An Evaluation Study of an Intervention Program to Promote the Health and Quality of Life of Residents of an Old Age Home through Proper Nutrition and Physical Exercise

An experimental intervention program to promote the health of the elderly and improve their quality of life was implemented at the Beit Bayer old age home in Jerusalem. The program, implemented as a cooperative effort between ESHEL and the home, focused on two areas: increasing physical exercise and improving nutrition and feeding. It introduced significant changes in the routine activity of the old age home, which required additional staff, equipment, and other resources. A team was assigned to implement the program, in close cooperation with the staff of the home.

The evaluation study, which was funded with the assistance of ESHEL, addressed both the implementation of the program and its outcomes. Three interim reports, which were submitted to ESHEL, reviewed the staffing and equipment inputs of the program, processes, and new activities in the program and their intermediate outputs. They provided feedback to those involved in the program, identified its strengths and weaknesses, and examined ways to improve it. This report summarizes the program’s implementation and outcomes. Among the findings:

  • In the area of physical exercise, new instructors, trained to work with the elderly, were recruited and structured work plans and specific treatment goals that are adapted to various levels of functioning were formed. In addition, a reliable tool for evaluating the functioning of the semi-independent and frail elderly was developed and put into regular use in the routine evaluation and follow-up of the residents.
  • In the departments for semi-independent and frail elderly and at the day care center, the number of PE classes and participants increased. In the department for the mentally frail and in the nursing care department, new programs were implemented, such as a program to encourage residents to walk, seated exercises, and exercise with  the aid of an assistive device for standing. More exercise equipment was purchased.
  • During the program, there was a small improvement in the functional status of the frail residents and of the visitors to the day-care centers and their number of falls declined.
  • In the area of nutrition, structured work procedures and protocols on many issues were developed, such as treating nutritional at-risk situations, feeding residents and assessing food consumption. In addition, a dietician joined the staff of the departments for the semi-independent and frail elderly.
  • Kitchen work procedures and its contacts with other departments were improved and new, suitable equipment was purchased. Steps were taken to improve the service in the dining rooms, such as purchasing aesthetically pleasing dishes, replacing trays with paper placemats and extending the time allowed for meals.
  • All of the above contributed to reducing the number of residents at nutritional risk and improving nutritional indices.

The program introduced positive changes in the home, and contributed to raising staff awareness of the importance of exercise and diet to the residents’ quality of life. Many of its components were adapted to the resources of the old age home. The program and the evaluation study have been presented to a wide audience, including managers of other old age homes, members of ESHEL’s steering committees, senior officials at the Ministries of Health and Social Affairs, and participants at conferences in Israel and abroad.  Various ways of implementing many of its components in other homes in Israel are now being examined.