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

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

The role of activities in the IDC process is crucial.  Activity professionals bring a wealth of
knowledge into the care plan process, defining the resident’s specific individual traits,
preferences, lifestyle, religious/spiritual expressions, behavior, likes and dislikes, leisure
lifestyles, relationships, social skills, cognitive skills, memory recall, responses to sensory
stimulation, and more.  Without the activities component of the care plan, there would be a
medical care plan rather than a quality of life approach.  

As an Activity Director, I have spent countless hours in care plan meetings.  Too many to
count!  At times, the meetings seemed to be endless.  Unfortunately, there are many times in
which there is no activity representation, leaving the IDC summary and the care plan, absent
of vital, personal, individualized, information and strategies.

As a consultant, I train activity professionals to be confident, outspoken, and outcome based
during the care plan process.  I have witnessed care plan meetings where the MDS
coordinator skips the activities component or simply states the types of activities the resident
participates in, rather than the specific responses residents have to activity interventions and
programs.  Other times, the IDC team looks to the activity professional for recommendations,
answers to important issues such as pain, behavior, psychosocial issues, falls, restraints,
nutrition, resident rights, communication, and so on.  

Often times, in care plan meetings, I have experienced disagreements with the IDC team in
terms of resident abilities and responses.  I explain to the team that residents may respond
differently when in a social setting, than they do during medical care.  For example: residents
may respond to a variety of sensory stimulation techniques such as opening their eyes,
vocalizing, smiling, etc. but do not respond when provided with ADL care.  Residents may
also find it easer to express themselves verbally or non-verbally when in a group setting or a
one to one intervention with an activity staff or volunteer.  I encourage activity professionals
to voice these observations and not back down because of the differences in observations.

I was once dismissed for reporting that a resident in a semi-comatose state seemed to be
responding to the music therapy sessions as evidenced by smiling.  I was told that it was
impossible for the resident to voluntarily respond to external stimuli, therefore, the
observations reported by the Music Therapist, were overlooked.  Several months later, after
bi-weekly music therapy sessions, the resident responded to the Music Therapist with a
“thumbs up” movement.  This was reported to the IDC team and this time, taken seriously.  
The resident began receiving Physical, Occupational, and Speech Therapy, and after about
nine months of therapy, the resident was off of the feeding tube, able to move his upper
extremities, speak, socialize, sing, etc.  He was soon discharged home.  I tell activity
professionals this story to encourage them to speak out and share their observations with
the IDC team, regardless of the differences of opinion.

It is also important for activity professionals to be an active member of the IDC team to learn
as much as possible about clinical conditions, medications, other disciplines, etc.  I was
always one to ask a lot of questions.  The care plan meeting is the best place to learn this
type of information. Knowledge is power and helps build confidence.  This learned
information is then used to formulate professional assessments, RAPs, care plans,
programming, and so on.

Activity professionals often feel there is a lack of understanding about the role of activities
and they are right.  Participation in the IDC process is one of the methods we educate others
about what we do, why we do it and the benefits to the residents. For care plan information,
resources, and samples, visit

For those of you going for Track 5 NCCAP Certification, or would like to enhance your care
planning and documentation skills, Re-Creative Resources will be hosting an all-day
documentation workshop entitled, “Taking the Write Path: Recreation Documentation for
Quality of Life” on April 12, 2007 at the Canterbury Care Center in Cedar Grove NJ. For
more information visit

Copyright Kimberly Grandal, 2007.  All rights reserved.
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