Fostering Socialization among Residents in Long-term Care Setting

In-service at VA, Menlo ParkBy Rustyn Mooney, OTS

Socialization- defined in Occupational Therapy Practice Framework as a skill and an occupation•Social Interaction skill: is a performance skill observed during a social exchange. Skills include: approach, eye-contact, regulate, question, express emotion, disagree, transition, response time, takes turns, acknowledge, heed, conclude, thank

•Social Participation: “the interweaving of occupations to support desired engagement in community and family activities as well as those involving peers and friends.”

Health Benefits of Socialization1. Potentially reduced risk for cardiovascular problems, some

cancers, osteoporosis, and rheumatoid arthritis

2. Potentially reduced risk for Alzheimer’s Disease (AD)

3. Lower blood pressure

4. Reduced risk for mental health issues such as, depression

5. Protection against illness because it boosts the immune system

6. Those who are socially connected live longer

Psychosocial Benefits of Socialization

1. Gives sense of purpose and belonging2. Improves quality of life3. Strengthens existing relationships4. Improves role competence5. Increases self-esteem 6. Contributes to a positive mental outlook

Psychosocial Benefits of Socialization

7. Increases self- confidence 8. Enhances occupational performance 9. Increases engagement and participation 10. Maintains cognitive function11. Promotes well-being

Preventing and Assessing Social Isolation

1. Evaluate patients ability to establish and maintain relationshipsa. Informal conversation on socialization, relationships, self-

concept.b. Formal assessment: i. Independent Living Scales (ILS) – social adjustment

subscale. ii. Lubben Social Network Scale (LSNS)

Goals of Therapeutic Socialization1. Embed social interaction during activity/treatment to:

a. foster social connection1. promote and reinforce appropriate social skills2. decrease possible behavioral issues between peers

b. Identify deficits, teach specific skills and give the client the opportunity to practice these skills in a supportive environment.

c. Foster self-awareness during treatmentd. Provide a milieu to reflect on positive past experiences and

build new ones to improve self-esteem.

Promoting socialization in your practicePurposeful socialization between resident and practitioner1. Get to know the resident by asking a personal questions during each

session. Have purposeful social interaction: meaningful discussion, shared activity, promote interaction with others, etc. Embed this in your treatment, so that it becomes natural and expected by the resident.

2. Foster self-awarenessa. What did you do well? b. What did you like or didn't’ like? c. What are your goals for treatment or for next time?d. Build in an assessment question at the end of each session:

how did the resident feel before and after the session?3.Encourage social interactions with others

Promote socialization in your treatmentPurposeful socialization between resident and practioner3. Set a psychosocial goal- to promote social skills, self-esteem, self-

awareness, and increase quality of life.

4. Reflect on your own deficits in the area of socialization: How can I do better in interacting with my resident? What can I do to promote socialization in my practice?

Promoting socialization in your practicePurposeful socialization among residents1. Identify deficits: What are the barriers to this person’s social

interaction? What can you do to address that barrier? 2. Promote peer interaction

a. One on one treatment- after session, encourage social interaction with another resident or promote participation in a therapeutic group.

b. In a therapeutic group- design groups that promote peer sharing and interaction.

Therapeutic Group socialization

1. Have two residents complete a project together, play a game, or complete a word search/crossword together.

2. Design groups that promote common interest between veterans

3. Have veterans work in teams to complete a project together

4. Encourage veterans to read questions out loud to the group/teach the group.

5. Take an extra step to promote interactions on the units

Sample work from Therapeutic groups

Coat of Arms

Coat of Arms- Purpose of Group

1. Self reflection and awareness- What personality traits doe I have? Who’s important to me? What am I good at? What do I enjoy?

2. Social interaction skills- taking turns, listening, responding

3. Build self-esteem- feels good to share about yourself

4. Find commonalities between the veterans

5. Foster friendships between veterans

Spring Art Activity

Purpose of Group- Spring Art1. Reminiscence- what does spring remind you of?

2. Social skills- giving a compliment to your peer

3. Self-awareness

4. Build relationships

5. Increase self-esteem

Where have you visited?

States and National Parks

Purpose of Group- Travelling

1. Reminiscence- places I have visited, who I was with, what did I see?

2. Social skills- listening, taking turns, responding to others, eye contact, acknowledge, conclude

3. Commonalities: “We were born in the same state”

4. Build friendships- learn about each other

What are all the hats you’ve worn?

Purpose of Group- hats worn

1. Reminiscence

2. Social skills- listening, responding, etc.

3. Self-awareness- what am I good at?

4. Build friendships

5. Increase self-esteem-

Reflection and Personal Goal

Own self-awareness- How can I do better in interacting with my resident? What can I do to promote socialization in my practice?

Share with a peer

ReferencesAmerican Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68 (Suppl. 1), S1-S48.

Bermis, E. (2013). The importance of socialization at senior living communities. Aging and Caregiving. Retreived from: http://www.umh.org/assisted-independent-living-blog/bid/271766/The-Importance-of-Socialization-at- Senior-Living-Communities.

Diament, M. (2008). Friends make you smart: Boosting social interaction is key to your mental health. AARP Bulletin, Nov. 21. Retrieved from: http://www.aarp.org/health/brain-health/info-11-2008/friends-are- good- for-your-brain.html.

Freeborn, Donna. (20160. Older Adults and the importance of social interaction. Health Encyclopedia. University of Rochester Medical Center. Retrieved from: https://www.urmc. rochester .edu/encyclopedia/ content. Aspx? ContentTypeID=1&ContentID=4513.

Hermann, H., Saxena, S., Moodie, R. (2005). Promoting mental health: Concepts, emerging evidence, practice, World Health Organization, A Report of the World Health Organization and Department of Mental Health and Substance Abuse in Collaboration with the Victorian Health Promotion Foundation and the University of Melbourne. Retrieved from: http://www.who.int/mental_health/evidence/MH_Promotion_Book.pdf.

ReferencesLubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J.C., Stuck, A.E.(2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. Gerontologist. Aug, 46(4) 503-13.

Lubben, J., Gironda, M. (2004). Measuring social networks and assessing their benefits. In Social Networks and Social Exclusion: Sociological and Policy Perspectives. Eds. Phillipson, C., Allan, G., Morgan, D.Ashgate.

Tinglin, C. (2016). Therapeutic socialization offers support. Today’s Geriatric Medicine, 7, 3, 28. Retrieved from: http://www.todaysgeriatricmedicine.com/archive/052714p28.shtml

Umberson. D, and Montez, J. K. (2010) Social Relationships and Health: A Flashpoint for Health Policy. Journal of Health and Social Behavior, 51(Suppl): S54–S66. doi: 10.1177/0022146510383501