What brings people together better than recreation? As activity and recreation professionals we can make ourselves even more indispensable to our care centers by using our talents as team builders.

We have the skills to assess leisure interests, motivate participation, and lead enjoyable programs.  Here are some ideas to get you started:

• Develop a recreational interest questionnaire for new employees to complete to find out what they enjoy.
• Lead an icebreaker activity at the beginning of staff meetings.
• Find out people's favorite rewards and find ways to grant those wishes.
• Look for ways that the full staff team can join the fun a little bit during your recreation programs.
• Initiate incentive games for assisting participants to programs.
  

One of the quickest ways to make any substantial change is to go to the center of power. Select a time to present your plan to your Administrator or Program Manager. Take care to present the problem and your solution in a positive manner. You might clarify the problem with consideration to these three concerns:

1. Survey guideline changes for skilled nursing homes may soon mandate interdisciplinary activity escort assistance. Draft changes to two regulation documents for skilled facilities in the United States, indicate Resident "transportation" by the full interdisciplinary team as part of activity compliance.
    
2. Without interdisciplinary assistance, the activity department cannot conduct activities of a high quality level. When activity staff can remain in an activity room before, during and after a program they can conduct programs with substantially improved quality. They can more adequately welcome and greet participants, involve participants in the anticipation of each activity; they can enhance social connections and complete some program evaluations.
    
3. Escorting participants to activities is paired with improved interdisciplinary attention to, and familiarity with, participants' interests, preferences, and accomplishments.

As you present the needs for a structured Escort Program you can explain the potential benefits. This bulleted list might help. An Activity Escort Plan can:

• Help to avoid survey deficiencies
• Enhance a team spirit of quality care
• Improve each and every program
• Assist greater numbers of participants to beneficial activity programs.
  

Escorting participants to programs becomes the responsibility of the entire staff team. In simplest terms, when time to take a break is announced, every staff person who can leave their chair or their work area takes a break to invite some potential program participants. They then encourage and assist the participant to attend the given program. A selected time such as 10:00 am and/or 2:30 pm may be selected for each weekday or perhaps for just one day a week at the onset.

"Take a Break" is wonderful in action because participants have new faces inviting them and more people taking an interest in their recreation involvement. Housekeepers, receptionists, nursing assistants, activity staff, volunteers, administrators, charge nurses, dietary staff, maintenance workers and business office personnel are all united in their attention to program preferences.

To get this program started consider the following steps to success:

1. Inquire to the various department heads to coordinate a best time and/or day for the majority of the staff to assist most safely and conveniently.
    
2. Request that your Administrator help to in-service the staff, on the purpose, benefits, and the procedural steps for "Take a Break".
    
3. Prepare the participant rosters as needed or as desired. Some care centers have all of the staff first go to look at the rosters at the nurse's stations to find out who may be interested in the given program. Roster lists can help to organize which staff should invite whom.
    
4. About 15 minutes prior to the onset of the program, announce the program, the location, and the time program will begin.
    
5. All available staff will go to find someone to invite to the program. If someone declines, the staff person should invite someone else. The rosters can be helpful to avoid having participants invited over and over by many staff persons for the same program. A check mark can indicate if someone has already been invited. Similarly, participants' responses to invitations can be recorded onto the roster by use of a key code, such as a "D" for declined invitation.
    
6. A selected song might be played over the intercom as an auditory cue for the duration of "Take a Break".
    
7. Appreciation must be shown, in many different forms, to all of the staff who take part in making the "Take a Break" program successful.
    
8. Remember that key to the success "Take a Break" is the willingness, enthusiasm, and enforcement of the Administrative team. You will likely need to foster the atmosphere that the escort program is a care home administrative program, not "just" a recreation department program.

To introduce and reinforce the new escort program you might make up some flyers to put around the facility. Consider these key points for your flyer:

Taking a Break is as Easy as 1-2-3 !

1. Listen for the "Take A Break" announcements.
2. Go find out which participants to invite.
3. Invite the participant and escort them to the program or, go back to step 2 to invite another participant.

Everyone takes a break and we all benefit! Thank you!

2. Mystery Resident

Mystery Resident was an idea sent to Creative Forecasting by a reader. This program has been put into action with success in skilled nursing care homes with use of the following specific steps:

Select a Resident for the day using the following guidelines.

A. On the first few days, select a Resident who essentially likes to come to programs but needs an invitation, reminder, an escort, or assistance to come to the program of interest.

B. After some measures of success, select Residents who take a bit more encouragement.

C. Select finally some Residents who present challenges to encourage or assist to programs. Announce to the staff that the recreation/activity team has selected a mystery resident for the day. This might be done at morning meetings or by informally talking to staff as they begin their rounds.

Progressively give up to three clues, each clue a little more specific. As examples, fifteen minutes before that program you might announce that the Mystery Resident particularly enjoys the activity at hand.

Then, ten minutes before the program you could announce the general location of the Participant's room.

Finally the color clothes that the Resident is wearing could be announced right before the program is scheduled to begin if the Resident still hasn't arrived. Have a little prize ready for the staff person and for the Mystery Resident when they arrive.

3. Raffle Ticket Rewards

Perforated paper raffle tickets can be used with success for this incentive program.

The raffle tickets that work well are the type that are used for opportunity raffles and can usually be purchased at party stores.

You'll need a large interesting container such as a plastic Sun Tea container, the wheel of raffle tickets, and some good prizes.

Each time a staff person brings in a participant to a program, write the staff persons name quickly onto a raffle ticket and drop it into the container. You could also record the participants name if you want to reward your "frequent flyer" participants.

Continue to do this for any or every program and for the desired duration of time. You might start with one week at first and then later go for a full month. At the end of the week or month, sort the tickets by person. Make announcements to announce the staff person who helped to escort the most participants. Award Prizes.

Consider writing a newsletter article, or making up a bulletin board, to celebrate the staff persons with the busiest feet and the most helpful hands.

Keep a tally sheet to show how many participants are assisted to programs each month. The organized data may be able to show your supervisor how well the program works over time.

Preparing for More OBRA Changes

With consideration to proposed Interpretive Guidelines for OBRA's activity regulations within F248, Recreation Therapy Consultants recommends the following for skilled nursing facility activity departments:

• Add humor-related programs to your calendar one or two times monthly. Consider titles such as: Just for Fun, Rx Laughter, Comedy Matinee, Happy Hour, or Tickle-Me-Pink.
   
• Add community connections or community service programs to your calendar one or two times monthly. Consider titles such as: Card Writing, Keeping in Touch, Children's Corner, or Fundraisers Club.
   
• Include to your calendar programs which explore a variety of new hobbies, new roles, new interests or new skills. Consider titles such as: Something New, Interesting Inventions, What's New, or What's My Line.
   
• Add a newcomers welcoming group one or two times monthly. Consider titles such as: Meet your Neighbor, Welcoming Luncheon, Welcome Wagon, and New Neighbors Coffee. (Look for help from Social Services or Admissions.)
   
• Add meaningful-work related programs to your calendar one or two times monthly. Consider titles such as Linen Folding, Coupon Clipping, Lions Club Stamp Collecting, or Helping Hands.
   
• Add to your monthly calendar cultural, ethnic, and religious activities to meet the needs of a diverse Resident population. Consider parties, dances, celebrations and special meals.

Consider the composition of Resident Care Plans. Keep in mind that care plan goals should not merely focus on attendance at a certain number of activities per week but should focus on what is hoped to be achieved through the Residents participation in these programs and should specify the outcome in terms of the Residents reaction to the offerings.

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