Therapeutic recreation in the ALF

We as administrators often fail to see the importance of the “activities” program. The first problem is we fail to see this as more than just “activities”. These are life enrichment tools that add value and give fulfillment to the lives of older adults. The enrichment programming in an ALF provides structure to the resident’s day and gives them different events to attend throughout the day. While the programming may differ from community to community the DOSS has regulated the following to occur in every ALF:

22VAC40-73-520. Activity and recreational requirements.

  1. Activities for residents shall:
  2. Support the skills and abilities of residents in order to promote or maintain their highest level of independence or functioning;
  3. Accommodate individual differences by providing a variety of types of activities and levels of involvement; and
  4. Offer residents a varied mix of weekly activities including those that are physical; social; cognitive, intellectual, or creative; productive; sensory; reflective or contemplative; involve nature or the natural world; and weather permitting, outdoor activity. Any given activity may involve more than one of these. Community resources as well as facility resources may be used to provide activities.
  5. Resident participation in activities.
  6. Residents shall be encouraged but not forced to participate in activity programs offered by the facility and the community.
  7. During an activity, each resident shall be encouraged but not coerced to join in at his level of functioning, including observing.
  8. Any restrictions on participation imposed by a physician shall be documented in the resident’s record.
  9. Activities shall be planned under the supervision of the administrator or other qualified staff person who shall encourage the involvement of residents and staff in the planning.
  10. In a facility licensed for residential living care only, there shall be at least 11 hours of scheduled activities available to the residents each week for no less than one hour each day.
  11. In a facility licensed for both residential and assisted living care, there shall be at least 14 hours of scheduled activities available to the residents each week for no less than one hour each day.
  12. During an activity, when needed to ensure that each of the following is adequately accomplished, there shall be staff persons or volunteers to:
  13. Lead the activity;
  14. Assist the residents with the activity;
  15. Supervise the general area;
  16. Redirect any residents who require different activities; and
  17. Protect the health, safety, and welfare of the residents participating in the activity.
  18. The staff person or volunteer leading the activity shall have a general understanding of the following:
  19. Attention spans and functional levels of the residents;
  20. Methods to adapt the activity to meet the needs and abilities of the residents
  21. Various methods of engaging and motivating residents to participate; and
  22. The importance of providing appropriate instruction, education, and guidance throughout the activity.
  23. Adequate supplies and equipment appropriate for the program activities shall be available in the facility.
  24. There shall be a written schedule of activities that meets the following criteria:
  25. The schedule of activities shall be developed at least monthly.
  26. The schedule shall include:
  27. Group activities for all residents or small groups of residents; and
  28. The name, if any, and the type, date, and hour of the activity.
  29. If one activity is substituted for another, the change shall be noted on the schedule.
  30. The current month’s schedule shall be posted in a conspicuous location in the facility or otherwise be made available to residents and their families.
  31. The schedule of activities for the past two years shall be kept at the facility.
  32. If a resident requires an individual schedule of activities, that schedule shall be a part of the individualized service plan.
  33. The facility shall promote access to the outdoors.
  34. In addition to the required scheduled activities, there shall be unscheduled staff and resident interaction throughout the day that fosters an environment that promotes socialization opportunities for residents.

Top Takeaway:

  • Offer residents a varied mix of weekly activities including those that are physical; social; cognitive, intellectual, or creative; productive; sensory; reflective or contemplative; involve nature or the natural world; and weather permitting, outdoor activity. Any given activity may involve more than one of these. Community resources as well as facility resources may be used to provide activities.

Having a fruitful activity program requires an understanding of the unique needs of each resident. Based upon their healthcare diagnosis certain activities may be more beneficial than others. Ensure you are doing your due diligence in respecting the needs of your residents in regard to therapeutic recreation.

Pro Tip:

  • Ask for input from your residents as to what type of activities they would like to see in the community.
  • Provide incentives for residents to attend events. You could give them ‘community name’ bucks to spend in a community store
  • Build buy-in from all staff members to promote healthy activities of residents