An ‘Identification of Needs’ process should be undertaken within the first few weeks of a new client's arrival at a nursing home facility.
Clients should be assessed on various aspects of their lives; sleeping patterns, diet, cognitive ability and mobility among other things. The assessment is a team effort involving RNs, Leisure & Lifestyle staff, and other care providers.
Recreation staff have the task of assessing the ‘Social and Human Needs’ of clients which includes leisure and recreation.
‘Leisure’ consists of various activities an individual may engage in during his/her free time.
‘Recreation’ is any pursuit engaged in during leisure time that is organised for social purposes.
However the ‘Social and Human Needs’ assessment of residents encompasses much more than just leisure and recreation. Some of the areas the Recreation Therapist must also consider are social needs, emotional needs and physical and spiritual needs.
The identification of needs is usually collected in two documents; the ‘Social Profile’ and the ‘Resident Assessment’. The more elaborate and detailed the information collected, the better.
The ‘Social Profile’ is a form that is usually given to the residents to fill in upon admission. If the resident is not able to fill it in, then a relative will do so. Each facility has its own ‘Social Profile’ which may go by a different name at your facility.
The ‘Social Profile’ form should include background information and personal preferences:
The ‘DT Resident Assessment’ endeavors to collect social, emotional and spiritual needs and also all sorts of information that could hinder or enhance recreation and leisure.
Start with the resident:
Interview family and friends:
Other Health care providers and staff:
Past and present skills and interests
Find out what hobbies they enjoyed, jobs they had and which aspect of the job they liked. We should not assume that just because a lady was a dress-maker she necessarily enjoys needlework. The reality may be that it was financial hardship which compelled her to take up this occupation and she may even resent it.
Religious (and cultural) background
Religion plays a central role in the lives of many older people. Does this person wish to attend Church services? Can you meet this need by providing transport? Find out if you need to engage ministers of religion and/or lay people to make individual visits to residents who are bed ridden or unwilling to attend religious programs. Do they wish to have access to broadcasts or telecasts of religious programs? Have they expressed what sort of religious rites they would like to receive when the time comes?
What role they played in the family? Mother, father, older sister, bread-winner. Is there any estranged member in the family?
Personality What sort of personality do they have: sensitive, loving, controlling. Sensory loss can affect the personality of certain people. They may become angry and/or aggressive.
Dementia What sort of diagnosis do they have? Alzheimer’s, stroke, neurological disorder? Even mild dementia plays often havoc with a person’s social life and often propels personality change.
Community affiliations Did they belong to clubs, choirs, folk dance groups in the past? Would they like to continue to do so?
Past memories (reminiscing) Are there painful memories you should know about? Sad memories of wars, refugee camps etc. Do they mind talking about their memories in WWII?
Now that the needs are assessed you have to establish what sort of problems relating to activities this person may have. Various degrees of cognitive function are needed to participate in games, craft, gardening, exercises and all other activities you may have. The same applies for motor function. Some of the areas to consider are:
Some activity related needs and problems:
You also look into other issues that may encumber their participation in activities such as:
Emotional needs, when met in a balanced way are said to have the power to improve mental health. Many of our most basic human emotional needs are expressed as feelings. Despite sharing those feelings, we all differ in the intensity of the need. One may crave security where another craves independence. One may have a longing to be understood and another to be left alone (solitude). That’s why it is imperative that you find out exactly what is the resident’s most neglected emotional need. Does he/she wish to feel?
|Clear headed (not confused)||appreciated||in control|
As you ask yourself these questions, you will start to get a mental notion of what is required. You can now consider:
Indeed, you are now ready to write your Care Plan. Good luck! Don’t forget to download samples of goals and interventions.
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Spiritual support for people with dementia in nursing homes and other care facilities is vital to their well-being and a requisite for the holistic care we strive to achieve