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Idaho State Veterans Home – BoiseNursing Procedure ManualContentsActivities . 2Purpose . 2Activity Plans. 2Monthly Activity Calendars . 3Activity Types: . 3Spectator group activity, . 3Performing group activity . 3Independent – Interdependent group activity, . 3Interdependent group activity . 3Procedures for Group Activities . 4Birthdays. 4Purchasing/Budget . 5Progress Notes . 5Outing Protocol . 6Protocol for Wandering/Lost Resident during an outing. 7Protocol for resident injury during a facility sponsored outing. . 7Vehicle Communication Procedure. 7Dress Code while on Activity Outings . 7Dress Code for Specialty Days during the Calendar Year . 7Pet Therapy Protocol . 8Activities1Chapter 1

Idaho State Veterans Home – BoiseNursing Procedure ManualActivitiesPurposeIt is the policy of the Idaho State Veterans Homes to provide an organized activity program. Theactivity program is a composite of a variety of processes and services designed to stimulate trainand promote residents to achieve greater self-sufficiency. The program provides social,educational, and physical experiences to support the individual in making adjustment to orreversing handicaps or disabilities.Activity PlansAn activity program shall be developed for each and every resident, according to his or herspecific needs and interests. All residents shall be encouraged and assisted to be involved, atwhatever level is appropriate for the resident. Individual programming shall include one or moreof the following: group activities, special events, outings, 1:1 visits, sensory stimulation, andindividual activities.The completed activity plan is discussed with the Recreation Assistant and Nursing Supervisor onthe unit and plans are made for its implementation. It is then filed in that nursing care resident’schart under the care plan section.Each resident has the right to refuse participation in an activity. If a resident refuses to participate,the Recreation Assistant shall document the refusal, the attempts made to encourage the resident,and the alternate means employed to keep the resident active physically, mentally and socially.ISVH-Boise will have a written program designed to meet the findings of the comprehensiveassessment, individual interest, and the physical, mental and psycho-social well-being of eachresident. Each resident’s program will be driven by a comprehensive assessment, which takes intoconsideration: individual interests, physical condition, mental and psychosocial well-being.In compliance with the MDS guidelines, upon admit, each resident will be observed for anassessment period determined by the MDS Coordinator prior to the completion of the activityportion of the MDS (section F 0300- F0800). The MDS and CAA’s will be completed by the duedate assigned by the MDS Coordinator. An activity care plan will be developed by day 21. (F279)An initial activities interest interview and assessment will be completed prior to the completion ofMDS Section F0300-F0800.The Activity Coordinator is responsible to see that the initial activity interview and assessment arecompleted, the MDS is completed, and the care plan is developed, within the prescribed periodsof time.Activities2Chapter 1

Idaho State Veterans Home – BoiseNursing Procedure ManualA resident’s attending physician shall approve and sign the resident’s care plan which includes theactivity care plan indicating it is not in conflict with his overall plan of care. An activities progressnote will be completed in conjunction with the 30-day resident review.Each resident’s care plan may be reviewed at least quarterly, upon a change of condition, andannually. Summaries may be written with no less than a quarterly summary, change of conditionsummary, and annual MDS. The Activity Coordinator is responsible to see that summaries arecompleted.Monthly activity participation records shall be kept allowing an accurate recapture of the month’sparticipation, when writing a summary. The Recreation Assistant shall keep the monthly activityparticipation record current. Each record shall be completed by the 10th of the next month andsent to the Activity Coordinator for review. The sheets will then be filed by unit in the ActivityCoordinator’s office. Participation records will be kept for a calendar year.Scheduling of ActivitiesMonthly Activity Calendars shall be developed under the direction of the Activity Coordinator.The calendar shall reflect planned group activities, be posted, and be large enough for the visionimpaired.The Activity Staff meets monthly and plans the activities for the monthly calendars. TheRecreation Assistants design special activities for each level of participation, both group andindividual. These schedules are developed prior to the last week of the month for the followingmonth’s calendar. In addition to the major activity calendar, an individual unit calendar is preparedand maintained on the individual units. The calendar boards on each floor are prepared byVolunteer Services and are posted a week in advance in order to allow for the posting of changes.Activity Types:Spectator group activity, such as attending an athletic contest or a movie, where members of thegroup are passively involved, not actively participating.Performing group activity, such as dancing or singing, where people are performing for them orfor others.Independent – Interdependent group activity, such as making decorations for a special eventprogram, where the total project is dependent on each group participant making the same item orperforming the same task as all other members of the group.Interdependent group activity, such as creating a scrapbook where the completion and success ofthe project is dependent on each participant completing a separate and distinct part of the totalproject.Activities3Chapter 1

Idaho State Veterans Home – BoiseNursing Procedure ManualProcedures for Group ActivitiesScheduling of rooms, equipment, etc., is done in advance. Decisions are made during the activitystaff meetings as to which staff member will act as coordinator and be present at each activity.That individual is also responsible for completion of the activity sheet. At times, it may not benecessary for the Activity Coordinator to stay for the entire activity, i.e., evening guestentertainment. Volunteers can be utilized to monitor the activity with the more independentresidents.BirthdaysIt is our goal to recognize and honor each resident’s birthday and make that day a special occasion.Recognition of a resident’s birthday may include, but is not limited to:1.2.3.4.A birthday greeting on the resident’s doorA balloon bouquetIndividual birthday cakeSinging “Happy Birthday” in the dining room or group settingFamilies and organizations are encouraged to participate in the celebration of resident birthdaysthrough gatherings and special activities.The Recreation Assistants shall be responsible for coordinating birthday recognition details.Lists of upcoming birthdays are given to the American Legion Auxiliary (ALA), who preparebirthday cards, and provide Canteen Coupons for every resident on their birthday. A list is alsogiven to the Volunteer Coordinator who purchases the cakes with funds provided by the LadiesAuxiliary to the Fleet Reserve Association. These cakes will be purchased the morning of thebirthday for birthdays during the regular work week and on Friday for those birthdays occurringon the weekend. All cakes will be placed in the Activity Kitchen, and the Recreation Assistantwill make arrangements to see that the cake is delivered to the resident in a timely manner.The birthday list is finalized and mailed to the ALA representative with the Activity Calendareach month. It is maintained on the Activity/Volunteer Services Administrative Assistant’scomputer.Birthday cards for residents are received from a variety of sources. All are given to theRecreation Assistants for delivery to veterans.1. Cards are received from the ALA.2. Cards are received for those participating in the Adopt-A-Vet Program.3. Cards are received from the White House for those veterans over 80 years of age (See"White House Greetings") and are prepared by the ALA volunteer.Activities4Chapter 1

Idaho State Veterans Home – BoiseNursing Procedure Manual4. If cards are received for a resident who has been discharged, consult with VolunteerCoordinator for proper processing.Birthday parties are organized and directed by Recreation Assistants or other nursing staff.Individual ActivitiesOne-to-one activities are scheduled as frequently as possible according to the individual’sactivity plan. Each resident should have special individual activities at least once a month. TheRecreation Assistant should schedule these activities between scheduled group activities. Theseactivities may include volunteers visiting with veterans on a one-to-one basis. Examples ofindividual activities include, but are not limited to:1. Visit about current events2. Reminisce about the past3. Visit about family4. Give edible treat5. Bring in Homemade Goodie6. Take outside on porch7. Take outside for a walk8. Help resident write correspondence9. Read letter or card to resident10. Validation – listen to resident’s concerns and feelings11. Help resident select television or radio station12. Hand or back rub13. Family in to visit14. Fun and Games (ball toss, blow bubbles, puzzles, trivia, etc.)15. MoviePurchasing/BudgetRequests for purchases will be made to the Activity Coordinator for approval. They will then goto the Volunteer Coordinator for approval through IVAL’s activity fund.Progress NotesMonthly charting, i.e., summaries, quarterlies, annuals, etc., is to be completed on each residenton a rotating basis. Plans are reviewed and, if necessary, a request for modification is referred tothe Activity Coordinator so that a new plan may be developed. A record of each resident’sparticipation, as well as reasons for their nonparticipation, is documented and their recreationaltherapy goals addressed.Revised 02/07, 10/10, 01/14, 10/15Activities5Chapter 1

Idaho State Veterans Home – BoiseNursing Procedure ManualOuting ProtocolIt is our goal to ensure the safety of our residents and assure a pleasurable experience.The Activity Coordinator is responsible to see that all details are coordinated, and that staff andvolunteers are adequately trained prior to the event.ISVH-B Activity outings are alcohol free. Exceptions may only be made by coordination betweenAC, RNM, MSW and resident's MD.BEFORE:1. Identify outing to be conducted2. Identify residents to participate; invite family members as appropriatea. identify residents wishing to attendb. Review limitations with nursing, dietary, and social services, as needed (i.e.coordinating manual w/c for residents who use an EMD. EMD's are not taken onfacility sponsored outings.3. Arrange transportation through the maintenance departmenta. assure that all volunteers/staff are in serviced in safety techniques4. Coordinate escorts, including staff and volunteers5. Identify and gather needed equipment and resources, i.e.:a. Cellular phoneb. sunscreenc. Personal care items (clothing change, gloves, wipes, etc.)d. Fluids/snacks (cups, napkins, etc.)e. Oxygen, disposablesDURING:1. Assure personal care and safety by:a. Maintaining consistent monitoring of resident whereabouts at all times1. buddy system2. resident and escort roll callb. Provide regular hydration and snacksc. Assure resident comfort according to climate, i.e.: sunscreen, shade, hats, laprobes, jackets, etc.d. Provide toileting, re-positioning, and personal cares, as needede. Ensure that medications are dispensed appropriately and as prescribed byqualified personnel on day long outings, i.e., Twin Falls Fishing Trip.2. Prior to departure from activity, all residents shall be accounted for and personal needsshall be addressed.3. Residents shall be transported back to the Veterans HomeActivities6Chapter 1