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.
Activity SOS: Success-Oriented Sensory Stimulation
By Kimberly Grandal BA, CTRS, ACC
Executive Director, Re-Creative Resources Inc.

Although many residents may benefit from sensory stimulation, the target audience most
commonly includes individuals with moderate to severe cognitive impairment, those who
demonstrate repetitive, self- actions, such as rubbing table trays or chairs, residents who
demonstrate little or no response to external stimuli, and residents with impaired communication.

The planning phase is a very important part of success-oriented sensory stimulation
programming. Identify which residents will benefit, assess their needs and interests, and plan
accordingly. You may choose to offer a general sensory program which focuses on ALL the
senses such as Discovering Your Senses, Sense-Abilities or the S.P.I.R.I.T. program (Sensory
Program and Individualized Recreation Intervention and Techniques). Other programs may focus
on a specific sense such as Picture Identification, Name That Sound, or Taste and See. The
following is a list of some creative names for various sensory programs:

  • Snoezelen                          Feel and Describe                Name That Sound
  • Aroma Therapy                  Sensory Awareness              Sensory/Nature Videos
  • Hand Massages                 Five Alive Sensory                Seasonal Sensory (Autumn etc.)
  • Picture Identification           S.P.I.R.I.T. Program             Color Sensory (i.e. Orange)
  • Sensory Stretch                 Discovering Your Senses     Sensory and Music
  • Sensory and Movement     Tactile Stimulation                Taste and See
  • Making Scents                   Sense Abilities                      What’s the Sense?

There are many methods to providing a quality therapeutic sensory program. Some tips include:

  • Offer group or 1x1 sessions in the morning
  • Offer the same time each day
  • Offer in a quiet and comfortable setting
  • Provide as tolerated
  • No more than 8-10 residents for one staff
  • Attempt to stimulate ALL of the senses or pertinent senses
  • Create individualized sensory kits (send a letter to family members requesting items that
    would be most important and meaningful to the resident-contact Kim Grandal from Re-
    Creative Resources Inc. for a free sample letter)
  • Create theme-related sensory kits such as the patriotic kit pictured
  • Utilize a sensory planning form (available through Re-Creative Resources Inc.)
What’s the sense? How do you know if it is working? Many recreation and activity professionals
become frustrated and experience burnout because they feel that the residents are not
responding to the techniques. It is very important to remember that even the smallest response is
worth the effort. Facilitators should embrace every response and observe if the resident:

  • establishes/maintains eye contact/opens eyes
  • has the ability to track objects
  • responds to music by singing, clapping, tapping, or humming to music
  • demonstrates verbalization such as words, phrases or sentences
  • exhibits vocalization such as moans, nonsensical sounds, etc.
  • expresses laughter or sadness
  • displays various facial movement and expressions such as grimacing, smiling, sadness,
    tearfulness, licks lips, tongue movement, etc.
  • demonstrates focus or increased in attention span
  • awakens, stays awake, or is sleeping
  • decreases repetitive motions, agitation, yelling
  • consumes food/fluids

Documenting residents’ responses to sensory stimulation programs another important task and
should be written in progress notes and IDCP summaries. Utilizing a specialized sensory tracking
form (available through Re-Creative Resources Inc.) is recommended. In addition, care plan
goals should be outcome based. Example: Mary will respond to olfactory stimulation by opening
eyes and smiling 3x weekly during session sessions in 3 months.

The following are examples of sensory stimulation techniques, recommended equipment and
precautions for all 6 senses: Olfactory, kinesthetic, tactile, visual, auditory and gustatory.

Encourage residents to smell and identify the following: perfumes, colognes, potpourri,
aromatherapy oils, popcorn, favorite foods, fresh baked bread or cookies, scented lotions, herbs
and spices, flowers, coffee beans, mothballs, etc.  Ask residents what the smell reminds them of.  
Recommended equipment: variety of scents, aroma fan/diffuser, cotton balls, swabs, etc.
Precautions: aromatherapy oils are not to be used with residents with severe respiratory illness
unless otherwise determined by physician; be aware of any allergies; do not apply aromatherapy
directly on skin; some aromatherapy oils have contraindications-educate yourself!

Encourage physical movement through music, turning pages of a book or magazine, familiar
movements, squeezing foam, etc. Provide passive range of motion or hand over hand guidance
as needed. Recommended equipment: egg shakers, exercise scarves, batons, pom poms,
ribbons, rain sticks, etc. Precautions: know resident’s physical limitations; observe for shortness
of breath overexertion and be cautious of residents with cardiac problems.

Have residents feel the objects and ask them to identify the object.  Ask simple questions:  “Does
this feel soft to you”.  Utilize items that are soft, hard, bumpy, smooth, warm, cold, etc.
Recommended equipment: manipulatives, variety of balls, stuffed animals, feathers, pat mats,
textured objects, sandpaper, warm and cool water, ice cubes, brush, comb, common household
objects.  Precautions: Be aware of allergies, and be cautious of touching. Some residents may
prefer to not be touched; others may experience pain when touched.

Use visually stimulating pictures that are simple, familiar and have contrasting colors.  Use props
when possible, in conjunction with pictures.  Utilize verbal cues and ask simple, open-ended
questions. Recommended equipment: mobiles, pictures, variety of props, reminiscent items,
water panels/bubble towers, rope lights, light sprays, effect projector, nature videos, etc.  
Precautions: when utilizing blinking lights, moving pictures and projections, observe for over
stimulation. In addition, some research shows that mirror balls may cause dizziness or nausea
and facilitators should show great caution for individuals with epilepsy. When in doubt, discuss
with nursing!

Utilize rhythmic music to stimulate and soothing music to calm. Recommended equipment: music
tapes/CD’s, nature tapes, musical instruments, sound wave machines, bells, whistles, alarm
clock, horns, party noise maker, minute timer, listen to seashells, talking books. Precautions:
Monitor/alter the volume as needed and keep distractions to a minimum.

Use a variety of foods that are in accordance with residents’ diets, flavored swabs or flavored lip
balms may be used for residents who are NPO.  Use foods that are flavorful such as: oranges,
lemons, pudding, ice cream, mints, etc.  As the resident if the food is salty, sweet, sour, smooth,
etc.   Match tastes: have the resident taste cherry Jell-O and match with a picture or point to a
bowl of cherries.  Precautions: offer foods that are in compliance with the resident’s diets and
preferences and be cautious of allergies.

The most important aspect of sensory stimulation is the one-to-one interaction that is provided. It
is a great way to provide meaningful activity and stimulation to those residents who are
moderately or severely cognitively impaired and those who demonstrate little or no response to
stimuli. With a little creativity, planning, perseverance, and empathy, activity professionals,
recreation therapists, volunteers, family members, and other healthcare providers, can offer a
success-oriented sensory stimulation program that will significantly enhance the quality of life of
the residents!
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