ENABLING MEANINGFUL ACTIVITIES IN DAILY LIVING AND QUALITY OF LIFE IN NURSING HOMES: STEPWISE DEVELOPMENT OF A MULTIDISCIPLINARY CLIENT-CENTRED APPROACH

Background: Engagement of Nursing Home residents (NHR) in meaningful activities of daily living (MADL) enhances autonomy and Quality of Life. This project aimed to develop an approach to identify and enable NHR’ needs for... [ view full abstract ]

Background:
Engagement of Nursing Home residents (NHR) in meaningful activities of daily living (MADL) enhances autonomy and Quality of Life. This project aimed to develop an approach to identify and enable NHR’ needs for MADL.
Method:
The approach was developed based on Campbell’s (2008) ‘framework for design and evaluation of complex interventions to improve health care’ including (1) a qualitative study with 15 NHR exploring their MADL needs; (2) a survey with 143 NHR determining the components of a new MADL approach; (3) a qualitative analysis of 21 ‘good practices’; (4) 6 focusgroups with different stakeholders (nurses, management, activity-coaches, occupational therapists; n=69) to identify their visions on MADL and to support implementation; (5) a systematic review on interventions to enrich MADL and finally (6) the development/evaluation of a new approach in one living lab examining the feasibility, benefits for NHR and acceptability for the staff.
Results:
A client- and activity-oriented approach was developed, characterized by an active participatory attitude of NHR and caregivers. Based on a systematic therapeutic process, four phases are distinguished, from an initial ‘getting to know each other’, over an all-encompassing evaluation of the wishes, desires, priorities, facilitating and inhibiting factors. After cataloguing the resources and strengths of the NHR, a plan to enable NHR’ preferred MADL can be developed.
Conclusion:
This promising empowering approach needs to be further examined in a RCT to evaluate its outcome and implementation potentials.
Application to Practice:
This approach guides NHs to develop a creative and innovative attitude towards NHR’ MADL.