Enriching recreation therapy for a culturally diverse facility

The Report: June / July 2008 vol.29 num.2

by LAURA BUSHEIKIN and YUKIE KURAHASHI

o-Ann Tisserands job as a recreational therapist at Talarico Place in Castlegar is rewarding: in a facility where approximately 75 per cent of the residents are of Doukhobor heritage, each day brings rich cultural exchange.

As well, many of the programs she coordinates have an inherently heart-warming appeal ... for instance, pet therapy, where dogs visit the facility, and gardening therapy, where residents not only work in the garden but also harvest, process and serve up the results.

But what Tisserand values most of all is seeing the residents faces light up as a result of her programs. -Its the smiles," she says, simply, her dark eyes also smiling. -Its the way they still love life and still feel useful even though theyre obviously older and might not be in great health.

-Many times people become so isolated in their homes before they come to a residential setting. Their mobility decreases, they dont have a drivers license, they are unable to walk. For a lot of these ladies, thats how they got around ... they walked everywhere ... so as soon as their ambulation started going down, they were isolated in their homes." For such people, the activities and outings Tisserand organizes can feel like a return to life.

-I really find it fulfilling when someone who was so unhappy starts laughing and smiling and really enjoying themselves."

While the smiles are Tisserands most immediate reward, she also appreciates the therapeutic value of the activities in improving the health of residents. Recreational therapy differs from just plain recreation, she says, in its focus on a specific outcome. The discipline has been part of the North American health care system since the 1940s, and has proven to deliver measurable improvements in cognitive, physical and psychosocial status.

-Recreation is a great motivator because for the most part its something they want to do. For instance, when we go out on the bus, theres stairs. We have only four wheelchair spots on the bus but we have 12 ambulatory spots, so it really motivates them to go up the stairs of the bus because they want to go out."

Recreational therapy is most directly therapeutic in a one-on-one format targeting a clients individual needs.

-If someone is working on something specific, you design a program around that outcome. For example, if someone in short-stay really wanted to go home, but to do that they needed to be able to walk stairs, we could design a program around that," says Tisserand.

However, with 54 long-term residential beds (as well as four short-stay beds and two palliative/respite beds), Talarico Place is primarily a long-term care facility. For these residents, recreational therapy mainly takes the form of group programs aimed at maintaining quality of life.

-We do outings twice per week ... well take them to restaurants, well go shopping at the malls, we go to community events, things like that. And of course Bingo: everyone does it. We do a group fitness class, we have bowling, and have a horse racing game which they love. We have church services that come in that we facilitate, and music groups that come in," says Tisserand.

The pet therapy program, run by St. Johns Ambulance, is extremely popular, she says.

-Its really neat because some of the people are very low functioning and dont really react to a lot. But when they put their hand on the dog, they react right away ... theyll smile or pet the dog. Big smiles ... there are some people who barely ever smile. And when they see the dogs they get really excited and really happy."

In planning programs, Tisserand needs to consider the needs of the many residents in the facility of Doukhobor heritage.

The Doukhobors are descendants of Russian religious dissidents who immigrated to Canada in the late 19th century, and until recently lived in tight-knit communities, preserving their language and traditions.

Some of these traditions contribute to Tisserands programming; for instance, the Doukhobor focus on self-reliance means they are great gardeners, which helps maintain a strong gardening program.

-We start in the spring by sowing seeds ... tomatoes and cucumbers and flowers. Then we plant them in the garden, and theyll help with the weeding, and one resident who is very functional will do all the watering throughout the summer. And then we harvest. They like to have the cucumbers and tomatoes cut up at lunch," says Tisserand. -And we have one lady who likes to can tomatoes from our garden."

The Doukhobor community also brings challenges.

-Many of them dont speak English very well, and they resisted sending their kids to school ... so many dont read or write," says Tisserand. This makes some programming more difficult. For instance, an activity involving reading excerpts from newspapers to stimulate conversation didnt work with the Doukhobors because of literacy and language barriers.

-And they also have a shared history of sadness," says Tisserand. -Im not sure if youve heard about how the Doukhobor children were forcibly taken away from their parents. Well, these are the parents whose children were taken away."

Interaction between the Doukhobors and the English-speaking residents involves negotiating not just language but also cultural differences. For example, the Doukhobors are pacifists, so they do not observe Remembrance Day. However, many of the other residents are veterans, and this leaves only a small group to attend celebrations in their honour.

-Its an interesting mix," says Tisserand. Although Tisserand loves her job, it has its frustrations. -Because of the crunch with staff theres only two of us and were both part time. As the other departments ... like nursing or physio ... get smaller, they start wanting you to take on things that other departments might have done, such as porting residents from their rooms to meals, helping in the dining room, serving coffee and tea, helping them butter their toast."

-I can see more and more of that coming our way. We can do that, but that means were not going to have time to do something else more enriching. A highly trained professional assessing and providing recreational therapy is of immeasurable value to residents. But currently, theres little time for preparation or research or building new programs or doing more one-to-one activities."

At the same time, Tisserand stays motivated by appreciating the improvements in overall physical function, mood and motivation associated with her programs, and most of all by enjoying, every day, the smiles on the faces of her clients.