Study of adaptation services for newly admitted elderly in elderly care facilities

. In response to the deepening aging problem, China has adopted a series of laws and regulations to promote the aging industry. "Medium-and Long-term Plan for Actively Responding to Population Aging" and "Opinions on Strengthening the Work on Aging in the New Era" were successively issued by the CPC Central Committee and the State Council. The report noted that a number of departments have improved the support system for old-age services and have continuously enhanced supply capacity. A growing number of elderly people are choosing institutional care over other forms of care, and it is the old-age service industry that is most favored by them. Moving to an unfamiliar environment such as a nursing home can cause the elderly to feel anxious, lonely, helpless, and afraid. Elderly people are often affected by this in terms of their physical and mental health. In order to improve the quality of life of newly-admitted elderly, it is crucial to shorten their adaptation process.


Information about staying with the elderly
Institution H, which has 213 beds, is home to more than 50 elderly people.Nursing homes can accommodate self-care elderly, semi-disabled elderly, and disabled elderly.The majority of them are aged 71 to 86 years old.The elderly have more cultural and entertainment options, but they eat and live more regularly.A number of newly admitted elderly people were selected to be part of the adaptation group because they are particularly lonely.Article selection criteria included: (1) Ability to participate in activities and take care of oneself in the elderly.
(2) Adapting to and accepting the institution's new environment is difficult for the elderly after they move in; (3) Within three months of moving into an elderly care facility, social workers recruit them.
Ultimately, 5 elderly people with self-care ability were selected, and the basic situation of these elderly people was assessed.As a result of exchanges, elderly people explained that part of the reason is discomfort caused by a change of living environment, and that living with unfamiliar elderly is unavoidably uncomfortable.In addition, foreign scholar Neikrug said in his 2010 study on sleep disorders in nursing homes, "Sleep disorders are common among the elderly, especially those living in nursing homes, and environmental factors, their own diseases, habits and other factors can contribute to insomnia." [2]

Institutionalization of management
Institutional managers usually stipulate when elderly residents eat and get up to assist management.Nursing home life is very temporal, and the pace is very uniform.
In the case of fixed schedules, the elderly often have no choice but to abide by and lack the right to make their own decisions.Adapting to this pace of life is often a challenge for new residents.As shown in Table 3, newly admitted elderly have a flat score on the service attitude and life care provided by elderly care institutions, but low scores on institutional management flexibility.The conversation between the old man and the manager is below the elevator door.
Managers: I let the nurse accompany you, Grandpa.You cannot go down alone.
L: I just want to go along, you are busy with you, don't worry about me.
Managers: Grandpa, you must be accompanied when you go for a walk in the courtyard.I called Aunt Wang, and she came over after cleaning up the room.
Many elderly people prefer to walk alone, according to the management.In order to ensure the safety of the elderly, however, the institution has clear regulations that require caregivers to match the elderly.

Physiological service need 3
Many elderly people who have just entered a nursing home are depressed and feel abandoned.According to the old man, he said: "I cannot do anything, and my main task is to wait for death, so there is no point in living."--

20220118H
Their declining mobility causes the elderly to have negative emotions, believing that they cannot do anything, which is a burden on their children.
During the first days of the stay, the elderly are experiencing negative emotions and psychological pressure.Nursing homes have been shown to cause certain psychological problems.In China, children who send their parents to nursing homes are often regarded as "unfair" and the elderly who live there are often treated as "unfortunate" and "abandoned" by their families.Therefore, we need to pay special attention to the adaptation of newly admitted elderly.

Physiological service need 4
When a person enters a nursing home, the original communication network will be broken, as they have established a complete network of communication in the originally familiar environment.Strange people and the elderly are prone to loneliness when they are placed in an unfamiliar environment.This makes it difficult for them to adapt to the institution's environment.As a result, it is important to facilitate familiarization with the institutional environment and personnel, as well as the building of interpersonal relationships, for the elderly.Old man l said: "I don't want to chat with other people.I prefer to stay in my own room, and I don't know what to say to others.I used to play with a few friends at home, but now that I'm in the agency, I don't expect to meet new people."-20220119L Other elderly people's activities are also quite limited, based on observation.An old man said: I'm afraid of not finding my way back to my room.The old man told me that people can only feel comfortable and safe in their own rooms.

Overall objectives
Ensure that new residents are adapted to the elderly.

Specific objectives
1. Enhance the lives of the elderly and tap into their interests 2. Provide an enhanced sense of identity and belonging to the elderly 3. Provide psychological and physical support to the elderly.A theme activity was held to celebrate the Lantern Festival so that the elderly felt at home.

Casework
The author chooses Y elderly who do not adjust to the rhythm of life considering the situation of the elderly.
After a fall, group member Y entered the nursing home for about a month because he needed nursing care and rehabilitation.It was difficult for him to adjust to institutional life.There were numerous mouth sores in the corners of the old man's mouth, and he told the social worker he couldn't adjust to the environment here and hoped to go home soon.After learning about this situation, the social worker and the head nurse developed a rehabilitation plan for the elderly Y and worked with the elderly to develop a daily plan A week of persistence has resulted in very significant changes in the physical and mental state of the elderly.According to Elder Y, life is equally full with a plan.
Moreover, social workers have adopted music intervention therapy in response to the insomnia of the elderly, and the soothing music has alleviated the anxiety of the elderly.
Interventional services assist the elderly in developing a rehabilitation training program and daily activity plan.With crutches, the elderly can walk independently and have a slight improvement in their physical health.As well as alleviating psychological pressure, music therapy has also improved the quality of sleep for the elderly.It is still necessary for intervention services to be effective in general.

Basic overview of the group
There are five sessions of activities in the group, which is an adaptive group.The workflow includes initial acquaintance, group building, showing strength, strengthening connections, and reviewing the journey.

The purpose of the group activity
Provide social support to the elderly, help them adapt to their new environment, and close the distance between them.

Group activity time
The elderly are energetic and highly motivated during this time, so the elderly are engaged in group activities lasting 45-55 minutes twice a week at around 3:30 p.m..

Group activity effectiveness
There are roughly three stages to group activities.In the first stage, group members get to know each other, and in the second stage, they explore the advantages of each other and cultivate group leaders.The third phase reviews the group's activities and summarizes them.
During the first stage of the program, social workers plan a meeting for group members and promote mutual understanding among them.A simple setting of the game did not stimulate the initiative of the elderly in the activity.Therefore, social workers pay attention to each elderly person's feelings and increase the difficulty as appropriate.ed.Follow norms and reach verbal agreements whenever possible.
In the second stage, members of the group gain a sense of belonging, and social workers prepare materials beforehand.The team members displayed their hobbies in the talent competition.During the event, H was very active and improvised a short poem at the end of the group activity.Eventually, the social workstation played down the role of the leader, allowing the elderly to lead.
During the third stage, social workers review the whole process of group activities with the elderly to help them consolidate their changes.The social worker reviews the entire process of group activities with them.Combine game play with sharing.Let us know about the most noticeable changes you've observed since participating in an event and how the game has improved your teamwork.

Themed events
Social workers and staff at elderly care institutions held activities related to the Lantern Festival.The activity process is divided into three parts, the first part is to twist the song, the second part is to participate in the game, and finally eat tangyuan together, as a result of the entire process, the tacit understanding and trust between the team members have been significantly improved, resulting in an atmosphere of warmth and joy in the nursing home.

Service summary
During the adaptation period, newly admitted elderly are helped through casework, group activities, and thematic activities.According to an early survey of the elderly, three elderly people slept less than 7 hours, and two elderly people slept poorly.The Pittsburgh Sleep Quality Index Scale (PSQI) [4] was used to assess the sleep quality of the elderly.The lower the PSQI index, the better the sleep quality.The elderly are divided into two groups: music therapy [5] and control.Music therapy was implemented by professional personnel using music to intervene in the elderly, while the control group was checked regularly and prescribed sleep aids by medical personnel.Clearly, the elderly in the music therapy group have improved their sleep quality.In addition to meeting caregivers and managers, the elderly can communicate with them whenever they encounter problems in their daily lives by participating in the activities.They formed friendships as well, and after dinner they would visit each other, participate in the hospital's recreational activities, and walk together.

Service reflection
As social workers provide services to the elderly, it is necessary to consider not only the newly admitted elderly, but also the multi-system links between nursing staff, nursing homes, and communities.One of the ways we can intervene is by setting up a relationship with the elderly.In order to evaluate and care for them when they first enter the institution.The second objective is to familiarize them with the institution's environment and answer their questions promptly.The third step is to fully mobilize the social sector support network of the elderly, help the elderly to strengthen the connection with their children and friends, dilute the sense of abandonment of the elderly, and help them to build a social support network in the hospital and improve their interpersonal relationships.We can integrate resources for the elderly and improve their abilities through the linkage model involving "social work + family + peers + nursing home + hospital + community" [6] .

Fig. 1 .
Fig. 1.Comparison of subject scores before and after the intervention (points).

Table 1 .
An assessment of the situation of newly admitted elderly people.
1.3 Service object requirements1.3.1 Physiological service needA sleep duration of less than 7 hours is considered sleep deprivation.Moderate sleep is 7 to 8 hours.It is already too long to sleep for 9 hours.According to the table, three of the five newly admitted elderly people slept less than seven hours.Two elderly people had poor sleep quality.

Table 2 .
New Elderly Resident Sleep Quality Questionnaire.

Table 3 .
Following is the scoring table for how the newly admitted elderly manage the institution (1-10).

Table 4 .
Adaptation service plan for new seniors at Facility H

Table 5 :
Table of group activities

Table 6 :
PSQI scores before and after the two groups of interventions were compared