Dear Debbie: Archive #01
By Debbie Hommel, BA, CRA, ACC
Executive Director of
DH Special Services
Last Updated
01 APR 2006
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Nursing Home Activities Defined
About Debbie

Debbie Hommel, BA, CRA, ACC,
is the Executive Director of DH
Special Services. She is a
Certified Activity Consultant on
State and National level, with over
twenty-seven years of experience
in providing direct care and
consultation to long term care,
medical day care, assisted living,
and ICF/MR facilities throughout
New Jersey, New York, Maryland,
and Pennsylvania. She is an
experienced trainer and workshop
presenter, conducting a variety of
seminars throughout the Tri-State
area for the Activity Professional,
Administrator, and allied
healthcare professional. Debbie
Hommel is an active member of
Activity Professional Associations
on State and National levels. She
is ACC certified through the
NCCAP. She is a founding
member of the New Jersey Activity
Professionals' Association,
serving terms as Vice President
and President. She received the
Weidner Lifetime Achievement
Award in 1994 and the Monmouth
& Ocean County Activity
Professionals Life Achievement
Award in 1999.
Dear Debbie Questions & Answers
Posted from Newest to Oldest
Question:  I am a new activity director for an assisted living with two houses with two
different populations, I have replaced an activity director, it is very stressful I have to plan two
different calendars, I don't feel I have much support and the pay is minimal, any suggestions?

Answer:
 That is a tough one.    To plan two schedules with one person is difficult  no matter
what.  I would think your first step is to gain some support  somewhere.   Scheduling a meeting
with your administrator seems to be in order.  I would suggest having several plans defining the
type of support you would need (through caregivers, contracted services, etc.).   Whatever plan
he/she endorses, they should support and help you carry it out.  Support can be sought through
volunteers, the caregivers, family members or the residents themselves.  Meeting with the
residents and determining some activities they could do on their own, with some set up would
be a priority.  Then scheduling programs you would need to do around that schedule makes
sense.  Meeting with the caregivers and identifying some of their interests and potential for them
to conduct programs might help.  The bottom line is, there is so much one person can do. But
together and as a team, so much more can be accomplished.  Hopefully, you can sell that
message.
__________________________

Question:  Can you tell what is ADC Track 5 "Window of Opportunity" is all about? Should
Activity Directors be worry about this or should they embrace it? If you can't help me do you
know someone that can? Please comment.

Answer:
 Not sure what you mean about activity director's  "worrying" or "embracing" this track.  
The NCCAP ADC Track 5  is an opportunity for certain individuals to gain certification if they meet
the standard.  If you are already certified as an ADC, it doesn't pertain to you.  If you are not
certified and have six years of activity experience in the past ten years; completed a basic activity
course of anywhere from 36-90 hours between the years 1991-2001; and have 30 hours of
continuing education (six hours of which has to include the topic of activity documentation), then
you would qualify.  If you have the experience and the activity course as defined, and are lacking
the continuing education - then I would try to get the 30 hours of continuing education and apply
prior to December 31st, 2006. This track will be discontinued after that date.  It is also applicable
to individuals who have already gotten the ADCP  or AAC certification and meet the qualifications.
  You would have to do a level change by completing the Track 5 form and paying the level
change fee.   You can download the form from the NCCAP site at www.nccap.org.
__________________________

Question:  I am wondering how to get more church involvement at the nursing home I work
at, have any good ideas? I also would like to get some students from area colleges to come
and volunteer there time as part of there college course,how do I go about getting that
arranged? Also,just where does one start in a new position as an AD at a nursing home? I a
bit nervous.

Answer:
 Hi, welcome to the rewarding world of therapeutic activities.  I answered a similar letter
from another new activity professional - a few letters down from this one.  I listed a bunch of site
which might be helpful.  There are plenty of resources out there - if you have the time to go
through them.  As far as getting more support from area churches, I would suggest
determining the needs of your residents first - identifying specific religions that are noted in the
assessment.  Once identified, I would  contact those area churches first.  A phone call is a good
start, but  nothing works better than a face to face meeting. Making an appointment and meeting
with the pastor will allow ample discussion of your residents' needs and possible ideas for
programming. Preparing for the meeting by having specific program ideas, including formal
gatherings, 1-1 visits, Bible Study Groups, Hymn sing programs or whatever else you think your
residents might enjoy is also helpful.   I would also have a plan prior to contacting the colleges.  
Knowing what majors the local college offers will give you some direction in what department to
approach.  The human services or social science majors would be most receptive to interfacing
with your facility. The experience with the facility should provide some educational value to
the student and the course of study, so you would need to present experiences that would serve
that purpose.  I would also suggest tapping into your local or state activity associations.  Most
states have wonderful networks which offer priceless support. Good luck! Debbie
__________________________

Question:  I am looking for anything that could get our men more involved in activities.  A
men's group?  Any ideas?

Answer:
 Interesting you should ask that question.  I just finished the April article for "The Activity
Director's Office" newsletter [
Activity Director Monthly}and understanding and programming for
the male resident was the topic I chose.   Check out the April (2006) issue for some ideas.
__________________________

Question:  Where are courses available in Houston, Texas for Certified Activity Director?

Answer:
 This is the link from the NCCAP site which lists the instructors in the state of Texas.  
http://www.nccap.org/about/educators/texas.shtm  There are a few listed for Houston.  You would
need to contact them to find out their class schedules.
__________________________

Question:  I was just reading your Questions & Answers column and saw your reference to a
home-based activity service.  I am interested in finding out more about offering this type of
service.  Any links you could provide or persons you can put me in touch with would be most
helpful.  I hold a BA in Sociology/Gerontolgy, MEPAP 1 and years of volunteer experience in
activities, pet therapy, special event planning, etc.  I have also been a caregiver for two close
relatives with Alzheimer's.  I currently work PT in my family's business (Internet sales) and
would like to find a PT activities position.  In my area most assisted living facilities only
employ a FT AD; SNF's are pretty much only hiring CNA's as PT Act. Asst's.  The idea of
starting my own activities business is very intriguing and something I would like to explore
further.  Any suggestions you can give me would be greatly appreciated.

Answer:
 I don't know all the details of setting up such a business, but I have heard of them and
seen them available in the industry.  My comments are based on what I have read, seen and
heard - not direct experience.  My thinking would be that you would have to set it up similar to a
home health agency.   The company would need to be bonded and insured.  There should be
some strong method for screening applicants and checking references.  There should also
be some sort of assessment or screening process and monitoring system.  Possibly, the
therapist would do the screening and setting up the home recreation program and then activity
assistants would conduct the interventions with follow up from the therapist.  Another way would
be for one individual to simply make the service available. There are minimal regulations, if any,
regarding contracted home care if the individual is paying privately.  You could just advertise the
service, define a rate and wait for the phone calls.  I would still think having credentials (like
NCCAP) and having insurance would be imperative.  I live in an area surrounded by retirement
communities.  I could probably create a flyer or brochure, mass mail it to the communities and I
am sure someone would call. Another option, is to obtain a per diem position as a companion
with a home health agency.  In my area, there are several positions that one can contract through
a home health agency - including medical staff, nursing assistant staff and companions.  The
companion keeps the client company, helps with simple chores around the house, takes them
shopping and could do recreation if so inclined.  This is a completely open market.  The
individuals creating the programs are the ones who will be defining a standard.  Unfortunately, it
also leaves opportunity for people to be taken advantage of.  Good luck,
__________________________

Question:  I am currently looking for a class to attend to learn the new guidelines for activity
documentation.  I plan to attend one within the next few months. But I need an answer to this
question.  My questions is this, I have been told by the medical records person that I have to
have the activity assessment done within 72 hours. In the pass it has been within 14 days
after admission.  I usually have them done within 5 days.  I told her I had not heard or read
anywhere that it had been changed to 72 hours from 14 days.  Do you know if this is true?  
And if it is true where can I find the new rules so I am not missing anything else.

Answer:
 To my knowledge - the Federal regs have not changed the time frames of
documentation - so that is not where it is coming from.  I am not familiar with Ohio regs and time
frames, so you need to check to see if they have changed.  I would doubt it though, because
most State regulations coincide or coordinate required documentation with Federal Standards.
The new ruling for the Federal regs is not final yet.  My understanding it is in the final stages, to
be implemented by April, May, June?   I am e-mailing you the draft that I have, under a separate
email.  Keep in mind - the draft is not final and there could be changes to what I am sending you.
  Contacting your State activity association is also recommended as I am sure they are working
to keep informed and will be arranging training that will help Ohio activity professionals. Their
web site is
http://www.rapohio.org/   Good luck
__________________________

Question:  My name is ____ and I am a new activities director for an independent/assisted
living community. I have always wanted to work with elders and now I am so excited to have
a job in the field. This is a new thing to me, however, so I am feeling kind of lost. The
community I work in has not had an activity director in 2 months, and have had 5-6 in the last
year. The staff is so helpful and nice, but I feel kind of thrown in.... I was wondering if you
could offer me any helpful tips or advice that would make my transition easier. I am not
certified, and actually I don't know what that even means...I am from GA though, so from what
I know, I don't have to be. Could you also maybe point me to some professional resources or
maybe give me some tips about organizations I should belong to? I appreciate in advance
your time and help! Its greatly appreciated. Thanks and God Bless you!

Answer:
 Welcome to the exciting world of recreation and activities.  This is a growing field and if
you enjoy your job - you will always have a place to work.  There is an association in Georgia
which might be able to help you out.  Their web site is
 http://www.gaap.net/    There are many
activity based web sites on the net with lots of program ideas.  If you go to the link page of this
site, they have lots of activity sites listed.
http://theactivitydirectorsoffice.com/WebLinks.html
Also, when you visit each activity based site - they all have a link page of their own.  You won't
have enough time to peruse them all, that is for sure. You should subscribe to the
recommended programming periodicals - Creative Forecasting  
http://www.creativeforecasting.net/  and also consider A New Day
http://www.ggapublishing.com/index.html   If you go to both of their web sites, they will both send
you a complimentary copy for review.  There is also a great web site called Activity Connection
which you need to subscribe to, but has lots of ideas.  
http://www.activityconnection.com/  I think
you can get a free trial month also.  Between all of them, you will have more programming ideas
than you can use.  But you will need to determine if they are appropriate for your resident's level
of functioning and ability.  There are also several news groups for activity professionals,
including
http://groups.yahoo.com/group/activityleadershipforseniors/ and
http://groups.yahoo.com/group/ActivityChat/  and
http://groups.yahoo.com/group/activityprofessionalsonline/
If you sign up for these groups, you will get e-mails daily with conversations and information
from other activity professionals.  They offer new ideas and a forum for questions if you have
them. Hopefully, that will get you started. One final thought, involve your residents in developing
the program, if you haven't already.  Surveys, meetings and 1-1 discussions with your residents
can provide you with helpful information regarding programs they have enjoyed in the past and
also have not liked. Good luck and have fun!
____________________________

Question:  Is there a certification class available near Los Angeles?

Answer:
 Hi, you would have to contact the instructors in California.  You can obtain a listing
through the NCCAP site by going to
http://www.nccap.org/about/educators/california.shtm
You can also contact the State NCCAP representative for California which is listed here   
http://www.nccap.org/about/educators/state_rep_california.shtm
Finally, you could visit the State association in California as maybe some of their members
might be able to refer you to some local training.
http://scaap.net/  Good luck, Debbie
____________________________

Question:  I Have been working as a activity director and love the feeling it gives me.  I wish to
step up and join all convention with other activity professionals.  I want to get certified by the
state if possible and learn more.  Please write back.   Your friend ____.

Answer:
 You need to check your State regulations and what they define for the qualifications of
director.   Many States are very well organized with strong State associations as well.   If you tell
me your state, I could better direct you in that area.   You also should look at the National
Certification Council for Activity Professionals, as that is the national certifying body.  They list
representatives and class instructors, by state, who might be able to help you also.  Their web
site is
www.nccap.org.
____________________________

Question:  I work in a long term care facility in West Milford and I am very interested in
becoming an activity director.  Can you help me?

Answer:  
To become an activity director in NJ, you would need a minimum of the MEPAP I
course and three years of work experience - to work in a nursing home or medical day care
facility.  National certification is an advisory requirement.   To find the instructors in your area, visit
the NCCAP site at
www.nccap.org.
____________________________

Question:  I have searched high and low for the new surveyors guidelines for F-248.  Car
Selman presented at a conference and provided several resources and none of them have
the guidelines.  Could you be so kind as to e-mail them.  I would be very thankful.

Answer:  
To my knowledge, they are not posted on the Internet anywhere yet.  I do not have them
on disc.  I could mail them to you, if you email me your address.
____________________________

Question:  I have been asked to give a talk to a local Parkinson's group about  what type of
activities would be beneficial. I have looked at a lot of  Parkinson's websites and there really
are no activity suggestions. Do you have any suggestions? Thank you so much for you help.

Answer
:  Focusing on adaptation skills to address the losses and limitations associated with
this disease seems to be the right route.   Since fine motor skills and having a good grip are an
issue - using built up grips on any device used would help.   Additionally, using an anchor or
anchor device to hold any objects or projects being worked on - would also help.  Endurance
and becoming tired are sometimes an issue, so room visits and 1-1 activities might be more
appropriate.   Additionally, focusing on the emotions associated with losses being felt would be
important.  This can be done through reminiscent groups, discussion groups and creative arts
programs where they can express themselves through non-verbal means.   Exercise in a sitting
position will help the resident remain limber.  Focusing on stretching and range of motion
oriented activities will contribute to flexibility and possibly reduce stiffening and tightening up.  
Spiritual support is often welcome by this population.    Individualizing any past interest through
the use of various adaptive devices seem appropriate.   I wrote an article for this web site a few
months back on adaptation.  There are some helpful hints as well as some web sites which
offer equipment. Look through the archives and you should find them.  Good luck, Debbie
____________________________

Question:  Hi my name is ___ I work in a nursing home with both dementia residents and
elderly I would like to get certified there is no where around my area, where I can get
certified as an activity professional. My co-worker gave me your name shes also trying to get
recertified we are having a difficult  time trying to find someone in our area can you help us
out.  I live in the Boston Lynn area...

Answer:
 Have you checked with the NCCAP site?  They list instructors by each state.  There are
several instructors in Massachusetts.  I would think they must  offer the course throughout the
State.   Go to
http://www.nccap.org/about/educators/massachusetts.shtm and check out the
instructors that might be near you.   Your other option is to take the course via independent study
or on line.   The instructors who do that are on this page:  
http://www.nccap.org/about/educators/index.shtm.  Finally, check with the state representative in
your area for additional help.  Their names are on this page.

http://www.nccap.org/about/educators/state_rep_massachusetts.shtm
 Good luck,
____________________________

Question:  In 1998 I was certified for activity director, here in southern California.  I did not
use it. Now I must use it because need new career. My last job was a certified nursing
assistant. My question is do I need to get certified again or can I simply renew my old  
certification?

Answer:
 Unfortunately, if you let your certification lapse - you need to start all over again to
obtain the NCCAP one.   I would suggest you visit the NCCAP site to see what you need to do to
re-gain certification.   Their site is
www.nccap.org.
I would also suggest you contact the people in your State activity association as I do not know
the State requirements for California.
http://www.scaap.net/   They can better tell you what you
have to do to meet California requirements.  Good luck, Debbie
____________________________

Question:  I was wondering if you could help me.  I have a Bachelors in Business
Administration.  My dream job is to become a Geriatrics Program Director, but I don't know
where to start.  I live in Chicopee, MA.  

Answer:
 Hi, I do not know the State requirements to be a director in Massachusetts.   You could
have to contact some state representatives to find out what exactly do you need.   But, a first step
might be to obtain an assistant position in a facility to gain some paid experience.   Then you
should take the MEPAP course.   Then, depending on the State requirements - when you meet
them, you can start applying for director positions. This is the link for all the instructors in your
State.  They should be able to tell you State requirements and where the classes are.
http://www.nccap.org/about/educators/massachusetts.shtm
This is the link for the State representative to Massachusetts and they should also be able to
help you find out State requirements and connect you with professional groups in your State.
http://www.nccap.org/about/educators/state_rep_massachusetts.shtm  Good Luck!
____________________________

Question:  Could you give me an idea what the salary might be for an activity director for an
assisted living facility might be in Indiana? I am not certified. I have a Master's in Music
Education and 15-20 years experience in event planning.

Answer
:  I am sorry I do not know what the salary ranges are in Indiana.  One of the previous
letters to this site asked a similar question about salary.  I referred them to the TR Director salary
survey.
http://www.recreationtherapy.com/salarysurvey2004a.htm  You can also contact your
Indiana State Activity Association to see if they can offer greater insight.
http://members.aol.com/iadassoc/
____________________________

Question:  I need information regarding the draft guidelines for F-248 I was not able to find at
www.cms.gov type in draft guidelines.  

Answer:
 The proposals are not available on line.  I don't think they are available anywhere on
line.  You could contact your State Activity Association, as they might have a copy to send you.  If
your facility has an activity consultant on staff or a corporate/regional activity person, they should
have a copy.  I could send you a copy if you can't find it through any other means.   Email me your
address.
____________________________

Question:  do you have a list of diversional activities by age group (pediatric).  I am doing a
project for school and would appreciate this information. Thanks - fellow student

Answer:
 I do not have anything specific to pediatrics.  Also, I am not sure if you meant
physically/cognitively challenged pediatrics. However, to find age and developmentally
appropriate items and tasks - looking at objects/tasks that are of interest to whatever age group
is a suggestion.   In working with geriatrics, we look at their histories and
preferences and find items related to that information.  With children, looking at their preferences
(trucks, cars, blocks, puzzles) and introducing them with whatever adaptation is needed seems
appropriate.  You can check out the Montessori method as that is based on offering diversional
and developmental tasks to children.  I would also check out catalogs like S and S
http://www.ssww.com/ and Flaghouse http://www.flaghouse.com/ as they sell all sorts of
manipulatives.
____________________________

Question:  I am a resort activities director in the North Georgia Mountains. We are a private
resort over 1,000 acres, horse stables, swimming pool, tennis courts, RV and cabins.  I have
been trying to find a site that  I could go to for ideas and to share some on mine.  I just got
down with the New Year Eve party and had a turn out of about 265 people.  We are a family
resort and have a lot of active middle age owners.  Do you have any ideas where I can get
some help and ideas? Any help would be appreciated.  Thanks in advance for your help.

Answer:
 I would think you would need to venture into the area of parks and recreation which is
more focused on your setting and population.  The National Parks and Recreation Association
might help you find some resources.
http://www.nrpa.org/  I would also suggest Internet
searches using words like "community recreation".  I put that in and all sorts of sites came up.   
You can look to see what other counties, towns and resorts are doing.  There are many activity
based sites which you can find linked from this site and many others like it.  They offer many
ideas but they may not be appropriate for your population.  Good luck!
____________________________

Question:  I have been asked for a calendar of recognition dates like dietary week, nurses
week, etc.  If you have something could you send it to me?

Answer:
 This is the website I use to look up recognition dates. http://www.pohly.com/dates.html
____________________________

Question:  Where do I obtain the 90 hour modular from?  What is Radiant Harvest?  I am
interested in an on-line course.

Answer:
 To obtain a listing of on-line instructors, you can visit the NCCAP site.
http://www.nccap.org/about/educators/index.shtm  This page has the instructors listed by State
and have the independent study instructors listed on the bottom.
I do not know what you mean by Radiant Harvest?
____________________________

Question:  I would like to know what an expected salary would be for an Activity Director
(also known as Director of Recreation Therapy).Who has there CTRS and a BS & MS in the
field of recreation who works in a long term care facility?

Answer:
 The TR Directory did a survey focused more on TR.  You can review the results at
http://www.recreationtherapy.com/salarysurvey2004a.htm
____________________________

Question:   Can you tell me where I would be able to find skits for activity staff members to do
to entertain residents?

Answer:
 I would suggest going to the library.  I know that sounds like an old fashioned idea but I
would look in teaching, scouting and spiritual resources.   There are some older books with
skits and drama plays for these groups.   I have this great book called "The Fun Encyclopedia"
and it is a variety of games, activities and plays for all ages.   It was published in the 1940's and
could have been used by a school teacher, Sunday school teacher or scout leader.   I am not
suggesting the residents are children but the plays and skits of long ago would be something
they could respond to.  As far as current resources, when I looked it up on a search engine on
the Internet - teaching resources and Bible school resources came up. But to my knowledge,
there is nothing specific to therapeutic activities, geriatrics and skits.  Possibly in the therapeutic
recreation realm, there might be something in working with troubled youths or individuals with
psychiatric concerns.  Idyll Arbor is a good company with those types of resources.  
http://idyllarbor.com/cgi-bin/SoftCart.exe/?E+scstore   Also Mental Health and Wellness
Resources is a good company with all sorts of games and interactive things
.
www.wellness-resources.com.  Sorry I am not much more help on this one.
____________________________

Question:    I have just enrolled in the activity directors program at my local community
college which starts in Jan.   I just come across [the Activity Director's Office] website and
find it very informative.  I understand from reading on the site that it is a very busy but
rewarding career.  I'm wondering just how many AD's a nursing home or assisted living
home hires to take care of the busy work load and the different shifts?  Also, could you
inform me on what the going rate of starting pay would be and any information about
benefits?  I haven't come across any information so far on this.  I want to be the very best I
can be!  Thank you very much and may God richly bless you.

Answer:
 Congratulations on furthering your career.   The activity profession can be very
rewarding and diverse.  Staffing patterns in nursing homes, assisted living facilities and medical
day programs vary from state to state.  There are no federal mandates for resident to staff ratios.  
In NJ, we have a minimum of one staff member to 53 residents in the nursing home.  Most
facilities in NJ exceed that minimum requirement by staffing one staff member to 30-49
residents at the least.  Day programs in NJ require a one staff member (including all staff, not
just activities) to nine clients.  I am not sure about other states.  You would have to check the
individual state regs.  As far as salaries - that varies across the country as well.  We are not the
best paid profession, but that seems to be changing.  We have to remember, we are a new
profession and are still paying our dues, so to speak.  The salaries are increasing steadily and
that may be due to the increasing professionalism of each activity professional.  The fact that you
are taking the activity course and will become a qualified and eventually certified activity
professional will contribute to our professional base.   There are two posted salary surveys for
our profession, that I know of.   Our NJ Activity Association has completed a few salary surveys
and they are posted on our State web site.
http://www.njactivitypros.org/news.htm
The National Certification Council for Activity Professionals (NCCAP) also did a salary survey
recently.   
http://www.nccap.org/survey/2005_salary_survey/index.shtm
The TR Directory web site also did a salary survey but it also includes CTRS professionals in
other settings.
http://www.recreationtherapy.com/salarysurvey2004a.htm
Good luck!
_____________________________

Question:  I recently  was transferred to a new facility of which the majority of our clients our
Alzheimer's and  Dementia Patients.  I've been having trouble with implementing activities for
this group. Please refer me to some books or anything that may be able to help me out.  I was
used to working with the more higher functioning. Also I'm interested in continuing my Part II
course.  When will you have something closer to Cumberland county

Answer:
 Good luck in your new center.  You are right, the population in your new center is a bit
more impaired than where you used to work (having visited both sites).  I would suggest
beginning by grouping the residents by level of functions.  That would give you a sense of what
you need to do.  Some may need a diversional approach (puzzles, folding, life skills), and some
may need more sensory approaches.   You have to find a way to balance your time
between the groups.   Possibly setting up some passive approaches with the one group, while
working with the second group.  I would also suggest involving the program assistants in your
efforts.  Your center used to have a few staff who were assigned to the room.  Assigning them to
one of the groups while you are working with the second group might ensure everyone gets the
right amount of attention.  As far as books go, Recreation Therapy Consultants
(
http://www.rec-therapy.com/index.html) have a good sensory book called ESP.  I am also
enclosing a link (
http://www.alzheimersbooks.com/100.Activitiesbooks.html) which has several
good books.  "Failure Free Activities" and "Doing Things" are both class
good books for activity ideas.As far as my next advanced class, just updated my web site with the
new schedule.   (
http://www.dhspecialservices.com/schedule.htm)  The next advanced begins in
February in Riverton (Burlington County).  Take care and good luck.
_____________________________

Question:  Hello, I recently took an activity directors position. I need some ideas for small
group for after supper. 5:30 or 6:00. I was told we are suppose to do this twice a week. Is this
correct? Thanks

Answer:
 Congratulations on your new position.   The required number of evening programs
may vary from State to State.   The federal regs do not mandate a number.   In NJ, we are
required to conduct a minimum of two evening programs per week.   I am not sure about other
States.  Evening programs can be supervised by activity staff or conducted by volunteers or other
staff in the building.  If conducted by people other than activities, there should be a monitoring
tool in place to ensure the program occurs and to identify residents who are  participating.   To
decide what to offer, canvas your population to determine who remains active after the evening
meal and who might be interested in a program.  Scheduling a variety of programs, then
monitoring the response to the programs would also tell you what seems to be working.  What I
have seen on various calendars for evening programs is the infamous Bingo, which always
draws a crowd; movies; simple games; and socials.   Activities that require effort and thinking
(Trivia or crafts) are not well received.  You also might want to look at the needs of your
cognitively impaired population.   They sometimes need a solace or relaxation oriented program
in the evenings.  However, if introduced, that type of program should be offered daily - not just
once or twice  a week. Good luck and have fun!
_____________________________

Question:  Hello! I've talked to you before about going to classes can you please tell me
where I can attend classes for activities director? Thank You.

Answer:  
Hi, it depends on what state you live in.  You can access the approved instructor listing
on the NCCAP site.  Go to
www.nccap.org and go to instructor listing page.  There you can pull
up your State for the approved instructors.  They also have a listing on the bottom of that page of
approved instructors who offer the course via Internet or independent study.
Good luck!
_____________________________

Question:  I am interested in receiving a certification to become an Activity Director. Where
can I receive that certification? I have visited the NCCAP website, but they require you to have
4000 hours. How can you have 4000 hours if you have not worked in the field?

Answer:
 Hi, The certification process is a combination of work experience, continuing
education, and formal education.  When all three components are met, you meet certification
standards and receive the title.   Many facilities hire entry level staff (assistants) without
experience which will allow you to accrue work experience hours. 20% of those hours can be
volunteer hours.   If you have related skills and abilities, directors are often willing to train you.  
Once you get a paid position, then think about taking the Modular Education Program - activity
training class.  You can find instructors in your state by visiting the NCCAP site and looking on
the instructor listing page.  They list instructors by state and also those who offer the course
through independent study.  Even though it seems like a lot of work and time, it can happen if
you put your mind to it. Good luck!
_____________________________

Question:  Just a thought,,,, It would be wonderful to have links to free clip art.  I have a hard
time fining holiday related clip art for my monthly newsletter.  I use your site often,,,, It has
been a god send.

Answer:
 Thank you.  I use the computer programs in my computer for clip art - Microsoft Word
and Publisher have great clip art.  I have also bought the cheap CD's that have lots of clip art.
There is also Dover Publications.  They are a clip art site.  I use their things on occasion.  
http://store.yahoo.net/doverpublications/   I also go to images on Yahoo and Google.  I type in
whatever I am looking for and it is amazing what comes up.  I use those for finding reminiscent
and word game pictures too.
_____________________________

Question: I'm taking over as activity director at a assisted facility with 105 residents. I'm
curious about starting a resident council. Do you have any info on how to start this? Some
guidelines I could work with?  Thanks

Answer:
 If you are starting the Council from scratch, I would suggest putting up some notices
posting a general meeting.  At the first meeting, review the purpose of the Council with the
residents, outline potential Council formats, structure and such.  With an assisted living
population, they should be able to participate in creating their own council.  You might have to
spread the business over a few meetings, but that would begin the process.  Eventually, you
should hold elections for officers, develop by-laws and a system to follow up any resident
concerns.  Minutes should be kept in a binder and maintained safely and privately.  There is a
great web site devoted to Resident Councils and they sell an excellent book (Resident
Council Handbook) on Council development and management.
http://www.residentcouncil.org
There is also another one called the Resident Council Coalition which also has some
interesting info available.  
http://www.npbdc.com/resident.htm Here is an article on forming a
council.
http://www.ltcombudsman.org/uploads/99ResCouncil.pdf#search='resident%20councils'
_____________________________

Question: Help!! I just tried to order decorations from Paradise Products and after 52 years
they have gone out of business. Do you know any other sources for the type of decorations
they carried.

Answer:  
I know, that is pretty depressing but I guess good for them, as I hear they are retiring.
There are lots of other party catalogs on line.  I have several listed on my party page of my site.
http://www.dhspecialservices.com/specialevents.htm
_____________________________

Question:  Hi Debbie. I am in Massachusetts and interested in taking a certification course
for activities director. Do you know of any courses I can take for this. Any help is welcome.

Answer:  
There are lots of instructors in Massachusetts.
http://www.nccap.org/about/educators/massachusetts.shtm
They are listed on the NCCAP site, under state instructor listings.  Hopefully, if you contact them
directly, they can help you find a course close to you.  You also have two NCCAP state
representatives you can contact who also might be able to help.
Diane Perry  
dperry@NHS.healthlink.org  978-921-5020 ext 2102
Anne Eagan  
Activitylady@aol.com  508-879-8000 (w)
_____________________________

Question:  The nursing home I am currently working at is looking for an activity consultant to
visit.  Do you know anyone--or are you--interested in doing that type of thing?  I would
appreciate any information you would be able to give me!!  Thanks-- (Pennsylvania)

Answer:  
 I tried to reach you by phone but was put on hold and disconnected and when
I called again, they never picked up. In any case, I would suggest looking on the NCCAP site at
the instructor page.  Many instructors are consultants and may be able to help you or direct you
to someone in your area.  Visit
www.nccap.org and go to instructor listing section for
Pennsylvania.  I looked there for you already and there are a few who seem to be in your area.
Hope that helps,
_____________________________

Question:   We have approximately five very vocal and instigative residents.  Although we
already assist residents on outings, including them and they also go out with family all the
time, they are still not satisfied.  We are in a dilemma with state/federal guidelines.  Can we
make a policy of our own regarding outings? We have a facility of 99 residents and everyone
needs a fair chance to be assisted on an outing.  We would love to have your input. Thank You

Answer:
 That is a challenging situation.  I appreciate vocal and assertive residents but not at
the expense of others who are less able to advocate for themselves.  You are right that you need
to be the advocate for all residents and ensure fair and just services are provided to all.  That can
be done through developed polices on trip frequency and rotation of residents through the trip
list.  Involving your residents in the process through Resident Council may make them feel a part
of the decision.  Reminding them nicely that there are 89 other people who live in the building
that deserve a chance to go on trips is appropriate.  Keeping a trip log is also helpful where they
sign in and can monitor when the last time they went on a trip themselves .  Hope that helps and
good luck.
_____________________________

Question:   I am currently an activity assistant at a nursing home and considering making a
career  of it.  However, I want to be more than just an activity director.  Is this possible and if
so what steps should i take to get there.

Answer:
 There are many opportunities within long term care and the field of aging.  Some
activity professionals go on to become administrators of their facilities, which is one way to
promote interdisciplinary respect and involvement.  Other experienced activity professionals
become consultants.  One idea which I find intriguing is a home based activity service, similar
to home health aides.  Not many people are doing it, but I think there will be opportunities in the
future for this type of specialized work.  An increasing emphasis is to keep the elder in the home
as long as possible.  At home recreation/activity services could contribute to that goal.
Deciding what you want to do is sometimes the hardest decision.  Attending workshops, reading
information about our profession and work settings, and keeping your mind open to new ideas
will hopefully help you decide.  I saw a quote in today's paper from "The Complete Life" which
seems fitting.   "In simplest terms, a leader is one who knows where he wants to go, and gets
up and goes".
_____________________________

Question:  I'm a new activities director in a nursing home. Help I need some new ideas.

Answer:
 Congratulations on your new career.  The good news is you will never be bored and
you will never be out of a job if you are good at what you do.  We are so lucky as a profession
because there are so many resources available to us.  Hopefully, you have found all the activity
web sites which specialize in activities for elders.  I visit them regularly and I find new ideas all
the time.  Join your local activity professional association.  They often offer ideas at each
meeting, new resources and updates that are necessary for us to remain current.  Finally -
theme activities are the best in my book.  Routine programs become new when a holiday,
seasonal or life theme is applied. Take the horse racing game for example (Sea Bay Game
Company sells them).  Instead of the same old horse racing, try Bunny races in the Spring time
or Witch races at Halloween or Reindeer races during December.  Many routine activities
become new and fun when the theme is applied.  Good luck and have fun!
_____________________________

Question:  Do you have any activity in-services for types of activities available and
relationship to mental and physical well-being?

Answer:
 I have done inservices on that topic and I think the best inservice is one where
participants are able to experience the benefits themselves.  Rather than tell people what the
benefits are, bring some of these activities we do to the inservice and conduct them with the
staff. Add some prizes and refreshments and people leave the inservice refreshed and hopefully
with a beginning understanding of why we do what we do.  
_____________________________

Question:  Please tell me where I can find some senior appropriate one act plays.

Answer:
 (I have to work on this one.)
_____________________________

Question:  What type of audit tool do you have for chart audits? This is reference for out CQI
meetings. Thank You!

Answer:
 There are many audit tools for activity documentation.  You have to decide what are you
auditing for?  Timeliness of records?  Content?  Follow through?  Different audit tools are
designed to address each of these issues.  To assess timeliness, create a check list with the
required entries and deadlines for completion.  To create one for content, another checklist
would note specific aspects of documentation that should be included.  Finally, for the outcome
oriented audit, there should be some section allowing observation of resident to determine if the
care was delivered as defined.
_____________________________

Question:  I am a gerontology student (67 years old),with only 2 years of credits at Ocean
County College. I would like to find out where there is a good activities certification course.
Thank you in advance for your help.

Answer:
 Hi, welcome to the world of activities.  You are in my home turf - Ocean County.  I have
classes starting in September.  Go to my web site for details.   D H Special Services
_____________________________

Question:  How do you get the nursing staff to work in accordance with the Activity Dept to
transport residents to programs. I have set up a program for low functioning resident to
attend sensory stim. programs on certain day and it is very difficult for my 2 staff to transport
and start the program on time, 9:30. When I bring this problem up to the DON, they tell me
that the nurse's have to pass their meds before the resident go to activities. Should I change
the start of my programs to 10:00 a.m. HELP!!!! I work in a facility that holds 196 residents on
2 levels, so my staff are responsible for 130 of those residents on the 1st floor.

Answer:  
You are dealing with a problem that has been in existence since I started in the field.  
In my experience, I find the attitudes and mindsets of the administrative staff (DON and
Administrator) have a huge impact upon our ability to integrate services.  Your DON has made it
very clear what her priority it.  And we have to remind ourselves that everyone feels their job is the
most important and is very vested in getting their own job done.  However, with the new
interpretive guidelines for F-248, it isn't about staff and their priorities - it is about the resident
and what is best for them and what they want.     There are several references in the new
guidelines regarding adjusting care and treatment so residents can attend activities when and
where they want to.  There are several mentions of how it is everyone's duty to promote and
assist residents to their preferred and appropriate programs.  I would start mentioning these
changes in interpretive guidelines to your DON and Administrator. Don't give up and if you do
change the time of your program - change it because it is right for your resident  - not the nurses.
_______________________________

Question:  I have read and attended a seminar regarding change. I was surprised to see I
was a real grump when it came to change. I scored the lowest when it came to
embarrassing change.  You are so right when you say we have to embrace change and be
prepared for change as this is truly the only true fact in our profession. Thank you for your
support of the profession and have a great day.

Answer:
 Thanks for your kind words.  I agree change is difficult, no matter how it is packaged.  
We all have our comfort zones which are difficult to leave sometimes.  We all need to support
each other during these pending changes and the hopeful growth of our profession.
Good luck!
_______________________________

Question:  I have an Activity Assistant that is interested in Certification. When is the next
class available? We are in Ewing, NJ.

Answer:
 My class schedule can be accessed at
http://www.dhspecialservices.com/schedule.htm
___________________________

Question:  What are the necessary steps to become a Consultant?

Answer:
 I would think the first step in becoming a consultant is to be the best activity
professional you can be.   Hone your craft, expand your scope of knowledge on a daily basis, be
open daily to to new ideas, obtain national certification, become an active member of your local
and state activity associations, become a mentor to the new activity professionals entering the
field and be a role model to the staff within your department are some of the components of
being an exceptional activity professional.   The National Certification Council for Activity
Professionals has a Consultant certification which requires a college degree (Bachelors) work
experience, consulting experience and continuing education.  You can visit their web site at
www.nccap.org and download the requirements. But, individuals do consult even without the
formal credentials.  If you work for a large organization and they recognize your above average
skill and ability, they may ask you to assist some of the other facilities within your organization.
_______________________________

Question:  Sadly to say when our department is sent information concerning changes they
are not passed on to us.  Only through a piece of mail that slipped by administration that we
learned of some changes.  We have very little information; but know enough that we will be
tagged due to our part on the MDS's not being complete.  Also, we are hearing that they (the
state, of Texas) is hitting the Activities pretty hard in areas they have never touched on in the
past.  Could you please direct me to the web page so we can obtain the proper information?  
Thank you in advance!

Answer:
 The  web site which will post the changes once they are final is the Center for Medicare
and Medicaid Services (CMS) site at www.cms.gov However, I would suggest you contact your
local or state activity associations for updates and networking on regulations and current
surveys. Check with NAAP for the local State contact.  At the very least, become a member of
NAAP (
www.thenaap.com)  as they will certainly keep the membership informed of the changes
as they occur.
___________________________

Question:  I understand there are new guidelines in the federal regulations for Activity
Directors.  Are you aware of any changes that are coming in  the future.

Answer:
 The actual regulations themselves are not changing but there are proposed changes
to the interpretive guidelines which accompany the regulations for nursing homes.  These
interpretive guidelines assist surveyors to determine if the facility is meeting the regulations.  A
proposed draft was issued last Summer, with an open comment period.    A date for the final
release has not been given.  My personal opinion is the additional interpretive guidelines (which
were developed with input from professionals actually working in our field) will only help the
surveyors truly assess our efforts and programs.  The majority of surveyors are not trained
activity or recreation professionals and they would benefit from more specific guidelines and
standards to guide them in determining effectiveness of programs and interventions.   Some of
the additional guidelines focus on specific methods and techniques for individualized and
interdisciplinary care planning.  The guidelines emphasis the interdisciplinary model, involving
all staff in promoting participation in activities and assisting
to and from programs.   Additional guidelines in evaluation of the program focus more
specifically on activities which most good activity programs have in place, including community
activities, outdoor programming, adaptive programs for all levels of functioning and culturally
diverse activities. The new guidelines also some discussion of developing age appropriate
activities and  discouraging the use of children's toys.  Finally, there will be more emphasis on
the use of adaptive equipment which I think is important.  The use of large print materials,
stabilizers for craft work, and special equipment for games and leisure tasks are noted within
the interpretive guidelines.  As mentioned earlier, I welcome these more specific interpretive
guidelines.  They will support the work we already do and guide those departments needing to
expand their services and approaches. The January and March issues of Creative Forecasting
had very good articles on the changes.   They offered some checklists which would assist your
department in developing additional programs or simply checking what you are doing to the
pending guidelines.  Creative Forecasting can be subscribed through
http://www.creativeforecasting.net/   But keep in mind - these interpretive guidelines are not final
and may be revised again before the final rule.  Read your professional publications or read your
NAAP newsletter if you are member to remain informed as to the latest information.
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