Leisure education with homeless persons with mental illness by Mary Ann Keogh Hoss Ph.D., CTRS

Efficacy of prescribed TR protocols on falls and injuries in nursing home residents with dementia by Linda Buettner, Ph.D., CTRS (http://www.atra-tr.org/shop/efficacy.htm )

The number of older adults in the United States is growing, and falls among the older adult population are a serious and significant problem. Approximately 33 percent of older adults 65 years of age and older fall at least once each year. Injuries caused from a fall are a predisposing factor in 40 percent of the events leading to long-term nursing home placement among older adults. In the long-term care setting, two thirds of older adult residents fall once a year on average. The survival rate of long-term care residents who have had to be hospitalized for injuries resulting from a fall has been estimated to be only 63 percent. Approximately 47 percent of residents die during their hospital stay for a fall.

Although recreation therapists provide a variety of services for older adults with dementia across the long-term care spectrum, few comprehensive therapeutic programs address the problem of falls in this setting. It is essential that the recreation therapist be able to address the area of falls prevention since injury- causing falls have serious consequences requiring medical attention, hospitalization, significantly increased costs, and limitations in activity.

This research was completed on three special care units and it explored the programmatic issue of prevention of falls for older adults with dementia. The recreation therapist had the opportunity to help alleviate a major injury risk and to save health care dollars by addressing this problem. This project tested a three-part fall prevention program using morning walking, afternoon exercise, and evening relaxation programs with high-risk residents. A significant improvement over the control group was found with an estimated cost savings of $49,000 in the two-month intervention period.

Contact the author at: Linda L. Buettner, Ph.D., CTRS, Center for Positive Aging, 2280 Aaron St., Port Charlotte, FL 33952 (941) 883-2425 or by email: lbuettne@fgcu.edu

Efficacy of animal assisted therapy- A Therapeutic Recreation Intervention Using Animal-Assisted Therapy: Effects on the Subjective Well-Being of Older Adults
By Nancy E. Richeson, Ph.D., CTRS

The effects of a therapeutic recreation intervention using animal-assisted therapy (AAT) on the subjective well-being of older adults were examined using the Positive and Negative Affect Scales and the Satisfaction With Life Scale. In a 4-week study, 37 nursing home residents with no recorded cognitive impairments (mean age 82.5 years) were randomly assigned to 1 of 3 groups: control, AAT, or student visitors. The AAT group showed statistically significant increases in overall satisfaction with life and on the feelings interested and excited when compared to the control and student-visitors groups, and statistically significant increases on the feelings enthusiastic, attentive, interested, and inspired when compared to the control group. Results provide new experimental evidence for using AAT in geriatric therapeutic recreation programs.

The AAT project produced two journal articles the first titled, A therapeutic recreation intervention using animal-assisted therapy: effects on the subjective well-being of older adults was submitted to the American Therapeutic Recreation Annual and is in press. The second article, an evidence-based animal-assisted therapy protocol and flow sheet for the geriatric recreational therapy practice was published in the American Recreational Therapy Journal. 2002; 1(1): 25–31.

Furthermore, the research has been presented at the American Therapeutic Recreation Association 2002 Annual conference, the Maine Gerontolological Society 2003 Annual conference on Evidence-Based Practice in Geriatrics, and in numerous workshops, conferences, and lectures across the New England region. The research was highlighted on local television stations, newspapers, and college and alumni newsletters. As well as given attention on the University of Southern Maine’s web page. In addition, the associated press picked up the newspaper article and the research was highlighted in 5 regional newspapers including the Boston Globe.

The effects of aquatics on depression by Becky Berlin, MS, CTRS

Hello! My research was: Aqua Therapy for Depression. This research study compared the impact of two different aquatic intervention programs on inpatient adults with symptoms of depression. One aquatic intervention program utilized structured aquatic exercise only. The other pool program did the same aquatic exercises, but also included a short cognitive therapy technique in each session. The control group had neither. The Beck Depression Inventory was used as both a pre and post score.
Overall, patients who received the combination of aquatic activity with cognitive therapy experienced a significantly greater reduction in depressive symptoms compared to the control group. The study did have limitations, but was effective in demonstrating that existing trained staff can implement a simple research program and achieve positive documented patient outcomes.
Respectfully submitted by Becky Berlin, MS, CTRS

Air mat therapy for the treatment of agitated wandering and aggression by Marcia Shalek, CTRS focuses on the ever-increasing need to improve services to the geriatric population.

Air mat therapy for the treatment of agitated wandering and aggression
Recreation therapists have identified disturbing behaviors as the top area to address in the long-term care setting (Buettner, 2002). These behaviors lead to increase in behavior controlling medications and decreases in quality of life in nursing homes. There is a scarcity of research in recreation therapy that examines treatments for specific disturbing behaviors like vocalizing, aggression, passivity, or wandering. This study will be a controlled trial of sensory air mat therapy for agitated wandering and aggression. This grant answers the research question ”Will a clinical trial of sensory air mat therapy reduce agitated wandering and aggression in nursing home residents with dementia?”

The Effectiveness of a Recreational Modality (Tai Chi Chuan) in Enhancing Health Status and Reducing Health Care Costs in an Elderly Population. By Andrew Paterna.
Andrew A. Paterna, Ph.D.
University of Connecticut, 2003

This study examined the health benefits of a Tai Chi Chuan exercise program with volunteers participating in a four-month recreational activity. Tai Chi Chuan can be described as moving yoga and meditation combined. A series of movements derived from the martial arts; performed slowly, softly, and gracefully, with an emphasis on deep breathing.

Participants (91) were divided into three groups: two interventions, one control.

Intervention: Tai Chi Chuan classes, two days/week (group 1), and one day/week (group 2). The control (group 3), attended nutrition class one day/week. All sessions were 60 minutes. Volunteers were recruited to participate in the study and were assigned based on town of residence and, sites were randomly selected to host the groups. Participants were 60+ years; (Mean = 71.7 years), and included 75 women and 16 men; fairly active, community dwelling individuals, members of senior centers or residents in a senior housing unit. Group 1 (Vernon, CT) n=21, Group 2 (Manchester, CT) n=32, Group 3 (South Windsor, CT-control) n=38. The study examined the effectiveness of this treatment based on: attitudes about health and recreational activity, life satisfaction and, physical testing measures (balance, blood pressure, body fat percent, flexibility, grip strength).

Initial results indicate significant changes in balance, blood pressure, and flexibility among the groups, with no significant findings in health attitudes or life satisfaction. In further evaluation, both treatment groups were collapsed into one for further comparison. This analysis also shows significant treatment group changes, in balance, blood pressure, and flexibility. Finally, a third analysis, using equal group sizes (computer-random selection of cases), shows significant findings for both treatment groups in balance, blood pressure, flexibility, and the mental component summary (life satisfaction). These results indicate that Tai Chi Chuan may be a useful recreational modality in a physical or cognitive rehabilitation program for older adults.

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I hope to publish these findings in the Annual in Therapeutic Recreation and would like to apply to present my findings at the New England Therapeutic Recreation Association’s Annual Conference next year (2004), and will apply to present at the ATRA Annual Conference in Washington, D.C. (2005).
Thank You,
Andrew Paterna

2003 Bernie Thorn Efficacy Research Fund Grants:

Magic as a Therapeutic Intervention proposed by Leandra A. Bedini, Ph.D., CTRS

"Magic as a Therapeutic Intervention" proposed by Leandra A. Bedini, Ph.D., CTRS explores the use of magic tricks as a therapeutic intervention that will address rehabilitation goals. According to Dr. Bedini, "The field of Recreational Therapy is unusual in that it uses myriad interventions to address therapeutic goals in physical, social, cognitive, and emotional domains. Sometimes, however, it is difficult to find an intervention that is engaging and effective at the same time. The use of magic tricks as a therapeutic intervention that will address rehabilitation goals in all domains has great potential to be a technique that is not only unique and engaging, but also easy to learn for both therapist and client, inexpensive, and most of all, effective in addressing a wide variety of goals."

The Use of Relaxation Techniques for Management of Pain and Blood Pressure proposed by Carol Graziano-Perez, CTRS and Christina Jones, CTRS

"The Use of Relaxation Techniques for Management of Pain and Blood Pressure" proposed by Carol Graziano-Perez, CTRS and Christina Jones, CTRS of Mayo Clinic in Scottsdale, AZ will explore how relaxation techniques help to impact patients' well being. Graziano-Perez explains, "At some point in their hospital stay, most patients have to cope with pain and/or stress. Medical interventions usually entail prescribing of medications, but recreational therapists can offer additional, non-medicinal resources. One of these options is relaxation training. These techniques assist patients with the skills they need to cope with various stressors associated with their hospital stay and health status. In addition, patients can carry over these new skills into their daily lives. By measuring pain levels and blood pressure, as well as patients' subjective value of the intervention, this project will demonstrate treatment outcomes and promote value and credibility of TR contributions to patients' care."