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Approximately 43% of US seniors feel lonely on a regular basis. This loneliness is directly linked to rising levels of depression, a serious problem that is plaguing residential care facilities from nursing homes to assisted and retirement living. A study in the December issue of the Journal of Aging proposes a revolutionary, new approach that would move current practices from resident care to resident engagement.
The study begins by analyzing the traditional process where well-intentioned staff members create a calendar of “light” social events for residents. Designed to entertain and distract, the schedules typically include field trips, games and exercise classes, and social gatherings. These activities, the researchers argue, treat the residents as passive recipients of care. In this environment, residents complain that their days lack meaning and express frustration with what feels like paternalistic treatment. The researchers propose replacing this system with one that focuses on service to others and social support. The new methodology, which would involve the residents and value their input as a critical component of program development, is expected to bring higher quality psychosocial care.
Specifically, the proposed system would replace “superficial” programing with emotional and meaningful social activities matched to the residents’ interests. This newly designed schedule would provide opportunities for individuals to become socially engaged and find personal fulfillment. One example cited was a therapeutic gardening program involving children.
In addition to developing an environment of productivity and contribution, the researchers recommend creating avenues for peer support, where residents build bonds of connectedness. Members who feel affiliation to a social group go out of their way to care, support and help each other and keep their group positive and sustainable. With reciprocity comes enhanced social identity and friendship.
The researchers predict that shifting from entertainment and distraction to engagement and connection will result in dramatic reductions in loneliness and depression. Moreover, they expect that this culture change can apply to and benefit all residents, including those with dementia. This is especially important because individuals with dementia often face discrimination, unmet needs, a lack of independence, and a reduced feeling of belonging. Some even suffer interpersonal violence.
The study outlines a model called Resident Engagement and Peer Support (REAP) that has three sequential steps. First, there is an assessment of which group activities are meaningful for each resident and how participation and engagement can be achieved or enhanced. The second undertaking is to identify or explore new or existing groups that would foster relationships and promote positive social identities. The final step would be to determine groups or clubs centered on service to others.
Although the costs of implementation must be analyzed and there are always challenges associated with incorporating new methodology, this model could potentially reverse the trends of declining mental health in our residential care population.
Notes:
Theurer, K., Mortenson, W. B., Stone, R., Suto, M., Timonen, V. & Rozanova, J. (2015). The Need for a Social Revolution in Residential Care. Journal of Aging Studies, 35, 201-210.
