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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2006 Jan-Feb;21(1):15–22. doi: 10.1177/153331750602100109

Factors that relate to activity engagement in nursing home residents

Ann Kolanowski 1, Linda Buettner 2, Mark Litaker 3, Fang Yu 4
PMCID: PMC10833215  PMID: 16526585

Abstract

Many nursing home residents are unoccupied and at risk for poor health outcomes because of inactivity. The purpose of this study was to identify characteristics of residents with dementia that predict engagement in activities when activities are implemented under ideal conditions. Data from a clinical trial that tested the efficacy of individually prescribed activities were used to address the study aim. Thirty subjects were videotaped daily for 12 days during 20-minute activity sessions. Measures of engagement (time on task and level of participation) were taken from these videotapes. Univariate logistic regression analyses indicated that cognitive status and physical function explained a significant amount of variance in engagement. Efforts to promote function may facilitate even greater benefits from prescribed activities by improving capacity for engagement.

Keywords: nursing home residents, dementia, activities, engagement, participation

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Contributor Information

Ann Kolanowski, School of Nursing, The Pennsylvania State University, University Park, Pennsylvania..

Linda Buettner, Interdisciplinary Center for Positive Aging, Florida Gulf Coast University, Fort Myers, Florida..

Mark Litaker, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama..

Fang Yu, School of Nursing, The Pennsylvania State University, University Park, Pennsylvania..

References

  1. MacRae P, Schnelle J, Ouslander J: Physical activity levels of ambulatory nursing home residents. JAPA. 1996; 4: 264-278. [Google Scholar]
  2. Bates-Jensen BM, Alessi CA, Cadogan M, et al.: The minimum data set bedfast quality indicator: Differences among nursing homes. Nurs Res. 2004; 53(4): 260-272. [DOI] [PubMed] [Google Scholar]
  3. Mor V, Branco K, Fleishman J, et al.: The structure of social engagement among nursing home residents. J Gerontol B Psychol Sci Soc Sci. 1995; 50(1): P1-P8. [DOI] [PubMed] [Google Scholar]
  4. Alessi CA, Yoon EJ, Schnelle JF, et al.: A randomized trial of a combined physical activity and environmental intervention in nursing home residents: Do sleep and agitation improve? J Am Geriatr Soc. 1999; 47(7): 784-791. [DOI] [PubMed] [Google Scholar]
  5. Lemke S, Moos RH: Quality of residential settings for elderly adults. J Gerontol. 1986; 41(2): 268-276. [DOI] [PubMed] [Google Scholar]
  6. Mitchell JM, Kemp BJ: Quality of life in assisted living homes: A multidimensional analysis. J Gerontol B Psychol Sci Soc Sci. 2000; 55(2): 117-127. [DOI] [PubMed] [Google Scholar]
  7. Buettner L: Utilizing developmental theory and adaptive equipment with regressed geriatric patients in therapeutic recreation. Ther Recreation J. 1988; 22(3): 72-79. [Google Scholar]
  8. Achterberg W, Pot AM, Kerkstra A, et al.: The effect of depression on social engagement in newly admitted Dutch nursing home residents. Gerontologist. 2003; 43(2): 213-218. [DOI] [PubMed] [Google Scholar]
  9. Schroll M, Jonsson PV, Mor V, et al.: An international study of social engagement among nursing home residents. Age Ageing. 1997; 26 Suppl 2: 55-59. [DOI] [PubMed] [Google Scholar]
  10. Resnick HE, Fries BE, Verbrugge LM: Windows to their world: The effect of sensory impairments on social engagement and activity time in nursing home residents. J Gerontol B Psychol Sci Soc Sci. 1997; 52(3): S135-S144. [DOI] [PubMed] [Google Scholar]
  11. Spore DL, Horgas AL, Smyer MA, et al.: The relationship of antipsychotic drug use, behavior, and diagnoses among nursing home residents. J Aging Health. 1992; 4(4): 514-535. [DOI] [PubMed] [Google Scholar]
  12. Voelkl JE, Fries BE, Galecki AT: Predictors of nursing home residents' participation in activity programs. Gerontologist. 1995; 35(1): 44-51. [DOI] [PubMed] [Google Scholar]
  13. Horgas AL, Margrett JA: Measuring behavioral and mood disruptions in nursing home residents using the minimum data set. Outcomes Manag Nurs Pract. 2001; 5(1): 28-35. [PubMed] [Google Scholar]
  14. Phillips CD, Chu CW, Morris JN, et al.: Effects of cognitive impairment on the reliability of geriatric assessments in nursing homes. J Am Geriatr Soc. 1993; 41(2): 136-142. [DOI] [PubMed] [Google Scholar]
  15. Kolanowski AM, Litaker M, Buettner L: Efficacy of theory-based activities for behavioral symptoms of dementia. Nursing Research. 2005; 54(4): 219-228. [DOI] [PubMed] [Google Scholar]
  16. Cohen-Mansfield J, Marx M, Rosenthal S: A description of agitation in a nursing home. J Gerontol. 1989; 44(3): M77-M84. [DOI] [PubMed] [Google Scholar]
  17. Chrisman T, Tabar D, Whall A, et al.: Agitated behavior in the cognitively impaired. J Gerontol Nurs. 1991; 17(12): 9-13. [DOI] [PubMed] [Google Scholar]
  18. Cohen-Mansfield J, Billig N: Agitated behaviors in the elderly. I. A conceptual review. J Am Geriatr Soc. 1986; 34(10): 711-721. [DOI] [PubMed] [Google Scholar]
  19. Colling KB: A taxonomy of passive behaviors in people with Alzheimer's disease. J Nurs Scholar. 2000; 32(3): 239-244. [DOI] [PubMed] [Google Scholar]
  20. Kolb B, Whishaw IQ: Fundamentals of Human Neuropsychology, 3rd ed. New York: Freeman, 1996. [Google Scholar]
  21. Folstein M, Folstein A, McHugh P: Minimental state. J Psychiatr Res. 1975; 12: 189-198. [DOI] [PubMed] [Google Scholar]
  22. Wilkinson I, Graham-White J: Psychogeriatric dependency rating scales (PDGRS): A method of assessment for use by nurses. Br J Psychiatry. 1980; 137: 558-565. [DOI] [PubMed] [Google Scholar]
  23. Kovach C, Magliocco J: Late-stage dementia and participation in therapeutic activities. Appl Nurs Res. 1998; 11(4): 167-173. [DOI] [PubMed] [Google Scholar]
  24. Costa P, McCrae R: Revised NEO Personality Inventory and NEO Five-Factor Inventory: Professional Manual. Odessa, FL: Psychological Assessment Resources, 1992. [Google Scholar]
  25. Kolanowski A, Buettner L, Costa P, et al.: Capturing interest: Therapeutic recreation activities for persons with dementia. Ther Recreation J. 2001; 35(3): 220-235. [Google Scholar]
  26. Costa P, McCrae R: Manual Supplement for the NEO-4.Odessa, FL: Psychological Assessment Resources, 1998. [Google Scholar]
  27. Aguero-Torres H, Fratiglioni L, Guo Z, et al.: Dementia is the major cause of functional dependence in the elderly: 3-year followup data from a population-based study. Am J Public Health. 1998; 88(10): 1452-1456. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Boyle PA, Malloy PF, Salloway S, et al.: Executive dysfunction and apathy predict functional impairment in Alzheimer disease. Am J Geriatr Psychiatry. 2003; 11(2): 214-221. [PubMed] [Google Scholar]
  29. Fitz AG, Teri L: Depression, cognition, and functional ability in patients with Alzheimer's disease. J Am Geriatr Soc. 1994; 42(2): 186-191. [DOI] [PubMed] [Google Scholar]
  30. Reed BR, Jagust WJ, Seab JP: Mental status as a predictor of daily function in progressive dementia. Gerontologist. 1989; 29(6): 804-807. [DOI] [PubMed] [Google Scholar]
  31. Thomas VS: Excess functional disability among demented subjects? Findings from the Canadian study of health and aging. Dement Geriatr Cogn Disord. 2001; 12(3): 206-210. [DOI] [PubMed] [Google Scholar]
  32. Engelman KK, Mathews RM, Altus DE: Restoring dressing independence in persons with Alzheimer's disease: A pilot study. Am J Alzheimers Dis Other Demen. 2002; 17(1): 37-43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Delbaere K, Crombez G, Vanderstraeten G, et al.: Fear-related avoidance of activities, falls and physical frailty. A prospective communitybased cohort study. Age Ageing. 2004; 33(4): 368-373. [DOI] [PubMed] [Google Scholar]
  34. Lazowski DA, Ecclestone NA, Myers AM, et al.: A randomized outcome evaluation of group exercise programs in long-term care institutions. J Gerontol A Biol Sci Med Sci. 1999; 54(12): M621-M628. [DOI] [PubMed] [Google Scholar]
  35. Schlicht J, Camaione DN, Owen SV: Effect of intense strength training on standing balance, walking speed, and sit-to-stand performance in older adults. J Gerontol A Biol Sci Med Sci. 2001; 56(5): M281-M286. [DOI] [PubMed] [Google Scholar]
  36. Meuleman JR, Brechue WF, Kubilis PS, et al.: Exercise training in the debilitated aged: Strength and functional outcomes. Arch Phys Med Rehabil. 2000; 81(3): 312-318. [DOI] [PubMed] [Google Scholar]
  37. Schnelle JF, MacRae PG, Ouslander JG, et al.: Functional incidental training, mobility performance, and incontinence care with nursing home residents. J Am Geriatr Soc. 1995; 43(12): 1356-1362. [DOI] [PubMed] [Google Scholar]
  38. Hall C, Smith A, Keele S: The impact of physical activity on cognitive function in older adults: A new synthesis based on the concept of executive control. Eur J Cogn Psych. 2001; 13: 279-300. [Google Scholar]
  39. Rolland Y, Rival L, Pillard F, et al.: Feasibility of regular physical exercise for patients with moderate to severe Alzheimer disease. J Nutr Health Aging. 2000; 4(2): 109-113. [PubMed] [Google Scholar]
  40. Sobel BP: Bingo vs. physical intervention in stimulating shortterm cognition in Alzheimer's disease patients. Am J Alzheimers Dis Other Demen. 2001; 16(2): 115-120. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Buettner L, Ferrario J: Therapeutic recreation-nursing team: A therapeutic intervention for nursing home residents with dementia. Annu Ther Rec. 1997; VII-VII. [Google Scholar]
  42. Buettner L, Lundegren H, Lago D, et al.: Therapeutic recreation as an intervention for persons with dementia and agitation: An efficacy study. Am J Alzheimers Dis Other Demen. 1996; 11: 412-412. [Google Scholar]
  43. Buettner L, Fitzsimmons S: Activity calendars for older adults with dementia: What you see is not what you get. Am J Alzheimers Dis Other Demen. 2003; 18(4): 215-226. [DOI] [PMC free article] [PubMed] [Google Scholar]

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