The realization of meaningful activities for nursing home residents: insights from focus groups with staff members

Introduction Meaningful activities of daily living (MADL) are essential to promote the identity and quality of life of nursing home residents (NHR). MADL offer structure in time, stimulate social interaction and positively... [ view full abstract ]

Introduction
Meaningful activities of daily living (MADL) are essential to promote the identity and quality of life of nursing home residents (NHR). MADL offer structure in time, stimulate social interaction and positively affect autonomy and well-­being. Nevertheless, an admission in a NH covers a loss of MADL. Therefore, NH are expected to offer a range of activities. However, they don’t fulfill the needs of NHR and are often meaningless.

Methods
This qualitative study used eight semi-­structured multidisciplinary focus groups, including occupational therapists (n=21), nurse assistants (n=20), recreational therapists (n=20) and NH managers (n=5). All interviews were audiotaped and coded line­‐by-­line. Data were analyzed open-­minded, using content comparison to determine the preconditions and influencing factors of organizing MADL.

Results
The NH­‐staff reported eight different factors and preconditions for organizing MADL in NH. MADL are dynamic and strongly related to changing abilities of NHR. Therefore, a consequent and continuous monitoring is needed. Although, MADL are mostly organized spontaneously and rely on the ‘gut feeling’ of caregivers. An achievable, well‐structured approach to identify, realize and monitor MADL is lacking. It appeared crucial to know the life history, needs, wishes and capacities of NHR. However, NHs don't have protocols to enhance MADL, neither they use tools to evaluate and improve MADL.

Conclusion
MADL should be organized in a more structured and transparent manner. This study indicated the need for a practical and interdisciplinary guidance to identify the needs of NHR concerning MADL and to enhance the realization
of MADL for NHR.