THE IMPACT OF ENVIRONMENTAL FACTORS ON ENGAGEMENT AND MOOD OF PERSONS WITH DEMENTIA ATTENDING RECREATIONAL GROUPS

Abstract

Nonpharmacological interventions aim to address the needs of persons with dementia thereby improving their quality of life and preventing or reducing behavioral symptoms. Such needs include social contact and engagement with meaningful activities. Because prior research has shown that social activities are the most engaging for persons with dementia, we studied the impact of group activities in this population. In this study, we examined the impact of group topic and environmental factors on engagement and mood of persons attending recreational groups. Participants were 69 nursing home residents with dementia with an average score of 4.19 on the Cognitive Performance Scale (1=intact and 6=severely impaired). All were invited to two rounds of ten activity topics (e.g., singing) in their units. Therapeutic recreation staff members who ran the groups and research observers independently rated participants' level of engagement, active participation, attitude towards the activity and positive mood during group activities and non-group control conditions. Additionally, the time of day during which group activities were held and the groups' sizes were recorded, and temperature, light, and noise were rated. Background variables and level of cognitive function were taken from the MDS-2 in participants’ health record. Significantly higher ratings of participants' engagement and positive mood were observed during group activities than during the control observations – according to both research and therapeutic recreation staff (all p<.001). Cognitive functioning was significantly related to all outcome variables and served as a covariate in all analyses of environmental factors (p<.001). Group content was a significant predictor of all outcome variables (p<.001). Loud background noise and small group size were associated with significantly worse outcomes in some of the analyses (p ranging between ns to p<.001). The results support the importance of groups for persons with dementia. They also highlight the role of some environmental factors (e.g., designing space that would minimize external noise) in optimizing group activities for this population. Such groups should form a basis for nonpharmacological interventions for persons with dementia.