Recreation for those ageing
with and into disability
CACL
Living Well in Our Communities: Thriving As We Age
May 7, 2013
Concord, NH
www.nepassage.org
© University of New Hampshire – Northeast Passage
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
www.nepassage.org
© University of New Hampshire – Northeast Passage
Programs
 Adaptive Sports &
Recreation
 Recreational Therapy
 Teaching and
Research
www.nepassage.org
© University of New Hampshire – Northeast Passage
Difference between
Adapted Sports and Therapeutic Recreation
www.nepassage.org
© University of New Hampshire – Northeast Passage
Aging into disability
www.nepassage.org
© University of New Hampshire – Northeast Passage
Physical Decline
 Decreased
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Strength,
Endurance,
Mobility,
Flexibility,
Balance
 Increased
 Fatigue
 Weight
 Pain
 Cycling
 Three wheels
 Bike path
 Tandems
 Gardening
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Large garden
Smaller garden
Garden mobility aid
Extended handles
Raised garden beds
www.nepassage.org
© University of New Hampshire – Northeast Passage
Cognitive
 Deficit
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App store
Concentration
Memory loss
Problem solving
Planning
Impulsivity
Safety Awareness
 Support
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Find your car
Organizers
Reminders
Map My…
 Games
 Memory games
 Problem solving games
 GameChanger
www.nepassage.org
© University of New Hampshire – Northeast Passage
Social/Emotional
 Isolation
 Loss of identity
 Loss of friends
 Pass away
 Move away
 Frustration
 Difficulty making new
friends
 Anger
 Low motivation
 Depression
 Loneliness
www.nepassage.org
© University of New Hampshire – Northeast Passage
Benefits of Recreation
• Increase in physical
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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?
www.nepassage.org
© University of New Hampshire – Northeast Passage
Making it Work
 What does this activity
require?
 What do I have?
 What do I need to
change or supplement?
www.nepassage.org
© University of New Hampshire – Northeast Passage
Activity Modifications
 Intensity
 Rules
 Duration
www.nepassage.org
© University of New Hampshire – Northeast Passage
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
www.nepassage.org
© University of New Hampshire – Northeast Passage
Select a New Activity
 What did you get from the  What new activity fills that
old activity?
need?
www.nepassage.org
© University of New Hampshire – Northeast Passage
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
www.nepassage.org
© University of New Hampshire – Northeast Passage
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
www.nepassage.org
© University of New Hampshire – Northeast Passage
Qualitative Research Results for Ageing into/with Disability
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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
www.nepassage.org
© University of New Hampshire – Northeast Passage
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.
www.nepassage.org
© University of New Hampshire – Northeast Passage
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
www.nepassage.org
© University of New Hampshire – Northeast Passage
Tom’s story
www.nepassage.org
© University of New Hampshire – Northeast Passage
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