Recreational Therapy Blog

HAVE WHEELCHAIR…WILL TRAVEL

Charlie Nature MS Ed. HTR

MS patients lead Self-Help groups. Currently, there are between 15-20 thousand MS self-helps in the United States. Groups are held in various places including healthcare facilities, board rooms, the library, accessibe homes and other suitable places in the community. All groups last between 1 1/2-2 hours.
Groups tend to start small. One must refer to the old Calvary Hospital axiom: 3 is a group - a maxim widely accepted on its intrinsic merit. In an effort to help myself, I am starting a Self-Help group on August 19th, 2008. The MS society provided me with traning. They are supporting me in this endeavor. The group is being held in a completely accessible setting; a modern Nursing Home. I am using the Para-Transit system to get there. Have Wheel Chair…Will Travel

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UNIVERSAL DESIGN, ITS TIME IS NOW

By  Charlie Nature  MS Ed. HTR            http://www.horticulturaltherapy.info/

Imagine being an individual who must plan his leisure pursuits only to places with Universal Design. From bathrooms to various venues, universal design is opening doors & leisure activities for disabled Americans as never before.

John Dillon State Park, in New York, made camping accessible with roll-in Adirondack sites. Newer hotels, built in the past two years, offer a choice large or small  ADA suites with roll-in showers. Nature centers provide “Wheels On The Trails” access. Broadway Shows remove seats to make way for wheelchairs and charge nominal fees for the user and one companion. Beaches provide access to the water. Happily, the list goes on. 

People with disabilities are finding more choices to share with families and friends. I ejnoy planning trips and discovering places that accommodate my needs. Unfortunately,  some  conferences are held in places that are minimally ADA compliant. I propose that future conferences be held in places that exceed ADA standards. Otherwise, it is ironic that people with certain disabling conditions cannot attend certain conferences if the accommodations are lacking universal design.  Universal deigns time is here.

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Being an RT on Vacation

 by Charlie Dixon, MS, CTRS

 I recently went on vacation to Hawaii with 10 other family members.  Each member of the group wanted to do different things but also wanted to do things with each other.  Several members didn’t like to plan and just wanted to do things as it came up.  But in order to do things in a resort area we had to do some planning so as not to get shut out of restaurants we wanted to eat at or to do specific activities.

So, it fell upon the RT in the group to do the planning and getting everyone in the group to agree to a plan. 

Even on vacation it seems that an RT can’t get away from his/her work

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TR IN THE GARDEN

By CHARLIE NATURE       http://www.horticulturaltherapy.info/              

Spring 2008 beats the last two. In 2006, I spent spring in an acute care hospital for one month  and in a physical rehabilitation hospital for 29 days. In 2007, I spent spring in an acute care hospital for three weeks; and in a nursing home for 23 days.  (Talk about seeing health-care and spring from a different perspective!)

This  spring, I am accessing therapeutic recreation from my van and motorized wheelchair. I traveled to the Stamford Nature Center. I visited  miles of trails, a brook garden via a 1/4 mile wheelchair path through the woodlands.  At home, I am building an accessible garden with favorite sensory plants, vegetables and herbs. Life continues but, not without challenges. I know what life had to offer before I became a quad.  I begin to find meaning in my life today, still my condition demands all my attention.

I minimize and dread progressive disease. I plan how to adapt. My wheelchair is so large, Ineed to plan every move.  I go for treatments, therapies and lately, out to dinner and a movie. I dream of running, sailing, paddling, camping, hiking, music festivals and picnics. I miss  working in TR. I miss teaching at the New York Botanical Garden. Regardless, I enjoy Spring from where I sit. I am thankful for that.

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On the other side

by Charlie Dixon, MS, CTRS 

Just this past week I had become a consumer of services.  My aunt with dementia needed hospitalization and then a transfer to an assisted living care facility or 24 hour live-in service.  Since my aunt lived 4 hours away and I was the closest relative I had to take care of her needs.  I searched and toured facilities, contacted various agencies, talked to social workers, adult protective care agency, police, doctors, nurses, etc.

The week long family emergency was one of the most stressful events in my life.  I started to think about how families that come to the psychiatric facility where I work must go through.  They probably are going through high levels of stress as they work to obtain care for their loved one.

 Patience, understanding, and care are words that will be going through my mind as I interact and see family members coming to our hospital.

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10 REASONS WHY A CTRS CREDENTIAL IS MEANINGFUL

CHARLIE NATURE  MS Ed. HTR    AKA: CHARLES SOURBY                  http://www.horticulturaltherapy.info/  

1. A CTRS is an undergraduate qualification  but, it sets a standard for TR.

2. A CTRS is not universally needed for a job in TR but, it is increasingly required by facilities.

3. A CTRS is perpetuated by ceus., that meet various standards but,  ATRA carefully evaluates TR conferences before awarding them.

4. A CTRS is awarded by the NCTRC office that is actively sending staff to training sessions on customer service.

5. A CTRS does not guarantee a salary increase but, a CTRS’s earning potential is excellent in big city markets.

6. A CTRS exam is easy for some,  hard for others but, the NCTRC  insures the test is administered in a way that is fair to all including those with disabilities.

7. A CTRS is one of the lowest paid health-care professionals but, with increased evidence based testing (EBT),  this may change.

8. A CTRS is out of the research loop but, can increase the “body-of-knowledge” simply by recording positive outcomes and improvements.

9. A CTRS: Can Take Recreation Seriously and needs too. 

10. A CTRS plus  two bucks and change, gets a Subway Sandwich  for someone who is typically shut out of such pleasures.

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THERAPEUTIC MOMENTS

Charlie Nature MS Ed. HTR   http://www.horticulturaltherapy.info/  

Therapeutic moments occur when the therapy, therapist(s) and program participants connect. Karma, good rapport and well written activity protocols lead toward therapeutic moments. Furthermore, meeting the clients “where they are at” is paramount. Therapeutic moments transcend subjectivity and academic polemics.  Research in efficacy based treatment reveals that therapeutic moments happen one-on-one, in small groups and less frequently, in large group programs that boost statistics. In conclusion, individual and small therapeutic recreation groups increase the potential for therapeutic moments.

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RT vs RT

Charlie Nature MS Ed. HTR   http://www.horticulturaltherapy.info/

Recreation Therapy vs. Radiation Therapy 

Therapeutic recreation is the provision of Treatment Services and the provision of Recreation Services to persons with illnesses or disabling conditions. The primary purpose of Treatment Services which are often referred to as Recreational Therapy, are to restore, remediate or rehabilitate in order to improve functioning and independence as well as reduce or eliminate the effects of illness or disability. The primary purposes of Recreational Services are to provide recreation resources and opportunities in order to improve health and well-being.  (Recreation Therapy.com., 2008)

Radiation therapy involves treating disease with penetrating beams of high-energy radiation. For example, radiation therapy is used to treat cancer – alone or in conjunction with surgery and/or chemotherapy. Radiation therapists are highly skilled members of the cancer management team. They are responsible for accurately recording, interpreting and administering the treatment prescribed by radiation oncologists. During treatment, therapists help physicians use fluoroscopy, X-ray films or CT scans to localize and outline anatomical areas requiring treatment.  (Mayo Clinic, 2008)

As a recreation therapist, I treated people who suffered through radiation  therapy. Some had radiation burns, others  endured emotional issues, and  others  got scar tissue. Regardless, all received an increase in personal isotopic radioactivity. As a patient with progressive relapsing MS,  I recieve radiation therapy for diagnostic clarification, via radioactive  MRIs, lesion monitoring, swallowing evaluations and pre or post-surgery. I am interested in recreation therapists conducting a study on the efficacy of providing TR services to patients who receive radiation therapy.

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Playing Catch 22 in New Zealand

Kia ora from New Zealand.  Charlie invited me to share a bit about TR in NZ so here goes…

It all began about 9 years ago when Eastern Institute of Technology Hawke’s Bay (North Island east coast) got together with Dr Glenda Taylor (a Kiwi living in the USA and doing TR).  Ultimately, the Bachelor of Therapeutic Recreation degree got started in 1999 and three years later the first 5 graduates emerged.  In 2000, Southern Institute of Technology in Invercargill (South Island south coast) started teaching the same programme but the degree was called Bachelor of Health Science (Therapeutic Recreation). The two schools trucked along with small class numbers, (mostly) enthusiastic students, lecturers and practicum providers until the schools decided the programme wasn’t financially viable. Now there’s only a  few students finishing their studies with no new intakes for a couple of years.

Previously there was no TR profession in NZ so it wasn’t only a new course that was being introduced.  Many graduates have jobs but they have had to find them, create them, educate employers, etc.  Not many are given the job title of Recreation Therapist.

So here’s where the frustrating game of Catch 22 comes in. We can’t get the profession established without more graduates and the schools won’t offer the degree until heaps more people sign up to take the course.

It was a fun degree to do and most of us were “mature students” not school-leavers.  The degree has helped graduates into jobs in Aged Care, Mental Health, and Intellectual Disability agencies. 

We do have a young professional organisation, about 70 graduates though not all have continued in the field, and some people doing TR related jobs.

Check out the NZTRA website www.nztra.org

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GIVING UP A CTRS

By Charlie Nature MS Ed. HTR    http://www.horticulturaltherapy.info/

As a CTRS, I found the ceu. upkeep oppressive, given my status as a quadraplegic. Over the years, I devoted myself to a career in TR. I taught, presented, ran programs and signed  ceu. forms. I gave up my CTRS because I can no longer practice TR.  Recently, I spent time in medical facilities, rehabilitation hospitals, nursing homes and outpatient clinics. 

Still, in between,  I commuted to the Bronx using a variety of adaptive devices. I started with a cane, then a pair of loft strands, rolling walkers with seats, self-propelled (hand-powered) wheelchair and finally, a Jazzy motorized wheelchair. I cruised on bumpy sidewalks, crossed busy intersections and drove on the streets when curb cuts were unavailable. The trains, para-transit buses and accessible commuter buses worked for me. 

The time spent waiting for connections sometimes afforded me leisure. I  experiencined professionally run recreation programs as a client. I spent months in hospitals  undergoing surgeries, therapies, tests, examinations and endless paperwork.  I learned something about the CTRS credential: use it,  or lose it. I recently retired, bought a van with a lift, am in the process of remodeling my home beyond ADA standards and planning vacations in new hotels for me and my family. I cannot lose the intrinsic sense of self actualization I learned through TR.  May the profession continue.

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