Rec therapy: not just fun and games

The Report: January / February 2004 vol.25 num.1

by YUKIE KURAHASHI

ames Benson does not walk. He bounds. His compact frame can barely contain his energy, and when he smiles, he smiles with his whole face.

Benson speaks emphatically, con spirito. His passion for his work makes him speak quickly and fluently about his job and his clients.

But there is one topic that renders him speechless with frustration: the Fraser Health Authority’s recently announced plans to lay off all recreation therapists in the region.

Asked about that decision, he slows down and takes a moment to collect his thoughts.

“I’m a strong advocate for recreation therapy because it does so many wonderful things. It is statistically proven that participating in recreation programs transforms people: it helps with their self esteem, increases their functional physical being.

“When I was at university, the buzz word was ‘holistic.’ You do everything – the spiritual, the social, the physical, and the cognitive areas for every individual, and you try to build up all these areas within the day, or within your program for the individual,” he said.

“But recreation is always cut first. We make our job look fun and easy; it might look like anyone can do it,’” he said.

“In the Fraser Health Authority, they cut the whole program and brought in people with lower credentials,” he said. “The people I work with – the other health care workers – are all great people. I admire them. But it’s a terrible mistake to cut rec therapists and replace them with aides.

“I am sure the board of the Fraser Health Authority would not hire a CEO who just got a diploma and is fresh out of school to run their organization.

“We need experienced people to assess what the programs are and why we’re doing them. It’s not enough to say, ‘It’s Tuesday so it’s crafts’ or ‘It’s Friday so it’s bingo.’ Are you going to initiate something – step out of the box and say, ‘OK, this lady likes to kayak. We’ve got disabled sailing; let’s try that out.’ Or are we going to keep to bingo, because, well, I don’t have the education or knowledge to try more stimulating activities with residents, or do an assessment.” he said.

Benson, who works at the Priory and Aberdeen sites of Juan de Fuca Hospital, described the complex role of recreation therapists working in long term care.

“Recently, a third-party survey of residents and family members ranked Aberdeen number one out of all BC extended care facilities for having the most mentally stimulating programs. When I heard that, I jumped for joy.

“We provide a therapeutic program for recreation or leisure,” he said. “The most important thing is the assessment of the individual; we do an assessment with every referred client. You find out what they’ve done in the past, what they like to do now. Then you take in their current strengths and weaknesses, and you program for them and with them to use recreation and leisure to enhance their life.

“We’ve taken people to camps; people kayak, they sail, they ski, they do everything. We’ve gone skating, we’ve gone fishing, we have our therapeutic bike.”

Benson swells with pride as he wheels out the bright yellow DUET bike: a combination bicycle and wheelchair. The bike is built so that a resident can ride in a secure seat in front of the handlebars, while the therapist pedals.

Benson gently straps a resident into the chair. She seems to be a woman of few words, but she beams at him the whole time he is in her field of vision. As his hands work the straps, Benson keeps up an affectionate patter. As he wheels the bike outside, the resident grins from ear to ear, her eyes lit up with joy.

Benson later describes the effect the DUET bike has had on residents. “It’s so moving how this has changed their lives. One lady even told me, ‘This bike changed my life,’” he said. “I’ve ridden it when I’ve given in-services to my colleagues on how to drive the bike, so I know what it feels like. You feel very majestic.

“It’s very soothing, very comforting,” he said. “You’re sitting up, so you are using a lot of muscles to sit up and look around, observing the neighbourhood.

“We’re finding in people with dementia that their ability is increased, and their vocabulary is increased. They’re more alert. They laugh more.”

Two years ago, Benson conducted a study involving the bike’s effects on residents.

“The hypothesis was that participating in the DUET bike program would help decrease depression in the elderly. We used the geriatric depression scale and the Cornell Scale for Depression with people with dementia to test our group before the ride,” he said.

“We also had a control group, and we gave them the same tests. We did a pre-test and a post-test, and we found that we were able to decrease the feelings of depression by 15 per cent. That’s an amazing result,” he said.

Benson sees many other benefits from the DUET bike program. “When we first went out, the first week, we went around the block. People said, ‘Where are you from?’ And they didn’t even know where we lived,” he said. “Now, people know our names, we know their dogs, we know their kids, they bring us flowers. We really became part of the community. Just hearing their happy voices and seeing people’s smiles afterwards – that is truly an honour to be able to bring people out like that,” he said.

Another program that Benson promotes is the reminiscing group. “I like to use a theme and props to enhance memory, and we use the reminiscing program to let people recall their past. They’re fascinating stories. And by showing interest in them in their life, it builds the resident’s self-esteem and self-worth, and helps with their life review,” he said.

“These people are a store-house of oral history: stories about working during the Depression, living through the war, even cooking. These ladies, they cooked on wood stoves and baked all their bread.

“But even our more simple programs have a huge effect,” he said. “For example, we make candles at this time of year out of beeswax. I’ve had arthritic people with bent fingers say, ‘I can’t do that, I can’t.’ Well, with a little bit of adaptation and a little bit of help, all of a sudden these people are making beautiful tapered candles that we then sell in our craft shop,” he said.

“People in the community buy them, and come back and say, ‘I had them on my Christmas dinner table – the candles that you made.’ That is community, and that’s helping each other,” he said.

“It’s helping the resident to see that ‘Yes, I can accomplish something. I can do something that’s worthwhile and that brings happiness to other people.’”