Hong Kong people have a very long life expectancy. In 2018, the expectancy of life at birth for men and women was 82 years and 88 years respectively (1). After retiring from 65, elders still have a long time to live. Participation in activities is a good way to improve elder's adaptability and provide a chance of social interactions with others. Suitable activities are especially important for those elderly living in residential care home which can help them adapt to the life of homes.
The importance of activities to the elderly living in residential care home
- Have suitable sensory stimulations to the residents which can promote their physical, cognitive, social and emotional control.
- Offers an opportunity for the residents to keep in touch with the outside world which makes their life engaged.
- Broaden their social circles, able to meet new friends, reduce their sense of loneliness and helplessness, avoid the disconnection between the residents and society.
- Learn different kinds of skills so as to help them better understand their abilities, enhance their self-confidence, and rebuild their self-image. (2)
- Some researches indicated that elders with dementia living in residential care home who attended more meaningful activities, or activities matching their abilities allow them to make full use of daytime, consume excessive physical strength, and reduce idle or nap time, thus help to develop a structured daily routine and reduce behavioural and psychological problems. For example, participating in reminiscence activities can improve mood and cognitive functions (3); sensory stimulation activities such as music therapy can reduce anxiety, restlessness and agitated behaviours(4).
Classification of Recreation and Leisure activities
There are many types of activities, according to WHO "International Classification of Functioning, Disability and Health" (5), examples of some recreation and leisure activities are listed below:
- Play: Engaging in games with rules or unstructured or unorganised games and spontaneous recreation, such as playing chess and cards.
- Sports: Engaging in competitive and informal or formally organised games or athletic events, performed alone or in a group, such as bowling.
- Arts & Culture: Engaging in, or appreciating, fine arts or cultural events, such as going to the museum or art gallery, or acting in a play, reading for enjoyment or playing a musical instrument.
- Crafts: Engaging in handicrafts, such as pottery or knitting.
- Hobbies: Engaging in pastimes such as collecting stamps, coins or antiques.
- Socialising: Engaging in informal or casual gatherings with others, such as visiting friends or relatives or meeting informally in public places.
- Other recreation and leisure
Caregivers can choose suitable activities for elders according to their needs. For passive residents, group activity is more suitable as it encourages participation through group dynamics. Group activities also involve less manpower and are more practicable in residential care home settings.
How to select and design suitable activities for elderly in residential care home (6)
Caregivers can select and design an activity for residents systematically through the following steps:
- Use a holistic approach in assessment, bear in mind residents' interest, preference and abilities.
- Observe the residents' physical, cognitive, social and emotional status in their daily lives and note their impairments and limitations.
- Consider environmental factors and constraints; try to match the objectives when designing activities.
- Consider the aims of each activity, the nature (e.g. small group: 2 - 8 residents or big group: 9 or more residents), type (cognitive, physical, self-care, religious or leisure activities), number of participants and their abilities. Based on the above information to decide on the date, time, frequencies, leader of activity, number of staff required, equipment and venue preparation.
- Gather residents with similar interests, needs and traits. The number of participants will depend on their physical abilities. A suitable group size is around 6 - 8 participants and may need to scale down to 2 - 4 participants for those frail or require special care.
- As most elders may have difficulty in concentrating, activity should not last more than 45 minutes. Duration can also be adjusted according to the attention span of individual resident.
- Select an activity that suits the residents' physical and cognitive abilities. The level of activity should be appropriate. Do not choose activities for competition purposes.
- Provide different kinds of activities for residents to choose to avoid boring.
- Match the aims of activities. Simple activities will be enough which focus on residents’ participation. Let them enjoy the process and encourage them to gain a positive experience with a sense of achievement.
- Match residents' daily schedule such as folding clothes, horticulture, and simple cooking tasks, etc.
- Select activities that allow flexibility in the level which can be adjusted for different residents.
- Select a quiet, comfortable environment to avoid disturbance.
- Prepare all the necessary equipment beforehand, so that there is no need to leave the group during the activity.
- Ensure environmental safety, for example, clear passage, stable furniture; avoid using sharp tools, etc.
- Prepare a reality orientation board with the date, weather, and title of activity for demented residents which can be posted in an eye-catching area. Prepare the residents psychologically by informing them before the activity.
- Prepare a program rundown and checklist. List out all the content, steps and necessary equipment needed so that the caregivers can be more familiar with the procedures.
- Provide residents with a name badge. During the activity, address residents by their names so that they can become familiar with each other.
- Encourage residents' participation in the activity and allow them to make attempt to try in their capabilities. For example, even if the physically disabled residents are unable to join, they can observe and cheer up others.
- Encourage residents to utilise their knowledge and skills. During group activities, encourage them to help each other by arranging more capable residents to stay close and help the less capable ones.
- Use graphics or words to prompt the residents.
- Sit in a circle with a table in the center so that residents can have eye contact with each other and facilitate their usage of materials.
After the activity, we can evaluate the activity by the following criteria:
- Evaluate the process of the activity, for example, residents' participation and their degree of engagement.
- Evaluate the effectiveness of the activity, for example, whether the activity enhances residents' skill in daily living, communication skills, improve their concentration or change their degree of happiness, etc.
- Can the objective of the activity be achieved? For example, can the activity enhance residents' sense of belongings?
Elders can pick up individual activity according to their own interest and hobbies which can enrich their lives in the home.
- Horticulture brings vitality and hope to them. Elderly caring the plant can build up a habit and find sustenance in life. Select some plants that can survive easily under any environment.
- The Internet is an unlimited source. Although the elderly are in homes, educational computer games and online news can help to train their cognitive function and allow them to keep up with the outside world.
Participation in activities can bring elders' a sense of achievement and provide an opportunity to develop their skills and talent. Caregivers should arrange different kinds of activities so that residents with different physical abilities, backgrounds, and interests can make the best use of their potential, enhance their self-worthiness and gain satisfaction in life.