This presentation will provide an overview of the BCCPA Mitacs-SFU project to develop a best practices guide for recreational therapy (RT). OLTCA and ACCA are also partners in this project. Along with reviewing the results of a survey on recreational therapy in LTC that was undertaken in BC, Alberta and Ontario it will present the final RT best practices guide.
Presented by:
- Dr. Kim van Schooten, Centre for Hip Health and Mobility, University of British Columbia
- Dr. Yijian Yang, Centre for Hip Health and Mobility, University of British Columbia
- Brenda Kinch, President, BC Therapeutic Recreation Association
Definition
Statistics of AD
A brief introduction
Signs and symptoms of AD
NMDA receptors
Classification
Causes
Risk Factors
Pathophysiology
AD… The great unknown
Treatment Options
Future Trends
The biomedical model of health has been dominant around the globe since several decades. The main content of shared document is to explain its actual meaning, its core principles and its claims about health and illness. At the end, some of the critical suggestions have been highlighted for the readers to create an awareness among the health professionals for adopting the other more appropriate models of health in order to exceed the longevity with health promotion.
Dasen brajkovic: What is Mental Health?? Mental health refers to the maintenance of successful mental activity . This includes maintaining productive daily activities and maintaining fulfilling relationships with others .
Milen xx philippines mental health promotion and practice strategiesMilen Ramos
PROMOTION OF MENTAL HEALTH AMONG WOMEN IN PHILIPPINES
CELEBRATION OF INTERNATIONAL WOMEN S DAY
STAGING MENTAL HEALTH PROMOTION AND SERVICES
INDIVIDUAL, COMMUNITY AND NATIONAL INTERVENTION
Definition
Statistics of AD
A brief introduction
Signs and symptoms of AD
NMDA receptors
Classification
Causes
Risk Factors
Pathophysiology
AD… The great unknown
Treatment Options
Future Trends
The biomedical model of health has been dominant around the globe since several decades. The main content of shared document is to explain its actual meaning, its core principles and its claims about health and illness. At the end, some of the critical suggestions have been highlighted for the readers to create an awareness among the health professionals for adopting the other more appropriate models of health in order to exceed the longevity with health promotion.
Dasen brajkovic: What is Mental Health?? Mental health refers to the maintenance of successful mental activity . This includes maintaining productive daily activities and maintaining fulfilling relationships with others .
Milen xx philippines mental health promotion and practice strategiesMilen Ramos
PROMOTION OF MENTAL HEALTH AMONG WOMEN IN PHILIPPINES
CELEBRATION OF INTERNATIONAL WOMEN S DAY
STAGING MENTAL HEALTH PROMOTION AND SERVICES
INDIVIDUAL, COMMUNITY AND NATIONAL INTERVENTION
A presentation on the newly introduced cross-cutting symptom measures in DSM5. I'd made this as part of my psychiatry residency, and the article describes why the need came about, the process of formulating and testing the new cross-cutting system and the repercussions this will have on psychiatric practice
Protective factors against suicidal acts in major depression:Reasons for living, Journal Club Presentation in the Dept of Psychiatric Nursing, Kothamangalam
Impact of religion and spirituality on health and psychologyMichael Changaris
These slides explore the importance of religion in individuals lives. While more the half of Americans identify religion or spirituality as vital to their lives therapists and doctors often do not include these beliefs in their treatment.
The Psychodynamic Model - An Introduction to FreudnoiseTM
Sigmund Freud was the first to see mental illness in purely psychological terms (rather than physical or spiritual causes). From unconscious drives, "ego defences" and child development to the idea of the "talking cure" - the origins of modern psychotherapy and counselling.
Using innovative new technologies to help seniors remain safely in their own ...BCCPA
Target audience will be informal and formal caregivers who support seniors living at home in various stages of physical and cognitive decline. The presentation will look at new assistive technologies to address issues such as reduced independence and safety. The presentation with review role of CanAssist in development of new assistive technologies and examples of relevant new technologies to support seniors to remain safety in own homes.
Presented by:
- Robin Syme, Executive Director, CanAssistm, University of Victoria
- Paul Green, Product Manager, CanAssist, University of Victoria
Workplace Health and Safety: Tips, Traps and Trends in Health CareBCCPA
Interactive workshop will address key health and safety topics relevant to health care employers. This program will arm participants with a better understanding of WorkSafeBC’s new dual model investigation protocols, new enforcement options including citations and compliance agreements and employers legal obligations to respond to WorkSafe BC orders and enforcement proceedings. It will also provide overview of how WorkSafe BC and WCAT respond to claims by workers that they have been retaliated against for exercising their OH&S rights. It will also review the most recent bullying and harassment claim decisions.
Speakers:
- J. Najeeb Hassen, Partner Roper Greyell
- Alissa Demerse, Partner, Roper Greyell
A presentation on the newly introduced cross-cutting symptom measures in DSM5. I'd made this as part of my psychiatry residency, and the article describes why the need came about, the process of formulating and testing the new cross-cutting system and the repercussions this will have on psychiatric practice
Protective factors against suicidal acts in major depression:Reasons for living, Journal Club Presentation in the Dept of Psychiatric Nursing, Kothamangalam
Impact of religion and spirituality on health and psychologyMichael Changaris
These slides explore the importance of religion in individuals lives. While more the half of Americans identify religion or spirituality as vital to their lives therapists and doctors often do not include these beliefs in their treatment.
The Psychodynamic Model - An Introduction to FreudnoiseTM
Sigmund Freud was the first to see mental illness in purely psychological terms (rather than physical or spiritual causes). From unconscious drives, "ego defences" and child development to the idea of the "talking cure" - the origins of modern psychotherapy and counselling.
Using innovative new technologies to help seniors remain safely in their own ...BCCPA
Target audience will be informal and formal caregivers who support seniors living at home in various stages of physical and cognitive decline. The presentation will look at new assistive technologies to address issues such as reduced independence and safety. The presentation with review role of CanAssist in development of new assistive technologies and examples of relevant new technologies to support seniors to remain safety in own homes.
Presented by:
- Robin Syme, Executive Director, CanAssistm, University of Victoria
- Paul Green, Product Manager, CanAssist, University of Victoria
Workplace Health and Safety: Tips, Traps and Trends in Health CareBCCPA
Interactive workshop will address key health and safety topics relevant to health care employers. This program will arm participants with a better understanding of WorkSafeBC’s new dual model investigation protocols, new enforcement options including citations and compliance agreements and employers legal obligations to respond to WorkSafe BC orders and enforcement proceedings. It will also provide overview of how WorkSafe BC and WCAT respond to claims by workers that they have been retaliated against for exercising their OH&S rights. It will also review the most recent bullying and harassment claim decisions.
Speakers:
- J. Najeeb Hassen, Partner Roper Greyell
- Alissa Demerse, Partner, Roper Greyell
Enhancing & Improving Health Outcomes of Your Residents: A Collaborative Appr...BCCPA
This panel presentation will take a closer look at three key areas of seniors health in residential care (falls, pressure sores, and meaningful engagement in everyday activities) and how collaborating with occupational therapy can lead to reducing injury, hospitalization and associated costs in residential care. Presentation will share best practices for mobility assessment and prescription, pressure sore management and prevention. It will also share experience of a BC residential care providers and OT provider to highlight a successful collaboration in action to improve health & well-being of residents/staff.
Speakers:
- Michelle Whitehouse, Director of Care, Zion Park Manor
- Amit Kumar, Occupational Therapist and Director
- Giovanna Boniface, National Director of Professional Affairs, CAOT
Seniors Quality Leap Initiative: Using Data to Drive Improvements in Resident...BCCPA
The Seniors Quality Leap Initiative (SQLI) is collaborative of 12 nursing homes across Canada and US whose vision is to become North Americas leading provider consortium for benchmarking clinical quality standards. The presentation will share the methods used (both the key success factors and challenges) to administer the survey to residents in long term care and how the results are being used within each SQLI organization to drive improvements.
Presented by: Jo-Ann Tait, Program Director, Elder Care and Palliative Services, Providence Health Care
Improving Sustainability of BC's Home and Community Care SystemBCCPA
In the face of unprecedented growth in the seniors population, health systems across Canada are challenged to ensure sustainability while addressing consumer expectations and respecting the wishes of individuals to remain independent as long as possible. Waitlists for access to continuing care services, and the high numbers of seniors that remain in hospital while no longer requiring acute care, demonstrate potential mismatches between supply and demand. As the population of seniors continues to grow, this disparity will continue to increase, unless practices within health systems change. Island Health will share its experiences supporting seniors to live independently.
Person Centered Care through Integrating a Palliative Approach: Lessons from ...BCCPA
Aging adults are entering residential care facilities with more advanced disease than in the past and their length of stay is shorter. Most health care providers in these facilities do not receive targeted education and training in palliative care, nor are they confident to have crucial conversations about goals of care and end of life challenges with residents and their families. Due to limited capacity to manage predictable symptoms related to end of life and insufficient planning, many residents are transferred to hospital in crisis and die in the Emergency Department or acute care wards.
This presentation will showcase some of the initiatives by identifying common themes, unique features of each and strategies for success. Opportunity will be given for delegates to ask questions and brainstorm how lessons learned from these initiatives could inform the care provided at their own facility.
Presented by:
- Jane Webley, RN LLB Regional lead, End of Life, Vancouver Coastal Health (EPAIRS and the Daisy project)
- Dr Christine Jones, Island Health (SSC project: Improving end of life outcomes in residential care facilities: A palliative approach to care)
- Kathleen Yue, RN, BSN, MN, CHPCN (c) Education Coordinator, BC Center for Palliative Care
A Collaborative Digital Art Network for Healthy AgingBCCPA
Presentation summarizes the efficacy of a network for collaborative art established at the Elim Campus of Care to facilitate continuum of therapeutic care to its residents. Utilizing a suite of rich and interactive media applications seniors can engage in self-directed collaborative artwork for therapeutic purposes. Through experimentation and trials the study provides evidence based evaluation of the role of digital media and the impact of virtualization in art therapy groups.
Presented by:
- Marian Heemskerk, Director of Community Care, Elim Christian Care Society
-Tejinder Randhawa, CEO Mobile New Media
The Health Employers Association of BC (HEABC) provides a broad range of services to member organizations.This talk will outline a number of the programs and services provided.Topics touched on will include collective bargaining, joint benefit trusts, health human resource planning and knowledge management. Time for questions from the audience will also be available.
Presented by: Michael McMillan, CEO HEABC
Leadership at the Bedside – Making the Change that Needs to HappenBCCPA
This panel presentation looks at the role of LPNs and HCAs within the context of the continuing care system. Along with changes to the regulation of LPNs, HCA education has changed including skills to work in both acute, residential and community setting with higher complexity of residents / client. Despite this there is little support for the transition for care needs. The HCA is the unrecognized leaders that support RN/LPN teams and have taken on many roles and responsibilities. The problem that has plagued the LPN and HCA working relationship has been the absence of role clarity for both professions and enhancing value for both working together collaboratively. The presentation will look at a LPN/HCA model that could better serve the health system.
Presented by:
- Anita Dickson, President, Licensed Practical Nurses Association of BC (LPNABC)
- Brenda Childs, Treasurer, LPNABC
Enhancing Efficiency and Best Outcomes in Community Care: CBI’s Transitional ...BCCPA
In October 2016, CBI opened its first transitional and residential care in Burnaby, BC. Led by a multidisciplinary team that includes nurses, physiotherapists, occupational therapists, social workers, speech therapists, dieticians, behavioural interventionists and personal support workers, the facility provides specialized health care to support patients leaving hospital who are not yet able to return to their own home. This unique service also decreases hospital length-of-stay, admission and readmission to the hospital and wait times in emergency rooms. Join us and learn more about how our Transitional Care model helped patients, hospitals and funders to achieve excellent health and financial outcomes.
Presented by: Poonam Jassi, Director of Operations BC, CBI Health Group
Is Home Really Best? Private Home Care Agencies and Technology Can Make Home ...BCCPA
This presentation is about how technology can increase family involvement in person-centred care planning in home care. The Conference will be the first time the results from this UBC Masters Research project will be presented.
In a 2017 UBC survey of home care agencies in greater Vancouver the study aimed to determine
1) what are these home care agencies challenges in providing quality person centred care to their clients
2) home care agencies perceived benefits and barriers in using health information technologies.
Survey findings will help both public and private care providers understand how to better collaborate in caring for aging seniors.
Presented by: Christina Chiu, CEO, CareCrew, MHA Candidate
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
Health Care Consent, Aging and Dementia: Mapping Law and Practice in BCBCCPA
In October 2016, the Canadian Centre for Elder Law working with ASBC started a 16 month project on the law and practice around health care consent in BC with a focus on older adults and adults with dementia. This project will address issues around health care consent with a focus on older adults and adults with dementia. Along with addressing the legal framework surrounding health care consent it will highlighted related issues such as polypharmacy, etc.
Presented by:
- Krista James, National Director, Canadian Centre for Elder Law
- Alison Leaney, Provincial Coordinator, Vulnerable Adults Community Response, Public Guardian and Trustee
- Barbara Lindsay, Director, Advocacy and Education
Park Place Seniors Living: Our Journey to Operationalize Strength Based Leade...BCCPA
This panel presentation is focused on the Park Place experience and our exploration with the many ways the theory of strength-based leadership can be applied within our organization. We will provide a corporate perspective and the experiences of three Park Place sites leaders in implementing a strength based leadership approach and through their individual lenses share the work they have done to support their teams at the local level.
Presented by:
- Lynda Foley, VP Quality Assurance, Park Place Seniors Living (PPSL)
- Elaine MacDonald, Site Administrator, New Horizons Care Centre, Campbell River, PPSL
- Margot Hagerty, Site Administrator, Newport Harbour Care Centre, Calgary, PPSL
- Jody Edwards, Site Administrator, Spring Valley Care Centre, Kelowna, PPSL
Promoting Exchange, Enhancing Resources: How Connecting Organizations Improve...BCCPA
Improving workplace safety in continuing care often means undertaking significant culture change. Organizations often find themselves re-creating the same programs as neighbouring organizations, with similar outcomes. The PEER Resource Network was initiated by SafeCare BC to address two key issues raised by the continuing care sector:
1. Managers lack the resources to support the development of a safety culture within their organizations;
2. Continuing care organizations largely face the same root workplace safety issues.
In this workshop, participants will:
1. Learn about PEER’s innovative model and the preliminary results of the initiative (both quantitative and qualitative data).
2. Understand how PEER’s structure contributes to collaborative learning – and how this supports organizational excellence in workplace safety.
3. Engage with fellow participants in PEER-like exercises to glean insight into solutions for their organization’s own safety challenges.
4.Develop new connections to support the implementation of those solutions.
Presented by:
- Jennifer Lyle, Executive Director, SafeCare BC
- Saleema Dhalla, Workplace Health and Safety Programs Director, SafeCare BC
Before There is a Cure, There’s Care: Building a Dementia-Friendly B.C.BCCPA
BC continuing care sector has a role to play in building a dementia friendly society because before there is a cure, there’s care. Through this workshop participants will learn more about the Society’s vision, including how they can join the movement toward a more dementia friendly BC. They will also hear about how the Society can be a partner in the care they provide through First Link, education for health providers and other resources throughout the province.
Presented by: Maria Howard, CEO Alzheimer Society of BC
Coaching skills can help people maximize their strengths and increase responsibility, accountability, creativity and resourcefulness to overcome challenges and achieve results. The primary coaching skills presented in this interactive presentation will focus on the principles of a coaching conversation, listening, the art of asking curious questions, leading cultural change, and how to promote responsibility and accountability to support people to elicit their own solutions and strategies and take action to implement these solutions.
Speaker:
Callie Bland, Executive Coach, RN and CEO, Coach Callie Consulting
8. Recovery Oriented Services in Mental Health and Addiction Management.pdfKingsleyOkonoda
Recovery from mental illness involves much more than recovery from the illness itself. People with mental illness(es) may have to recover from the stigma that they incorporated into their very being; from the iatrogenic effects of treatment settings; from the lack of recent opportunities for self-determination; from the negative side effects of unemployment; and crushed dreams.
The rehabilitation team conventionally includes the physiatrist, rehabilitation nurse, physical and occupational therapist, speech pathologist, rehabilitation psychologist, and social worker or case manager, with availability of other services such as nutrition and respiratory therapy.
Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals.
The speakers and Anya de Longh and Jim Phillips.
Whole Health in Your Practice Day 1/3 MorningCristalyne Bell
Whole Health is part of collaborative effort by the Pacific Institute for Research and Evaluation, VA Office of Patient Care and Cultural Transformation, and University of Wisconsin Integrative Health Program to transform healthcare and help people live healthier, happier lives, and more purpose-driven lives.
Learn more: https://wholehealth.wisc.edu/courses-training/whole-health-in-your-practice/
At WriteSteps Occupational Therapy, Danielle comprehensive evaluation is offered in numerous areas, including visual motor skills, visual perceptual skills, handwriting, self-care, and sensory integration. Danielle has extensive experience performing evaluations and tailors her evaluation to fit the needs of each child she works with.
The rehabilitation team conventionally includes the physiatrist, rehabilitation nurse, physical and occupational therapist, speech pathologist, rehabilitation psychologist, and social worker or case manager, with availability of other services such as nutrition and respiratory therapy.
Health education is a vital part of community health nursing, because the promotion, maintenance, and restoration of health require that patients understand health care requirements. Health education is an integral part of all health services and all health personnel's who are responsible for providing health care.
Similar to Evidence-Informed Guidelines for Recreation Therapy programs to Enhance the Mobility of Older Adults in Long-Term Care (20)
LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
COVID-19 PCR tests remain a critical component of safe and responsible travel in 2024. They ensure compliance with international travel regulations, help detect and control the spread of new variants, protect vulnerable populations, and provide peace of mind. As we continue to navigate the complexities of global travel during the pandemic, PCR testing stands as a key measure to keep everyone safe and healthy. Whether you are planning a business trip, a family vacation, or an international adventure, incorporating PCR testing into your travel plans is a prudent and necessary step. Visit us at https://www.globaltravelclinics.com/
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
2. Therapeutic Recreation
Is a process that utilizes functional interventions, leisure
education and recreation participation
to enable persons with physical, cognitive, emotional
and/or social limitations
to acquire and/or maintain the skills, knowledge and
behaviours
that will allow them to enjoy their leisure optimally, function
independently with the least amount of assistance and
participate as fully as possible in society.
3. Trends in Therapeutic Recreation
• Leisure Ability Model
– Is the most common TR model which provides a framework for
Leisure participation, education (skill development) and
Therapeutic Interventions
• Strength Based approach
– well-being is defined as “a state of successful, satisfying, and
productive engagement with one’s life and the realization of
one’s full physical, cognitive, and social-emotional potential”
(Carruthers & Hood, 2007)
4. Trends
• Person Centred Approach
– Based on Kitwoods work and is a concept which is intrinsic to
recreation involvement – the person is at the centre of their
choices around leisure and requires all providers to ‘know the
person’
• Montessori approach
– a method of breaking down skills required to fully participate in
an activity of interest to an individual. This approach is used
when the individual may no longer be able to participate
independently and freely in their leisure due to cognitive changes
they have experienced.
5. Examples of Strengths-Based Planning Process –
“I” Plan Assessment Summary
Joe is an 88 year old man with dementia.
He has a short attention span. He is very
pleasant most of the time. Joe likes to
walk around the facility a considerable
amount of his waking hours. He is unable
to distinguish between areas he is
welcomed to enter and those where his
is not welcomed. His ambulation skills are
excellent; no assistance is required. Some
residents are disturbed by him because
he may enter their rooms against their
wishes. He prefers to be with staff at all
times as he does not tolerate being
alone. He and his wife raised 11 children.
Joe owned a hardware store and was a
respected businessman in town.
I am Joe. I owned a hardware store for
years in town, and am respected in my
community. Most of my life I have been
active and around a lot of people, which I
really enjoy. My wife, Ann and I raised 11
wonderful children. I don’t remember
things as well now, but I enjoy life and
like people. I am usually in a pretty good
mood. I do love to walk – it calms me. I
enjoy walking most with others. I often
look for others to walk with me and will
look in rooms and hallways here at the
home to find walking companions.
7. Recreation Therapist
A professional who uses assessment and
interventions to empower the individual to find
meaning through leisure by promoting optimism,
independence, healthy lifestyles and by teaching
leisure related skills. (CTRA)
8. Recreation Therapist
• Recreation Therapists with an undergraduate degree in
TR have the training and education to identify strengths
and work with the whole person.
• More recently there is the opportunity for recreation
therapists to Certify with the National Council for
Therapeutic Recreation Certification (NCTRC). The
CTRS® credential is the only international certification
designed to protect the consumer of recreation therapy
services.
9. Recreation Therapist
• Therapeutic Interventions (as cited in the Sr. Advocate report)
‘can only be carried out by a therapeutic recreation team’
• In residential care a recreation therapist needs to be regularly
monitoring and adapting the therapeutic recreation care plan
to preserve and support individual abilities
10. Recreation Program Assistant
(aka Activity Worker; Recreation Therapy Assistant)
• The Therapeutic Recreation (TR) team includes a TR
assistant who works with the recreation therapist
• This person delivers TR interventions and programming
• Assistants have a variety of qualifications from no
qualifications, certificate, diploma or a degree
11. About BC Therapeutic Recreation
Association
• Professional membership requires academic standards
and continuing education credits to maintain
professional standing
• Newly trained professional applicants must hold a
degree in Therapeutic Recreation or be certified by
National Council for Therapeutic Recreation (NCTRC)
12. Benefits of Membership for BCTRA
professional, supporting and student
members
• Resources for practitioners
• Education for members
• Access to current research
• Financial supports
• Networking
• Student support
• Advocacy for the profession
13. BCTRA - benefits to employers
• Information about the association
• CTRA Standards of practice
• Standardized Recreation Therapist Job
Description
• Employers can post jobs
• Direction, contacts for more information about
TR opportunities to ask questions
• Therapeutic Recreation Links
14. Summary – current trending best
practices in Therapeutic Recreation
• The whole person approach
• Strengths Based
• Do with…….not for
• Shift in thinking ………caregivers to care partners
• Opportunities & Choice (Some people need more
support to make a choice)
• Traditional large groups are not beneficial for many
• Small groups – provide more person centred outcomes
• One to one – may be the only way to engage some
residents
• Process not the end result
15. References
Anderson, L., & Heyne, L. (2012). Therapeutic Recreation Practice: A
Strengths Approach. State College, PA: Venture Publishing, Inc.
Hood, C. & Carruthers, C. (2007) Enhancing Leisure Experience and
Developing Resources: The Leisure and Well-Being Model, Part II.
Therapeutic Recreation Journal, vol. 41, #4, p.298 – 325
Mackenzie, I. (2015). Placement, Drugs, and Therapy ... we can do
better (p. 11, Rep. No. 3). Victoria, BC: BC Office of the Seniors
Advocate.
17. Effects of Recreation Therapy Programs
on Mobility in Older Adults in Long-term
Care: A Systematic Review
Yijian Yang, PhD,
Postdoctoral researcher
Centre for Hip Health &
Mobility,
Department of Family
Practice,
18. Background
• Recreation therapy plays an essential role in
enhancing mobility among older people in long-
term care (LTC).
• However, there is lack of clarity about the range
of recreation programs currently offered and the
effectiveness of these programs for older adults
of different physical and cognitive status.
31-05-2017 BCCPA Annual Conference 18
(Reference: Crocker et al. Cochrane Review 2013)
19. Aim and approaches
• To survey evidence on the nature and
effectiveness of recreation therapy (RT) to
enhance mobility in LTC:
– Literature review of current evidence
– Electronic surveys with RT professionals
31-05-2017 BCCPA Annual Conference 19
20. Search strategy and inclusion criteria
31-05-2017 BCCPA Annual Conference 20
Search terms
Recreation /leisure &
long-term care/nursing home
& older adults
& mobility
Identified
studies
Database
Pubmed
CINAHL
AgeLINE
CENTRAL
PsychINFO
Inclusion Criteria
1. published in English
2. from 1990 – present
3. In residential care
4. quantitative studies
5. mobility as primary outcome
21. Flow chart of search procedure
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Potentially relevant studies (n = 963)
Medline – PubMed (n=422)
CINAHL (n = 127)
AgeLine (n=349)
CENTRAL (n=58)
PsychINFO (n=9)
Potential articles based on reading the title
(n=189)
Potential articles based on reading the
abstract (n=82)
Included in the systemic review (n=64)
Articles excluded as duplicates for irrelevant (n=774):
- Not a research study (n=169)
- Not residential care setting (n=83)
- Unrelated study objectives (e.g., cardiovascular, sleep,
continence, etc.) (n=379)
- Beyond scope of review (e.g., delivery of care) (n=83)
- Duplicates (n=58)
- Other (blank results) (n=2)
Articles excluded after reading the abstract (n=107):
- Additional duplicates (n=12)
- Not a research study (n=37)
- Not residential care setting (n=6)
- Primary outcomes not mobility-related (n=41)
- Beyond scope of review (n=11)
Articles excluded after reading the full-test (n=18):
- Primary outcomes not mobility-related; Not a RT
intervention) (n=14)
- Not a research study (n=2)
- Not residential care setting (n=1)
- Beyond scope of review (n=1)
BCCPA Annual Conference
23. Recreation therapy (RT) programs
• Common RT programs:
– Walking (n = 19),
– Strength/resistance training (n = 18), 10 with walking, dancing or active games
– Tai Chi (n = 8)
– Dancing (n = 7)
– Active ball games (n = 6)
– Exergaming (n = 4)
– Yoga (n = 2)
• Delivered by:
– Physiotherapist or occupational therapists (n = 18)
– Trained exercise instructors (n = 13)
– Recreation therapists (n = 4)
– Care staff or research assistants
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24. Primary outcome measures
• Outcomes related to mobility:
– Functional mobility
• (e.g. Timed Up & Go (TUG), gait speed and the 6-minute walk)
– Balance
• (e.g. One-leg stand, Berg balance scale, tandem and semi-tandem stand)
– Muscle strength
• (e.g. Quadriceps strength, hand grip strength)
– Flexibility
• (e.g. Sit and Reach, shoulder range of motion)
– Performance of activities of daily living (ADL)
• (e.g. Functional Independence Measure, Barthel Index)
– Falls
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25. Effects of RT programs on primary outcomes
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0
5
10
15
20
25
30
Functional
Mobility
Balance Muscle Strength Felixibility Performance of
ADL
Reduced falls
Numberofstudies
Walking Tai Chi Active ball game Strength training Exergaming Dancing Yoga
26. Secondary outcomes
• Fear of falling
– Improved in 7 studies
• Quality of life
– Improved in 3 studies
• Depression
– Improved in 2 studies
• Self-esteem
– Improved in 2 studies
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27. Summary
• Effective RT programs that improved functional
mobility for older adults in LTC were walking
program, Tai-Chi, and active ball games.
• Tai Chi, dancing, and exergaming also improved
strength and flexibility. Resistance training was
commonly incorporated into other programs.
• Walking program is generally feasible for older
adults with a broad range of cognitive function.
• Most participants in the studies are women, and
cognitively less impaired.
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28. Facilitators and barriers
• Facilitators:
– Clear instruction and demonstration
– Peer and facility staff reinforcement on the participation
– Using an attendance record to monitor adherence
– Personalized interventions
– Low cost and easy to implement
• Barriers:
– Difficulty in following instructions for individuals with dementia
– Distraction when interventions taking place in public areas
– Low staff / resident ratio
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29. Limitations
• None of the 64 studies provided a clear definition of
recreation therapy.
• Many studies were not sufficiently blinded.
• Study sample size was generally small
• Loss to follow-up was remarkably high.
• Lack of male participants in the studies.
• Did not involve participants with moderate to severe
dementia.
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30. Acknowledgement
• Injury Prevention and Mobility
Laboratory
Stephen Robinovitch, Professor
All lab members
• Centre for Hip Health and
Mobility
Heather McKay, Professor
Joanie Sims-Gould, Assistant
Professor
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31. Effects of Recreation Therapy Programs
on Mobility in Older Adults in Long-term
Care: Survey of Recreation Therapists
Kim van Schooten, PhD
Postdoctoral researcher
Dept. Biomedical Physiology and Kinesiology, Simon Fraser University
Centre for Hip Health and Mobility, University of British Columbia
32. Which programs are most effective
and suited for specific phenotypes?
17-05-01 32BCCPA Conference, van Schooten
33. Electronic survey of RT experts
Aim:
• to gain insight into recreation therapist’s current
practice of mobility enhancement among long-
term care residents
Specifically:
1. to identify the highest regarded programs;
2. to identify beneficial programs for specific outcomes in
the domain of mobility (falls, physical activity and
physical capacity) and well-being;
3. to identify suited programs for phenotypes based on
gender, independence and cognition
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34. Demographics of respondents
• 437 respondents
• 92% female
• 65% full time
• 25% had 10 to 20 yrs
of experience
• 51% RT and 40% RT
manager
• All involved in
planning, leading and
assisting of RT
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86
18
96
60
35
17
2
35. Questions - Highest regarded
programs
Please rank the following programs based on your belief in
their effectiveness to restore and maintain mobility among
long-term care residents:
• Exergaming
• Cooperative ball games
• Dancing
• Competitive ball games
• Group exercise/structured group programming
• Yoga
• Tai Chi
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36. Response - Highest regarded
programs
1. Group exercise (36%; e.g. Sit and Be fit, Osteofit,
Carefit, Fun and Fitness)
2. Cooperative ball games (17%)
3. Dance (12%)
4. Tai Chi (11%)
5. Yoga (11%)
6. Competitive ball games (10%)
7. Exergaming (3%)
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37. Questions - Beneficial on specific
outcomes
In your opinion, is this program beneficial for the majority of
residents to promote:
• Physical
– Independence in ADL
– Safe mobility
• Balance
• Strength
• Endurance
• Flexibility
– Fall reduction
• Social interactions
• Psychological well-being
• Cognitive function
17-05-01 BCCPA Conference, van Schooten 37Anderson & Heyne, 2012
38. Response - Beneficial on specific
outcomes
• Physical
– Independence in ADL: Yoga and Group exercise
– Safe mobility: Yoga
• Balance: Tai Chi and Yoga
• Strength: All high
• Endurance: All high
• Flexibility: Yoga
– Fall reduction: Yoga and Group exercise
• Social interactions: Ball games
• Physchological wellbeing: All high
• Cognitive function: All moderate
Overall quality of life
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39. Questions - Suitability for
phenotypes
In your opinion, is this program in the current
format beneficial for people with a specific:
• Gender (Men/women)
• Cognitive performance (CPS 0-2, 3-4, 5-6)
• Activity of daily living performance (ADL self
0-2, 3-4, 5-6)
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40. Response - Suitability for
phenotypes
• Gender
– Men: All high
– Women: All high
• Cognitive performance
– CPS 0-2: All high
– CPS 3-4: Ball games high, Tai Chi moderate
– CPS 5-6: Coop ball games & Dancing moderate, Tai
Chi low
• ADL performance
– ADL 0-2: All high
– ADL 3-4: All high
– ADL 5-6: Ball games moderate, Tai Chi low
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1
2
3
4
5
6
7
Tai Chi Yoga Coop. Ball
games
Dancing Exergaming Comp. Ball
games
Group
programs
Men
Women
1
2
3
4
5
6
7
Tai Chi Yoga Coop. Ball
games
Dancing Exergaming Comp. Ball
games
Group
programs
Intact
Mild
Severe
1
2
3
4
5
6
7
Tai Chi Yoga Coop. Ball
games
Dancing Exergaming Comp. Ball
games
Group
programs
Intact
Mild
Severe
41. Conclusion
1. Structured group programs are rated most effective to
improve mobility in older adults in LTC, followed by ball
games and dancing
2. Yoga was favoured for most mobility outcomes –
scientific evidence is still lacking
3. Suitability is ranked similar among phenotypes, except
for people with severe ADL/cognitive impairments, who
may currently be underserved
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42. Acknowledgement
Injury Prevention and Mobility
Laboratory
Prof. Stephen Robinovitch, PhD
All lab members
Centre for Hip Health and
Mobility
Prof. Heather McKay, PhD
Assis. Prof. Joanie Sims-Gould, PhD
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43. Could we use the Inter-RAI MDS,
specifically ADL and CPS, scores
as screening for allocating
residents to interventions?
44. Would differentiation of specific
groups of residents (phenotypes)
be more feasible than
individualized programs and
more effective than a “one-size-
fits-all” approach?
45. Should we aim for a core set of
outcomes for all (recreation)
therapy programs in residential
care?