Case Management, Guardianship Support, Life Care Plan, Medical Consultation

Exploring Therapeutic Recreation: Part One

 July 14, 2016

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

Recreation is defined as any activity done for enjoyment while not working.  The activities we chose for our own pleasure or amusement are essential to our wellbeing, and that speaks to us all.  Therapeutic recreation, on the other hand, addresses a specific percentage of the population. Otherwise known as recreational therapy, the occupation tends to the physical and psychological recovery of sick, injured or disabled individuals. When referred to as mere ‘rehab’, images of a sterile ‘doctor’s office’ environment and repetitive exercises with gym equipment might be what come to mind. Well, we simply cannot wait to provide a mere glimpse of the sports and activities that have been adapted for therapeutic purposes. After all, fun remains the heavy weight champion of motivators. There is no reason to lose sight of this important fact just because our purpose is so very serious. Our clients inspire us by defying the very notion of limits on a daily basis. So stand by as we attempt the impossible and make a concerted effort to squeeze the grand scope of therapeutic recreation into this tiny space.

The Great Outdoors

Summer:  Exit that sterile indoors environment immediately. Cease all repetitive exercise. Drop that gym gear. We are taking this outdoors. Just because you have special needs does not mean you require a special facility removed from all of the adventure awaiting you on God’s green earth. Are you ready for the list of sports awaiting you this summer?

  • Rock climbing
  • Canoeing/kayaking/rafting
  • Hiking
  • Horseback riding
  • Off-roading!

Did we omit anything? If we did, it was only due to limit of space. The point is this. In martial arts, in order to teach you to break a wooden board, a sensei will instruct you to aim through the board, not at it. Our philosophy is similar. If our aim is to get you back on your feet, you can bet we will have you on a horse, in a boat or riding an all-terrain vehicle. You can look forward to piloting some of the latest models in cross-country bikes, downhill bikes and road bikes. Just like any other facet of recreational therapy, the vehicles work best when adapted to you and your specific needs.

Winter: Summer is in your rearview. The leaves have settled all around you. It’s getting a bit chilly. Do you head indoors? I didn’t think so. The programs we have researched are run all year round. Even with snow on the ground, instructors are waiting in their winter coats with a season’s worth of challenges for you. Sure, there is snowboarding. There is even still some climbing to do. Though, I think we both know what sport rules the slopes. ‘Skiing’ would be the one and only correct answer!

The irony has not escaped us that many of us think of injuries when we think of past skiing adventures so we thought it best if we highlighted the various modes of safe and reliable “transportation” awaiting you on the slopes:

  • The monoski involves you sitting on a single ski. Upper body strength is a must. Hey, we said safe, not sane. This is an aggressive sport that requires a high level of concentration.
  • The biski offers one more ski than the monoski, obviously. With that comes a bit more stability but the same access to the course.
  • A skibike adds one more feature in the form of handlebars. Maximum stability comes with maximum steering.

The Great Indoors

It is not lost on us that all of the above activities outdoors. That is the simplest contrast between the aforementioned recreation and the next aspect of this form of therapy. Painting a picture of a disabled man or woman mastering a sport that the majority of the population doesn’t even attempt is certainly heroic. What about the elderly? What about those with degenerative mental conditions such as dementia? For the most part, the catalyst for the adversity that disabled athletes face is behind them. Recreational therapy can also be an intervention targeted at elders with dementia and related symptoms such as agitation.

Anyone who has worked intimately with elders suffering from dementia might let you in on an interesting conundrum. Some elders may be complacent, causing you to forget they are there. Some may seize your attention and refuse to let go. Neither of these situations are optimal. The temptation may be there to leave well enough alone or simply distract but as a recreation care partner, it is your responsibility engage all of them in meaningful activities. We have come a long way from the facilities of yesteryear where senior citizens in wheelchairs would simply be lined up along a wall or in front of the television between meals. Ideally, we should even be well beyond simply corralling or herding our seniors in order to provide a break for the other care partners. If anything, the key word missing from therapeutic recreation and recreational therapy is activity.

A well-trained and effective Recreation Care Partner does not look at the elders in his or her care and see limitations any more than the minds behind the amazing athletic gear designed for disabled athletes. Their potential can be drawn out in much the same way, with the appropriate activities. These probably cost a whole lot less than the sporting equipment. Nursery rhymes, proverbs and cliches do not leave one’s memory quite as willingly as other information. Call and response activities where the care partner begins a phrase and allows the participants to finish them are highly effective and enable elders with dementia to prove something important to themselves. Their minds still function. They may function differently but they function nonetheless.

The care partner simply must continue to go after other dimension of the mind that may not be as inhibited.  Music is probably the greatest example we could suggest. Lyrics and melodies clearly come from someplace other than the cognitive or recognitive areas affected by dementia. Sing-a-longs may seem like distraction or entertainment but they are not. They clearly stimulate areas of the brain that are still quite functional. Even musicianship does not go quietly into the night. You may learn that one of your elders used to love to play the piano. It turns out the facility has a piano. Let her sit at that piano and then marvel as her fingers dance to life on that keyboard.

Achieving a positive outcome is all the reward we need. For you, the reward is in the process. Finding the process that brings you maximum enjoyment is part of the premium care management we take pride in providing.  Here in Part One of Therapeutic Recreation, we hope to have dramatically opened up our world to you and that you’ve jumped in with both feet. In Part Two, we are going to laser focus on two more groups that we have been privileged to advocate for: military veterans and Special Olympians.

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