THERAPEUTIC RECREATION INTERVENTIONS CREATED By Crystal Chapman CTRS EDTC560 Erin Warham June 28,2004

Introduction: Therapeutic Recreation “A profession of specialist who utilize activities as a form of treatments for persons who are physically, mentally or emotionally disabled.” “Recreation therapy utilizes various activities as a form of active treatment to promote the independent physical, cognitive, emotional an d social functioning enhancing current skills and facilitation the establishment of new skills for daily living and community functioning. “ Quotes taken from Http:// www/atra-tr/org/benefitsintergral.htm. Ameraican Therapeutic Recreation Association Web site utilized for vast amounts of recreational therapy links.

Delivery Services Therapeutic Recreation services are delivered in a variety of settings including: Rehabilitation Hospitals, Nursing Homes Sub acute Care Substance Abuse Facilities Prisons Residential Homes for persons with disabilities

Commonly Used Interventions Reality Orientation Validation Sensory Stimulation Exercise Programs Social Programs Pet Therapy Five domains of Therapeutic Recreation

Reality Orientation Should only be used with the appropriate audience Appropriate audience is determined by the comprehensive assessment of function level Who? What? Where ? When? Why?

Reality Orientation Application Small Groups One to One Emphasize Self-Awareness Clarity the Day, Date, and year Elaborate on Weather, Seasonal information Encourage Family involvement Educate the Family

Need for reality orientation Cognitive Loss Permanent or Temporary Memory Loss Deterioration due to Dementia Diagnosis of Alzheimer’s Disease “Sun Downing” Brain Injuries General Orientation to New Surroundings Persistent Vegetative State

Reality Orientation Task Breakdown. Segmentation Task Coordination How many steps? What are the Necessary Skills needed Cognitive, Social etc.) Task Coordination Amount of Control, Skills needed, multiple tasks Complexity of Tasks Simple, Moderate or High

RO Sample: Hugging a Grandchild Step 1: What does the resident need to know? Step 2: What muscles/movements must be coordinated? Step 3: What social skills are involved? Step 4: What are the emotional responses involved?

Reality Orientation Reality orientation boards are commonly utilized in many facilities. They include Day of Week Month Date Year Name of Facility Season Weather Scheduled Activities Upcoming Holidays

Validation Validation is NOT Reality Orientation The Resident Directs the Interactions Staff does not Attempt to Redirect Resident “Goes with the Flow” of the Resident Must be taught to the staff for consistency

Validation Implementation Ask Questions” The 5 W’s Who, What , Where, Why, and When Re-phrase Utilize Long Term Memory, Reminisce Make or avoid eye contact Mirror Movements

Sensory Stimulation Gustatory (Taste) Tactile (Touch) Olfactory (Smell) Auditory (Hearing) Visual (Sight)

Sensory Stimulation: Application Sign Language Communication boards Taste Recognition Music, Sound recall Object Recognition Center on One Sense Focus on a Topic such as a Holiday Utilize All senses Cooking Groups Reminiscing Activities Aromatherapy

Exercise Programs Balance Program Restraint Free Program “Walk to Dine” Walk and Wheel Club Falling Leaves program Exercise Bands, Batons, Streamers Modified Dance Gardening Utilize Rehab Equipment

Social Programs Social Dining Candlelight diners Lunch Bunch Hydration Carts Theme Meals Cinco de May Pizza parties Birthday Parties New Year’s Eve

Things to Remember Offer Substitutes Always have a plan B Physicians order for Alcohol Communicating to Volunteers Codes Wrist Bands Colored Dotes Meal Cards Lists

Pet assisted therapy Animal Assisted Therapy The Eden Alternative

Pet Assisted Therapy Animal Facilitated Programs Benefits Increased Willingness to participate Provides Comfort Enhances Home-like environment Positive effects on staff Ability to receive desired response (Promotes self-esteem) Challenges Locating pets with good temperament Finding pets tolerant of wheelchairs, confused residents and unpredictable behavior Ability of pets to stay focused Liability Infection Control

Pet Assisted Therapy: Establishing a Program Written Autorotation for Administration Prepare Written Program Description Contact Local Agencies to recruit trained Participants Establish Evaluation Educate Staff

The Eden Alternative Views Long term care facilities as “Habitats for human beings rather than institutions for the elderly.” Seeks to Eliminate Loneliness Helplessness Boredom

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