A Time to Remember

EFFECTS OF SOCIAL RECREATION ON PROGRESSION OF

DEMENTIA -INFLICTED RESIDENTS OF A NURSING HOME

A Thesis Title Presented to the Faculty of the

Health Related Science
Olivarez College of Paranaque

In Partial Fulfillment of the

Requirements for the Course
Bachelor of Science in Nursing

BY:
Reyes, Rosemarie Carreon
Olivas, Arlyn Padua
Sirot, Angelica Mercado
August 2016

I.

Introduction

Background of the study

As defined by the World Health Organization, Dementia is a progressive

and degenerative condition that affects memory, thinking, behavior,
emotional and day-to-day functioning. Some of its signs and symptoms
are memory loss, confusion to time and place, loss of communication
skills, inability to reason out, gait, motor, and balance problem. This
condition affects people 60 years of age and above.
There are 47.5 million people suffering from Dementia worldwide, and an
estimated 7.7 million cases every year. In the Philippines, the estimated
prevalence rate is 11.5% for people 60-69 yrs. Old and 15.6% beyond 70
(asiandementia.org).
We will be using the experimental method in this study. There will be two
groups observed, one is the control group where we will introduce simple
social activities on a daily basis while the other is the uncontrolled group
where the usual activities in the home will continue. According to an article
on Researchgate.net, a person afflicted with Dementia is happier during
leisure activities than during the ordinary time. By encouraging nursing
homes to extend the time for activity of social recreation for the affected
residents, we might help the delay or reverse the progression of the
disease if detected in its early stages.

Statement of the problem

For a person diagnosed with Dementia, a rapid decline in the quality of his
life and of his family members as well as a massive increase in cost of
care is inevitable. This is the reason most cases of Dementia lead to
institutionalization. These institutions are nursing homes which aim to
provide sufficient health and social care for the patient to promote
optimum brain performance and delay cognitive decline.
Unfortunately, despite its prevalence, this disease has been largely
ignored in the Philippines. There have been no programs focused on
improving the well-being of a patient with Dementia. The purpose of this
study is to resolve whether certain activities like social recreation affect the
progression of the disease in such way that it improves the emotional and
mental well-being of the patient.

II.

Review of Related Literature and Studies

Related Literature
1. In the book" Essentials of Gerontological Nursing" by Patricia A.
Tabloski, Involvement with meaningful activity is important for
maintenance of functional abilities and social involvement
providing a feeling of success and accomplishment, improving
mood, and reducing disruptive behaviors. Even in the late stage
of dementia, persons can enjoy activities such as Snoezelen,
relaxation induced by providing pleasing sensory stimuli in a
multisensory environment.
Explanation:

2.

Participation and enjoyment of leisure activities in school-aged

children with cerebral palsy

Abstract
The objective of this study was to characterize participation in leisure
activities in children with cerebral palsy (CP) and identify determinants
of greater involvement. Ninety-five children of school age (9y 7mo [SD
2y 1mo]) with CP were recruited, and participation was evaluated with
the Childrens Assessment of Participation and Enjoyment in a subset
(67/95; 42 males, 25 females) who could actively participate in
completion of the assessment. Most had mild motor dysfunction (Gross
Motor Function Classification System: 59% level I, 23% level II, 18%
levels IIIV) and had a spastic subtype of CP (23 hemiplegia, 17
diplegia, 16 quadriplegia, 11 other). Biomedical, child, family and
environmental predictor variables were considered in the analysis.
Results demonstrated that these children were actively involved in a
wide range of leisure activities and experienced a high level of
enjoyment. However, involvement was lower in skill-based and active
physical activities as well as community-based activities. Mastery
motivation and involvement in rehabilitation services enhanced
involvement (intensity and diversity) in particular leisure activities,
whereas cognitive and behavioral difficulties, activity limitations, and
parental stress were obstacles to participation.

Children with cerebral palsy (CP) experience motor impairments, as

well as deficits in other domains, which impact on their ability to move,
solve problems, communicate, and socialize. These children may,
therefore, also be at risk for less participation in leisure activities.
Participation, defined as taking part or being involved in everyday life
activities and roles, is a new concept brought to the forefront by the
World Health Organizations International Classification of Functioning,
Disability and Health.1 Leisure activities are typically those in which an
individual freely chooses to participate during their spare time because
they find such activities enjoyable. Participation in leisure activities has
emerged as an important outcome for children with disabilities, with
benefits that include fostering friendships, enhancing skill
competencies, and developing personal interests and identity. 2
A recent systematic review on participation in leisure activities in
children and adolescents with CP has highlighted that very few studies
have described this domain in this particular population. 3 A Canadian
study reported that the pattern of participation did not differ for
children with CP in comparison with those with other physical
disabilities.4 Another Canadian group found that children with CP
exhibited important disruptions in their participation in life situations,
particularly in recreational and community-based activities. 5 Within the
school setting, children with CP demonstrated limitations in their ability
to participate in playground and recess activities. 6 Evidence suggests
that children with a variety of disabilities are involved in fewer
activities than their peers, and that these activities tend to be homebased and less physically active, with fewer social engagements. 4,7,8
Little evidence exists as to which attributes are facilitators or barriers
to involvement in and enjoyment of leisure activities. Identification of
these attributes is important in guiding future programs, services, and
policies aimed at enhancing participation. Variables that are emerging
as possible determinants are the following: child factors, such as
severity of disability; personal factors, such as age, sex, and
socioeconomic status; and environmental factors that include parents
education, family preferences, social supports, and environmental
resources.3,7,912 Further validation of these findings in children with
physical disabilities is needed to determine which factors are generic
(non-categorical) and which are disability-specific (categorical).
Furthermore, exploration of other potentially modifiable attributes such
as motivation, specific developmental problems, family function, and
access to services is needed.
Traditionally, health care for children with CP focuses on early
diagnosis, precise classification, and efforts to diminish motor
impairments such as spasticity, muscle weakness, and decreased
range of motion, and to manage associated challenging medical
comorbidities. Rehabilitation programs have begun shifting focus from

minimizing deficits to enhancing functional success and participation in

spite of persisting deficits. Targeted interventions aimed at improving
quality of life and participation are lacking, in part because of limited
data on the factors that influence these outcomes. 13 Further evidence
is needed to identify attributes of the person and their environment
that might potentially be modified to promote participation and
community engagement. The primary objective of this study was,
therefore, to describe the level of participation in leisure activities in
children with CP and to identify factors that are associated with
diversity, intensity, and enjoyment of these activities.

http://onlinelibrary.wiley.com/doi/10.1111/j.14698749.2008.03068.x/full

3. The Enjoyment of Formal and Informal Recreation and Leisure

Activities: A comparison of schoolaged children with and
without physical disabilities

Abstract
Despite the fairly extensive literature on the developmental benefits of
youth's participation in organised, outofschool activities, little is
known about the participation of schoolaged children with physical
disabilities in formal recreation and leisure activities, both in
comparison with their participation in informal activities and with
children who are typically developing. Enjoyment of formal and
informal activities was examined for 427 children with physical
disabilities and 354 children without disabilities, aged 614 years. It
was predicted that children without disabilities would report
significantly greater enjoyment of formal than informal activities,
whereas this would not be the case for children with disabilities. This
prediction was confirmed. Children with disabilities also participated in
significantly fewer formal and informal activities, and participated in
these activities less intensely than did children without disabilities. The
mechanisms responsible for psychological engagement, enjoyment,
and the developmental benefits of participation in activities are
discussed, along with implications for research and clinical practice.

http://www.tandfonline.com/doi/full/10.1080/1034912090286855
8?src=recsys

4. Enhancing physical and social self by recreational act on

physical disbilityhttp://scholar.google.com.ph/scholar?

q=+effects+of+social+recreational+activities+applied+to+spin
a+bifida&btnG=&hl=en&as_sdt=0%2C5&as_vis=1

Related Studies
This study aims to describe the impact of social recreation to elders
suffering dementia in nursing homes

According to Harmer & Orrell (2008), Residents with dementia

describe the most meaningful activities as those that address their
psychological and social needs
Explanation:

In addition to that, Colling (1999), Passitivity is characterized by fewer

displays of human emotions, withdrawal from interactions with others
and surroundings, and a decrease of motor activity.
Explanation:

Also, Ayalon et al. (2006), Recreational activities have been used in

research studies to reduce passive behavior and prevent functional
decline, but recent systematic reviews of these studies have found
modest effect sizes for most activities.
Explanation:

Moreover, Carpenter et al. (2000), Residents with dementia have

difficulty of communicating their specific activity interest, one
methodological improvement in the identification of interest has been
the development of preference lists for use by interviewer.
Explanation:

Furthermore, Reid, Everson, and Green (1999), Found out that of the
activities reported by staff to be preferred by patients, only 42% were
moderately interesting, based on patient's actual approach/avoidance
responses.
Explanation:
Additionally, young children, elderly individuals, and those with
Dementia respond especially well to smiling; it is a positive way of
making a connection with them. (Burton & Ludwig, 2015)
Explanation: One thing health care providers can do to improve their
relationship with a patient is to smile. Smiling has a positive effect, not
only to those receiving the smile but also for the person giving it. If a
single smile can have a positive effect to dementia patients, a
prolonged positive exchange through social recreation could yield even
better and lasting results on the behavior and affect of the patient.

More of, dementia is a progressive, irreversible loss of intellectual or

cognitive abilities like reasoning, math or abstract thinking and
develops slowly. A patient with mild to moderate dementia may exhibit
delirium in an unfamiliar environment. (Chulay and Burns, 2010)
Explanation: A dementia patients disposition and behavior may be
improved by getting him familiar to his surroundings and peers through
regular social activities and interaction.

Likewise, after 2 weeks in the nursing home, a student noted that the
residents of the dementia unit were often very sad and withdrawn. He
also noted that one of the nursing assistants often talked to the
residents about their childhood memories, tales of growing up and
other life stories. This noticeably lessened the residents sadness and
improved their well-being. (Trueman, 2014)

Explanation: Letting patients freely talk about their life is a good way to
help with their behaviors and depression rather than just giving them
their medications.

Similarly, the system and the staff in facilities do not have the
structures, processes, and knowledge to provide quality care to the
current population of residents with dementia. Preparing for the
dramatic shift in demographics of the elderly population demands large
changes in the system and the needed resources to provide quality
care. There is a need to identify and test interventions to prevent
behavioral problems, promote functional ability, and prevent excess
disability of persons with dementia. (Cowen and Moorhead, 2011)

Explanation:
One way of addressing the behavioral problems through social
interaction, we could prevent disability and promote functional ability
for persons with dementia.

II.I Synthesis

III.

Conceptual Framework