Author: Deborah B. Hummer, DNP, RN, MSN, GCNS-BC
National Hartford Center of Gerontological Nursing Excellence (NHCGNE)
Distinguished Educator in Gerontological Nursing
Assistant Professor, Nursing
McKenzie-Elliott School of Nursing
University of North Carolina at Pembroke
One University Drive
Pembroke, NC 28372
Purpose: The purpose of this quality improvement project aimed at replicating the implementation of a sit-to-stand exercise program in a small 20-bed Assisted Living (AL) facility in rural North Carolina.
Significance: As the geriatric population continues to increase, AL will continue to be a viable option for aging adults in the United States with an expected growth at a rate of 5.3% in the next six years (Grand View Research, 2021). One of the main reasons for placement in AL is functional decline and the subsequent need for assistance with activities of daily living (ADLs) (AHCA & NCAL, 2020). Healthy People 2030 reports that in 2018, only 41.3% of adults 65 years of age and older that suffer from reduced physical or cognitive function engaged in any type of physical activity. Research has demonstrated a strong positive correlation between elder individuals’ physical functioning and their ability to perform ADLs (Candela, Zucchetti, Ortega, Rabaglietti, & Magistro, 2015; Hall & McAuley, 2011).
Outcomes: The primary outcome was for the residents to maintain or improve function in performance of their ADLs. Even with the challenges of COVID-19, the AL staff and residents found a way to continue the exercise program with a high level of participation and thus prevent avoidable decline in residents’ independence with ADLs.
Implications: The findings of this quality improvement project indicate that nursing staff can break the cycle of dependence in AL residents with a twice daily sit-to-stand exercise so that it becomes part of the residents’ daily routine.
American Health Care Association (AHCA) and National Center for Assisted Living (NCAL), (2020) Facts and Figures Retrieved from: https://www.ahcancal.org/Assisted-Living/Facts-and-Figures/Pages/default.aspx
Candela, F., Zucchetti, G., Ortega, E., Rabaglietti, E., & Magistro, D. (2015). Preventing Loss of Basic Activities of Daily Living and Instrumental Activities of Daily Living in Elderly: Identification of Individual Risk Factors in a Holistic Perspective. Holistic Nursing Practice, 29(5), 313–322. https://doi.org/10.1097/HNP.0000000000000106
Grand View Research (2021) U.S. Assisted Living Facility Market Size, Share & Trends Analysis Report, And Segment Forecasts, 2021 – 2027 Retrieved from: https://www.grandviewresearch.com/industry-analysis/us-assisted-living-facility-market
Hall, K. S., & McAuley, E. (2011). Examining indirect associations between physical activity, function, and disability in independent- and assisted-living residents. Journal of physical activity & health, 8(5), 716–723. https://doi.org/10.1123/jpah.8.5.716
Healthy People 2030 Retrieved from: https://health.gov/healthypeople/objectives-and-data/browse-objectives/older-adults/increase-proportion-older-adults-physical-or-cognitive-health-problems-who-get-physical-activity-oa-01