Date Published: April 5, 2018
Publisher: BioMed Central
Author(s): Jiska Cohen-Mansfield.
Individuals suffering from dementia and residing in nursing homes often feel lonely and bored. This study examined the engagement and mood of people with dementia in group activities, and how personal characteristics, such as cognitive function, may impact on an individual’s responses to group activities.
The study included 102 participants, who took part in group activities while their mood and engagement levels were observed. Participants were invited to attend 10 different types of group activities, each of which was offered twice.
Results found improved engagement and mood during group activities as compared to control no-group times. Significant relationships between the type of activity and ratings of engagement and mood were also found. Although participants with higher levels of cognitive functioning manifested greater responsiveness to groups, the pattern of response to different contents did not differ by cognitive function.
This study shows the potential utility of group activities for improving quality of life of persons with dementia and demonstrates a methodology that can be used for quality improvement to optimize group contents. Future research should expand the range of contents of group activities in order to enhance the options for improving mood and engagement of individuals with dementia.
Persons with dementia residing in nursing homes and long-term care settings are often not engaged in any activity . Low levels of engagement and understimulation are problematic because they can result in boredom and loneliness that may lead to behavior challenges . A potential way to mitigate these issues is to engage multiple persons with dementia in group activities. Group activities can provide individuals with dementia the opportunity to interact with both staff members and other residents within a social context while being engaged in an activity. Therefore, it is important to understand the impact of group activities on engagement and the possible related outcomes. The Comprehensive Process Model of Group Engagement serves as a conceptual framework to understand engagement of persons with dementia within group activity settings . This model posits that environmental (e.g., physical and group environments), stimulus (e.g., content of activities), and personal attributes (e.g., age, cognitive functioning) impact on the engagement and affect levels of individuals taking part in the activity, which can, in turn, influence behaviors of persons with dementia. In particular, stimulus attributes, such as the content of a specific group activity, may differentially impact engagement and may also interact with other attributes, such as characteristics of group members.
The results provide relatively clear answers for the three research aims. Group activities were clearly superior to control time without such groups. Participants’ levels of engagement, mood, and sleep varied with group content. While persons with higher level of cognitive function manifested more positive effects in response to the groups, the relative responses to the various group contents did not differ by cognitive function.
Group activities form an important tool in providing persons with dementia an adequate quality of life and as a nonpharmacological intervention to prevent behavior problems in this population. These benefits are based on activities diminishing boredom and loneliness in this population. This article provides the first comprehensive evidence that such groups can significantly impact engagement and mood—as compared to unstructured time. The article also shows that group content does matter, in that different contents may result in significantly different outcomes, although it appears that good use of quality groups may be more important than their content, as many group contents did not differ significantly from each other. As such, the findings provide basic building blocks for forming the science of group activities for persons with dementia. In addition, the process presented in this article of immediate assessment of the impact of group activities provides a timely feedback for detecting failures in protocols or materials or in mismatch between those who participate in the groups and the content of the activities presented. This provides information allowing for continuous improvement in the content of activities. This study demonstrated that this content makes a difference, thus indicating the importance of using such improvement mechanisms in the selection and design of activities.