Meaningful Engagement
Improving resident quality of life by adopting an integrated working approach.
Theme: Maintaining Identity
Improving Meaningful Activity and Meaningful Engagement in Care Settings
Cohort 12
Meaningful activities are often activities tailored to meet individuals’ needs and preferences, whereas meaningful engagement is the relationship-building process that promotes social and emotional wellbeing, trust, collaboration, and empowerment.
Aim
Participants recognised COVID-19 restrictions was having a negative impact on residents health and wellbeing so aimed to increase opportunities for meaningful activity and meaningful engagement to improve resident health parameters and re-establish routines and connections halted during this time.
Who was involved
Residents, relatives and staff.
My Home Life tools and resources used
My Home Life Frameworks, Image cards and Emotional touchpoints.
Quality Improvement Project
- Introduce an activity schedule to include activities such as music, arts and crafts, reminiscence, intergenerational activities, and visits to local petting farms
- Co-create personalised activity plans that are meaningful to each resident
- Celebrate and learn about the culture of new internationally trained staff
- Explore language that inspires and motivates residents to take part in activities
- Managers should lead by example and role modelling meaningful engagement conversations with residents
- Staff to meaningful engage with residents during personal care tasks
- Whole health approach to encourages parity of physical, mental and social wellbeing of residents
- Activity schedules added to handover sheets each shift
- All staff will be involved in activities with residents to promote meaningful activity and engagement being everyone’s business
Outcomes
Using the ‘Being Appreciative’ My Home Life Framework (Discover, Envision, Co-create and Embed) of collaborative quality improvement, residents shared activities 'were a bit of crack'', ''they help me feel calm'', and that ''I don't want to be involved but I like to be included'' during the ‘Discovery’ stage.
During ''Envision and Co-creation'' stages of the group considered that one size does not fit all in terms of meaningful activity, but by getting to know residents preferences, introducing choices, identifying language that helps residents take part, and engaging all staff in activities, not just the activity co-ordinator, the positive outcomes of meaningful activity and meaningful engagement have a profound positive impact on resident wellbeing.
Positively impact residents sleep patterns, reduce sundowning symptoms, improve eating and drinking, as well as reducing falls in the home. (See table below).
| Month | Number of falls |
|---|---|
| December | 8 |
| January | 6 |
| February | 2 |
| March |
4
(resident on respite had three falls) |
| April | 1 |
| May | 2 |
Key learning
My Home Life participants benefited greatly by the peer support in the group. It helped promote the sharing of ideas, resources and learning. They were able to move beyond initial concepts and expectations of what constitutes a meaningful activity, and view activities as a dynamic and important part of well-being.
Next steps
Publish quality improvement in research journal.
Bradley R, Ryan A, Penney S (2024) Improving meaningful engagement in long-term care settings. Nursing Older People. DOI: 10.7748/nop.2024.e1495
Exploring Meaningful Activities through Coaching and Supervision
Cohort 15
Aim
To develop a template that supports staff to deliver meaningful Activity
Who was involved
Residents, relatives and staff.
My Home Life tools and resources used
My Home Life Frameworks, Image cards and Emotional touchpoints.
Quality Improvement Project
- Develop a resource for meaningful activities
- Develop a coaching and supervision template based on My Home Life tools and frameworks
Outcomes:
Participants developed a resource flyer for activities and created two acronyms to support development and engagement of activities:
ENGAGE
E – Engage
N – Nurture and
G – Generate
A – Activities for
G – Growing
E – Enjoyment
SMILES
S – Sparking
M – Meaningful
I – Interactions
L – Lifting
E – Everyone’s
S – Spirits
Key learning
The Coaching and Supervision template was piloted in two care homes. Following feedback, questions were adapted and changed to gauge a better understanding of how staff were feeling.
Integrated Approaches to Meaningful Engagement for Residents Living with Dementia
Cohorts: 19-22
Aim of the Project
To enhance opportunities for meaningful engagement for people living with dementia through partnership with Alzheimer's Society.
Who was involved
Residents, relatives, staff and Alzheimer’s Society
My Home Life tools and resources used
My Home Life Integrated QI methodology model, Frameworks, Image cards, Emotional touchpoints and Magic wand.
Quality Improvement Project
- Develop a newsletter to share ideas, approaches and examples of meaningful engagement taking place in the care setting.
- Enhance staff knowledge and understanding of meaningful engagement.
- Deliver training sessions to meet specific areas of support for staff.
- Embed a ‘lead by example’ culture of meaningful engagement.
- Create space for residents to spend quality time together, e.g. lunch clubs and supper clubs
- Create opportunities for group reminiscence
Outcomes
Improvements in the atmosphere in the home, staff morale, and staff understanding of meaningful engagement with residents. There was reduced episodes of agitation, a reduction in falls, positive weight gain for residents with low BMI, and improved levels of hydration.
Residents said,
“I have more opportunities to meet other residents and feel a part of something”.
“I feel a lot more involved.”
“The staff inform me about the day’s activity plans”.
“I enjoy chatting with others while playing board games, cards quizzes etc.”
“I enjoy the conversations between staff and residents. Anyone can get involved.”
“It’s good having a chat and a sing along.”
Family said,
“It is wonderful to hear mum talking about what she did during the week. She looks forward to getting involved and getting to know others.”
Key learning
Meaningful engagement is recognised by leaders as a significant factor to improving the quality of life of residents living in care settings. Identifying how to integrate the concepts of meaningful activity and meaningful engagement would help move away from task-focused care and towards person-centred practice.
