Is Your Activities Program
Up To Snuff?
By Kevin McElroy, Administrator
Avalon Garden Nursing Home
St. Louis, MO

Nursing Homes are facing numerous challenges and changes as we move into the
new millennium. State and Federal surveys are getting tougher and more punitive.
Assisted Living and other retirement communities are taking away more slices of an
already small pie. And the consumers themselves, our residents, are demanding more
services and care than even a decade ago.
   The nursing homes that will survive in the future are the ones that realize it is their job
to meet all of their residents needs. It isn't just about feeding, changing, and medicine
anymore. It is about socialization, spiritual life, and friendships as well. It is making
sure residents are satisfied emotionally as well as physically.
   One of the ways nursing homes achieve this is through a vibrant, diverse activity
program. Activities tend to be one of those areas that is extremely easy to implement yet
seems to get overlooked by many homes. Activities is not putting in a movie in the VCR
and having a bingo game once a week. A true activity program should be designed to
meet the resident’s social, spiritual, and emotional needs.
   And the activities program is an area that state surveyors will be paying more
attention to in the future. Here are the "10 red flags" that surveyors will look for in
regards to activities:
  • The activity area is too noisy or too small. You need to make sure that you have
    areas that are adequate to meet the needs of the residents for that activity, and
    that the area is not constantly being interrupted by outside noise or incidents.
  • There are long periods of time with no activities. No one expects there to be
    activities taking place 24 hours a day, seven days a week. But each day on the
    activity calendar should include numerous activities the residents can choose
    from, and should be taking place during the morning, afternoon, and evening
  • There are insufficient supplies to meet resident needs. Facilities should make
    sure there is enough money in the activity budget to give the activity staff the
    tools they need to put on a creative, exciting activity program.
  • Residents appear bored, sleep through activities, or do not attend. Facilities can
    no longer blame low attendance on the residents "not being interested." If the
    residents are not interested, then the facility is presenting an activity program
    that is not meeting their needs! Activities are designed for the residents, not for
    the staff.
  • Activities insult the dignity, intelligence, and/or age of the resident. Activities
    should be designed to meet the residents interests and abilities. I have seen
    many homes where residents are sitting around a television watching children's
    cartoons or children's television programming. There is nothing wrong with
    allowing residents to watch TV if they want. But instead of "Sesame Street," put
    in a classic movie, the news, or other programming that the residents say they
    would enjoy.
  • Facility cancels activities, or does not follow schedule. It is up to the facility to
    ensure that not only they create an exciting and interesting activity calendar, but
    they actually follow it! While sometimes things may come up that make changes
    unavoidable, for the most part the facility should strive to follow the calendar.
  • No observation or documentation of specialized programs for bed/ room bound
    residents. The facility must provide activities for all residents, not just the ones
    who are able to make it to the activity room. Also, ask if there are things you
    could do for the resident who is bed bound to make the day seem more
    promising, such as bringing in books on tapes, movies, or daily 1-to-1 visits.
  • Facility staff does not invite or help residents to activities. The facility has more
    responsibility than just putting up an activities calendar. Staff should be
    constantly encouraging residents to attend activities, and helping those who
    need help to get to the activity. The resident always has the right to refuse to go
    to an activity, but sometimes residents need a gentle nudge to encourage them
    to get involved.
  • There is insufficient staff to meet resident needs and interests. The activity
    department must be staffed appropriately to make sure there is enough
    manpower to put on the type of programs residents need and deserve. Facilities
    can also work on developing a volunteer program to supplement and support
    their activity staff.
  • The Activity staff members are the only ones involved with activities. One of my
    catch phrases I use a lot is "it's not just one person's responsibility, it is
    everyone's responsibility." This holds true with activities. It is up to everyone to
    help ensure residents are getting involved and getting the assistance they need
    to participate in activities. From the housekeeper to a CNA to the Administrator,
    sometimes an encouraging word is all the resident needs to get involved.

A successful activities program requires everyone's help and assistance. We are hired
to meet ALL of our residents needs, and this includes activities. Encourage and support
your residents to get involved, make friends, and socialize with others. This will not only
help their emotional health, but a positive mood will help their physical health as well.
Your help can make an activity program more dynamic and interesting for all of your
Pathways to the Past
by Sandra Stimson ADC, CALA, CDP
Executive Director,
Alternative Solutions in Long Term Care
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Sandra Stimson has
experience as a corporate
consultant, Corporate Trainer
and National Speaker. Her
experience is in long term
care, as Activity Director,
Director of Alzheimer's Units
and Assistant Administrator of a
550 bed long term care county
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is a Life Replay Specialist.  
Sandra implements dementia
units nationwide.  Sandra has
written several books,
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and Pet Express Pet Therapy
Program. Sandra has been a
facilitator for Alzheimer's
support groups and is the
Awards Chair for the NJ
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Professionals.  Sandra is the
Executive Director of
Council of Certified Dementia

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