Design of living environments for nursing-home residents: increasing participation in recreation activities.
Items alone don’t create fun—staff prompts triple nursing-home lounge use.
01Research in Context
What this study did
The team worked with nursing-home residents in a lounge area. They set out puzzles, blocks, and other hands-on items.
Staff gave gentle verbal prompts like "Come try this puzzle." They measured how many residents joined the activities.
The study used an ABAB design. They added prompts, took them away, then brought them back to see the effect.
What they found
Without prompts, only about one in five residents touched the items. With prompts, three out of four joined in.
When prompts stopped, participation dropped again. Prompts were the key, not just having the items there.
How this fits with other research
Nakamura et al. (1986) later showed older adults can also learn phone chat skills with the same prompting idea.
Mazur et al. (1992) proved group-home staff need ongoing coaching to keep prompting residents. The 1975 finding still holds.
Shih et al. (2010) used a Wii board instead of puzzles, but the ABAB pattern looked the same.
Why it matters
You can fill a room with games, but people won’t play until someone invites them. A quick "Come sit here" or "Try this piece" is the switch that turns on engagement. Use ABAB data to show admin why staff prompting must stay in the job description.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Place two puzzles on a lounge table and prompt every resident who walks by.
02At a glance
03Original abstract
Nursing-home residents have frequently been characterized as unoccupied and disengaged. At the outset of the present study, most residents were to be found in their own rooms, not exhibiting gross motor behavior or social interaction, and not participating in appropriate activities. To modify residents' levels of participation with the environment, a manipulative area was provided in the lounge. Participation in the lounge averaged 20% on days when the activity was not available, but increased to a mean of 74% on days when equipment and materials were given and residents were prompted to participate. When prompts were withdrawn and materials were available only by request, mean participation fell to 25%. The findings demonstrate that manipulative activities can support a high level of participation with the environment, if residents are prompted to use equipment and materials.
Journal of applied behavior analysis, 1975 · doi:10.1901/jaba.1975.8-261