Dining Room Enhancements to Empower Long Term Care Residents
Yun Cho, University of Calgary, Community Rehabilitation and Disability Studies, Calgary, Canada
Email: Yun Cho
Empowerment is essential in improving the quality of life for residents in long term care. The dining room enhancement project focuses on residents having the capability, the right to voice their inputs and make change, and have the right to make choice. These values relate to the idea that empowerment within this long-term care setting bridges the gap between residents and management. This resident-led project to improve the dining rooms mainly focuses on the empowerment aspect, however, it also addresses the issues regarding an uncomfortable environment, an experience that is not home-like, an institutionalized setting, and a setting that depicts visual negativity. For these reasons, the residents’ voices were heard, management understood the underlying issues of a social gap as well as concerns regarding the dining room environment. The decisions led by the residents were implemented into the dining room renovations with funding from Calgary Health Trust, and support from key players within management and the community. The outcomes of this dining room project include strengthened connections between management and the residents, a domino’s effect, and the establishment of a home-like dining experience.
Keywords: residents, empowerment, long term care, choice, social gaps, home-like environment
Empowerment is an important factor in determining quality of life for residents in long-term care (Schoberer, Leino-Kilpi, Breimaier, Halfens, & Lohrmann, 2016). By providing empowering decisions for residents, this increases residents’ self-autonomy, independence, as well as self-efficacy (Schoberer et al., 2016). The dining room enhancement project led by a group of residents, aged 18 to 65, is a measure of empowerment within the decision-making process. As a facilitator, I recognized this empowerment as a driving force to engage active residents who are involved in their lives and have their voices heard in a positive and productive way. The empowerment aspect of this project focuses on the dining rooms as the institutionalized and uncomfortable setting of these rooms were a major concern among the residents. This concern is a result of top-down approaches that fails to recognize the needs of residents. As well, residents from this age group were subject to discrimination based on the stereotypical long-term care environment that mostly represents a 65+ population. Gaps between management and the residents demonstrate discrimination and status loss for residents, reflecting distinctive labels that separate both groups as “us” versus “them” (Shin, 2015). As well, there is a lack of research regarding quality of life for younger populations in long-term care (Persson & Ostwald, 2009). For these reasons, the dining room enhancement project recognizes the need for place identity that represents the younger residents, and the project promotes empowerment by giving residents the right to voice their inputs and make change, the right to make choice, and to be capable.
The dining rooms considered for this project are the two first-floor dining rooms of the facility, and the residents that are partaking in this project are first-floor residents. The first-floor residents voiced their opinions on the current environment of the dining rooms. The responses outlined that the dining rooms are not home-like, are unchanging, have too much negative energy, are a depressing place to eat, look institutionalized, and are uncomfortable. The residents also voiced their expectations of a changed environment. These opinions include bringing back positive energy, bringing together creative minds to deinstitutionalize, creating a place that is tidy, organized, uplifting, and calming, and creating an environment where eating is enjoyable and health-focused. With these opinions, a small group of first-floor residents and myself formed a committee that will interact and work with the other first-floor residents and management. I encouraged the residents to lead the committee to promote empowerment, and I became the facilitator for this committee.
Our next steps involved weekly focus meetings to plan our project. We considered the following questions: What do the residents want to see in this changed environment? What is the budget? Where will we receive funding? What are some cost-effective measures, and who will support us with this project? Regarding the first question, the residents and myself discussed certain aspects of the dining rooms that need to be changed. We considered new paint, new music, ceramics for décor and for table centerpieces, real plants, wall art, fluorescent light covers, wood valances, wallpaper, barn doors, new tables, place cards, and place mats. With all these in place, the total cost came to $10,255.10, and to secure funding, I wrote a funding proposal to Calgary Health Trust for $12,000. I asked for more than what we need to leave room for extra costs (shipping, installation fees) that may contribute to our cost. We found support from outside organizations as well as members from this organization. Whilst planning our future dining rooms, the residents and myself prepared two presentations: one presentation targeted the majority of the first-floor residents and the other presentation targeted management of this facility. The presentations are important for buy-in to carry on with the action process. The planning process is a reflection of the methods of this dining room project.
Our monthly planning process resulted in buy in from stakeholders, funding approval, and delivering the message of our dining room project to a larger audience. The resident presentation was successful in that all the residents agreed that this project needs to be carried forward. The major piece to this buy-in was that the dining rooms needed change, and it was meaningful in that the residents were leading this project. There was a similar reaction from the management presentation, which included the first-floor client service manager, head nurse, registered nurse, director, and administrator. The director, however, proposed that this project should be presented to other management within the facility, and management within the organization. This was a pivotal point as our dining room project could deliver a message that would promote change within all the facilities within the organization. The larger presentation consisted of higher-level management from various backgrounds, including public health, Calgary Health Trust and the CEO of the organization. Again, there was successful buy-in and management were willing to carry forth with the message of empowerment for the residents. With three successful presentations, our project funding was approved for $12,000, there was a domino effect that occurred, and residents, staff and management, and I carried forth with the action processes of this project. The dining rooms were painted, staff and I ordered the items that are needed for the dining rooms, and management supported us by allocating more funding to our project. The project received an additional $18,000 for changing the tables in the dining rooms, which were 29 years old and need to be replaced due to health and safety issues. The important aspect of this project is that the resident voices were heard and residents were given a choice. By doing so, management reflected on this project and created a board that represents the resident population. The purpose of this board is to have residents address their concerns, address certain activities that they would like to engage in, and have other comments that need to be heard. In other words, this board is a communication board for the residents. Currently, the dining rooms are undergoing change, and the residents and I are expecting the changes to be completed by the summer of 2019.
This project did not only change the dining rooms, but it also empowered the residents. This empowerment aspect is driving momentum within the organization to implement change that addresses the needs of residents. This project is only a start, but the results are showing a dominoes effect, interactions between residents and management, and change towards a positive environment. For this reason, empowerment is an important aspect of enhancing quality of life for residents within long term care (Schoberer et al., 2016).
Persson, D. I. & Ostwald, S. K. (2009). Younger residents in nursing homes. Journal of Gerontological Nursing, 35, 22-31.
Schoberer, D., Leino-Kilpi, H., Breimaier, H. E., Halfens, R. J. G., & Lohrmann, C. (2016). Educational interventions to empower nursing home residents: A systematic literature review. Clinical Interventions in Aging, 11, 1351-1363. doi: 10.2147/CIA.S114068
Shin, J. (2015). Declining body, institutional life, and making home – Are they at odds? HealthCare Ethics Committee Forum, 27(2), 107-125.
Author Biographical Notes
Yun Cho has recently completed a bachelor’s degree in Community Rehabilitation and Disability Studies, and has applied for a Master’s in Occupational Therapy at University of Alberta.
International Journal of Disability, Community &
Student Perspectives 2019