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Evidenced Based Practice
Providing Effective Recreational Therapy
Interventions For Geriatric Clients
Jo Lewis, MS/CTRS
Megan C. Janke, Ph.D., LRT/CTRS
Objectives
Upon completion of this session, the participant will be able to:
Identify three evidenced based interventions for Recreational Therapy treatment for older adults.
Verbalize the criteria established by CMS for Recreational Therapy treatment.
Verbalize the steps needed to implement Recreational Therapy treatment.
What Is Recreational Therapy?
Recreational Therapy “means a treatment service designed to restore, remediate and rehabilitate a person’s level of functioning and independence in life activities, to promote health and wellness as well as reduce or eliminate the activity limitations and restrictions to participation in life situations caused by an illness or disabling condition.”
American Therapeutic Recreation Association
TR Definition Statement (July 2009)
CMS Definition• Services that are provided or directly supervised by a
qualified recreational therapist who holds a national certification in recreational therapy, also referred to as a “Certified Therapeutic Recreation Specialist.”
• Recreational therapy includes, but is not limited to, providing treatment services and recreation activities to individuals using a variety of techniques, including arts and crafts, animals, sports, games, dance and movement, drama, music, and community outings.
• Recreation therapists treat and help maintain the physical, mental, and emotional well-being of their clients by seeking to reduce depression, stress, and anxiety; recover basic motor functioning and reasoning abilities; build confidence; and socialize effectively.
• Recreational therapists should not be confused with recreation workers, who organize recreational activities primarily for enjoyment.
MDS 3.0 RAI Manual, Appendix A
Time For A Game!
Cognitive Functioning
Short term memory Long term memory Following directions Safety awareness Communication skills Word finding ability Money management Attention span Writing skills
Physical Functioning
Endurance Strength Flexibility Gait- walking in room or
in facility Locomotion Balance Walking balance Standing balance Sitting balance Transfer skills
Bed mobility Toilet transfer Toileting Dressing upper/
lower body Eating Grooming/ personal
hygiene Bathing Fall reduction
Emotional/ PsychosocialWell-Being
Apathy/ Passivity Depressive symptoms Anxiety Communication skills Social skills Self-Esteem Coping skills Motivation Disturbing behaviors
Other Areas To Address Pain
Decrease pain Increase functional abilities
Community reintegration Independence in community
setting Community resources
Weight Loss/ Gain Caregiver
Evidence Based Practice (EBP)
Based on the integration of: Research Clinical expertise, and Client’s preferences, beliefs and values.
Why is it so important? Why utilize evidence in your
practice?
Sources of Evidence RT/TR Journals
Therapeutic Recreation Journal Annual in Therapeutic Recreation American Journal of Recreational Therapy Other Professional Publications
Simple PleasuresDementia Practice Guidelines
Other Professional Journals RT Wise Owls
Recreational Therapy Evidence Based Practice: Strengthening the Profession (Temple University)
http://rtwiseowls.com
Looking at the Literature…
Integrating Research Into Your Practice
Define the problem or area to be addressed.
Review relevant literature. Internet search with key terms
Try different terms Analyze the research Formulate a plan
CMS Requirements for RT Treatment The physician orders the therapy; The physician’s order includes a statement of
frequency, duration, and scope of treatment; The services must be directly and specifically
related to an active written treatment plan that is
based on an initial evaluation performed by qualified personnel The services are required and provided by qualified
personnel The services must be reasonable and necessary for
treatment of the resident’s condition CMS MDS3.0 RAI Manual Section O page 19
Implementing Recreational Therapy in Your Practice Educate!!!! Receive referral defining problem Obtain Physician’s Order for RT evaluation Complete the evaluation using a standardized
assessment tool Obtain Physician’s Order for RT treatment
Scope, Frequency, Duration Develop Plan of Care Implement plan
Document sessions Evaluate using same assessment tool
Continue, D/C, or Revise Plan of Care