Debbie Hommel's A.D. Tips
Dedicated to helping Activity Professionals with the daily operation of their department.
by Debbie Hommel, BA, CRA, ACC, CRTS, Executive Director of DH Special Services
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Executive Director
DH Special Services
About Debbie

Debbie Hommel, BA, CRA,
ACC, CRTS, 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.
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Activity Questions
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for Activity Professionals
in Long Term Care Settings

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By Debbie Hommel, ACC, CTRS

Most activity and recreation professionals will agree that the activity assessment is the
starting point or the foundation of the therapeutic process.  There is much emphasis on
the individualized aspect of the assessment and information collected and how it is
noted on the assessment form.  Specific information about the resident/client’s
functioning, including physical, cognitive and psycho-social needs, is helpful in
designing just the right approach that can be introduced with success.  The Federal
regulations (F-248) also outline the importance of gathering very specific information
about the individuals’ past and present leisure and recreational interests with the intent
to involve the elder in programs tailored to their individual likes and dislikes.

Transitioning that information into appropriate and individualized programming is often
taken for granted and sometimes overlooked.  Common assessment mistakes include
not collecting enough relevant information or worse yet, not translating the documented
individual needs or interests into applicable or appropriate programming.  There are
two common activity classification methods, recognized in the activity profession, for
coordinating identified resident/client interests with appropriate programming.  One
classification type is associated with the specific benefits connected with the type of
program which will be discussed in this month’s article.  Another classification type
was introduced by the National Association of Activity Professionals in 1990 and
focuses on the three categories of programming, maintenance, supportive and
empowerment, which will be discussed in next month’s article.

The most common type of program classification relates identified needs to the
programs that can fulfill those needs.  When first learning about therapeutic activities,
categories of activities are commonly utilized.  For example, physical activities are active
games, exercise programs and other programs encouraging range of motion and
movement.   To use the program therapeutically, the activity professional would
recommend or encourage resident/client involvement in the physical activity if the
assessment determined a need to increase physical movement, improve circulation,
improve mood, or strengthen different parts of the body.    Knowing the resident/client
and knowing the scope of program benefits allows the activity professional to use
activities in a therapeutic way.  

Other categories of activities include:

  • Cognitive: Stimulate basic and past cognitive skills of memory and decision
    making.  Sample activities would include rote trivia, matching activities, and
    games like “Penny Ante”.  
  • Intellectual: Stimulates more complex cognitive skills and intellectual functioning
    of learning and reasoning.  Sample activities include more difficult word games
    involving reasoning and problem solving, discussion groups requiring debate
    and opinion, and learning activities.
  • Social: Stimulating interactive and social skills in a group setting and meeting
    the individuals’ need to belong and be part of a group.  Sample activities would
    include food and discussion socials, parties, and any program where
    conversation is fostered.                      
  • Spiritual: Stimulation of faith or religious based values and needs.  Sample
    activities include formal church services of any kind, bible readings, hymn sing
    and meditative programs
  • Expressive or creative: Focus on creative expression and personal expression
    through tangible means. Sample programs would include drama, writing,
    painting, creative arts, crafts, cooking, or gardening.    
  • Affective:  Focus on the emotional expression or emotional connections
    between individuals.  Sample activities would include reminiscing, life review,
    theme programs with familiar tasks from the past and discussions on shared
    life topics.
  • Awareness, sensory or diversional:  These are some of the categories which
    focus on the needs of the cognitively impaired.  These activities offer a sensory
    or solace oriented approach for the very impaired or a diverting approach for the
    more active cognitively impaired elder.  Sample activities would include sensory
    programs of all kinds, hand massages, environmental videos or sounds, or life
    skill tasks.  

The activity professional learns early in their career to group and categorize activities to
support the benefits the resident may obtain through participation in the particular
activity.    With experience, we learn rather quickly that many activities have multiple
benefits, depending on how they are implemented and how the resident is engaged.
For example, a physical activity can enhance physical functioning but there are also
social aspects to most physical programs which is also beneficial.   It is the activity
professional who uses the activity appropriately and in a therapeutic way with the right

Next month, we will discuss the program classifications of empowerment, maintenance
and supportive.