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Beyond Bingo: Innovative Activities at Today's Nursing Homes

Angela Haupt, Lisa Esposito

Time for change.

Bingo, Bible study and birthday parties -- at some nursing homes, that's as good as it gets. Traditionally, long-term care facilities have come up short in the activities realm, relying on old standbys that aren't meaningful or particularly enjoyable. But change and innovation have arrived, which means seniors could be belting karaoke tunes one night and watching comedy on YouTube the next.

"We're past just trying to fill time," says Natalie Davis, a Dallas-based consultant who specializes in gerontology and teaches courses on developing activities for long-term care residents. "We want to enrich their lives." Here's a sampling of some innovative nursing home activities:

Individualized activities.

What fascinates one resident will coax another to sleep. The best nursing homes do individual assessments of residents -- what their likes and dislikes are, says Alisa Tagg, president of the National Association of Activity Professionals. "That helps their interests coincide with what we offer." If a handful of residents move in around the same time and are all interested in gardening, for example, the activity director may start a gardening club and invite those folks to join -- plus anyone else who's interested.

Therapeutic cooking.

Many activity rooms are equipped with kitchen items, Tagg says -- not necessarily an oven, but tabletop cooking equipment such as a hot plate, microwave or toaster oven. While residents measure and mix ingredients (chocolate chip cookies are a popular choice), they tend to reminisce, similar to "the old days when the kitchen was where everyone gathered to shoot the breeze while someone was cooking," Tagg says.

Some facilities, Davis adds, hold "celebrity chef" nights -- the local mayor or beauty pageant queen, for example, comes in to demo how to cook his or her favorite meal.

Musical activities.

Whether you're playing an instrument or singing your heart out, performing can be social and satisfying. Bell choir, drum circle and vocal choir are among musical programs residents can participate in at Concordia at Villa St. Joseph, says Chris Gebhart, activity director and volunteer coordinator at the long-term care facility in western Pennsylvania. When the drum circle performs, she says, it's rousing for the performers and audience alike.

Guided imagery.

Engaging the senses in creative ways encourages people to use their imaginations. "We have residents come together, and we use bubble machines and fiber-optic light tubes," Gebhart says. "We travel to places in our minds." Staff members may transport residents to a virtual beach experience: "Feel the sun on your back. Feel your feet in the sand. Can you smell the suntan lotion?"

Popcorn aroma or carousel music, for instance, can add to the mood and atmosphere. In a different setting, a sensory garden in an inner courtyard contains herbs, including basil, rosemary and lemon grass, she says. Wind chimes, a water fountain and an outdoor music machine let residents play songs or quietly indulge their senses.

Excursions away from the nursing home.

Venturing out into the community lets residents enjoy a change in their surroundings. "If you're lucky enough to have a facility with a vehicle that takes residents out," that can allow group excursions, Gebhart says. "It's always fun to go shopping or to a movie, museum or restaurant -- just to feel like they're part of a community that they lived in for years, and not just stuck in these four walls."

Facilities can coordinate trips with local business owners to ensure a smooth experience, like restaurant managers arranging tables in advance to readily welcome guests on arrival. Mall shopping has not been that successful, she notes, as merchandise can be costly and moving from store to store takes extra stamina. However, she says, shopping trips to individual stores, such as Walmart or Target, are extremely popular with residents.

Doing good for the community.

At one nearby nursing home, residents in knitting and crochet groups send the fruits of their labor to local hospitals, says Dallas-based geriatric care manager Kay Paggi. At another, folks bake cookies once a week, then present them to local firefighters. And Davis references a facility where residents made Mother's Day cards for new moms still in the maternity ward -- with words of advice from long-time parents to newbies. Other residents make dog biscuits for animal shelters, particularly appealing to seniors who had to give up their own dogs.

Robotic pets.

Residents with dementia can interact with robotic pets that look, feel and behave like real-life dogs or cats. At the Hebrew Home at Riverdale in New York, residents have access to robotic pets, says Catherine Farrell, director of therapeutic arts and enrichment programs.

Some residents know it's not an actual animal but others don't. "It doesn't really matter, to be honest, because it's all about the resident's experience," she says. "Even if they know it's not real, they'll often pet it anyway because of its response to touch. They often start to talk about pets (they once had) that are no longer a part of their lives." Many pet-friendly nursing homes allow real pets to accompany families on visits for moments of warm and furry companionship. Some facilities offer visits from therapy dogs and other pets.

Clubs for all.

Diversity and inclusiveness matter in nursing home activities. It's important to provide programs for all residents, Farrell emphasizes. A weekly Spanish club helps serve a large population of Spanish-speaking residents at Hebrew Home, she says, and everyone's invited to attend and join in events and festivities.

An LGBT group is another way to make residents feel more at home. "It's for any resident who identifies as LGBT or who is an ally of someone identifying as LGBT -- maybe someone in their family, or a friend or a loved one," Farrell says. "We're really proud of that group."

Art therapy.

At wine and cheese night, residents in some nursing homes brandish their paintbrushes while sipping glasses of chardonnay. Sometimes, each resident is given a blank canvas and told to paint his or her mood, as a song like Simon and Garfunkel's "The Sound of Silence" plays in the background, Tagg says. Or the group is presented with a piece of art and then works together to recreate the image.

Some facilities bring in art therapists for one-on-one sessions with residents, others display the finished products in art exhibits. Others take folks on field trips to museums, which often offer special programs for seniors.

Exercise for every ability.

Popular low-impact exercise options include aquatic therapy, Zumba, tai chi, yoga and walking clubs. And each can accommodate all sorts of physical limitations. Activity directors may, for example, be certified wheelchair yoga, or WHOGA, instructors, or be trained to teach chair chi.

"You can adapt to any level," Tagg says. "If someone has had a stroke and is paralyzed on one side, you can adapt the exercises to accommodate their paralysis. Or you can stay seated and do a range of motion exercises approved by the Arthritis (Foundation) -- simple things like wrist rotations or finger snaps."

Gardening.

It's a perennial favorite (pun intended), especially when folks from the Dallas Arboretum and Botanical Garden visit local nursing homes to help residents plant and pot, Paggi says. "Then the seniors have a garden they created."

Similar programs are available across the country. And some ambitious residents take their efforts further, working to create a sustainable wildlife habitat certified through the National Wildlife Federation. The process includes making sure gardens feature food and water sources, nesting boxes and places where wildlife can take shelter from bad weather and predators.

Music & Memory program.

Perhaps you recall the viral video a few years back: An elderly Alzheimer's patient in a nursing home starts out slumped over and unresponsive, then comes to life -- breaking into song -- as he listens to music through his headphones. It's a testament to Music & Memory, a program that creates personalized playlists for people in elder care facilities, reconnecting them with music they love. Research suggests personalized music is a way to bring joy to people with advanced dementia. Plus, it's a fulfilling activity, even for those who are on a ventilator or bedbound: It reduces agitation, and it helps enhance engagement.

Technology.

A slew of apps cater to people with dementia. Book of You, for example, helps families use words, pictures, music and film to create a digital book about their lives -- and nursing homes are eager to take advantage of these. There are other ways activity directors bring tech into the nursing home: "We'll do a virtual travel program, where we take residents back to their childhood homes using Google Earth," Davis says. Or, savvy residents will gather for YouTube hour. They might spend it watching comedy skits or studying different genres of music, Davis says.

College-type classes.

For residents who can benefit from high-cognitive, learning-type programs, the facility offers a program called "Hebrew Home University," which provides mental stimulation and fodder for discussion, Farrell says. Professors contract to come in for six- to eight-week rotations to teach topics from famous court trials to the history of Mozart.

Mental aerobics.

Mental aerobics is what Paggi calls brain games that are designed to be solved in a group setting. It might include, for example, verbal equations (the answer to "7 = D of W" is "days of the week"), fill-in-the-blank phrases and quizzes.

List-making is popular too, Paggi says -- like challenging residents to make an alphabetical list of reasons someone can't go to work that day -- A = appendicitis; B = bad hair day; C = coughing -- or of types of musical instruments, flowers or birds.

Movie night.

Nothing novel here -- except, perhaps, film choice. Paggi says she knows of one nursing home that showed "50 Shades of Grey" on the big screen. "I can't imagine what they were thinking," she says, then acknowledges that sex needn't stop when seniors enter long-term care. And, true enough, that's exactly why they need activities that acknowledge that fact.

Traditional favorites.

OK, who doesn't like to call out a triumphant "Bingo!" when the chips line up just right? There will always be a place at nursing homes for traditional games like bingo, dominoes, checkers and backgammon. Hebrew Home hosts two "gigantic" bingo games weekly, Farrell says. Because you can win no matter your level of cognitive skill, everyone can participate with dignity, she explains. "So, as a resident declines in cognition, they can still win as easily they did a month ago or a year ago because it's a game of chance."

Gebhart agrees that the game is an evergreen favorite. "Residents love bingo -- we can never take that away from them," she says. "But we definitely go beyond bingo."

Innovative Nursing Home Activities

Nursing homes offer a wide variety of creative, engaging and fun activities for residents:

-- Therapeutic cooking.

-- Music activities, from drum circles to bell choirs.

-- Guided imagery sessions.

-- Excursions.

-- Doing good deeds.

-- Robotic pets.

-- Art therapy.

-- Workouts, from walking to Zumba.

-- Gardening and wildlife habitats.

-- Music & Memory program.

-- Apps and technology-based activities, like virtual travel.

-- Special interest clubs and groups, like Spanish clubs and LGBT groups.

-- Brain games.

-- College-type courses.

-- Movie night.

-- Traditional games like bingo and chess.



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