What could be more therapeutic for anyone, at the end of a long winter, than a vacation to a warm, sunny island? For many of our nursing home residents, even an occasional ride in a car is denied, limited by physical or social restraints, and generally the long New England winters are spent within the confines of one facility. Our patient population is, for the most part, wheelchair or geri-chair bound, and requires a great deal of help with activities of daily living. This is not a population which is easily transported to events occurring outside of the facility but this time we wanted the residents to "go" somewhere - leave their usual surroundings and enjoy the sights and sounds of a very different environment.
Our staff took 32 of our 50 residents to the Hawaiian Islands. The trip was made possible by a great deal of imagination, love and volunteer effort. The planning process was headed by our recreational therapist and an army of volunteers. The community was encouraged to participate by donating clothing, souvenirs and artifacts of the Island culture. The response was wonderful.
On Tuesday afternoon, our residents boarded the "aircraft. " They entered their dining room, which had been transformed to look like the interior of a 747 airplane. They were greeted by their "pilot" and two "airline attendants." The facsimile of the flight included use of seat belts, oxygen masks, and the passengers were told the flight route and altitude. A member of the nursing staff narrated an Hawaiian slide show, and passengers were served Pina Colados midway by the attendants. During the flight, a wonderfully ambitious group of volunteers and nursing staff transformed the usual decor of the facility into a grand Hawaiian hotel, complete with lush flora, waterfall, colorful birds, grass huts, lanterns, posters and Hawaiian tourist information. The staff and volunteers donned colorful Hawaiian clothes, and when the residents "deplaned," they were greeted with leis and warm alohas. The residents were thoroughly enjoying their vacation and were delighted with the transformation in their surroundings.
The dietary department, directed by the dietician, planned meals and special desserts in the Polynesian cuisine and on the second day of the vacation, prepared a luau, minus the roast pig, for the entire facility.
Some of the volunteer contributions which added to the flavor of the residents' armchair vacation included music and dancing entertainment nightly, and a locai florist brought in baby orchids from Hawaii for every woman's hair, and every man's lapel. We had a wonderful time with the women because they needed to decide which side of their heads to wear the flowers on, left/available, right/attached, we had enough clothing donated so that staff and residents alike were appropriately dressed.
During the time of the visit, we noted that the residents' appetites and sleep pattern improved. The level of resident social interaction was definitely improved, as noted by the level of conversation during meals, and the increased interaction in the day room. Even levels of confusion decreased, as residents became more alert and enjoyed the changes in their environment. Concerns about the "vacation" exacerbating confusion in some of the residents were unfounded. It was an opportunity to enjoy something different, something fun, to experience a faraway place. We noticed that one resident, who had had a massive CVA which left her very disoriented and weepy, was in a less anxious state, and her spontaneous crying abated during the "vacation." The residents' and staff's attitudes certainly complemented one another, and everyone had a good time. The essential nursing activities were accomplished, but the aloha spirit prevailed, and each eight hour shift seemend to fly by. One of the comments made by two of the residents was "We never realized so many people cared about us." Another family spoke to me and said how much they appreciated our making this vacation possible for their mother.
The third day dawned, and after breakfast and some Hawaiian entertainment, it was time to "go home." The residents boarded their "aircraft," and began their journey Flying back, they saw the movie, "South Pacific," stopped in "San Francisco" for lunch (position changes, toileting, etc.), and when they finally deplaned, they were welcomed home by the staff who, again with volunteer efforts, had removed the Polynesian paradise and replaced it with the more familiar setting of the facility. The effects of the vacation continued even a week later, and people began planning next year's vacation immediately. Some of the residents have a desire to "visit" Disney World.
What is significant is what the human spirit and imagination are capable of when called upon to act and the positive therapeutic gain which occurs when residents participate actively. All too often, programs for the elderly are non-participatory and although they provide some necessary stimulation, full participation is so much more therapeutic. We are fortunate to have nursing and therapy personnel who recognize that patient needs are considered first. What will be beneficial to the residents takes priority over established patterns of task accomplishment which provide for the basics, but may not always provide for that intangible that brings renewed life to the smile of an 84 year old who thought her "traveling" days were over.