Lack of stimulation in elderly populations

¶ … stimulation in nursing homes for the purpose of helping residents remain active. The writer, who has worked in nursing homes for the past 27 years has experienced first hand the negative impact that lack of stimulation has had on her clients. The writer explores research regarding the topic and designs a plan in which it would be mandatory to gather information about the residents' prior interests when they move in and incorporate those interests into the daily care plan once they arrive.

Creating Stimulating Environments for the Elderly in Nursing Homes

Advances in medical science have taken mankind to heights never before imagined. Today people are living longer than ever before and with the added years they are working to maintain a high standard of living and quality of life. For those who are fortunate enough to remain healthy and live at home or with relatives this is often possible, however, for those that encounter health issues, or are unable to live with relatives as they age, a nursing home is often the only option. The concept of a nursing home is loving and warm. They are designed to provide a warm, comforting place for the elderly to spend their final years of life, while remaining active and engaged in the daily operation of the world. It is a good theory and one that many nursing home professionals attempt to carry out, but all to often nursing home residents are put in a home and left to languish until they die. Many nursing homes do offer some activities including shopping excursions, card tournaments and senior exercises throughout the week, however the activities are often regimented, and meant as a group activity. Too often when a senior citizen enters a nursing home their prior personal interests are pushed aside as they do not fit with the daily routine and cre plan that the home already has in place.

Having worked in a nursing home for the past 27 years I have seen what happens to the elderly as they enter the home and they are no longer being stimulated.

They give up. They come in full of enthusiasm, if not a bit nervous, and they start to interact. I can always spot the residents who have been there a long time because as the resident passes the time he or she begins to stop interacting. The lack of stimulation begins to take its toll and soon they sit and wait to die instead of getting up each morning ready to live.

Many people believe they are simply witnessing a natural progression toward death, however, I believe that if the residents were stimulated within the nursing home setting they would enjoy a higher standard of living fror their remaining years and perhaps live longer as well.

One recent project at a nursing home called the Eden Alternative provided individual residents with the ability to maintain independent lifestyles and to pursue previously held interests to great success.

The project involved a nursing home in the Midwest with 151 beds. The project was designed to last for two years and at the end of two years the project was evaluated for success or failure (Rosher, 2006).

The project was designed around previous research that concluded the most effective and humane way to deal with the elderly in homes was to create smaller communities within the homes, invert staff decision making so that those who are dealing directly with the residents have the most decision making power when it comes to the residents and to promote the staff to become close to the residents that they worked with.

The project suggested that staff members not be moved around shift by shift, but instead remain assigned to the same residents day in and day out for the purpose of getting to know them and understanding their individual personalities ad needs.

The project noted that previous nursing home regimes included bathing, eating and exercise schedules that were designed to make the staff jobs easier and more convenient with little attention paid to the need of the residents themselves.

The project promoted the development of self-directed teams where individual residents designed their own schedules and interest fulfillment.

Companion animals, plants and children visits were incorporated to the daily routines and residents decided where they wanted to spend their time and energy.

Before the plan was put into place data was collected so that the changes could be measurably recorded (Rosher, 2006).

In addition, before the plan began Phase I, the nursing home staff was retrained and agreement and enthusiasm for the plan was attained.

The culture change program was as success. Several residents were recorded as developing new energy and drive for life when allowed to pursue previous interests. One resident, who had dementia approached a newly obtained bird and talked to it for 15 minutes. She had raised birds during her adult life before entering the center and she was still able to advise others on how to care for and feed pet birds. Another resident who was blind and hearing impaired came alive with excitement when she was provided bunnies to pet and care for each day (Rosher, 2006).

Another study gauged at recording nurse response to patients with dementia illustrated the all too common response of forcing the residents to comply with schedules and interests that were convenient for the staff members, and ignoring any possible interests of the residents.

This study included 54 nursing home nurses from several different nursing homes and concluded that nurse responses to the patients was often lacking compassion or understanding (Kovach, et al., 2006).

In Common Problems in Hospitalized Older Adults, several issues were noted to prevail among the elderly population confined in homes. They included sleep issues, changes in mental status and sensory deficits that were not as prevalent before entering the hospital setting.

With almost three decades of experience in the nursing home field I think that my design of a nursing home that stimulates the elderly residents is based in solid information and evidence obtained over the years.

To change the pattern that research continues to see with regard to the elderly mental decline once they enter residential care facilities I would design homes that had a much different standard of practice.

My homes would mandate that residents entering the homes sit down with staff and family members and have an open honest discussion about the resident's interests before entering care. These interests would be recorded and a plan would be designed that would incorporate those interests into the resident's daily activity once he or she became a reside at the nursing home.