Mental patients in nursing homes. I. Social deprivation and regression.

Abstract

Abstract: A one‐year controlled study was made of 16 nursing homes containing 1,400 patients, 141 of whom were former patients of the Boston State Hospital. The purpose was to determine the effect of therapeutic activities in these settings. The design of the study is described.Institutional deprivation may be physical, intellectual or spiritual. Deprivation in nursing homes was found to be particularly related to: 1) lack of stimulation, 2) lack of adequate walking space inside and outside the homes, 3) lack of recreational and occupational therapy, 4) lack of space for group socialization and activities, 5) lack of a common dining room, so that patients have to eat off trays in their rooms, 6) absence of volunteer workers from the community, 7) separation of patients on different floors, and 8) minimal socialization between male and female patients. Case reports exemplifying deprivation reactions and regressive behavior (a warning signal of possible organic changes) are presented.Proposed programs for overcoming these problems include: 1) in‐service training of staff, 2) better communication between the state hospital and the nursing home, 3) intervention for emergencies or recurring problems, 4) the establishment of recreational and occupational therapy, and 5) the recruitment of volunteers to visit, conduct group games, and arrange extramural activities.