In senior living, we fixate on measuring engagement by checking off that someone attended a group activity. We do this month after month, compiling the data into reports. Our interpretation of this one-dimensional metric is used to tell a story of engagement, often placing people into buckets of high to low.
It is routine to report that 30-40% of residents get “involved” in group activities. Two huge questions:
- Are those 30-40% actually engaged or just “present”?
- What about the other 60-70% of the residents?
Is Attendance the Right Metric?
Industry practice is that attendance at activities is the gold standard for measuring the quality of a life enrichment program. But what about those residents who are not involved in organized group activities? We end up heading down this rabbit hole where management demands life enrichment team members add more variety to the calendar.
Unfortunately, adding variety usually means merely adding something “new”, found via Pinterest or the internet. We don’t actually take the time to go back to the source and discover what would connect with these “disengaged” residents. More often than not, we look outward for a solution instead of going straight to the source, the resident.
Variety vs Participation
Why is adding more variety not always the right methodology to increase engagement?
Survey after survey tells us that residents don’t feel like there is a lack of variety and opportunity to participate in group activities. But, when asked about their level of participation, they openly admit they occasionally, seldomly, or even never attend group activities.
What does this mean?
We ignore the idea that there is a personal preference around participation, something we need to take the time to understand for each resident.
Community Requires One Thing
In order to create community, there must be participation. But what participation looks like from resident to resident can be very different.
What if I pull weeds in the flower beds on a daily walk and no one sees me or marks it on my chart? Does that mean it didn’t occur and I am not meeting some kind of subjective dimension of wellness? Staff may miss this engagement, but it does not mean it didn’t happen or that the resident is not engaged in purposeful activity. That one flower bed is immaculate; Staff thinks the landscaper or grounds crew does well, but in reality, it’s Nancy “participating” in the community.
Maybe Mary did not attend the group activity to make a painting or assemble the table decorations, but she straightened each vase on the dining tables, making sure they were centered. Does that bother us, thinking “Why does she have to fix what I do?” There very likely is a story why she is doing this. Ask why, thank her for making it look even better, and tell her the dining room would be less inviting if it was not for her ability to see the little things.
We quickly jump to the idea that a lack of participation in organized activities equals disengaged, and subsequently risks isolation and depression. We begin to patronize and pity residents who mostly stay in their own space, only coming out for their meals.
What if we were to rethink our own practices around dining and realize a daily luncheon with 2-3 friends may be just the amount of interaction needed to fill one’s community engagement tank?
Whatever the case, we cannot assume either approach until we have asked.
How Do I Know This?
My mom is 69, widowed, and lives in a small rural town on a 30-acre farm. Yep, just Marilyn and her garden, fish, deer, birds, turtles, an overly complicated riding lawnmower, big ole tractor, and the neighbor’s cattle.
She has 8 close friends who look out for each other, mostly through text, and share a meal or outing once or twice a month. If I put on my senior-living-activity hat mom’s participation card looks sparse, even scary. If she were in a senior living community she might even go on a “watch list”. I will admit I’ve had her on my own watch list since the death of my dad three years ago. But when I took the time to listen, truly listen, during our last visit I learned a lot.
Her farm, her animals, tasks, and chores are the biggest sense of purpose in her life. I lamented to her that it frustrated me that she needed to leave Florida and go back to Texas to mow the pasture. She told me that it is so important that she stays on top of the farm and does not let it overgrow because then she has to rely on someone else.
The pride, purpose, and, dare I say, resilience she has learned in three years is beyond impressive.
While your residents may not be tending to a farm in their downtime, we need to look more holistically at what they are doing when they kindly decline participation in structured activities. While it may not look like much is happening in their life, they may actually have a fully satisfying life.
What self engagement transpires when we look beyond group structure?
Create Operational Procedures that Look Beyond Basic Participation Metrics
It is not easy or efficient to look at an individual’s path to community engagement. We know we are social beings and automatically default to groups as the best-case scenario. We need to be looking at each individual’s whole story.
We know extroverts and introverts seek different levels of alone and group time. We also are starting to better understand that passive engagement like reading, television, meditation, and relaxation has a place and serves a distinct purpose.
Passive is not necessarily sub-par in the ranking if there are other occurrences of movement and social stimulation in whatever dose is needed by the individual.
Well vs Unwell Assumption
Ask yourself and your organization if your measurement of engagement through group participation is falsely labeling residents as unbalanced when in fact they are doing fine. There is not a direct correlation between not attending group activities and lack of life satisfaction.
We do know when one lacks a sense of purpose and does not have opportunities for engagement it is detrimental to health and longevity. However, until we know people on an individual level and have a place of record for any staff to view personal preferences we must be extremely cautious, diagnosing people as compromised in wellbeing or disengaged in the community setting.
How do you make sure you are meeting the individual needs of residents in your community?