Re-Creative Resources
By Kimberly Grandal, BA, CTRS, ACC, Executive Director
Kimberly Grandal,

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

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

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.
Providing Internet Resources
for Activity Professionals
in Long Term Care Settings

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

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.
Care Plan 101: An Introduction to Care Planning for Activity and
Recreation Professionals
By Kimberly Grandal, BA, CTRS, ACC
Executive Director
Re-Creative Resources Inc.

Creating and implementing individualized care plans for residents in long-term care facilities is a
very important responsibility of activity and recreation professionals. The activity assessment
determines the content of the care plan. Not all residents will have an "activity-care plan", but
most care plans should have "activity-related interventions" found in the comprehensive care
plan. Care plans may be written regardless if a resident triggers on the MDS 2.0.It is important to
set realistic, measurable goals, interdisciplinary interventions, and create care plans that are
individualized and person-centered.  

What is a Care Plan?
The RAI user manual defines care planning as, "A systematic assessment and identification of a
resident's problems and strengths, the setting of goals, the establishment of interventions for
accomplishing these goals."

Why write Care Plans?
•        Document strengths, problems, and needs
•        Set guidelines for care delivery
•        Establish resident goals
•        Identify needs for services by other departments
•        Promote an interdisciplinary approach to care and assign responsibilities
•        Provide measurable outcomes that can be used to monitor progress
•        Meet federal and state requirements
•        Meet professional standards of practice
•        Enhance the resident's quality of life and promote optimal level of functioning!

What is a Care Plan Meeting?
A forum to discuss and review a resident’s status including any problems, concerns, needs,
and/or strengths

Who usually attends a Care Plan Meeting?
•        MDS Coordinator
•        Nurse(s)
•        CNA’s
•        Dietician
•        Rehabilitation Therapist(s)
•        Recreation Staff
•        Social Worker
•        Resident
•        Family Member/Guardian

When are Care Plans written?
•        A minimum of seven days after the MDS completion date
•        Some care plans warrant immediate attention
•        As necessary
•        Must review at least quarterly

The Role of the Recreation/Activities Department
•        Identify  the resident's leisure/recreation needs
•        Identify barriers to leisure pursuit and help minimize these barriers
•        Identify the resident’s leisure/recreation potential
•        Provide the necessary steps to assist the resident to achieve their leisure/recreation goal/s
•        Provide interdisciplinary support by entering a variety of recreation interventions on
various   (non-activity) care plans
•        Monitor and evaluate residents response to care plan interventions

Components of a Care Plan
•        Statement of the problem, need, or strength
•        A realistic/measurable goal that is resident focused  
•         Approaches/interventions the team will use to assist the resident in achieving their goal
•        Important dates and time frames
•        Discipline(s) responsible for intervention
•        Evaluation

Target areas for Recreation/Activities
•        Cognitive Loss
•        Communication
•        ADLS
•        Psychosocial
•        Mood
•        Nutrition
•        Falls
•        Palliative Care
•        Activities
•        Recreation Therapy
•        Pain Behavior
•        Restraints

Activity/Recreation Care Plan Samples
These are just a few samples. Remember, the most important aspect of care planning, is

Statements (the resident’s name is usually used instead of the word “resident”)
•        Resident has limited socialization r/t to depression
•        Resident prefers to stay in room and does not pursue independent activities
•        Resident is bed-bound r/t to stage 4 pressure ulcer and is at risk for social isolation
•        Resident demonstrates little response to external stimuli r/t to cognitive and functional
•        Resident enjoys resident service projects such as changing the R.O. boards
•        Resident becomes fearful and agitated upon hearing loud noises in group activities r/t to
•        Resident has leadership abilities
•        Resident prefers a change in daily routine and wishes to engage in independent craft

•        Resident will respond to auditory stimulation AEB smiling, tapping hands, or vocalizing
during small group sensory programs in 3 months
•        Resident will actively participate in 2 movement activities weekly in 3 months
•        Resident will remain in a group activity for 15 minutes at a time 2x weekly in 3 months
•        Resident will accept in room 1:1 visits by recreation staff 2x weekly in 3 months
•        Resident will socialize with peers 2x weekly during small group activities in 3 months
•        Resident will respond to sensory stimulation by opening eyes during 1:1 sessions in 3
•        Resident will actively participate in Horticultural Therapy sessions in the green house, 1x
monthly in 3 months
•        Resident will continue to assist other residents in writing letters on a weekly basis in 3
•        Resident will exhibit no signs of agitation during small group activities 3x weekly in three
•        Resident will engage in self-directed arts and crafts projects 1x weekly in 3 months

•        Provide a variety of music i.e. Big Band and Irish
•        Utilize maracas and egg shakers to elicit movement
•        Provide PROM to the U/E during exercise program
•        Involve resident in activities of interest i.e. singalongs, adapted blowing and trivia
•        Offer 1:1 visits in the late afternoon to discuss recent Oprah episode
•        Seat resident next to other Korean speaking resident during groups
•        Provide tactile stimulation i.e. hand massages and textured object i.e. soft baseball
•        Provide olfactory stimulation i.e. vanilla extract and cinnamon for reminiscing
•        Utilize adapted shovel and watering can during HT sessions
•        Provide easy grip writing utensils and a variety of greeting cards/stationary
•        Involve resident in small sensory groups i.e. SNOEZELEN and Five Alive
•        Sear resident near a window
•        Provide a variety of independent arts and craft projects
•        Provide adapted scissors and paint brush

Imagine that you are a resident in a long-term care facility and you are bed-bound for a health-
related condition and are at risk for social isolation and inactivity.  Write a goal and at least seven
interventions/approaches that are relevant to you.

Copyright Kimberly Grandal, 2007.  All rights reserved.