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

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.
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.
Subscribe to Kimberly's Newsletter
See Kim's You-Tube video "Activity Professionals in Action"  (Click Here)
By Kimberly Grandal BA, CTRS, ACC

Getting facility staff on board with activities and helping to provide opportunity for
meaningful activities for the residents is a major concern for activity professionals. The
Activity Director must get the support of the Administrator and the department heads in
order to truly create an environment that promotes an interdisciplinary approach to
quality of life. Even after the implementation of the revised F248 in June 2006, Activity
Directors around the country continue to express that facility staff members are simply
not assisting with activities. Be sure to meet with the Administrator first to discuss your
concerns and ideas and inform him/her that F248 clearly states that all staff members
are to promote meaningful activity, not just the activity staff.  

The Activity staff, often professionally certified through NCCAP or NCTRC, are specially
trained to facilitate activities that are designed to meet the needs and interests of each
resident, however, facility staff can supplement the activity program in a variety of ways.
The assessment, care planning and planning stages are key to successfully facilitating
a program of activities, therefore the Activity staff must commit to training facility staff and
communicating residents’ interests and needs.

When developing an interdisciplinary approach to quality of life program, it is important
to remember the following:

  • All interventions must match the needs and interests of EACH resident.  
  • All work-related activities must be included in the comprehensive care plan.  
  • Residents have the right to refuse activities.
  • Residents have the right to refuse to provide work for the facility.  
  • The intent is not for the residents to do our work, but to feel a sense of self-worth
    and purpose!

The following are just a few ideas on how each department can offer meaningful activity
experiences for the residents.


  • Incorporate meaningful activities into ADL’s and restorative programs.
  • Schedule medications, ADL’s, and treatments around residents’ favorite
  • Assign CNAs to assist in the day rooms and other activity areas.
  • Facilitate simple, groups, and one to one activities.
  • Incorporate resident interests into the daily CNA assignment.
  • Provide opportunity for residents to assist with making beds.
  • Staff Educator can provide in-services to residents such as diabetes, infection
    control, flu shots, dealing with residents with cognitive impairments, etc.

Food and Nutrition

  • Have residents’ favorite comfort foods readily available.
  • Create an ice cream cart or ice cream parlor that is always stocked with sweet,
    cold, treats.
  • Cook or do food preparations in a common area for residents to see and smell
    the food.
  • Host cooking programs and specialty dinners, breakfasts, etc.
  • Facilitate a Menu Planning Committee.
  • Provide cultural meals in accordance with resident’s tastes.
  • Provided meals that meet residents’ religious needs.
  • Provide opportunity for residents to set tables.
  • Have residents plan a meal.
  • Have residents do some food preparations.

Social Services

  • Assist with utilizing residents PNA to purchase electronics, adaptive equipment,
    decorations, community outings, etc.
  • Play a major role in the Resident Council process.
  • Purchase clothing, schedule beautician appointments, etc.
  • Facilitate a new Resident Support Group, Adjustment Group, or other support
  • Facilitate a Life Review Program (Group or one to one).
  • Provide One to One visits for reminiscing, support, and companionship.
  • Encourage family to bring in personal belongings to create-homelike
  • Have mock elections during voting seasons.
  • Facilitate Resident Rights Bingo.

Housekeeping and Laundry

  • Some residents may enjoy cleaning-give them a duster, cloth, broom, etc. and
    have them help.
  • Put on residents favorite TV station, music, etc.
  • Discuss what the resident is watching on TV, reading, etc.
  • Discuss family photos, memorabilia, etc.
  • Assist in facilitating specialty groups such as a men’s club, cultural programs,
    young adult groups, etc.
  • Provide opportunity for residents to fold towels and linens.


  • To cut costs, build items that can be utilized with the residents such as: garden
    boxes, tactile boards with various objects and textures, games (target toss,
    Wheel of Fortune Boards, etc.). If appropriate, have a resident assist.
  • Ask residents to assist with minor projects such as hanging a picture, repairs,
  • Assist in facilitating specialty groups such as a men’s club, cultural programs,
    young adult groups, etc.
  • Facilitate a wood working program (bird houses, shelves, etc.). These items can
    then be used to decorate facility or personalize a resident’s room.
  • Bring in videos of sporting events.

Business Office and Human Resources

  • Residents may be able to assist with folding brochures, mailings, some filing,
    clerical work, etc.
  • Have residents be part of an Employee Appreciation Program such as a
    resident committee that nominates employees for “Employee of Month/Year.”  
    Have a special recognition program where residents can present awards.
  • Have a resident greet family and visitors at the reception area.


  • Residents may be able to assist with folding brochures, mailings, some filing,
    clerical work, etc.
  • Put up a welcome sign, provide a welcome greeting card, flower arrangements,
  • Follow-up to see how the resident is doing and if they like their room and


  • Encourage residents to be part of marketing strategies such as news articles,
    videos, etc.
  • Some residents may even be able to assist in writing press releases, or
    interviewing other residents about what they like about the facility.  You may even
    bring a resident to a luncheon or meeting and have the resident express the
    positive aspects of the facility.  The greatest marketing tool we have is our
  • Implement the “Adopt-A-Nursing Home” Project.
  • Be on the lookout for community and volunteer opportunities.
  • Market specialized activity programs and special events.


  • Schedule therapy sessions around resident’s favorite activities.
  • Make recommendations and referrals to the Activity Department such as range
    of motion activities, ADL activities, cognitively stimulating activities, etc.
  • Utilize Pet-Facilitated Therapy
  • Provide opportunities for co-treatment groups such as cooking, gardening, etc.
  • Develop a Fitness Trail designating specific exercise that can be done standing
    or sitting.
  • Help co-ordinate a “Walk/Wheel- A-Thon” to raise money, or a “Senior Olympics”.


  • Host a monthly “Lunch with the Administrator” or “Meet the Administrator” for
    new Residents.
  • MC a special event
  • Attend Resident Council
  • Encourage Residents to be on facility committees
  • If possible, involve Residents in facility renovations.  Ask them about color
    preference, styles, décor, themes, etc.  
  • Be proactive in the Culture Change Movement.
  • Create an Administrative policy that supports and interdisciplinary approach to
    quality of life.

Although an interdisciplinary support to quality of life is prominently stated in the revised
F248 Activities regulation, it is not adherence to this regulation that Activity professionals
are concerned about, but rather the idea that all residents should be given an
opportunity to engage in activities that are purposeful, meaningful, therapeutic and
enjoyable. Truly providing a program of activities that meets the needs and interests of
each resident requires support, continuity, education, commitment and a complete
team approach.

Copyright Kimberly Grandal, 2007. All rights reserved.

Breaking Down the Silos: An Interdisciplinary Approach to Quality of Life In-Service ($15)
Do you need to educate healthcare providers in your facility about the importance of an
interdisciplinary approach to quality of life? Yes, we all do, especially since the
implementation of the revised CMS guidance to surveyors for Activities, F248. This in-
service will help you “break down the silos” in your facility and create a person-centered
environment. You receive an outline, PowerPoint presentation with teacher’s notes, a
student manual, an icebreaker activity, and a post-test. To order this in-service visit