Having worked in the long-term care industry for the past 27 years, I have witnessed many changes in all aspects of treatment, documentation, regulatory requirements, etc.

However, one of the areas that has remained the same in many facilities is the type of activities available to residents. Although some activities are individualized for specific residents, most group activities are geared toward the elderly population, such as Bingo, big band-type music and classic movies. Recently, many facilities, especially those that offer short-term rehab programs, have begun to experience an increase in clientele under the age of 65. As the clientele age ranges have changed, the types of activities being offered, in many cases, have not.

This lack of diversity in activities often leads to non-participation on the part of this younger generation of residents, and decreased social opportunities as a result. Lack of interest in the activities offered, also tends to lead to boredom, self-isolation, and can increase depressive symptoms, which then can have physical implications which further impact a resident's already comprised health status.

To determine just exactly what types of activities this younger group would prefer, I visited several long-term care facilities and interviewed some of them. In one facility, a man in his early 50s had recently undergone a below the knee amputation of his right leg. He stated that when he was well, he was very athletic and enjoyed playing basketball. He was aware that there are entire teams of basketball players that are confined to wheelchairs, and said, "If they can do it, so can I. I would love to get outside and be able to shoot some hoops."

At another facility, a woman in her 30s with multiple medical concerns, told me she enjoyed watching horror movies and playing video games. At yet another facility, a man in his mid 40s liked to listen to classic rock music and watch sports. He suggested that it would be nice if a bunch of the guys could get together sometime for a game night with snacks and soda. Many of the residents that were interviewed said that for the most part, they don't participate a great deal in the activities currently being offered. Unless there is an outing of some sort, they generally tended to spend most of the day in their room watching TV or napping.

Developing and implementing activities for this younger group of residents based on the above suggestions can be easily accomplished with minimal financial impact. Some facilities have begun to purchase video game systems as well as place computers in a common area for residents to access for e-mail and play computer games. At Bayberry Commons, we instituted a weekly night club, which is held from 7pm to 9pm in one of the unit dining rooms.

The doors are kept closed, so as not to disturb other residents, and music from the 1960s to current day is played. The overhead lights are dimmed, and the disco lights lit. Snacks and non-alcoholic beverages are offered. This activity not only draws a majority of the younger residents, but some of the elders as well. Several residents have provided positive feedback regarding this activity, and look forward to it each week.

The entire cost? Around $20 for snacks and beverages and two hours volunteered by a staff member. We've also recently purchased a Wii video game system and have weekly Wii team sports. The activities department also offers a variety of movies ranging from the classics, like "Meet Me in St. Louis" to more recent releases like "Mamma Mia". This range of activities works well for both groups of residents and affords all of them, regardless of age, the ability to socialize with their peers and enjoy themselves at the same time, which is the main goal for any type of group activity program.

As far as individual activities, for those residents who do not have a DVD player in their rooms, and who would like to watch a movie on their own, their could be an extra DVD player (inexpensive models are available for less than $40) that they can sign out for the night, and then return to the activities department along with any borrowed movies. The same could be done with head phones (which are also relatively inexpensive) for those residents that wish to listen to loud, rock and roll music.

By offering a variety of age-related activities, we generally see an improvement in resident satisfaction, which leads to improvement in overall disposition and outlook, which then leads to better participation in their medical regimen, and overall improvement or stability of health status.

Laurie Moulton is director of nurses at Bayberry Commons Health Center, Pascoag, R.I.