Sunday, February 1, 2009

Background Question #2

Please describe your view of what an "activity" is in long term care.

An activity is for me any focused effort by mind or body in work or play.

In long term care, activities are mostly planned and scheduled and seldom spontaneous. They are planned by staff with time limits. And are activities that may or may not be choices of the residents. Often activities are childish and boring because they have little meaning to the resident. So life is compartmentalized into SLEEP, SCHEDULED ACTIVITIES, and NOTHING, just fritter away. And often meaningful activities that happen outside the scheduled activities are not captured and named as such, for example, a meaningful exchange between a caregiver and the resident. Activities in long term care for the most part take place INSIDE the facility, and seldom in the community at large.

It seems to me that developing active people rather than activities might be good. I assume that an activity at a long term care facility would be highly structured and not leave too much room for the individual to make decisions about the outcome (but maybe i have just seen too many Simpsons episodes?) Actually, my sister worked at a facility for folks with early stages of dementia. It was a pretty high-end place but management was focused more on expansion than on quality care in her estimation -she did a lot of craft activities, residents watched movies together, an occasional field trip, stuff like that.

ANSWER FROM BETH MA Short term 'engaged' event, an event that engages people, or increases persons' self worth, although unfortunately, many times activities in long term care are events that keep as many people busy as possible while the staff can do their "work".

ANSWER FROM ARLENE G My image of this differs from an ordinary activity in three ways: first, rather than being driven by the participants' own desires, my perception is that "activities" are often organized by others for them, based on what someone else imagines they might enjoy or find edifying. Second, I imagine these activities are more strongly bounded than my own (i.e., "From two to four we'll have a clay workshop"), that shape and duration are imposed rather than organic. Third, my impression is that many of them seem purposeless in a way that could be infantilizing.

ANSWER FROM JUDY D Perhaps similarly… it is activities that feed into one’s well-being, soul and self esteem. In my experience in nursing homes, it could include music (playing, enjoying), exercise, social time with friends, games (especially games that stretch and exercise your mind), reading, watching television (hopefully informative and inspiring PBS programs!), and some online activity especially if it’s connecting with family and friends.

It is the same things, but they may have to be adapted to your current abiliities and functional level. It is not just BINGO, BIRTHDAY and CHURCH. Having a Red Hat Ladies Club, Romeo Club, having "classes" of things of interest i.e. cooking, decorating, volunteer work, things that bring a sense of purpose and personal satisfaction/self-esteem, whatever. Your residents should determine what activities you provide based on their needs, interests and abilities. Activities encompasses 1:1, independent, small groups, large groups, community outings, bringing the community in. They are designed to meet physical, social, spiritual, psycho-social, cognitive, and emotional needs - all spectrums of total body/mind wellness.

In long term care, activities are what we offer to people to keep them from feeling bored. They do not necessarily cause someone to feel successful or productive.


Separating the term activity for a moment from my assumptions—I think there are parallels to daily activity elsewhere. Times of day accompanying meals or preparations that give shape and rhythm. The other activity I think of is more a management of time—a time allotted to a proscribed event. I think of activities that are set up—set up with parameters, outcomes, products, perhaps expectations.


It's hard for me to imagine. I have no reference but for my grandparents in law. Grandmother-in-law, Maili, liked to socialize. She was kind of a party queen socialite and entertained into her final days. The grandfather-in-law was a painter and started to loose his identity when he had to stop painting. Both worked together on books. I suppose that was the same thing as I do - projects.

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