Institutional damage

In this case, by institutional damage, I mean that the person becomes so used to life in the nursing home after a period of care that they have difficulty coping with anything else and are afraid to leave the protected environment.

Something happens to us when all days are the same and others plan the time. When the food is served, the choice of clothes is made by someone else and the day mostly becomes a longing for the evening when you can go to bed and sleep. It affects well-being. Pay attention to whether any of the residents show signs of institutional damage. In this way, it is possible to prevent unnecessary suffering.

Many people who move into nursing homes stop planning their time. The person who is hospitalized has received so much support that he cannot manage on his own as personal responsibility is required. As others rule over time, the person becomes paralyzed or anxious before necessary choices. The effect is something that is well known from psychiatric long-term care, but will be the same in other care institutions where the staff control the planning.

Symptoms of understimulation can be similar to those of burnout. Likewise, it can make the person down, depressed or perceived as zombie-like, sitting and rocking or sleeping all day. Unfortunately, there is little written about institutional injuries.
It's easy to get into a situation where the time horizon is the next meal or going to bed. No longer knowing what day it is can contribute to confusion and to the person being perceived as demented even though it is depression. Inadequate dementia investigation can result in people being wrongly placed in dementia care.

When a person stops participating in the planning of their own life, several negative consequences can occur that affect their physical and mental well-being as well as their quality of life.

Here are some of the potential effects:

Loss of control: One of the most tangible consequences is that the person may feel a loss of control over their own life. They may feel that their wants and needs are no longer taken seriously, which can lead to frustration and a sense of helplessness.

Decreased self-esteem and self-confidence: When a person is no longer involved in the planning and decisions about their own life, it can negatively affect their self-esteem and self-confidence. They may begin to doubt their own ability and worth.

Increased stress and anxiety: The feeling of not being in control of one's life and its decisions can lead to increased stress and anxiety. The person's anxiety about the future and what will happen can become overwhelming.

Passivity and apathy: When a person is no longer involved in the planning of their life, they can become passive and apathetic. They may stop participating in activities and lose interest in things that once brought them joy and meaning.

Loss of meaning: A sense of meaning and purpose in life is important for well-being. When a person is no longer involved in the planning of their life, they may feel that their life has no meaning and that they are only following the decisions of others.

Physical and cognitive decline: Lack of participation and stimulation can negatively affect both physical and cognitive health. People may become less active and experience a decline in their mental abilities.

Social Isolation: When a person is no longer involved in planning their activities and social interactions, they may be at risk of becoming socially isolated. This can lead to loneliness and depression.

To promote a person's well-being, it is important to encourage and support their participation in decisions affecting their own lives. This means listening to their wishes and needs, including them in the planning process and respecting their autonomy. Providing opportunities for choice and control can help restore a sense of meaning and well-being to the individual who has ceased to participate in the planning of his or her own life.

Risks of only following the institution's routines

1. Lack of participation: When older people are no longer involved in the planning of their everyday lives, they can feel passive and lack a sense of control over their lives. This can lead to a sense of meaninglessness and loss of independence.
2. Reduced stimulation: If the elderly only follow the routines of the institution, they may miss the opportunity to participate in activities that interest them and provide mental and emotional stimulation. This can negatively affect their cognitive and emotional well-being.
3. Loss of identity: Stopping planning your everyday life can also lead to a loss of individual identity and self-expression. The elderly may feel that they are reduced to their care needs and lose their personal integrity.
4. Risk of isolation: If the elderly do not actively plan their days and participate in social activities, they can end up in an isolated situation. Social isolation can have serious negative effects on health and well-being.

The importance of continuing to plan your everyday life:

1. Maintained independence: By being involved in planning their everyday lives, older people can continue to experience a sense of independence and control over their lives. This promotes a sense of dignity and autonomy.
2. Mental and emotional stimulation: Planning activities that interest the elderly and challenge their mental and emotional abilities is critical to preserving cognitive health and well-being.
3. Social interaction: By actively participating in the planning of activities and routines, the elderly can also promote social interaction and build relationships with other residents and staff.
4. Identity preserved: Planning their everyday life based on personal interests and preferences helps the elderly to preserve their individual identity and self-expression.
5. Improved quality of life: An active and engaged everyday life can lead to an improved quality of life for the elderly. They may feel that they still have a lot to look forward to and experience in life.

It is important that older people in nursing homes are encouraged and supported in continuing to plan their everyday lives and be involved in the decision-making process about their daily routines. This promotes their well-being.

Reflection questions - institutional damage
Care staff:
-Is there accommodation that shows signs of understimulation.
- How do you work to get them involved in the activities at the nursing home?

Manager, nurse, occupational therapist and physiotherapist
- Do you see residents showing signs of understimulation?
- Are there measures you can take based on your profession to reduce the risk of institutional damage?
- What can you do as a team to prevent residents from receiving institutional damage?

Resident and next of kin:
- Do you see signs that residents of the nursing home are starting to suffer institutional damage of the type described above?
- What can you do yourself to keep the initiative over planning your everyday life?

Erland Olsson
Head nurse
Sofrosyne
Better care - every day