The Effect of Nature and Game Based Activities on Older People

The purpose of this study is determine the effect of nature and game based activities on happiness, spiritual well-being, frailty and cognitive status of older people in nursing home.

Hypotheses of the Research H0: Nature and game-based activities don't affect the happiness, spiritual well-being, cognitive function and frailty of older people in nursing home.

H1a: Happiness levels of older people in nursing home will be an increase after nature and game-based activities.

H1b: Spiritual well-being levels of older people in nursing home will be an increase after nature and game-based activities.

H1c: Cognitive function levels of older people in nursing home will be an increase after nature and game-based activities.

H1d: Frailty status of older people in nursing home will be a decrease after nature and game-based activities.

The number and proportion of older people is increasing in the world and in Turkey. The number of older people is attracting more attention with the increase in older people health and rates. Ageing leads to an increase in chronic diseases and a decrease in physical functions, activities of daily living, independence, quality of life and general well-being. Older people transition from their living environment to institutions that provide long-term care such as nursing homes or retirement homes due to problems due to aging. The levels of happiness, spiritual well-being and cognitive function may decrease and the level of frailty may increase in older people staying in nursing homes. Various intervention methods are developed due to the increase in health care needs due to health problems occurring in older people in nursing homes. Nature and game based activities are non-pharmacological and low-risk intervention method that has the potential to increase physical, cognitive and psychological health levels and includes many activities. Gardening activities, which are an effective, individual oriented and nature based intervention method that focuses on improving the physical, cognitive, spiritual and emotional health aspects of older people in nursing homes. Gardening activity is supporting active and healthy ageing, provide a difference and innovation to the health services provided to older people receiving long term care. Gardening activity is an effective leisure activity and one of the easiest ways to provide easy access to green spaces. Older people who participate in gardening activities experience simple activities such as touching plants, smelling plants, tasting edible ones and many complex activities such as collecting seeds, sowing, planting, growing plants, cooking with harvested plants. Older people are positively influenced by emotional stimuli such as colours, smells, tastes, sights, sounds and grow products that can be very valuable for them in gardening activities. Experiences in nature is an opportunity to create spiritual meaning for the older people and contribute to the increase in the spiritual well-being levels of the older people. Gardening include different activities according to the functional ability levels of the participants such as manual dexterity and physical strength. Accordingly, gardening activities have the potential to improve the vulnerability of older people staying in nursing homes. Indoor gardening board game which is nature and game based activity are organised for older people who are limited in their daily life activities but can use their physical and cognitive functions. Individual characteristics, environment and weather conditions can affect the applicability of activities in open areas. Therefore, board games are independent of weather conditions and highly suitable activity to prevent cognitive impairments. Older people can easily access plant materials and actively interact with each other during board games. Thus memory, cognitive ability, motivation, speaking skills and social aspects are positively affected. In this context, nature and game based activities which are an effective and individual oriented intervention method contribute to the improvement of physical, cognitive, spiritual, emotional health aspects and support active and healthy ageing of older people in nursing homes. In addition, these activities provide diversity and innovation in health services provided to individuals receiving long-term care.

Eligibility Criteria:
Inclusion Criteria:

* Older people who have been in a nursing home for at least 6 months,
* Older people aged 65 years and over,
* Older people with a Mini Mental State score of 24 and above,
* Older people who are open to communication and co-operation will be included in the study.

Exclusion Criteria:

* Older people with physical problems that may prevent them from participating in nature and game based activities (such as stroke, Parkinson\&#39;s),
* Older people with visual and hearing loss that may pose an obstacle to nature and game based activities,
* Older people with mental problems (such as dementia) that would prevent participation in nature and game based activities were excluded from the study.