‘When a hobby is more than just fun’
The NRH Therapeutic Recreational Service continues to improve mental health and physical well-being of patients. Stuart McKeever, NRH Recreational Therapist, takes us through the importance of Recreational Therapy in the NRH. The NRH Foundation provides annual grant aid funding to support the running of the Recreational Therapy Service in the NRH.
What is Recreational Therapy?
Do you have a hobby? Chances are you do! Could be something you can do in the privacy of your own home like knitting, playing music or painting, or maybe something more outdoor orientated like playing football, walking or gardening. Maybe you don’t even call it a hobby. It’s just an activity you really enjoy and that helps you unwind after a long, stressful day. Now what if you wouldn’t be able to do that activity anymore, the one that really helps you relax? What if, in a time where stress levels increase ten-fold like suddenly finding yourself confined to a wheelchair or having cognitive challenges… you’ve now also lost your usual stress relief activity?
When we think about rehabilitation, the things that come to mind are often the more ‘standard’ therapies like physiotherapy, occupational therapy and speech & language therapy. There is no doubt patients need all of these to reach their rehab goals. These therapies require a lot of energy and may, at times, unintentionally add to stress levels. Patients need to find a way to release some of that stress. What if we can offer them that, and at the same time incorporate some of their goals? That’s where the Therapeutic Recreational Service comes into play. Here, in the National Rehabilitation Hospital (NRH), we’ve seen some great results (and are facing some great challenges) with the Therapeutic Recreational Service (TRS) that we feel are worth sharing.
Goal
Let’s start with our overall goal: We want to improve mental and physical well-being, assist in rehabilitation progress, and promote functional independence and re-integration into the community through recreation to all patients in the NRH.
Objective
In accordance with our goal, it’s our objective to help promote and encourage the growth and development of a patient by providing/facilitating opportunities to become once again involved in previous recreation interests and activities and if this is unattainable, together with the patient, the TRS will explore other potentially fulfilling leisure and recreation options.
How do we achieve these goals & objectives?
Looking at our goals and objectives, we found there’s a number of successful ways to achieve these. One-to-one sessions, group activities, joint therapy interventions with other therapists, recreational outings and annual events that take place throughout the year.
One to one individual therapy sessions
Generally it all starts with a referral from the patient’s Occupational Therapist in the NRH. After which the Therapeutic Recreation (TR) Specialist assesses a patient’s recreation and leisure needs and develops and coordinates the delivery of a therapeutic recreation plan. The TR Specialist also provides information to a patient/family regarding therapeutic interventions such as increasing awareness and the facilitation of various recreational and leisure pursuits including sports, creative arts, hobbies, outdoor activities and social groups/events. The selected activities are based on patients therapy goals i.e. Physio, OT, SLT, Psychology, Social work etc.
Below is some feedback that has been received recently into the Recreational Therapy Service:
“As you know he was a really active teenager before his accident. He enjoyed being outdoors and cycling with his friends a lot. Since his accident he was unable to participate in these activities and was missing them greatly. Hand-cycling has enabled him to go on the grass with his friends again. He loves how mobile and active he feels when using the hand cycle and it has changed his whole outlook on life for the better. We can’t thank you enough for everything you have done for him and us”
(NRH Patient’s family member)
“In the other hospital no one thought about involving him in things he enjoyed before his accident. It has really got him interacting more and enjoying his other therapies too.”
(Family member of a NRH patient with an ABI)
Group Activity Sessions
We provide recreation and leisure programmes/activities in groups to patients such as Quiz nights, Arts & Crafts, Karaoke, Boccia, Games nights, Chess/Knitting clubs, Swimming Groups, Music Workshops, Yoga (relaxation/mindfulness classes) Photography courses, and cooking demonstrations, to name but a few.
Patient organised activities due to an expressed interest from our patients include, singing events, cookery demonstrations, outings to restaurants, cinema and shops – these all take place regularly. Many of these activities are coordinated by the patients with our assistance and encouragement.
The example below shows that the group activities also help patients reach some of their goals.
“As part of my role as Head of Learning & Development in LinkedIn I have to do a lot of public speaking. As such, facilitating in front of a group while standing without support for 10 minutes was an important goal for me. The weekly quiz night allowed me to do just that. I prepared the questions and then was quizmaster. Not only did I hit my goal but I was able to share that victory with a room full of people who knew exactly what it meant to stand there for those 10 minutes and triumph.”
(NRH patient with left sided hemiplegia)
“The feedback from patient’s families and staff has been excellent. There is also a real sense of life and busyness in the NRH in the evenings which is a major change from a few years ago. The choice of activities and the engagement with the community has been great. Well done to the NRH on expanding out this vital service”
(NRH Senior Speech and Language Therapist)
Events
Bi-weekly music performances also take place, from an array of talents and different genres; from rock, traditional and classical performers, bands and choirs. An example of this is the NCH (National Concert Hall) who perform workshops, concerts and music bedside to patients on the wards on a monthly basis.
“I came to the NRH kicking and screaming from another hospital. As I arrived to the NRH with my parents that evening, very upset, I could hear classical music coming from the NRH Chapel. My Parents and I went to the chapel and listened to the most beautiful performance (National Concert Hall Musicians). When the performance ended I felt relaxed and now ready for my stay at the NRH. I thought to myself “this must be an alright place”. I am always so grateful for that night and often feel thankful for this service existing.”
(Past NRH spinal patient who is now fundraising specifically for this service)
Celebration of Life through Music Week
As the story above and so many others show, music touches people in the core of their being. We all have that one tune that brings us back to our childhood, favourite holiday, first love. Music is emotion. Below is a quote from Medical News Today showing music benefits both mental and physical.
“We’ve found compelling evidence that musical interventions can play a health care role in settings ranging from operating rooms to family clinics. But even more importantly, we were able to document the neurochemical mechanisms by which music has an effect in four domains: management of mood, stress, immunity and as an aid to social bonding.”
(Medical News Today)
Annual Music Week Festival
Music is also life and that is why the NRH celebrates ‘Life through Music Week’ each summer. Each year’s Music Week receives positive feedback from therapists, staff and in-patients across all disciplines. With many reporting an increase in certain patient’s willingness to engage in their therapy sessions due to the music and increased positive atmosphere within the NRH.
All of the musicians who participate each year, over 150 of them, give their time and talents free of charge to which we, the TRS, are very grateful. The event finale is always a remarkable and unforgettable evening performance from musicians such as Davey Arthur and the Furey’s, Christy Moore etc. who kindly come to perform.
Music Week now has a major patient interactive element that compliments many of the patient’s therapies. The activities include iPad music lessons (assistive technologies), guitar lessons (memory, dexterity), karaoke (speech, social), song and poem sessions (creativity), music workshops where instruments such as tambourines, drums and triangles are handed out to the patients allowing them to join in and make some music.
Photography Exhibition/Competition and Calendar
We run a photography course in the NRH for patients. Photos in the past have been used to create a calendar, and some of our patients photos are currently being used for the NRH Charity Christmas Cards. We have also had the opportunity to showcase some of these images in a photography exhibition in Deansgrange local Library. This project provides an excellent platform to empower patients to develop their personal skills through the medium of photography.
Joint Therapy Interventions
As mentioned at the start of this article, our main goal is re-integration of the NRH patients back into the community and joint therapy sessions are one of the ways to achieve this. In this case the TRS works closely with the other NRH Therapists, for instance the Social Worker or Neuropsychologist, to ensure a therapeutic plan is compatible with the patients individualised rehabilitation plan. During the development of this plan we identify potential barriers to recreation, both now and after a patient’s return home and develop therapeutic intervention strategies to integrate/reintegrate this patient back into the community/facility or their home. Someone with severe cognitive issues for instance may need additional support when they want to play a team sport.
“The availability of activities and entertainment greatly contribute to the patients’ well-being and brings a sense of normality and community to the hospital experience which also has positive benefits for families and staff. In the interest of all groups it is important that the service is maintained, continues to develop and becomes a permanent service/dept. within the NRH.”
(NRH Senior Social Worker)
Days Out
Recreational Outings are facilitated on a basis of the needs of the NRH patients. Some of the recent recreational outings have included trips to the cinema and dinner night outs, attending IRFU rugby games in the Aviva stadium, Shopping trips, Gym trips, Fishing outings, Golf trips, visits to Croke Park, etc.