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by Debbie Hommel, BA, ACC, CTRS, Executive Director of DH Special Services
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Executive Director
DH Special Services
About Debbie

Debbie Hommel, BA, ACC,
CTRS, 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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Activities: Going with the Flow
By Debbie Hommel, ACC/MC, CTRS

Happiness.  A good life.  A meaningful life.  What does it truly mean to be happy and
engaged in the world around us?  What is the measure of happiness?  How can we tell
if someone is content and having a good quality of life?  With increasing emphasis on
person centered care and the individualized needs of the resident, the activity
professional is challenged to ensure every resident is having a good life.  But what is a
good life?  How can we tell if the elder is enjoying our programs or is truly content to be
a spectator in life?  An interesting concept which may assist not only the activity
professional but all care givers who work with the frail elderly is the concept of Flow.  
Flow is an individual mental state where one becomes fully immersed in the task at
hand and maintains an energized focus and full involvement in the activity.  

The concept of flow was proposed by Mihaly Csikszentmihalyi, a Hungarian psychology
professor and author of many books on the topic of flow. Csikszentmihalyi is one of the
world’s leading researchers in a branch of psychology called positive psychology.  
Positive psychology studies “the strengths and virtues which enable individuals and
communities to thrive”.  Positive psychologists are actively studying measurable
components of what makes a Pleasant Life, a Good Life and a Meaningful Life.  
Understanding these concepts is exactly what the activity professional needs in order to
validate and articulate the positive outcomes associated with resident/client
engagement in activity and recreation programming.  

So, how does one achieve flow? Csikszentmihalyi defined nine factors which contribute
to achieving the state of flow.   The following is a discussion of how the activity
professional can incorporate flow factors into programming.
1.        Clear goals.  The expectations of the group, activity or task need to be clearly
presented.  The goals of the group have to be attainable and aligned with the skills and
abilities of the participants.  Basic Activities 101 teaches us about having defined
objectives for our groups and the importance of adaptation.   So this first factor is an
easy component to work into our approach.
2.        Concentration and focus.  Having a specific topic or task allows for greater
concentration.  Rather than try to accomplish too much or focus on multiple tasks, it is
suggested to focus more deeply on less.  This is an excellent lesson for the activity
professional and may contribute to greater success within our programs.  We often try
to meet the needs of the many and practice non-stop multi-tasking.   Our emphasis on
accomplishing as much we can may be inhibiting our ability to truly engage in the task
at hand.
3.        Loss of self-consciousness.  To achieve flow, individuals need to feel a sense of
freedom in the participation.  As group leaders, we participate in the task or activities we
conduct.  Our ability to participate without self-consciousness is a catalyst to the elder
being able to participate freely as well.  
4.        Distorted sense of time.  To maintain a sense of order and minimize chaos,
activity departments and health care centers have long functioned on schedules and
calendars.  The activity professional keeps one eye on the clock while conducting
programs or setting up for the next.  Keeping a “handle” on time is a common concern
and can limit becoming fully immersed in the task at hand.  To achieve flow, we may
need to focus on spontaneity and not worry so much about “time”.  For this to occur, all
staff will need to adopt an attitude which will allow adjustments to schedules and daily
5.        Feedback.  The success or failure of the task/activity needs to be acknowledged
and addressed.  Successes need to be celebrated and failures need to be
acknowledged.  It’s easy to give positive feedback but what about those less than
successful programs?  Feedback or discussions about these activities or tasks are
just as important as the celebration of successes.  The camaraderie shared amongst
those individuals having “one of those days” can be just as effective as the connection
achieved during a shared good day.
6.        Balance between activity level and challenge.  The task cannot be too easy or too
hard.  The activity professional learns quickly to adapt to the various levels of functioning
involved in programs.  We must be wary of making things too easy as everyone enjoys
a challenge.  However, we want to ensure successful participation as well.  These are
basic skills of every activity professional.
7.        Control.  In order to achieve flow, the individual needs a sense of personal
control.  The activity department has long fostered decision making, personal choice
and autonomy.  As activity leaders, we strive to empower our elders in group process
and participation.  
8.        Intrinsic rewards. Participation should feel good.  If the individual is able to attain
some level of satisfaction physically, emotionally, intellectually, spiritually or socially, it
will engage the individual more fully.  The activity professional’s challenge is to identify
the internal motivators of each person, as that may vary.  In the basic activity training
programs, much emphasis is placed on the therapeutic benefits and outcomes
associated with participation in programming.  These benefits provide intrinsic rewards
to each participant.
9.        Absorbed in the activity. Becoming lost in the task at hand and being able to
eliminate all other distractions is a strong indicator of flow.   The activity professional
can set the elder up for success by fostering a trust relationship, eliminating
distractions and creating a supportive environment.  

Some of these factors of flow may be easier to foster than others.  Some of these
factors may simply be a matter of adjusting how we look at things.  You and your
resident/clients may have already experienced flow and you thought you were “just
having a good day”.   The activity profession needs to explore these new concepts and
integrate them into daily practice.   As the emphasis on quality of life grows, we will be
called upon to articulate specific means to create opportunities for “the good life” for all
who reside in our communities.  

“Our lives are not determined by what happens to us but by how we react to what
happens, not by what life brings to us, but by the attitude we bring to life. A positive
attitude causes a chain reaction of positive thoughts, events, and outcomes. It is a
catalyst, a spark that creates extraordinary results.” – Anon