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

2. 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 www/atra-tr/org/benefitsintergral.htm. Ameraican Therapeutic Recreation Association Web site utilized for vast amounts of recreational therapy links.

3. 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

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

5. 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?

6. 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

7. 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

8. 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

9. 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?

10. 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

11. 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

12. 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

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

14. 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

15. 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

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

17. 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

18. Pet assisted therapy
Animal Assisted Therapy
The Eden Alternative

19. 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

20. 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

21. 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

22. THE END