Recreational therapy: finding passion – and building connection

Monday February 10, 2020

For most of us, the subject of dementia is one that exists in the periphery of our minds – until it’s diagnosed in a friend or loved one. When we finally experience its impact, there’s a natural inclination to learn as much – and as quickly – as possible. Like so many challenging topics, dementia comes with a vocabulary all its own. The climb up the learning curve is littered with concepts we may comprehend, but we don’t fully comprehend. 

Take, for example, the phrase “Recreational Therapy.” In the residential memory care world, it’s a term that’s both familiar and important. Working with the words alone, the concept isn’t difficult to grasp: recreation is any activity we do for fun, and therapy is the process we undertake to identify and leverage our strengths – while working to resolve or mitigate our deficits. 

At the most basic level, the etymology has it right. But at its best, recreational therapy in a residential memory care facility is much more than an organized pursuit of entertaining activity. It’s an ongoing process, where skilled professionals work to truly know each individual under their care – while making a concerted effort to catalog and leverage the preferences, capabilities and nuances that can mean the difference between enjoying an occasional diversion – and making the most of every moment. 

Situational recreational therapy: individualized therapy for everyday life

For those new to the concept, it’s logical to think of recreational therapy as a range of activities. But in a memory care setting, some of the most effective forms of recreational therapy are deeply individual and deceptively subtle, with impacts that improve each housemate’s everyday life – while enhancing the residential experience for everyone. 

At The Mooring, that subtle form of situational recreational therapy begins the moment we meet a prospective housemate – and continues and evolves for as long as they remain in our care. One of the primary objectives of our intake process is to develop a clear sense of a new housemate. This process begins with a face-to-face interviews with the housemate and his or her family. During these meetings, we learn as much as we can about the housemate’s cognitive strengths and deficits, while gathering details about his or her history, preferences and aversions. If possible, we also reach out to close friends to better understand social habits, important experiences. The information we gather during this stage gives us a depth of information that jump-starts our acquaintance, ultimately enabling us to normalize everyday life, and to smooth the transition to a new setting.

We also establish a line of communication with the prospective housemate’s caregivers, including medical care providers and home care support team to better understand current diagnoses – and to bolster our ability to continue, build on and modify any strategies that have proven effective following his or her diagnosis. This information allows us to embrace efforts that have proven successful, and to avoid those that have proven ineffective.

Once a housemate transitions to The Mooring, our recreational therapy team engages in ongoing monitoring to gain a nuanced understanding of how different environments and stimuli affect his or her mood, appetite, and overall quality of life. We continually update each housemate’s files with what we learn, and share that knowledge with our team of care partners, who, as universal caregivers, are then able to leverage their knowledge to bolster each housemate’s sense that they’re safe, secure and surrounded by people who care. 

While our observation process is always underway, the knowledge we gain gives us a tactical toolkit to provide moment-to-moment support. When a care partner knows that a certain housemate often struggles during evenings, social situations or mealtimes, we’re able to avoid or mitigate agitation by changing environments or employing diversionary therapies. 

By way of example, some housemates experience “sundowning,” otherwise known as late-day confusion, where those with dementia experience confusion and agitation as day transitions to evening. For some housemates, the effects of sundowning are often reduced or even eliminated by the introduction of a set of headphones, an iPod, and a playlist of favorite songs. This simple intervention often serves as a calming respite that eases anxiety and breaks sundowning’s hold – allowing the housemate to relax and return to mealtime or other more peaceful evening activities. 

While that’s just one example of situational recreation therapy, countless others take place each and every day at The Mooring – and our recreational therapists are ever vigilant for new opportunities to improve each housemate’s everyday life. As a result of that everyday effort – augmented by frequent group-oriented recreational therapy opportunities – our housemates are able to live nearly every moment in the moment despite their dementia diagnoses. From our perspective, and certainly that of our recreational therapists, life is too precious to be endured – when it’s still possible for every moment to be lived, loved and embraced.

Group recreational therapy: something for everyone

Engagement is the archenemy of dementia. That’s one of the chief reasons why life at The Mooring is brimming with activity. From one day to the next, housemates have access to a variety of options to venture out into the community, to interact with others and to experience the world around them through both new and familiar pastimes. And while nearly every entry on our calendar provides the opportunity for recreation – and the therapeutic benefits it carries – many activities are purposefully included to serve specific therapeutic ends. The fact that they’re also fun? That’s just icing on the cake. Some of those activities include: 

Horseback riding. Few activities have a more powerful impact than therapeutic horseback riding. Care partners routinely relate the transformative power of both riding on and caring for horses. These experiences go deep, stimulating cognitive responses that – temporarily – seem to almost neutralize many of dementia’s effects. 
Swimming. A regular favorite of both housemates and care partners, swim therapy stimulates responses nearly as powerful as our equestrian therapy work. When water-loving housemates take to the water, they react naturally – often showing little hesitation or confusion. The effects of our swimming sessions often begin with anticipation, and continue as recollections are enthusiastically shared over the course of the ensuing hours and days. 
Music. Studies have long evaluated the impact of music on individuals with progressive memory loss. The findings have been universally positive, and our experience with music-based recreational therapy supports those conclusions. At The Mooring, each housemate has an iPod loaded with playlists of individualized music. As we grow familiar with each housemate’s response to everyday situations, we often employ those iPods with headphones to anticipate situations that may prove stressful. In almost every instance, housemates are able to transition calmly through those periods, enabling them to resume normal activity without experiencing agitation or confusion. 

On at least a weekly basis, we also invite local musicians to perform at The Mooring, allowing housemates to enjoy both music and social interaction in a familiar, comfortable setting. We also attend musical performances in the community on a regular basis. 

Periodically, we also host our popular “Music and Munchkins” program, where young students utilize our common areas to learn, hear and perform music both with and for housemates. This social activity leverages housemates’ universal fondness for children and music, and is among our most popular recreational therapy opportunities. 

Walking group. As both a social and physical exercise activity, our walking group provides both scheduled and spontaneous opportunities for housemates to engage and move. Whether we’re doing indoor laps throughout the house, traversing our forest paths, or visiting a local park or refuge, our housemates brighten at the opportunity to interact, move and explore their surroundings. 
Massage therapy. To soothe aching joints and reduce stiffness, we schedule regular visits by local massage therapists. The physical contact and social engagement is welcomed by most housemates, and the results are both emotionally and physically beneficial. 
Gardening. When spring finds its way north, our resident gardeners turn their attention to the raised garden beds situated in our secure backyard. From planning and planting to cultivating and harvesting, housemates are the driving force behind our agricultural production. And whether housemates are longtime gardeners or neophyte agrarians, they engage deeply in the process of caring for and growing both flowers and vegetables. And at harvest time, they also experience the deep satisfaction of enjoying the fruits (and vegetables) of their labor.  

While this list is by no means comprehensive, it provides a sampling of the types of regular recreational therapy opportunities either employed – or considered – in our efforts to help housemates to move, interact, and experience the joys of engaging pastimes. While no single activity addresses the passions of every housemate, the evolving, growing roster of activities includes something for everyone, and consistently demonstrates their value as tools in mitigating progressive dementia’s adverse impacts.