Occupation as a Quality of Life Constituent: A Nursing Home Perspective

Abstract

Occupational therapy, with its core belief in the occupational needs of individuals, facilitates independent and meaningful activity. When clients become elderly, frail and subject to multiple pathology, they may need the care of a nursing home. Here, through the lack of use of residual abilities, a spiral of decline in occupational performance can occur. To increase knowledge of the factors that contribute most to enabling occupational performance in nursing home settings, a study was carried out in the north-west of England (n=20). Semi-structured interviews were conducted with the matrons to determine the philosophy of care, the daily routines and the approach to activity provision for residents. The data were analysed using a person/environment/occupation framework. The results indicated that the level of function of the residents greatly influenced the amount and types of activity offered. The matron's role was found to be crucial in recognising the therapeutic value of non-traditional activities and in maximising the use of staff and resources to enhance quality of life for the residents. Flexibility and a creative use of resources were found to have a greater positive influence on the quality of life of severely disabled residents than official policy. In these settings, the role of the occupational therapist moves from hands-on provider to consultant, primarily to the matron.