The World According to Dr. El

Instilling hope: Needed for contentment, helpful for long-term care operations

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Eleanor Feldman Barbera, Ph.D.
Eleanor Feldman Barbera, Ph.D.

“I hope Santa brings me a Sony DS,” my 7-year-old told me the other day. I can tell you right now that Santa is not bringing her a video game player, but I didn't want to tell her that or spill the beans about Santa. So I did what I imagine most parents would do in that situation: I asked her what else she hoped Santa would bring.

There are many benefits of hope, according to an article in October's American Psychological Association Monitor. Researchers report that, “Hopeful people have a greater sense that life is meaningful.” In addition, “Hope is a strong predictor of positive emotions … and a necessary step on the path to contentment.”

Psychologists differentiate hope from optimism, saying that optimism is a feeling that generally good things will happen, while hope tends to be focused on more specific goals. Researchers state that social connections are an important part of being hopeful, counteracting the feeling of being invisible and alone.

Hope in LTC

So what does this have to do with long-term care? As it turns out, a lot.

The article referred to a 2001 study that examined the level of hopefulness of nearly 800 people aged 64-79. Several years later, 29% of those classified as hopeless had died, compared to 11% of those who were hopeful. Researchers note that hopeful people tend to make better health choices.

If hopeful residents are making better health choices, chances are they're more likely to comply with medical recommendations and dietary guidelines. They're more likely to get up and go to rehab, increasing your reimbursement rates. Residents who are hopeful, happy, and satisfied are more likely to refer people to your facility.

Helping residents feel hopeful

Residents often enter our facilities after a demoralizing health problem. They may be cut off from their usual support system and worried or fearful about the future. We can help our residents feel more hopeful by implementing the following ideas:

1.     A warm welcome from staff: First impressions really are important. Make sure their initial welcome feels personal and reassuring, reducing their feelings of being invisible and alone. I've watched new residents being pushed through the doors in stretchers or wheelchairs. The “pusher,” usually an ambulette driver, consults with the security desk for a room number while the resident is ignored.

Instead, train your staff, especially those at the front desk and those who will greet admissions on the floors, to make eye contact with each new person, smile and say, “Mr. Johnson, welcome to My Better Nursing Home.”

2.     A friendly greeting from peers: While staff members can provide important information and reassurance for residents, hearing it from others who have been through the same thing is invaluable. A resident welcoming committee shows newbies that there are people who are happy in your facility, leading them to believe that they can be happy too. Residents also can give the lowdown on things staff can't say, such as which staff members are grumpy and how to work around them.

3.     Foster their support network: While there's probably not enough time to phone everybody in a new admission's address book, making a couple of phone calls to key relatives and friends can get the ball rolling. Ask those people to phone some of the others and start a chain of connections.

Provide directions to your facility on your website or in your newsletter. Research shows that family members can help instill hope.

4.     Showcase rehab “stars”: Many people have trouble believing they'll recuperate from the injuries that have brought them to rehab. Show them it's possible by having successful residents talk to newbies about their progress since they've arrived. Sure, the rehab therapists can tell them rehab works, but when a peer with a cane and a discharge date tells a group of residents in wheelchairs that she rolled in too, the evidence of hard work in rehab is compelling.

5.     Emphasize past accomplishments: Remind residents of their past successes by having photos and other memorabilia of accomplishments in residents' rooms, by interviewing them for the community newsletter and discussing accomplishments in group or one-on-one activities. In rehab, ask residents to reflect on their youthful athletic prowess and use that experience and determination to help them now.

6.     Facilitate spiritual supports: A good source of hope for many is attendance at religious services. For some, it's attendance at 12-Step support groups (which have a spiritual foundation). While most facilities offer religious services, consider providing a way for residents to make or keep their 12-Step connections through on- and off-campus meetings or through phone and Internet meetings. For more on this, see Why Every Nursing Home Should Host Alcoholics Anonymous Meetings.

7.     Laugh: Humor is found to be another way to increase hopefulness. Consider bringing in a comedian for an entertainment night, or increasing the number of comedy movies available on the in-house television station.

Truthfully, many of our residents probably wish they weren't in our facilities, especially around this time of year. But if we can't give them their first wish, perhaps we can offer them the hope that where they are right now is a good place and that we'll help them make the most of it.


Eleanor Feldman Barbera, PhD, the author of The Savvy Resident's Guide, is an accomplished speaker and consultant with over 16 years of experience as a psychologist in long-term care. This blog complements her award-winning website, MyBetterNursingHome.com, which has more on how to create long-term care where EVERYBODY thrives.
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