Cheesy Activities in LTC

Long Term Care Columnist / Guide · Apr 15, 2009

I think all of us who work in LTC would do well to understand that previous generations did not consider bingo, card games and so on to be demeaning or childish at all.

I'm old enough to remember helping my mother and grandmother clean house from top to bottom in preparation for Saturday afternoon canasta sessions with their friends. This was a big event for ladies of their time, as were weekly trips to the beauty shop, bingo nights, bowling leagues, and church suppers. These were all part of the social customs our forebears counted on, even in hard times, for a few moments of enjoyment and bonding .........why ever would we want them to give up those entertainments?

I do think that some of the birthday and holiday activities can be a little hard on the dignity---I personally cringe inside whenever I see a 90-something wearing one of those stupid birthday hats---but I know if I were a LTC resident, I'd rather have "cheesy" decorations than none at all to relieve the institutional look and feel of most facilities. As for the employee parties, I see that as a separate issue that should be discussed in a different thread, but that's just me.

In the meantime, I would hope it is possible to discuss this, and even to disagree if necessary, in a professional manner and to leave off posting cheap shots and put-downs. Thank you.

Home Health Columnist / Guide · Apr 15, 2009

Do a search for "cognitive stimulation activities" and will come up with a treasure trove to spice up your programs:

http://www.recreationtherapy.com/tx/txcognitive.htm

As part of 3 generation group, my family helped develop and present cognitive stimulation programs for over 10 years with Horizons Unlimited: http://www.scs-delco.org/services/cognitive.php

Each kit was about a theme: Famous Black Americans, Roaring 20's, Walt Disney, France, New Orleans Mardi Gras, World War 2, Cooking, Life at the Beach, Christmas around the World, etc.

Showed 20-30 slides with script, had Life Magazine sized pictures on cardstock to pass around, artifacts to show related to theme, music to play during slide show and songs + sing-along sheets about theme, even crossword puzzles ---took 1-1 1/2 hrs to present programs.

locolorenzo22, BSN, RN · Apr 15, 2009

Ok, perhaps I can bring a different perspective to this debate. In my previous life, before nursing school, I was a activity director for 3 years, working in a MI nursing home with residents 18-98 years old. It was TOUGH to deal with, because my budget worked out to a roughly .86 per resident per month(200 residents) roughly 350 bucks a month....it's tough to manage because EVERY activity expense(food, decor, supplies, bingo, etc) came out of that. I can remember doing bingo(for things like decor, deodorant, personal items, candy, tickets to be the first one at karoke, a guarenteed spot on a outing(as we could usually only take 10 at a time), etc)

It was tough to think up new ideas...and even tougher when staff was the first to critizise. That would make some residents not come simply because they heard the staff call the idea stupid.....Is there a dollar store around? It usually would make the budget go a little farther. We did do the aforementioned pajama party and PJ day...I found some old hugh hefner looking silk robe, and the residents referred to the office as the mansion for the rest of that day. It takes some creativity...but it depends on how much they have to spend and energy to do. There is the unmentioned paperwork, meetings, etc...that every director has to go through.

Why does your letter have to be anonymous? why not bring it up to them directly? See what the resident council is bringing up in their meetings....And don't be the first to judge another professional without doing their job for a day.. you wouldn't like it if they offered suggestions about how you needed to nurse differently....

rn/writer, RN · Apr 15, 2009

Ask the residents themselves what kinds of things they would like to do. Including them in the planning for their recreation and activities seems essential if you want to them to feel satisfied.

Of course, there will be some who can't contribute much d/t cognitive problems, but I'm sure there are many who, with a little encouragement, could come up with all kinds of suggestions.

Bring in something that will stimulate conversation. A crate of blueberries, for instance. Pass a bowl around, letting each resident smell them and pop one into their mouth. Talk about going out in the summer and picking berries or making pies. Have the kitchen staff bake the berries into muffins. Have people write short poems about the blueberries or draw pictures of them. Pick a blueberry prince and princess. Find or make up songs about berries.

You can do this with just about any theme. Old toys. Going to dances. The Fourth of July. Pets.

You could also use old movies as a starting point. Or favorite actors. How about a Humphrey Bogart film festival over a weekend? Or maybe Cocoon?

Songs, smells, maps, recipes.

Use each item as a springboard to spark the residents creativity and draw out their personalities. This is so much more lively and enlightening than passive activities (now there's an oxymoron!) that don't require any emotional investment.

Finally, in the vein of scrapbooking, maybe you could help some of the residents put together legacy books that include pictures, poems, photographs, etc. full of their encouragement and wisdom for future generations. This could be an ongoing project that would impart and reinforce the idea that they have much to say to anyone willing to listen.

Keepstanding, ASN, RN · Apr 15, 2009

at least someone is trying to entertain these older adults. give them a little bit of credit :redpinkhe

praiser :heartbeat

melj0505 · Apr 15, 2009

My best friend works as an activities aide in nursing home. Here's some of the stuff she does with her residents during her evening program..

- arts&crafts (painting, etc.)

- movie nights (she tries to pick favorite movies from their generation that were popular when they were younger)

- bingo

- 'themed' nights (a popular one they have is happy hour..the residents have a party with drinks but they're nonalcoholic..like virgin margaritas and odouls nonalcoholic beer)

- trivia (war time, europe history, american history, canadian history, sports, music, movies. the lists are endless!)

- card games

- discussion group (the residents in her LTC really like this one..everyone sits together and she brings up a topic..usually it's something in current events. they really like this bc it makes the residents still feel like people and feel connected to the world)

Once a month they celebrate all the birthdays of the residents whose birthday is that month. So for instance on April 21st, they may celebrate all residents' birthdays that fall in the month of April.

During activities, she'll play music that they would like to listen to..the stuff they listened to in their younger years. Frank Sinatra, Dean Martin, etc. She burns a CD @ home and brings it into work. Or you could make a playlist for your ipod and connect it to a ihome(which acts as a stereo for the ipod so music is heard t/o the room).

UM Review RN, ASN, RN · Apr 15, 2009

I've worked in nursing homes that had entertainers come in and perform for free once a month. One had monthly outings to the racetrack, not sure if it was dogs or horses. Lots of activities, especially for those in the Alzheimers unit.

Another one they used to have fun with is the Memory recordings. Someone would make video recordings of each person talking about something in their life that they wanted to pass on to the great-great-great grandchildren. And the family would get the video, all gift-wrapped.

There was always a need for Christmas gift money for the folks, so one year I made a gorgeous afghan and we raffled it off with the proceeds to go to Activities for Christmas gift money for the folks. Come to think of it, I believe one of the residents won the raffle. Anyhow, it was fun knowing that I was able to contribute.

systoly · Apr 15, 2009

A lot of LTC residents strive on set routines. So the repetitious activities may seem dull to us, but provide security and orientation for the residents. While departments such as the activity department (life enrichment) or PT, OT, etc. are responsible for their respective discipline, no one has ever stopped me from involving residents in or providing activities for them or suggesting activities to the activities department. It's a team effort. As far as appropriate activities are concerned, I believe, I'd rather provide an activity that could be construed as child like than take the risk of over stimulating or frustrating a resident. For instance, when trying to get residents involved in active ROM, we have successfuly used bubbles to get a resident to raise his arms when he otherwise wouldn't.

pagandeva2000, LPN · Apr 15, 2009

I would please like to post this here to see if I get more responses...
The activities director and coordinator at the LTC facility where I am employed work very hard, but they have been there many years and it seems they need some new ideas. The activities are so childish it is embarrassing.
I've heard of once a man twice a child but this takes the cake.
They buy decorations at Wal-Mart that are used to decorate 2nd grade classrooms and put them up around the nursing home. The activities consist of bingo and church. Today, the activities coordinator came and put an announcement on my desk advertising "National PJ Day" and a "slumber" party. I don't think I'm just being no fun or a stick in the mud or unappreciative of their efforts...the DON was there and said, "this is ridiculous." They act like they are entertaining 6 year olds, not adults. It is becoming very annoying to me but I would hate to burst their bubble or rain on their parade, they're very good people (but come on!)
Christmas is cheesy, especially the employee Christmas party. They buy a bunch of cheap crummy gifts for the party and I know it's the thought that counts but I can't believe there was much thought put into those gifts...
I would like to leave them an anonymous letter with some constructive criticism and suggestions on how to update their system. Can anyone give me any ideas? I was thinking at Christmas, rather than a bunch of junky things they could have a few really nice ones and just let everyone enjoy the food and company at the party, rather than worrying about everyone getting a gift for the sake of getting a gift.
If all anyone has to offer is a smart remark about how I need to worry about being a nurse and let the activities people do their jobs just save it. I'm not trying to be "better" or "superior" to anyone, it's a matter of seeing the patients treated in ways that honor their status as elderly people in a dignified way, not with big plastic childrens' decorations.

They might be purchasing the cheesy decorations so that those who have dementia may remember that this is some sort of celebration; even if they are not sure of what. Unfortunately, all employee parties give cheap gifts. I guess the premise is that it is better to purchase gifts for everyone than just a select few. What I would probably do, if this is a passionate feeling of mine is to offer a raffle in addition to the traditional employee party.

Ask your DON if you can take a survey of what the patients desire (and see if it can be honored rather than thrown under a rug), after all, she herself, said this is cheesy. If she give the go-ahead, then, start the footwork by asking the patients what sort of decorations/themes they may be interested in. You may have to see if the budget can allow it, but at least, it would be getting their input. You can do a search on line for wholesale party goods and share your findings with the activity director as well. Are there some churches or synagoges around? What is the faith of most of the clients? Maybe they can obtain volunteers to come to entertain or sit with them. Most importantly, I am curious...are the patients who are a&o X3 forced to participate whether they want to or not? Some may be very private people who are not interested in participating in anything. Not necessarily a personality flaw, but since it is their home, well, they have a right not to be bothered, either. Good luck in your project!

Jo Dirt · Apr 15, 2009

at least someone is trying to entertain these older adults. give them a little bit of credit :redpinkhe
praiser :heartbeat

if you will notice i acknowledged these people were very hard working. this is why i don't want to hurt their feelings. they try very hard. i don't want to let them know if i write them a letter with suggestions, because #1 i don't want any attention drawn to myself, #2 if it's a dumb idea i don't want to have attention drawn to myself and #3 if it *is* a good idea i still don't want attention drawn to myself #4) if it acts as an insult to them i wouldn't want them to know who did it. i think highly of these women and i don't want to insult them, but we need some ideas.

i've seen some good ideas here. i know money is limited, what they can do is limited, and time is limited, so it is no small feat to come up with different ways to entertain these people (not that they have to be entertained every day) but i think some fresh ideas would be great. i know the a/d patients color with crayons and there is an old farmer with severe a/d and they give him toy tractors to play with, and i understand this is about all those people have that they can relate to at this point. but we have some really sharp ones who would definitely benefit from more stimulating and sophisticated activities. i'll admit i'm not a very sophisticated person so i'm looking for ideas to give them.

Jo Dirt · Apr 15, 2009

Some may be very private people who are not interested in participating in anything. Not necessarily a personality flaw, but since it is their home, well, they have a right not to be bothered, either. Good luck in your project!

I think this will be me if I ever go to the NH.

I see what you mean about the decorations and the A/D patients.

pagandeva2000, LPN · Apr 15, 2009

Ok, perhaps I can bring a different perspective to this debate. In my previous life, before nursing school, I was a activity director for 3 years, working in a MI nursing home with residents 18-98 years old. It was TOUGH to deal with, because my budget worked out to a roughly .86 per resident per month(200 residents) roughly 350 bucks a month....it's tough to manage because EVERY activity expense(food, decor, supplies, bingo, etc) came out of that. I can remember doing bingo(for things like decor, deodorant, personal items, candy, tickets to be the first one at karoke, a guarenteed spot on a outing(as we could usually only take 10 at a time), etc)
It was tough to think up new ideas...and even tougher when staff was the first to critizise. That would make some residents not come simply because they heard the staff call the idea stupid.....Is there a dollar store around? It usually would make the budget go a little farther. We did do the aforementioned pajama party and PJ day...I found some old hugh hefner looking silk robe, and the residents referred to the office as the mansion for the rest of that day. It takes some creativity...but it depends on how much they have to spend and energy to do. There is the unmentioned paperwork, meetings, etc...that every director has to go through.
Why does your letter have to be anonymous? why not bring it up to them directly? See what the resident council is bringing up in their meetings....And don't be the first to judge another professional without doing their job for a day.. you wouldn't like it if they offered suggestions about how you needed to nurse differently....

You have certainly taught me something from a different prespective. I didn't know HOW limited those funds can be. 86 cents per patient per month may not be much to work with. Thanks for sharing that insight with us.