Active ingredients

Most people do not have to be told that there is a close
connection between an active life and a lengthy and enjoyable one.
But whereas we might dodge the need to exercise our brain and body,
care managers must not. It is their responsibility, emphasised by
the National Care Standards Commission and investigated by their
inspectors, to ensure that activities for older people are no
longer given low priority.

There are many opportunities for residents to escape from torpor
and few excuses for failing to help them. As the National
Association for Providers of Activities for Older People (Napa)
puts it: “A life of inactivity is tantamount to a sentence of
death.”

People in the UK are living longer. Research recently published by
Age Concern and the Department of Health shows how quickly the
population has aged. In 1900, the life expectancy for women was 65,
now it’s 80. Fifty years ago a British man reaching the age of 65
could expect to live for another three years, now the expectation
is 14 years.¹ By 2010 the retirement age may be 60 or
less (pensions crisis notwithstanding), which will provide an extra
25 years for women and 20 years for men. There is going to be
plenty of time to be active – in or out of a care home.

The medical evidence for activity is supported by social surveys.
The initial findings of the Economic and Social Research Council
growing older programme emphasise, says Professor Beaumont of the
Royal Hospital for Neuro-Disability, that “there are major factors
in survival, such as a person’s general health and cognitive
powers, but mental alertness and physical well-being are vital
factors too.” People who retire early and live at home initially
fare better. But when they need domiciliary care or move into a
care home, the availability of regular mental and physical exercise
falters. The four major demands – food, comfort, security and
medication – become the prime factors in care. Activity sinks to
fifth place or lower in the hierarchy of priorities.

Medical pressure for active retirement is matched by government
enthusiasm. After all, the government’s policy is to encourage
people to stay in their own homes for as long as possible, so
avoiding NHS and local authority costs for residential or hospital
care. The charities, too, promote good health through activities.
Age Concern, for example, has a programme called Ageing Well UK and
an ActivAge Unit with health mentors specially trained to give
information and arrange for volunteers to help with local
needs.

Care homes (with some notable exceptions) have not been in the
vanguard of change. They concentrate on the four main demands
already mentioned. But things are changing. NCSC inspectors are
helping to alter perceptions, demanding to see evidence of policies
and programmes, and asking how many activities are organised, and
how often.

The NCSC says that inspectors will ask if there is an activities
organiser. At Morton Grange in Derbyshire the owner, June Rye, is
the activities organiser. That’s an indication of the priority
placed on keeping clients active. Gladys, when 77, said she had
always wanted to fly in Concorde. Staff set up a “wishing fund” and
eventually Gladys took to the skies. The wishing fund, bolstered by
profits from bring-and-buy days, cake sales and donations, now pays
for visits to shows, Chatsworth House, and in-house entertainments.
Angela Naylor, the manager at Allington Court, a specialist Bupa
nursing home near St Albans, said: “One of our most successful
initiatives was to set up a ‘sensory room’ as well as an activities
room. Aromatherapy is very, very popular.”

Training staff to draw up policies and plan programmes for
residents’ activities has often been neglected too. But this is
changing. Veronica Read at City & Guilds predicts that the new
registered care managers award at NVQ level 4 will attract
“overwhelming demand from the 70,000 managers, deputy managers and
supervisors in adult care homes.”

The qualification includes the planning and implementation of
activity programmes as part of a care service and so training
organisations have geared themselves to offer this as part of their
service. Peter Lambourne, general manager of Heathercroft Training
Services (HTS) in Eastbourne, says that they are adding to their
training materials and revising assessors’ duties to ensure that
activities are integrated into their resources and processes.

HTS might be training the professionals, but there is also lots of
room for volunteer helpers. As Margaret Butterworth of Napa says:
“There’s the need – and plenty of opportunities – for the ‘outside’
to become more involved in the care of elders who are
‘inside’.”

Specialist groups such as Age Concern, Napa and Age Exchange
provide low-priced courses offering theory and practical tools to
assist organisers.

There are no national guidelines on activities: the NCSC says that
this would miss the point – that each care home must plan its
programme to match the needs and the wishes of its own residents
and their families. No “national curriculum” for activities, then.
The philosophy is one of self-help, but NCSC inspectors are looking
closely at care homes to see if there are initiatives for
activities that indicate thought, planning and action. 

Alan Jamieson is an employment, recruitment and training
consultant.

References

Napa publishes a newsletter and brochures including Why Are
Activities Important? and A Guide for New Activity
Organisers. Napa, Suite 211, 24-28 Hatton Wall, London EC1N
8JH. Tele/fax: 020 7831 3320. Age Concern Training has programmes
such as Through Other Eyes, a sensory simulation workshop.
Telephone 01543 503660 or fax 01543 504640 for details. Age
Exchange specialises in reminiscences: telephone 020 8318 9105 or
fax 020 8318 0060.

Key activities 

Some or most of these should be on a care home’s programme. 

• Physical activity – walking, dancing, yoga, tai chi, aerobics,
  gardening. 
• Music – both playing instruments and appreciation. 
• Crafts – knitting, flower arranging, painting, drawing,
  cooking, aromatherapy, massage, creative writing. 
• Visits – individually with families and in groups to shops,
  houses, gardens, garden centres, exhibitions, theatres, library,and
  museums. 
• Religion and spiritual life – going to religious services,
  counselling. 
• Family and friends – reminiscences, talks, discussion. 
• Games – chess, draughts, other board games, scrabble, puzzles,
  quizzes. 
• Media – radio, television, newspapers and magazines, using the
  computer.