A PILOT STUDY: A CLIENT-CENTRED APPROACH TO ENABLE MEANINGFUL ACTIVITIES IN DAILY LIVING IN NURSING HOMES

Background: Engagement of Nursing Home residents (NHR) in meaningful activities of daily living (MADL) enhances their autonomy and Quality of Life (QoL) but this is in reality barely not the case. Therefor this project aimed... [ view full abstract ]

Background:
Engagement of Nursing Home residents (NHR) in meaningful activities of daily living (MADL) enhances their autonomy and Quality of Life (QoL) but this is in reality barely not the case. Therefor this project aimed to test a client-centred and activity-oriented approach, characterized by an active participatory attitude of NHR and caregivers and based on a systematic therapeutic process. It distinguishes four phases, 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 creative and innovative plan to enable NHR’ preferred MADL can be developed.
Method:
In a pilot study, 24 cognitively healthy NHR (6 men, 18 women; mean age 87.08 sd 4.81; mean length of stay 39.92 sd 42.68) were included. Outcome measures were QoL, number of MADL, self-perceived performance, satisfaction, challenge, quality of the activities, participation and social contacts. Additionally all participants (NHR and professionals) were interviewed to perform a process evaluation.
Results:
All outcome measures improved although not significant. Only the number of MADL (p< .001), the quality of the activities (p < .001), social contacts (p<.05) did; participation showed a trend (<.057). All participants pointed out that social contacts were improved. Professionals mentioned more initiative from the NHR themselves.
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 might guide NH in a more enabling attitude towards NHR’s MADL.