martín
    (2009)
  • A.E. Peñafiel-Olivar

    Standard of Care on Nursing Homes: Autonomy and Dignity in Old Age

    (2010)
  • Cited by (32)

    • The influence of the down- and upscaling of activities in long-term care facilities during the COVID-19 visitor ban on caregivers’ exhaustion and ability to provide care and support: A questionnaire study

      2022, Geriatric Nursing
      Citation Excerpt :

      It is known that for healthcare workers employed in intensive care and emergency units feelings of not being able to provide the care that is needed lead to increased moral distress and burn-out symptoms,8 further stressing the need for LTCFs to critically review the meaningful activities they provide from a resident’ wellbeing perspective as well as from a care worker’ wellbeing perspective. Insufficient meaningful activities and a lack of time and staff were challenges in the long-term care sector before the pandemic,29 but were amplified by COVID-19. In lieu of long-term sustainable solutions, some countries or regions took innovative measures.

    • Modelling the quality of life goals of people living with dementia

      2022, Information Systems
      Citation Excerpt :

      This research has led to different quality of life frameworks to help people with dementia understand and communicate their life preferences and needs. Most of the frameworks focus on selected aspects of the person’s preferences and needs, such as framing a person’s quality of life choices [11], describing personal outcomes [12] and documenting preferred meaningful activities [13]. Moreover, all were developed for care workers to use manually, so there are no reported attempts to make the guidance from these frameworks automatic and accessible to carers with all but the simplest digital tools.

    • 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 Advances
      Citation 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 Geriatrics
      Citation 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.

    View all citing articles on Scopus

    Disclosure statement: No potential conflicts of interest were disclosed.

    View full text