Meaningful connections, also referred to as meaningful activities and meaningful engagement, are defined as:
“Interpersonal interactions, whether one-off or repeated, that foster feelings of being seen or heard, empathy, or enhanced social belonging; and/or lead to indicators such as reduced loneliness, increased engagement, or improvements in psychosocial outcomes” (Surgeon General’s Advisory, 2023).
Meaningful connections are created when daily interactions and activities are suited to a person’s preferences and needs, and engagement with residents living in care settings is positive.
Twenty-five care home leaders across Northern Ireland came together over four sessions between February – May 2025 as part of the My Home Life (NI) Leadership Support Programme (My Home Life – My Home Life). The aim of this was to co-produce a practical and meaningful resource designed to enhance meaningful connection for everyone who lives in, works at, or visits care home settings. The result was a Roadmap for ‘Enhancing Meaningful Connection,’ a co-created, visually engaging tool grounded in the real experiences of those living and working in care.
In the initial two sessions, leaders in collaboration with residents, relatives, and staff, co-created a visual Roadmap that would enhance meaningful connection in care home settings.
The Roadmap was designed to guide care teams and individuals to intentionally embed meaningful connection into daily practice by recognising:
- Opportunities that create meaningful connection (e.g. personal care, celebrating resident individuality, reminiscence, music and arts, conversation, etc).
- Appreciating why this matters to the person (e.g. feeling a sense of belonging, significance or achievement, or knowing someone is fully present and engaged while in their company, etc).
- Understanding the impact that meaningful connection can have on the person and the culture of the care home setting (reduced loneliness, improved relationships between relatives’, staff and residents, enhanced engagement in social activities, etc).
- Where can evidence of impact be collected (e.g. compliments and feedback, governance data, external reports, etc).
A description of the Roadmap can be found at the My Home Life (NI) website:
https://www.myhomelifeni.co.uk/quality-improvement/enhancing-meaningful-connection
Between April 2025 – August 2025 leaders implemented the Roadmap into their respective care home settings. The following is a synthesised analysis of four leaders’ experiences. The settings included, two nursing homes, one dementia care unit, and one learning disability setting. The total population of residents involved was approximately 140.
The implementation of the Roadmap differed by leaders’ interpretation of the needs of the care setting, reflecting its ability to be used in parts, or as an overall Roadmap. (See table 1).
Table 1: Summary of ‘Enhancing Meaningful Connection’ Roadmap in various care settings
| Nursing Home Setting
The focus of the Roadmap was to support staff to build relationships with residents and celebrate resident individuality. The aim was to improve resident mood and wellbeing and enhance staff morale within the care home setting. |
Learning Disability setting
The visual Roadmap was used to support resident communication and engagement in activity schedules. The aim was to empower residents to have more influence on activity planning. |
| Dementia Care unit Setting
The Roadmap was a guide to create opportunities of meaningful connection, during personal care routines and mealtime experiences. The aim was to create meaningful connection in everyday interactions with residents. |
Nursing Home setting
The Roadmap would support and train staff to recognise the importance of the social and emotional wellbeing of residents, alongside their physical health. The aim was to move away from task-orientated care towards care that is relational, curious and empathetic. |
Outcomes
Improvement in the quality of care:
- Increased focus on resident’s social and emotional wellbeing, alongside their physical health.
- Preventive care improved, with positive changes in falls data in two care settings and reduced PRN usage in one care setting.
- Care routines and mealtime experience became opportunities to meaningfully connect with residents.
Residents empowered:
- The visual Roadmap enhanced inclusivity of residents, eg supporting those needing visual aids.
- Residents had more influence on activity selection.
Increased interpersonal relationships:
- Communication between the care setting and families improved.
- Improvement in residents participating in social activities.
Enhanced culture in the care home setting:
- Improvement in staff morale with reduction in agency staff uptake within one care setting attributed to less staff sickness.
- External stakeholders, such as RQIA, acknowledging the changes in meaningful connection culture in their inspection report of the care home setting.
Feedback of the impact of implementing the ‘Enhancing Meaningful Connection’ Roadmap:
- Residents “It is nice to see the young people stop in just to talk”
- Relatives “My mother seems happier lately”
- Staff “I am finding more meaningful talking points and focusing on the residents experience rather than tasks”
- RQIA report “The importance of engaging with residents was well understood by the manager and staff (…) Staff understood meaningful activity was not isolated to planned social events or games (…) Residents were looking forward to planned events (…) Staff were observed sitting with residents engaging in discussion” [April 2025]
The embedding of meaningful connection over a six-month period in care home settings created some initial challenges although developed sustained and consistent improvements in clinical and relational care. A challenge acknowledged early by leaders on The My Home Life (NI) Leadership Support and Quality Improvement Programme was the time it takes to recognise the social, emotional, physical, and systemic impact of implementing a meaningful connection culture. That needs careful reflection in the beginning. The ‘Enhancing Meaningful Connection’ Roadmap supported both improved care for residents, and a stable workforce delivering care that is consistent, safe, responsive, and well-led. With a greater focus on meaningful relational care, the culture in care home settings became less task-driven, and staff became more present and engaged.
Next Steps:
- Participants attending The My Home Life (NI) Leadership Support and Quality Improvement Programme in February 2026 will implement the Roadmap in care settings to increase the evidence-base of the practicalities of its implementation.
- Develop a digitally interactive Roadmap that could be downloaded and used by any person living in, working in, or visiting care settings.
- Develop a training package for staff in care settings.
References:
- Surgeon General’s Advisory, U.S., Our Epidemic of Loneliness and Isolation, 2023.
- Meaningful Connections Roadmap, My Home life, 2025. https://www.myhomelifeni.co.uk/quality-improvement/enhancing-meaningful-connection