community - University of New Hampshire

Recreation for those ageing with and into disability CACL Living Well in Our Communities: Thriving As We Age May 7, 2013 Concord, NH

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Northeast Passage Living Beyond Disability

Using sport and recreation to assist individuals with disabilities to define, pursue and achieve their goals www.nepassage.org © University of New Hampshire – Northeast Passage

Northeast Passage  Established in 1990 to fill gaps in services  In 2000, merged with the University of New Hampshire  Nationally recognized leader in field of Therapeutic Recreation and Adapted Sports

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Programs  Adaptive Sports & Recreation

 Recreational Therapy  Teaching and Research

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Difference between Adapted Sports and Therapeutic Recreation

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Aging into disability

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Physical Decline  Decreased     

Strength, Endurance, Mobility, Flexibility, Balance

 Increased  Fatigue  Weight  Pain

 Cycling  Three wheels  Bike path  Tandems

 Gardening     

Large garden Smaller garden Garden mobility aid Extended handles Raised garden beds

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Cognitive  Deficit      

App store

Concentration Memory loss Problem solving Planning Impulsivity Safety Awareness

 Support    

Find your car Organizers Reminders

Map My…

 Games  Memory games  Problem solving games  GameChanger

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Social/Emotional  Isolation

 Loss of identity

 Loss of friends  Pass away  Move away

 Frustration

 Difficulty making new friends

 Anger  Low motivation  Depression

 Loneliness

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Benefits of Recreation • Increase in physical • • • • • •

activity and fitness, Social connectedness, Community engagement, Family relationships, Practice of functional skills in all domains, Stress management Self efficacy www.nepassage.org © University of New Hampshire – Northeast Passage

Identify the right activity  Recreation is personal  What do you like?

 Recreation is part of our definition  Who are you?

 Recreation is familiar  Talk about a great memory.

 Recreation is holistic  Why do you like this activity?

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Making it Work  What does this activity require?

 What do I have?  What do I need to change or supplement?

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Activity Modifications  Intensity  Rules  Duration

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Support systems  Who is out there?  What role do you want them to play?

 Friends, family, new people, volunteers, professionals www.nepassage.org © University of New Hampshire – Northeast Passage

Equipment Modifications  Alternate use for typical stuff  Adapted equipment

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Select a New Activity  What did you get from the  What new activity fills that old activity?

need?

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PATH Promoting Access Transition and Health  Assessment  Comprehensive intake interview  In clients home  Set goals

 Planning  Goals set based on input from client, caregivers, family and therapist

 Intervention  2 - 12 visits, supplemented by phone consults and online support over six to eight months.

 Evaluation  Attainment of personal goals  Standardized pre /post test QoL, Happiness, HRQol

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Comprehensive Assessment Examine  Current level of physical, psychosocial, and cognitive function  Current level of community interaction  Past, present and potential interests for involvement  Knowledge of accessible resources  Risk factors with potentially negative health impacts  Perceived and real barriers to participation  Personal network, care givers, and support systems

 Set goals for intervention www.nepassage.org © University of New Hampshire – Northeast Passage

General Treatment Areas 1. 2. 3. 4. 5. 6. 7. 8. 9.

Wellness Education Resiliency education and technique development Individualized Fitness Plan Practical Functional Skill Development Community Integration in Home Community Resource & Network Development Support Network Development Individual and Family Recreation Skill Development Care giver training, support, relief

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Qualitative Research Results for Ageing into/with Disability • • • • • • • •

Increased sense of self efficacy Perceptions of improved quality of life Improved social participation and engagement with the community Reduction in healthcare utilization Positive changes to health and the physical domain Partnership approach to treatment Emphasis on home-based intervention Personal meaning that informed treatment goals www.nepassage.org © University of New Hampshire – Northeast Passage

Case study  72 years old, lives alone,  Primary Diagnosis – post polio managed well until past eight years.  Secondary Dx - High BP, High Cholesterol, Pre diabetic, over weight, deconditioning

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Goals  TR GOALS  Improve overall health and fitness  Increase knowledge of community resources  Develop leisure interests

 Personal goal  Improve endurance to enable a visit to her place of birth on an island off the coast of Maine.

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Outcomes  Health and fitness through cycling, aquatics and walking  Weight was 242, now 205  Cholesterol was 227, now 200  BP was 196/90, now 140/80  Blood sugar was A1c 6.1 pre diabetic, now 5.9 no longer pre diabetic

 Community Resources & Leisure interests  Gained proficiency on computer to find events and resources  Joined walking club and YMCA

 Returned to the island in late July

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Tom’s story

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Questions  Contact: Jill Gravink, MS, CTRS/L Northeast Passage 4 Library Way Durham, NH 03290 603-862-0070 www.NEPassage.org

www.nepassage.org © University of New Hampshire – Northeast Passage