Remotivation was first used in psychiatric hospitals and schools for the developmentally disabled. As long-term patients were de-institutionalized, many were moved to nursing homes, board and care homes (assisted living), and adult daycare. Remotivation accompanied some of these patients to the new locations. Currently, people needing long term care live in a variety of residential facilities. Remotivation has been practiced in most of these locations with great success.
Culture Trends
Remotivation was developed to offset the medical culture of institutions, which are very task oriented and un-homelike They are designed to focused on "fixing" or "curing" the patient. This design unintentionally neglects or causes of the loss of normal healthy function not caused by disease. So remotivation was the original "culture change" movement beginning in the 1940s designed to change the culture of the hospitals to be more wholistic There are many people who cannot be "fixed" or "cured". So when chronic disease is the focus of care, the whole person must be cared for and nurtured. A balance must be made between attending to the disease and to maintaining the healthy well person that has not been altered by the diseases. Unintentional neglect of the "unwounded" aspects of the person led to unnecessary deterioration in functioning. Remotivation was designed to change the culture to prevent the loss of normal health abilities and restore a person who has lost these abilities due to causes other than disease or secondary to the disease. Remotivation teaches a care provider to focus on the "unwounded" healthy aspects of the person. The techniques learned nurture and develop the qualities of the person not damaged by disease.
When a person has lost normal function not damaged by disease, remotivation is needed to engage that person and facilitate normal mental and physical activities of daily living. The is rehabilitation or habilitation of the person's lost normal functioning. It is not the treatment of disease.
Example #1
Activities services are a required component of skilled nursing home care. Many nursing homes have had their activity director and activity assistants certified as remotivation therapists. A minimum of 15 minutes of activities is required for each individual resident in a nursing home (federal regulations). Individual remotivation sessions are provided to residents who are too ill or disabled to attend group sessions. Some facilities have sub-acute units with clients who are on ventilators or intervenes feeding/therapy tubes. Remotivation is applied in these situations very successfully as a means of providing meaningful socialization and activity.
Example #2
Most new residents of nursing homes have a long period of adjustment. They have experienced the loss of health that required that they be admitted into a nursing facility. This is a difficult period of stress and grief for many residents. Remotivation has been used in many creative ways to help these persons cope and adjust to their new life in the nursing home. When clients are discharged from a psychiatric hospital with an existing remotivation program to a nursing home with a remotivation program, then the remotivation group in the new nursing home serves as a familiar support group in which residents can make new friends and express themselves. This same kind of set up could be started in a general hospital to help reduce relocation trauma when elders must be admitted to general hospitals for treatment from nursing homes. Social workers, activity staff or volunteers who are certified as remotivation therapists can lead these groups.
Example #3
After a nursing home resident has lived in a new setting for some time, they can become very lonely and depressed. They may refuse to attend regular activities. Sometimes they even become mute and refuse to talk. This is when remotivation really SHINES! Conducting individual remotivation sessions with these residents gets them motivated again about life. They will almost always start talking again and eventually attend group remotivation sessions where they make new friends.
Example #4
Many facilities institute remotivation groups as a form of primary prevention and socialization in the facility. Institutional settings are not natural social environments. There is high resident turnover due to death and hospitalization and high staff turnover due to low wages and introductory jobs. With all this turnover of residents and staff, the resident can experience much social loss and uncertainty. Regularly held remotivation groups of 6 to 8 resident serves to provide a somewhat stable social support group (family group) for all residents of the facility. Even when residents leave the group and staff leadership changes, the familiar format and remaining residents provide valuable and necessary psychosocial support.
Example #5
Remotivation groups have been used as a patient education/support group for residents in many treatment and community settings. Residents in need of education/information on the nature of their disease or disability or on self care and the care they will receive from nursing staff, will find remotivation groups an effective and enjoyable way to learn. Activities, social work or restorative nursing staff certified in remotivation can lead these groups. Skilled nursing facilities must provide rehabilitation and restorative nursing services to clients to prevent functional decline that is not due to aging or disease. A resident’s decline cannot be due to lack of activity, depression or hopelessness. Remotivation is an ideal individual and group form of restorative nursing.
Example #6
Retirement villages or other forms of comprehensive care house residents that are very healthy and those who are very unhealthy and low functioning. Unlike other activities that do not adjust to the functional ability of the resident, remotivation is designed to adjust to the needs of residents of different functional levels. Alzheimer and other neurological disorders are very common in nursing homes. Extensive research has shown that remotivation is a very effective method of prevention and rehabilitation for persons with neurological disorders. The leader forms groups of patients with similar functional ability and thus the programming fits the needs of group members.
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