Activation in Long-Term Care

This project evaluated the activation programme at the Genossenschaft Alterszentrum Kreuzlingen using a participatory approach. Based on this, recommendations were made to develop a more needs-based activation offer for the residents.

Factsheet

Situation

In Switzerland, around 15% of persons over 80 years of age live in a retirement or nursing home. To improve the quality of life and well-being of their residents, many institutions offer activation therapy and/or activating daily routines. Activation therapy supports, maintains, and promotes the physical, cognitive, emotional, and social abilities of residents in a resource-oriented manner through targeted activities and interventions. These interventions are planned over a longer period of time, continuously implemented, reflected upon, and evaluated by activation therapists. Activating daily routines, in contrast, are offered spontaneously throughout the day and may include basic activities of daily living, rituals, or cultural events. The Genossenschaft Alterszentrum Kreuzlingen (GAZK) offers a wide range of activation activities for their residents. However, according to the RESPONS study by the Berne University of Applied Sciences, which examined the quality of life and care in Swiss nursing homes, the activation offer does not yet meet the needs of the residents. Experience has also shown that, despite ongoing improvements, activation offers are sometimes only sparsely used. In this project, the GAZK's activation programme was evaluated and recommendations for adapting the programme were elaborated in a participatory manner.

Course of action

In this project, ethnographic research methods inspired by rapid ethnography were used to gain a brief, comprehensive and differentiated insight into the current practice of activation at the GAZK, the needs of the residents, the views and support options of the staff and the expectations of the relatives regarding the activation offers. Data were collected exploratively and systematically through participant observation, ethnographic interviews integrated into the residents' daily lives, and document analysis. The aim of this approach was to involve residents in the evaluation process who were unable or unwilling to participate in conventional oral or written surveys for service evaluation. The analysis was carried out iteratively and in continuous exchange with the residents and staff of the GAZK.

Result

The research showed that the residents made regular use of the activities offered by the GAZK. In the interviews, the activities were described as attractive and varied, and the residents stated that the activities brought variety to their daily lives and enabled them to make new contacts. Nevertheless, the conversations highlighted certain aspects that were not considered optimal and led to the offer not being used. The following four possible areas of intervention were identified, and corresponding adaptation proposals were developed in a participatory manner: 1) inclusion, 2) individuality, self-determination, and resource-orientation, 3) social interactions and relationships, and 4) integration of daily living into the care process and use of resources in the home. An overview of the results and the developed adaptation proposals can be found in the summary.