Magazine article American Nurse Today

An Activity Menu for Older Adults

Magazine article American Nurse Today

An Activity Menu for Older Adults

Article excerpt

You are caring for Mrs. R, a 75-year-old woman admitted to your hospital with pneumonia. After a few days, Mrs. R starts frequently ringing the call bell. She says that her breathing is better, but she complains about everything else. Mrs. R tells you that her hospital bed is uncomfortable, her doctor hasn't gotten back to her about when she can go home, and her family hasn't visited. Finally, Mrs. R bursts into tears when she tells you that no one has helped her wash her hair in a week. You help Mrs. R reposition herself in bed and ask the nursing assistant to wash her hair. But you recognize that you have little control over Mrs. R's other complaints, and you're sure that she will continue to use the call bell excessively. You don't want staff to brush her off as "difficult," and you wish your unit had a resource that could better meet Mrs. R's psychosocial needs.

Older adults spend a considerable amount of time trying to acclimate to the unfamiliar hospital environment. While waiting for the next test or treatment, they struggle to cope with fears and maintain control of their lives. As a nurse, you recognize that Mrs. R's behavior reflects her profound loss of control. Being in the hospital prohibits her from performing her normal routine. She is isolated from her family and the creature comforts of home. Mrs. R's complaints and repetitive use of the call bell could be signs of boredom, which is a key issue for many hospitalized older adults.

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A nursing concern

At first glance, you might think your patient's boredom is not a nursing concern. But consider that boredom heaps frustration and powerlessness on top of the pain, anxiety, and uncertainty of illness. This situation may worsen as your patient heals because as she begins to feel better, her attention shifts away from focus on her disease. Uninteresting and unenjoyable activities, including time spent in a hospital bed, makes the time spent in the hospital feel like "forever" to patients.

At New Jersey City University, professors and accelerated BSN students observed the detrimental effects of boredom on older adult patients. In response, we created the Activity Menu, a kit of diversional, downtime activities for hospitalized older adults. The Activity Menu kit includes seven evidence-based activities (art making, craft making, The Reminiscence Journal, puzzles, listening to music, The Stretching Book, and the

Activities of Daily Living Book). Each of these activities can be performed at the bedside with or without assistance. Our accelerated BSN students produced the Activity Menu kit and then donated it to a partner hospital in the same region.

The Activity Menu kit is designed to increase patient choice and control while minimizing boredom. The activities within the kit promote positive thinking, encourage expression of emotions, and decrease isolation. Although the Activity Menu is a simple intervention, the effect of its positive outcomes could motivate patients to better participate in their care. We believe that the Activity Menu kit also can act as a template for other in-patient organizations to improve older adult patient outcomes.

Menu format

The heart of the Activity Menu kit is its menu--a list of the activities available to the patient.

Once the nurse identifies a patient is a candidate for the Activity Menu kit, he or she gives the patient a laminated menu card from which to order. Nurses confirm that the selection is appropriate for the patient's abilities.

The nurse then brings supplies and directions corresponding with the activity to the patient. Some of the advantages of the menu format include:

* Promotion of patient choice and control. Use of the Activity Menu allows the patient the choice of downtime activity, giving him or her control over something, however small, within the hospital environment.

* Convenient implementation. …

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