Re-Creative Resources
By Kimberly Grandal, BA, CTRS, ACC, Executive Director
http://www.recreativeresources.com/index.htm
Kimberly Grandal,
BA, CTRS, ACC

Kimberly Grandal, Founder
and Executive Director of Re-
Creative Resources, Inc., is a
strong advocate for the field
of Therapeutic Recreation
and Activities, with over fifteen
years of experience working
with the elderly in numerous
management and consultant
positions.  She is an Activity
Consultant Certified and a
Certified Therapeutic
Recreation Specialist. Kim is
a member of the New Jersey
Activity Professionals
Association and the New
Jersey/Eastern Pennsylvania
Therapeutic Recreation
Association.

In 1990, Kim graduated from
William Paterson University
with a BA in Sociology and
later studied gerontology
courses at Union County
College and Therapeutic
Recreation courses at Kean
University. Throughout her
career, Kim has been the
Director of Therapeutic
Recreation for several long-
term care facilities, including
one of NJ’s largest.

In 2006, Kim founded Re-
Creative Resources Inc. She
is a speaker for various state
and local activity associations
such as NJAPA, MOCAP, and
NJACA, as well as the Society
of Licensed Nursing Home
Administrators of NJ. She
also offers lectures for Re-
Creative Resources Inc.,
local colleges, and
community groups, and
provides consultation and
support to numerous
facilities in the state.

Kim is the editor and writer
for the “The Rec-Room", a
monthly newsletter published
by her company. In addition,
she writes monthly articles
for the Activity Directors Office
newsletter, and has
contributed articles to
Creative Forecasting
Magazine, and The
Continuing Care Insite
newsletter.

Kim is a recipient of the
Kessler Institute of
Rehabilitation 1997 Triumph
of the Human Spirit Award.  
Her passion is to promote
the field of Therapeutic
Recreation and Activities and
to unite Recreation
Therapists and Activity
Professionals. Kim currently
serves on the NJAPA board
as the Chairperson for the
Legislation Committee.
KIM GRANDAL
THE ACTIVITY DIRECTOR
Providing Internet Resources
for Activity Professionals
in Long Term Care Settings
admin@theactivitydirectorsoffice.com

Copyright 2004-Present
The Activity Director's Office
All Rights Reserved

Disclaimer
About
Re-Creative
Resources Inc.

Re-Creative Resources, Inc.
is committed to enhancing
the lives of long-term care
residents through the use of
Therapeutic Recreation. We
provide a variety of services
such as Therapeutic
Recreation seminars,
in-services, resources, form
development, program
analysis and development,
consultation, and support for
activity professionals and
recreational therapists. A
selection of downloadable
training materials and forms
are available for your
convenience as well as a free
job posting site.
ACTIVITY DIRECTOR TODAY
Class Acts: A+ Educational Activities for the Elderly in
Healthcare Facilities
By Kimberly Grandal BA, CTRS, ACC
Executive Director, Re-Creative Resources, Inc
www.recreativeresources.com

“Get over the idea that only children should spend
their time in study.  Be a student so long as you still
have something to learn, and this will mean all your
life.” ~Henry L. Doherty

Introduction

Whoever said “You can’t teach an old dog new tricks” certainly wasn’t referring to the elderly of
today. Many elderly individuals demonstrate great interest and ability to learn new information.
Aging should not be seen as purely a time of decreased abilities but rather as an opportunity for
growth, increased wisdom, and the attainment of new skills.

Recreation programs in healthcare facilities offer a diverse program of activities and that should
include educational opportunities.  Educational programs can range from out-of-facility classes,
to less formal learning activities and may be beneficial to residents and patients regardless of
their age, gender, ethnicity, physical abilities, and even, cognitive status.

Benefits and Purpose

Mortimer Adler said, “The purpose of learning is growth, and our minds, unlike our bodies, can
continue growing as we continue to live.” Educational programs are designed to offer residents
an opportunity to learn something new whether it is a fact, an idea, information, or a skill. These
types of programs greatly enhance self-esteem, motivation, and independence, as well as offer
opportunity for cognitive stimulation and socialization.

Many individuals that enter a long term care or other healthcare facility have not been exposed
to a vast array of ideas, cultures, beliefs, technology, etc. and may feel alienated. Offering
classes to increase their knowledge or learn new skills can be enlightening and rewarding for the
student and the teacher as well!  

Learning Environment

Educational opportunities may occur in numerous ways and in various places. Sessions may be
offered on a one to one basis or in a group setting. They may be formal and planned or provided
spontaneously. Educational opportunities may also be provided in an out-of-facility classroom
such as at a county or state school/university, or in a community center. In any case, it is
important to create or provide an environment that is conducive to learning. The Aguirre Institute,
November, 2000 suggests the following classroom characteristics:

  • Good acoustics (easy to hear conversation)
  • Sufficient table space for writing
  • Sufficient space for wheelchairs, canes, and walkers
  • Adequate heating and cooling system
  • •Non-slip stairs and floors
  • Chairs that provide needed back support and that students of different physical sizes can
    sit in comfortably
  • Short distance to accessible bathrooms

Learning Barriers and Adaptations

There are many barriers recreation professionals, “teachers”, may have to overcome before an
elderly person has a successful learning experience. Many of the adaptations utilized for
traditional recreational programming can be utilized for the elderly learner as well.

The most obvious of these barriers are the physical changes that often occur as we age.
Individuals with hearing or vision loss, decreased mobility, motor coordination, and so on, will
need their learning experience adapted. For those with visual impairments, utilize large print
materials with appropriate thickness, simple styles, and contrasting colors such as black on white;
speak slowly, repeat main points and paraphrase; utilize verbal and physical cues; provide bright,
non-glare lighting; and utilize other forms of sensory such as touch, sound and smell.

For individuals with hearing impairments it is important to maintain an environment that has the
least amount of outside noise and distractions as possible.  The facilitator or “teacher” should
speak slowly and clearly, facing the learner; speak normally and be cautious not to shout; and
use gestures, facial expressions and physical cues. The use of microphones, pictures and props,
flip charts and other audio/visual aids are also vital adaptations for the hearing impaired.

Cognitive impairments and short term memory loss are also common learning barriers for the
elderly.  It may be difficult for an elderly learner to understand the educational content or to even
remember what was learned. Sandra Cornett, RN. Ph.D, from the Ohio State University Medical
Center recommends the following:
  • Use consistent vocabulary (i.e. use the word “recreation” rather than similar words such as
    “leisure”, “activities”, “therapeutic recreation” etc.
  • Make no more than 3-5 points during a session
  • Use clues such as underlining words, arrows depicting sequence, bold letters, etc.
  • Repeat concepts. (i.e. topic: the benefits of  recreation-show a video, provide printed
    materials, do a word puzzle and engage learner in a hands-on exercise)
  • Utilize vocabulary that is familiar with the learner
  • Devise ways to reinforce learned material such as lists, pictures, summaries, charts, etc.
  • Give cues ahead of time such as a summary or introduction to what will be taught

Desire, interest and/or attitude are also potential barriers to learning. It is not uncommon for
elderly people to feel threatened by the idea of learning new information, especially technology.  
In this situation, the recreation professional may hear, “I’m too old to learn or “I’ve learned
enough”. It is crucial to identify the reasons for such reluctance and then try to break down those
barriers. The facilitator must have a positive, enthusiastic demeanor, give choices, and
encourage active participation. It important to set goals that are realistic and start off slow, if
needed. Offer informal educational sessions on a one to one basis to establish a rapport and to
spark an interest. Make the learning experience fun and interactive and provide extensive praise
and encouragement.

Some additional adaptations and tips for teaching the elderly include:

  • Use mnemonics. Mnemonics is a formula or rhyme used as an aid in remembering
    information (i.e. “I before E except after C” is a great spelling trick and for history, “In 1492
    Columbus sailed the ocean blue”.) For a large variety of mnemonics in many subjects, visit
    www.netnaut.com/mnemonics.html
  • Provide sufficient time for recall
  • Use of multiple choice or true false to help with retrieval of information
  • Offer morning classes
  • Make it fun!

For more tips on teaching the elderly visit: “Tips on Teaching Seniors” by Joel May at www.
ewingsnet.com/documents/Presentations/TipsonTeachingSeniors.pdf and
“Teaching the Elderly” by Sandra Cornett, RN. Ph.D.at
www.medicalcenter.osu.
edu/pdfs/PatientEd/Materials/PDFDocs/employee/elderly. pdf.

Educational Activity Ideas

The following is a variety of educational-type activities that may be offered to residents and
patients in healthcare facilities. Think outside the box, take advantage of all the potential
resources and let the learning begin.

College Courses

Offer opportunity for residents to enroll in a college courses at a county school, or state
college/university. These courses may be taken on-line, home study, or on the school campus. It
is important to remember that residents, especially younger residents, may wish to continue their
education regardless of their current health status.  The Social Service department should be
able to coordinate such educational opportunities through the state, county or town.

Speakers and Specialists

Residents in healthcare facilities benefit from educational sessions provided by a vast array of
experts. JCAHO emphasizes resident education and requires documentation of these services.
Utilize all the resources available in your facility. For example:

  • Staff Educator/Nursing: flu shots, infection control, aging, Alzheimer’s, cancer, smoking,
  • medications, various diagnosis/critical pathways such as stroke, heart disease, pain
    management, and other health education
  • Social Worker: Resident Rights, Advanced Directives Living Wills, PNA, dealing with
    difficult residents, adjustment to facility life, cultural diversity, getting along with a
    roommate, coping with loss and grief, etc.
  • Hospice: death and dying
  • Clergy: religious/spiritual support and education
  • Food and Nutrition: cooking demos or cooking tips, nutrition, various types of diets,
    diabetes, etc.
  • Rehabilitation Department: physical fitness and exercise
  • Maintenance staff: fire and safety
  • Ombudsman: Resident Rights

Language and Culture

There are so many traditions, languages, cultural information, etc. that can be shared with your
residents. Teach your residents how to say “hello” and “good-bye” in twenty languages or basic
words in various languages. For example, if you have a large percent of Spanish speaking
residents, offer the residents the opportunity to learn some basic words. In reverse, offer the
Spanish speaking residents the opportunity to learn some words in English. For a great article on
teaching ESL to the elderly, visit Bright Ideas: Tips for teaching ESL to the elderly coalition of
limited English speaking elderly, Aguirre Institute, Nov 2000 at
www.clese.org/Products/Tips%
20for%20Teaching.doc.

Offer classes on culture and traditions as well. Contact community culture clubs and invite them
to do presentations and travel clubs. Utilize a variety of pictures, props, clothing, and food to
make the experience unforgettable. For an extensive list of community and volunteer contacts
visit
www.recreativeresources.com/linkscommunity.htm

Technology Classes

It is important to provide the residents with the opportunity to keep up with today’s evolution of
technology. Web TV, internet access, and computer use are great ways in which the elderly can
maintain contact with friends and family, enable them to have greater access to current events,
as well as a chance to expand their leisure skills. More and more facilities are creating computer
labs to meet this need.  IN2L has developed a revolutionary program for the elderly which
accommodates their special needs. For more information, visit
www.in2l.com. To create an
intergenerational program, contact the local schools for volunteers. There are many high school
and college students that would be interested in teaching the elderly how to use computers and
the internet.  

Another unique idea is to contact your local Senior Net program. Senior Net provides adults 50+
access to and education about computer technology and the Internet. It is an international non-
profit organization for Seniors, taught by Seniors, for a low-cost, in small classes, at a speed and
in language that Seniors can understand and follow. For more information visit: SeniorNet at
www.
seniornet.org.

Leisure Education

Leisure Education is a service that is often overlooked in health care facilities. Peterson and
Gunn, 1984, define Leisure Education as, “A broad category of services that focuses on the
development and acquisition of various leisure-related skills, attitudes, and knowledge.”  The
primary purpose of Leisure Education is to “enable individuals to enhance their quality of life
through leisure.” Many elderly individuals would greatly benefit from this type of programming,
especially sub-acute patients, those with a new disability, those who are having adjustment
problems and individuals who have little interest in leisure pursuits. Peterson and Gunn’s Leisure
Education Content Model is as follows:












Many traditional activities can be transformed into a Leisure Education session. For example:
Leisure Bingo, Activity A-Z (name an activity that begins with each letter of the alphabet), Leisure
Word Scramble, and so on. Stumbo and Thompson’s book, Leisure Education A Manual of
Activities and Resources, has a large variety of great Leisure Education ideas.

More A+ Ideas

  • Music Appreciation: Introduce various genres of music as well as singers and musicians.
    Those old record jacks are full of music information!
  • Art Appreciation: Discuss a variety of artists, paintings, sculptures, styles, and techniques.
  • •Portrait in History: Chose a famous person in entertainment, history, politics, etc. and
    discuss their life and contribution to society.
  • Historic events: Remember important events such as wars, technology, space, inventions,
    etc.
  • Documentary movies: The library is filled with movies and videos of historic events and
    educational topics.
  • Book Clubs: Meet weekly to discuss a certain book or article.
  • Resident Council: Offer educational opportunities such as nutrition, health-related issues,
    safety, etc. at Resident Council Meetings. This will help to make the meetings more
    positive and productive.
  • FYI Group: Be creative and offer a wide variety of interesting topics!


Conclusion

Henry Ford once said, “Anyone who stops learning is old, whether at twenty or eighty.” The
benefits of educating the elderly are endless.  Recreation professionals continue to face the
challenge of providing a variety of stimulating activities to such a diverse population. Re-
developing and transforming some of the traditional word games, trivia sessions and discussion
groups is a great way to introduce education into the program of activities.

Once the barriers to learning have been identified and removed, the elderly will have the
opportunity for continued wisdom and knowledge. In a study by Rodriguez and Barbeito, an
elderly learner exclaimed, “Who could have told me that at this age I would still be able to learn
so much! “

References

Aguirre Institute. (November, 2000) Bright ideas: Tips for teaching ESL to the elderly coalition  
of limited English speaking elderly. Retrieved July 21, 2007 from
www.clese.org/Products/Tips%20for%20Teaching.doc

Amanda. (n.d.). Amanda’s mnemonics page. Retrieved on July 23, 2007 from
www.netnaut.com/mnemonics.html

Cornett, S. (n.d). Teaching the Elderly from the Ohio State University Medical Center
Department of Consumer Health Education and Wellness. Retrieved July 21, 2007 from
www.medicalcenter.osu.edu/pdfs/PatientEd/Materials/PDFDocs/employee/elderly.pdf.

Peterson, C.A. &  S.L. Gunn. (1984) Therapeutic recreation program design: Principles and
procedures. (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall.

Rodriguez, J. & Barbeito, Z. (n.d.). Producing and adapting educational materials with and for
the elderly in rural and urban contexts. Retrieved July 21, 2007 from
www.caen.iufm.fr/colloque_iartem/pdf/rodriguez_zapicobarbeito.pdf.

Stumbo, N. & Thompson, S. (1986) Leisure education: A manual of activities and resources.
Peoria, Illinois: Central Illinois Center for Independent Living and Easter Seal Center, Inc.



Suggested Reading and Resources

AARP-Lifelong Learning and Education  www.aarp.org/learntech/lifelong/?
sicontent=0&sicreative=742708561&siclientid=112&sitrackingid=356599&HBX_OU=50&HBX_PK=
elderly_learning

Cornell University Food and Brand Lab-Fun food psychology articles, studies, tips, cartoons, etc.
www.foodpsychology.cornell.edu

How to Do Things.com-Great articles on how to do many things like health, nutrition, exercise,
gardening, recreation, etc.
www.howtodothings.com

Mundy, J. (1998). Leisure education: Theory and practice (2nd ed.). Champaign, Illinois:
Sagamore.

Ohio Sate University Medical Center-Summary of Age-Specific Teaching Approaches
www.medicalcenter.osu.edu/pdfs/PatientEd/Materials/PDFDocs/general/agespecific-1.pdf

Senior Fitness Association-Fitness facts, tips and handouts
www.seniorfitness.net/sfafit.htm

Teaching Elderly Adults to Use the Internet to Access Health Care Information: Before-After
Study
www.jmir.org/2005/2/e19

U.S. Department of Health and Senior Services- Variety of health conditions and topics
www.os.dhhs.gov/aging/#care
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