When it comes time to find the right assisted living community or nursing home for your loved one, there are a lot of things to consider in finding the right fit, such as the quality…
When it comes time to find the right assisted living community or nursing home for your loved one, there are a lot of things to consider in finding the right fit, such as the quality of the medical care, fees and location. But in the scramble to find a good place for your loved one, it’s also important to consider the quality of life they’ll find in that community and whether they’ll be supported in living their best life possible.
Finding and engaging in appropriate activities for seniors — and these can run the gamut from hobbies and physical exercise to social events and outings — is a major component of a high quality of life for older adults in assisted living facilities and nursing homes. That’s because socialization and eliminating loneliness and isolation among older adults is a crucial component of staying healthy in our later years. “It’s a critical part of well-being to be able to interact with others and to have those social connections,” says Dr. Tanya Gure, section chief of geriatrics and associate clinical professor in internal medicine at the Ohio State University Wexner Medical Center.
One of the reasons why people begin considering moving a loved one into an assisted living facility is “because of increasing concerns about living independently and increasing concerns about social isolation,” she says. But just moving into a new community with other people around the same age isn’t enough; there have to be ways for these people to connect, interact and get to know one another that are fun, stimulating and provide a means of fostering that very important social connection. She says being able to interact with peers and build connections and relationships with others provides more meaning, purpose and value to their time living in an assisted living community or other long-term care facility.
Being active and engaging socially “makes residents feel happier and obviously, that has lots of benefit in terms of reducing depression,” Gure says, noting that “there’s some indication that isolation can be a big contributor to cardiovascular risk and depression in older adults.” This becomes especially true for older adults who have recently lost a spouse, which can “intensify feelings of depression and worthlessness.”
In addition to providing social and emotional support and connecting, socializing invariably involves communication, which can help improve cognition. “It helps to allow patients to utilize their communication skills and those interactions can be very helpful for keeping a high level of mental stimulation,” Gure says.
So, what’s the best way to forge these kinds of social connections, and which activities are right for your loved one? “It depends on where the senior is emotionally, cognitively and physically,” says Sue Johansen, vice president of partner services with A Place for Mom, a senior referral service based in Seattle. It all depends on who your loved one is. Interest in an activity and the ability to engage in a specific event or activity varies greatly from person to person in older adults just like it does in younger adults. Where one person really loves to garden, another might have a passion for cooking. And a community that offers lots of options to appeal to a range of interests may allow your loved one to explore old hobbies that perhaps they haven’t had the inclination to pursue lately, while also offering an opportunity to spark new interests.
This is why Johansen says it’s important to ask your loved ones what they’d prefer rather than just choosing for them. “An adult child’s assessment of what they want their patients to be doing is sometimes different from what the senior would choose to do.”
It’s also important to consider what your loved one would do if the options were limitless. “The most recent experience may not be them living their best lives,” Johansen says, as isolation and loneliness can lead to a decline in pursuit of enjoyment activities. “That’s something families need to consider. [Mom] watches TV and doesn’t do a whole lot right now,” might be the correct answer to the direct question of ‘what does your loved one like to do?’ But it doesn’t tell the whole story. She says families should think about “what would she do if she had more options available to her?”
Common senior care activities range from book clubs and gardening groups to social events, exercise classes, movie nights, foreign language classes, computer skills classes, lectures, shopping trips, outings, film festivals, art classes, Bible study groups and knitting circles. At Yorkshire Village in Hemet, California, for example, activities include:
— Daily scheduled group and individual cultural activities that include spiritual growth.
— Social and educational programs including holiday celebrations for residents and their families.
All of these sorts of activities and many, many more can be found in assisted living communities and nursing homes all across the country. While activities for elderly adults can take many forms, and there’s no single right mix of activities that will work for everyone, it’s important to look for activities that will engage and support your loved one, says Carol Cummings, senior director of Optimum Life Engagement at Brookdale Senior Living, a senior living company with communities across the country.
Maintaining community involvement is also important, Gure says, because it helps residents feel more connected to the wider world, and less isolated. “Community events that bring community programming into the facility are also very nice. Some places that I’ve had the good fortune of working with have school choirs that come to their buildings or other civic organizations that spend time there. Some church groups will bring members in for holiday songs,” and other events to ensure that elderly adults don’t feel forgotten, particularly around the holidays.
Cummings says virtually any activity can be a good one for the right senior, but it’s important to consider whether the offerings at a specific community are age-appropriate and worthwhile. As an example, she says Brookdale offers a BeFit course of exercise classes that provide upper body and lower body strength training, balance and core strength classes, walking groups and water aerobics classes. “Those are the kinds of things we want to see, as opposed to things that we might see in an old-school model of senior living like ball toss, noodle ball or balloon volleyball. Look for whether there is substance to these things going on in the community and look for that social connectedness. We’re not interested in keeping people busy for the sake of being busy. We want people to live life with meaning.”
Cummings says staff at their facilities are trained to “look at folks in a holistic way. Sometimes in the clinical world we can get focused on the diagnosis,” for example in the case of someone who’s diabetic or a fall risk and viewing them through the lens of their medical needs. “We need to understand those things. However, we teach our clinicians to put on the lens of wellness to get to know the person and know who they are, which transforms them from someone who’s a fall risk to Betty who loves to write and Jim who’s a retired teacher.” When staff get to know a resident’s story that can help them encourage the right type of activities and engagement.
Johansen agrees that a deeper understanding of the individual resident is important for determining which activities are best. It’s also important to “understand the environment in which that senior is most comfortable and most able to live their best life.”
Most facilities and communities publish a monthly calendar of activities, and when you’re considering a facility, you should ask whether you can review that community’s activities calendar to see what events and programs are offered. You can also ask whether the schedule is simply hung up somewhere, or do staff actively recruit residents to participate in various activities? Are residents encouraged to form their own groups? You can also ask whether you can attend a few of the events or activities yourself to get a feel for how these activities work, how engaged the residents and staff are, and other aspects of what it means to be a resident there. “Do you feel that there’s a buzz that would come from 100 or however many residents are living an engaged life there? Do you see things happening? Are there interactions with small or large groups in the community? Are people engaged in life? That’s something to look for when you walk in the door — do you see and feel that?” Cummings says.
Inclusion is also important, particularly for seniors who have more complex medical needs. For example, if your loved one is disabled or has mobility issues, it’s important to look for an environment that can accommodate these complications and still include the senior in activities and events. Specifically, for seniors with cognitive deficits and memory issues such as Alzheimer’s disease or dementia, Parkinson’s disease or another neurological or movement disorder, it’s important to find out whether the community you’re considering can cater to your loved one’s specific needs while still offering activities they’ll find engaging to help them maintain the highest quality of life possible. Johansen says you should ask how your loved one will be included. “If someone is in a wheelchair or has an assistive device, how are they accommodated? What sort of activities could somebody with ambulatory needs participate in, and are they right for the senior?”
She adds that for seniors experiencing cognitive decline, creative pursuits and combining creative elements such as music with light physical activity can be very helpful for preserving mental capacity. “You used to find that you’d go into the memory care community and would find a small group of seniors listening to music and folding napkins. That mix of the small, focused physical activity with the creative environment of the music is very stimulating cognitively and easy to do. It helps keep seniors with cognitive issues engaged.” While these types of activities may be evolving, the point is the combination of creative with light physical activity can make a difference for some seniors.
With dementia and Alzheimer’s care specifically, Johansen says many people revert back to an earlier time in their life, and that can be a source of frustration or anxiety when they feel like they can’t engage with the activities they did then, such as caring for children or going to work. “For women, they often think they need to get to a child or loved one and care for them. Men sometimes think they need to get to work, and that causes the agitation” and frustration that some people who have Alzheimer’s or dementia exhibit. One solution that some senior communities have hit on is to provide a room where there’s “a crib and some dolls and a small table for a child set-up. If a resident is having that agitation, they can care for a child. Likewise, there may be a desk that looks like a work station and if they are having that agitation they can go sit at the desk and be at work.”
Cummings says it’s important that assisted living communities and long-term care facilities aim to develop activities that encompass all aspects of health and wellness, and that the Brookdale model breaks it down into six dimensions: physical, emotional, purposeful, social, spiritual and intellectual. “We teach our clinicians that the six dimensions are vital signs. If we take the social dimension, if a resident is not doing well from a social perspective, we ought to see that as being as alarming as an elevated blood pressure or blood sugar because it will have the same negative impact on their health.”