INCREASING OLDER CARE HOME RESIDENTS’ WELL-BEING:
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AN EVALUATION OF MOTIVATIONAL CLASSES IN CARE HOMES
BY L J Gomez1, G M Fox2, J C McCreanor3, M Cattan4, Leeds Metropolitan University1,4, St James University Hospital, Leeds2,3
INTRODUCTION
In recent years considerable attention has been paid to physical and mental well-being of older people in care homes. Many care homes engage an ‘activity coordinator’ for this purpose. Another option is to contract an external agency to provide regular activities for care home residents. One such agency, ‘Motivation & Co.’, delivers structured group sessions of up to 5 ‘exercises’ for older people in residential homes across England. The purpose of the recreational classes is to improve or maintain physical and emotional well-being using word games, memory games, physical games and music. We have evaluated the impact of these hour-long motivational sessions on the participants and identified the perceptions and feelings of staff and participating residents about the classes.
To investigate the effects of the classes 1-3 observers (LG, GF, JM) observed residents of 2 residential homes immediately before, during and after the 1 hour sessions and identified indicators of well-being and ill-being. These indicators have previously been established and published[1]. It should be noted we did not use the full tool and adapted it to suit the purpose and timescale of the evaluation. Observations at a 3rd residential home were planned, but cancelled due to class leaders non attendance. Participation and the need for physical and verbal prompts were also noted along with sleep patterns over the same period. The evaluation took place over 7 weeks and all residential homes were taking part in the classes prior to the study. RH 1 was observed on 4 occasions and RH 2 twice. A total of 57 residents were observed, although the numbers attending each session varied.
Residents, staff and activities coordinators from each residential home were interviewed using semi-structured interviews recorded with consent. Thematic analysis of the interviews was undertaken separately by 2 observers and the results combined and re-reviewed for common key themes.
Ethical approval for the study was obtained from the Leeds Metropolitan Faculty of Health ethics subcommittee.
RESULTS
Key Theme 1 – Enjoyment
When asked what they thought of the sessions, residents replied:
‘I enjoyed it. I always do. Well it takes us out of ourselves. We don’t do a great deal otherwise. Only when we come here.’
‘Well I’m one of those people who enjoyed it all.’
The activity coordinators also identified enjoyment as a benefit of the sessions:
‘Very positive; they seemed to enjoy it. We used to do it once a month. Because they enjoy it we do it once a week now. So the residents quite enjoy it.’
The observations of well-being indicators demonstrated individual increases during the session compared to before. Well-being Indicators were generally noted to decrease by exercise 4 or 5 and after in the group as a whole.
More indicators of ill being were seen proportionally during the chair exercises in the groups as a whole.
Key Theme 2 – Participation
lncreased residents participation with external classes compared to ‘in-house’ classes was a leading interview theme particularly among the staff group.
The results from the observations demonstrated that residents present at the classes participated more often than not, and that physical exercises: playing skittles, beanbag hoopla and chair exercises attained greater proportional participation amongst the group than word games or quizzes. (see table 1)
Table 1
The table below shows the percentage of participation in activities
Activity % Participation No. Participating/Total
Skittles and music 100 24/24
Beanbag hoopla 92.9 26/28
Chair exercises 78.9 45/57
Naming flowers 65.4 17/26
Singing 62.1 18/29
General Knowledge 61.2 30/49
Sayings 50.0 4/8
DISCUSSION
This evaluation helps reinforce the generally held belief that older residents of care homes gain enjoyment from participation in organised activities and that well-being can also improve. It demonstrates a preference of residents in terms of participation in physical activity rather than verbal and quizzes. We noted that individuals with impairments were given assistance to participate in the physical activities and that impairments such as deafness may be a disadvantage for the verbal exercises. We believe more studies should be done in order to evaluate the benefits of activities for care homes residents as this may help direct providers in optimising their choices for residents.
Reference
[1] Bruce, E. (2000). Looking after well-being: a tool for evaluation, Journal of Dementia Care. Nov/Dec., pp.25-27, 8 (6).