Abstract
Abstract
Background: The global population of people aged 65 years and over is expected to rise from 761 million in 2021 to 1.6 billion by 2050. Many of these older adults have multiple comorbidities and functional impairments that make them particularly vulnerable during acute hospitalisation. Engagement in meaningful activities can be vital to older people’s care, particularly in acute hospitals. Evidence suggests that such engagement can have a positive impact on the patients’ hospital journeys. To ensure individualised support, it is important to understand the purpose of meaningful activities for older adults in acute hospital settings, including their definitions, implementation methods, and impact on patients.
Objectives: The aims and objectives of this scoping review were to:
• provide evidence of the impact of engagement in meaningful activities on older adults;
• identify barriers to the delivery of these activities;
• source evidence regarding older adults' experiences and perspectives on meaningful activities in hospitals.
Methods: The review stages identified in the Arksey and O’Malley framework were used. The electronic databases MEDLINE, CINAHL and PsycINFO were searched to discover relevant articles on meaningful activities/ older adults in acute hospital care. The results are reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) extension for scoping reviews. A total of 3,466 titles were identified in an initial search that used the term “meaningful activity”. Screening these articles using the keywords “older adults” and “acute care setting” cut this figure to 34. Some of these were duplicates or the studies had not been carried out in the UK; after excluding these, 24 articles related to the research interests remained. These 24 articles were screened and six were found to apply to adults 65 years and older. These six were analysed in the review.
Conclusion: The findings regarding the meaningful activity experiences of older adults in acute hospitals indicate that comprehensive models of care that embrace physical, psychological, social and spiritual frameworks are required. Summarisation of the data led to the identification of three themes: “physical, social and art activities”, “the benefits of meaningful activities”, and “the desire for meaningful activity”. Regarding the latter, patients in the studies highlighted the importance of taking part in meaningful activities during their acute hospital journeys. Regarding the first two themes, the reported observations and reviews of the evidence indicate that interventions that include physical exercise, music and art therapy improve mental health and well-being and alleviate anxiety and depression in older adults. Loneliness and isolation among some older patients may be eradicated through social interaction. However, implementation of such models in acute hospital settings poses a challenge, given the shortage of staff, particularly those trained in meaningful activity.