“A sense of purpose is best acquired when one has a sense of agency; that is, the power to affect one’s own destiny.” – Dr. G. Allen Power, Dementia Beyond Disease
To define engagement, it helps to first look at how other industries approach it. In the housing industry, for example, successful resident engagement means that a person is invited by the service provider to be an active participant in designing their day-to-day living thereby individualizing their experience in a purposeful way. The individual is therefore able to optimize their own health and wellbeing by participating actively in the amenities offered by the community and connecting with their fellow residents.
In the hospital industry, engagement means successfully cultivating “patient activation” or ensuring that every person can take an active role in making decisions about their care plan and how it is executed. By collaborating with patients in this way, the hospital maximizes positive health outcomes for the patient by empowering them to take an active role in their own care while simultaneously improving their bottom line.
The importance of engagement is something that experts in the aging and dementia field pay attention to when thinking about meaningful life for residents. Dr. Jiska Cohen Mansfield provides a basic definition of engagement for those living with dementia as “…the act of being occupied or involved with an external stimulus.” To truly achieve meaningful engagement, beyond just occupying the time of the person living with dementia, the provider or caregiver needs to deeply understand the needs and preferences of the individual. As Dr. G. Allen Power reminds us in his book Dementia Beyond Disease, those living with dementia can take an active role in determining how they are engaged and can certainly live purposefully as long as they have the help of their care partners.
“The view that people living with dementia can only receive care and have decisions made for them erodes autonomy, while meaning flows from the ability to make choices and give input into things that matter to oneself and others.”
The senior care industry could learn from other industries about the importance of preserving a person’s agency in the care process and how it is a necessary component of defining purposeful engagement. In fact, resident engagement can only be defined with the help of the person receiving care. Today’s providers need to recognize the absolute importance of understanding that every person, no matter their current cognitive abilities, can have a purposeful life if the community invests resources in the staff members who are charged with providing care. Optimizing resident engagement is a collaborative journey that should take place between all staff, residents, family members, and company leadership.
How can true person-centered resident engagement be accomplished? Providers can begin by building a solid foundation for successful engagement with three key ideas in mind:
- Empower Activity Professionals
Too often the activities department is understaffed and asked to accomplish a lot each day with a very small budget. These issues are made worse because resident engagement is still primarily tracked using paper-based strategies. Optimizing resident engagement means that senior leadership must elevate the role of those whose job it is to lead engagement by providing them with the time, tools, and budget they need to succeed. These professionals truly are “Chief Engagement Officers” and need to be treated this way.
- Using Technology as a Support
When technology is brought in to support the work of activity professionals, they can focus more of their time on meaningfully engaging residents, not just on research and preparation of engagement programming. With more time, the activities department can focus on communicating with each resident to better understand their current needs, planning engagement based on those needs, implementing the plan with the help of technology in real-time and evaluating their success based on the changing needs and preferences of the resident.
- Deeply Knowing the Person
Engagement cannot be optimized unless a care partner has the time they need to learn about a resident’s life and understand how to connect with them based on their current needs and preferences. By using the important work of the Preference Based Living team, a community can start implementing a strategy for:
- Learning about individual preferences
- Designing and implementing care aligned with those individual preferences
- Measuring the quality of preference-based care in diverse settings
Resident engagement professionals know that engagement is much more than just providing activities to occupy residents each day. A more accurate definition of resident engagement can be crafted when senior care providers approach their work by first asking three key questions:
- Are we engaging everyone in the community?
- Are we engaging each resident based on their current needs and preferences?
- Are we thinking about wellbeing and evaluating outcomes in real-time?
By asking these questions each day, a definition of successful resident engagement begins to emerge: it is the act of continuously collaborating with those in our care to ensure they can live each day with purpose, whatever that may mean for each unique person.