The benefits of multi-sensory environments for recreational therapy patients are many, especially since these environments can be tailored to the needs of a particular patient or group of patients. Currently, multi-sensory environments are being used to treat patients with learning disabilities, dementia, and even chronic pain. Here are some of the benefits of these environments in therapy situations:

Increase in mood

Several studies have shown that multi-sensory environments can have mood benefits for patients with moderate to severe dementia as well as learning disabilities. Because these individuals are often unable to connect with the world around them, they often suffer from depression or mood problems. A multi-sensory environment can increase a sense of connection, thus decreasing depression and sadness.

Better social interaction

For patients with learning disabilities, interacting with a multi-sensory environment often turns into interacting better socially. Exploring a multi-sensory environment often leads these patients to explore the world around them more fully and to connect more readily with individuals around them.

Improved concentration

This is a benefit that works especially well for those with learning disabilities. It seems that because those with learning disabilities are able to concentrate on their multi-sensory environment, they are more able to concentrate in the real world, as well. Plus, they gain greater self-awareness through a multi-sensory environment, which means they are better able to focus on school and social interactions.

Better communication

In both dementia patients and learning disabled patients, multi-sensory environments in recreational therapy have been shown to increase appropriate communication. Often, these patients become more self-aware as well as more willing to look into the world outside of themselves, which means they are better able to communicate with others after multi-sensory environment recreational therapy.

Pain management

Recently, multi-sensory environments have been used to help manage chronic pain. Recreational therapy in these environments can help reduce levels of pain and depression and increase coping skills. A multi-sensory environment can be exactly what the chronic pain sufferer needs in order to cope with pain without the use of heavy drugs.

Creating a Multi-Sensory Environment

A multi-sensory environment can be created in almost any therapy facility or home. According to the American Association of Multi Sensory Environments, this type of environment is essentially a room that blocks out outside noise and light so that the therapist or patient can control things like temperature, lighting, noise, and other sensory input. Many times, multi-sensory environments include controls that allow patients to manipulate the environment on their own, but some environments are set up so that patients can simply enjoy them.

If you want to create a multi-sensory environment in your therapy workplace – or even in your home, as some parents with special needs children might do – start by blocking out outside noise and light as best you can. Installing extra insulation around the room is one option, and blacking out and covering windows is quite easy.

Then, include things in your room such as different textures on furniture, lighting balls that throw lights around the room, and projectors that put up soothing, interesting images on the walls. You can also include things like a ball pit or bubble tube, aromatherapy candles, and even bits of food for the patient to taste and smell.

Financing a Multi-Sensory Environment

If you’re interested in creating a multi-sensory environment but don’t have the funding for it at the moment, Daniela Baker, blogger from CreditDonkey, says,  “Seek out alternative forms of funding via a fund-raiser.  If you don’t have the time to manage the fund-raiser yourself seek out local churches, Rotary Club, college fraternities, and other groups that are looking to help others.  Funds may also be found from grants.  Start your grant search at  ttp://www.grants.gov.”

Much recent research has shown that a multi-sensory environment can be helpful for patients with autism, brain injury, dementia, developmental problems, mental illness, and even PTSD. Clearly, any organization that works in recreational therapy should have a multi-sensory environment to aid other forms of therapy, as well.

Charles Sourby (who went by Charles Nature on this blog) passed away earlier this year.  I just found out about it today.  Charles was a recreation therapist who used horticulture therapy in his practice.  His last blog is seen just below this posting.  Charles was a frequent contributor to this blog and to the Therapeutic Recreation Directory.  We will miss you Charles!

A Certified Therapeutic Recreation Specialists (CTRS) provides leisure activities to individuals who present with a combination of physical, social, affective or cognitive deficits. These limitations, caused by a variety of disabling conditions, from Alzheimer’s disease to stroke, typify individuals that the CTRS works with. The CTRS chooses activities that ameliorate symptoms, teach adaptive technique and foster community reintegration.

A CTRS draws on experience, empathy and common sense when providing various Therapeutic Recreation (TR) interventions. The CTRS observes, assesses and develops a TR plan for each individual. The CTRS who presents with disabilities of a personal nature learns to consider his or her own challenges. My tenure prepared me for challenges and realities that impede leisure. Overcoming obstacles is my professional mantra. Bring the program to the individual. Break down barriers, provide comfort & individualism. I am the patient, a TR professional who benefits from TR…

What is Multiple Sclerosis?

Multiple Sclerosis is a progressive disease that attacks the central nervous system. There are approximately 350,000 persons in the United States with MS. Multiple Sclerosis. MS is the most common neurological disease diagnosed in young adults (ages 20 to 50) . For every person with muscular dystrophy or amyotrophic lateral sclerosis, there are more than ten people with multiple sclerosis. MS is more common among Caucasians than in other racial populations. Approximately two-thirds 2/3 of those diagnosed with MS are women. MS is devastating, progressive, disables people in the prime of their lives and is incurable MS SOCIETY 2011

Recreation therapy professionals see very few cases where the MS actually patient improves. This presents challenges: goals written to maintain functional ability, maintain range of motion and socialization; goals modified continually as the disease progresses; objectives dynamic. Healing is paramount. Adaptive equipment, universal design, supports and attitude makes life bearable.

Multiple Sclerosis patients incur huge costs for care. Costs in excess of about $47,000.00 annually are not uncommon. Medicare and Medicaid rules constantly change making services for the MS patient difficult to access and subject to the political climate in Washington.
Although there is no cure for MS , the medication and treatments for it have grown substantially over the past ten years. Interferon drugs, chemo therapy, physical and occupational therapy are to treat disease progression. Other medications, including anti-depressants and anti-spasm drugs treat symptoms that interfere with activities of daily living. Magnetic Resonating Imaging and other tests used for diagnostic tools, lead to further treatments. Rehabilitation and education contribute to wellness. MS SOCIETY 2011

Multiple Sclerosis is not a fatal disease but, is severely debilitating. Patients meet lifetime averages but with challenges that make life difficult and taxing at best. Caregivers face many challenges in preparing the patient for daily life. Whether it is activities of daily living, providing emotional support or paying bills, caregivers find themselves in the role of parent, spouse and helper. This leads to strained relationships in any family. Indeed, children in the family compete for attention from the primary caregiver who tends to the MS patient’s needs. MS SOCIETY 2011

UNIVERSAL DESIGN:

Recreation & horticultural therapist traditionally advocate for the clientele they help. The Americans’ With Disabilities Act: (ADA 1990), covers the civil rights for people with disabilities. The ADA is there to insure reasonable accommodations in public places, prohibit discrimination based on disabling conditions and to define disabilities. The ADA has paved the way to a new concept called Universal Design. Universal Design creates an environment where fewer and less costly modifications are needed.

“Universal design enables everybody—not just people with disabilities—to navigate, manipulate, and appreciate our world.” Curb cuts, non-slip flooring, grab bars and automatic doors make life easier for everybody.
Universal design has developed over the past 14 years but, is not exactly universal. Universal Design can eliminate the need for special accommodations.

Product and space designer are considering the universal needs of all people. The increasing number of people aging has product designers “slowly beginning to solve problems using the principles of Universal Design”. This has a benefit for all people. New technologies are entering the market place: adjustable kitchen sinks, power assistance vehicles, automatic doors and foot buttons for elevators.

There are seven principles that uphold the philosophy of universal design:

• Equitable: addresses wide range of needs

• Flexibility in Use: “hands free” operation of faucets, sliding doors

• Simple and Intuitive Use: high contrast, large “on/off” controls

• Perceptible Information: Telephone & remotes with large buttons

• Tolerance for Error: Glare reducing surfaces, non-slip floors

• Low Physical Effort: fat pen barrels

• Size and Space for Approach and Use: a standard width for doorways roll-in showers and bathroom stalls for wheelchairs & walkers

Universal Design goes beyond ADA compliance. Many hotels and conference have installed features of universal design, making their facilities exceed ADA standards. Universal Design takes into account ease of mobility, distance, functionality. Universal Design can eliminate many problems. Architects and planners need to build and environment that serves an ever increasing diverse population.

Universal Design is not Assistive Technology. Think of accessibility as a continuum. On one end is Universal Design: on the other is assistive technology. Technologies such as voice activated, keyless computer key-boards are designed for specific populations. Universal Design addresses the needs of the population as a whole. Together, both concepts improve the quality of life for everybody.
People who do not have disabilities do not always appreciate the difficulties and embarrassment that comes with having disabling conditions. The person with disabilities wants to function in the least restrictive environment. Universal design minimizes the disability and maximizes functioning for all. Universal Design brings the ADA up to date.

Adelson, Rachel (2004), Universal Design: Opening Every Door, Inside MS, October—December 2004.
Ibid
Ibid

A. Accessibility, Acquiring new skills, Active listening, Activity Analysis, Adaptive Aquatics, Adaptive techniques, Agency, Ameliorate, Arts & crafts, Assessment, ATRA, Attendance
B. Ball Toss, Balloon toss, Beauty culture, Behavioral objectives, Bingo, Birthday parties, Board games, Bowling
C. Cards, Care plans, Caring, Certification, Charting, Clinical, Coffee, Cognitive skills, Cohesive groups, Community Center, Companionship, Compassion, Conferences, Continuum, Control, Costumes, Counseling, Creative expression, Croquet, Current events
D. Decrease specific behavior, Diagnoses, Disabilities, Discussion groups, Disease, Display
E. Early onset, Elopement, End stage, Energy, Equipment, Evaluation, Excitement, Exercise, Experience
F. Facilitate, Facilities, Family & Friend supports, Fine motor skills, Flow, Following demonstration, Friendship, Fun, Functioning level
G. Games, Gardening, Geriatrics, Given the appropriate supplies and equipment, Goals, Gradualism, Gross motor skills, Groups
H. Hand-over-Hand, Hand-washing, Happy Hour, Helping, Holidays, Horticulture, Humor, Hyperactive, Holistic
I. Improve, Increase specific behavior, Independence, Individual activities, Innovation, Interdisciplinary team, Interests, Intervention, Isolation, Isometrics
J. Jigsaw puzzle, Journaling, Joyful
K. Kinesthetics, Knitting, Kaffee Klatch
L. Leadership, Leisure counseling, Leisure repertoire, Leisure skills, Lethergy, Letter writing, Licensure, Life review, Locus of control
M. Magic, Maintain specific behavior, Measurable, Medication, Mens’ club, Motivational rounds, Movies, Multi-purpose room, Music appreciation, Music & instruments
N. Needs assessment, Newspapers, Night club
O. Objectives, Observation, Occurence, One-On-One, Optimal, Organize, Outcomes, Overcoming Obstacles
P. Pantomime, Paradigm, Para-Professional, Participant, Partnerships, Passive, Peers, Performance, Perscriptive, Petty Cash, Pokeno, Policy & Procedures, Praise, Process, Program Plan, Program Protocol, Progress, Puzzles,
Q. Quality assurance, Quality vs. Quanity, Quantify
R. Rapport, Reality orientation, Recreation Room, Reduce specific behavior, Refreshments, Reminders, Research, Ring Toss, Room visits, Rounds, Rules
S. Self-directed activities, Self esteem, Singing Songs, Socialization, Special events, Sports, Statistics, Supplies
T. Teaching, Therapeutic rapport, Third party reimbursement, Time management, Tools of the Trade, Transport to program, Trivia,
U. Understanding, Universal design, Updating, Upon request
V. Values clarification, Venting feelings, Videos, Volunteers, Voting
W. Walking group, Wheelchair games, Whole person, Will, Winning, Womens’ club, Wood Craft, Wool, Word games,
X. 2x, 3x, 4x etc., Xeorox machine
Y. Yarn rolling, Yoga, Youthful
Z. Zoo Trips

by CHARLES SOURBY
I see myself as a therapeutic recreation enthusiast. I believe in the principles of TR from a client’s perspective being a patient with end-stage Multiple Sclerosis.

I am now a quadriplegic with slight use of my left hand. I type this with one finger. I battle aspiration pneumonia daily. I struggle to feed myself the meals my nurse prepares.

I use adaptive technology for all personal needs. I use a ceiling mounted, remote controlled lift system to get out bed. I see this as way to increase my leisure time.

I enjoy my gardens by painting the flowers and helping my wife with design.
I developed a website for my leisure and to stay involved with TR and Horticultural Therapy.

I help students from a variety of disciplines. I write TR blogs as part of my leisure repertoire. I continue to attend concerts and Broadway shows.
I am honored by this award. Thank you NYSTRA.

Sometimes within the next several weeks the two millionth visitor will stop by. Who will it be? In celebration for this event I am providing over thousand dollars worth of gifts and discounts to members of the Therapeutic Recreation Directory newsletter. To sign up for my TR Newsletter go to http://www.recreationtherapy.com/mlm.

Charlie Dixon, MS, CTRS

Some of you know that I was born and raised in Japan. My father was in the US Airforce and we lived in Japan for 20 years. I hope that you will join me in sending monetary support and/or prayers to our friends to the far east. Go to http://american.redcross.org/Earthquake to send $$ via Red Cross.

Charlie Dixon, MS, CTRS

I wrote about my plans to take a vacation in Cape Cod, my first since becoming a spastic quadriplegic. I rented an accessible hotel room in Eastham equiped with a roll-in shower, a king size bed that accomadated a Hoyer lift, a parking spot for my van, and all the perks I might need. I took trips to the beach, Province Town, restaurants, bicycle trails and National Parks. The beaches were not wheelchair friendly but, I took in all the sights and sounds of the sea. I closed my eyes to remember all of my pre MS vacations. I drew on my ability to use guided imagery to further my leisure experiences.

I thanked strangers who kindly encouraged me and voiced their support or offered me help. Eating lobsters seemed daunting until the cooks cracked the shells. Usually, I impressed folks with my high-tech motorized chair. I met a fellow with a Jazzy chair in P’town, we cruised the pier together. I received a post card from the Post Office Cafe to see the all male review and drag queen show. Lady Gaga, Beonce and Janet Jackson were the highlights of the evening. Sher and Liza Minelli are out of fashion.

Cape Cod lacks cabins that are accessible but, I had fun irregardless. I realize the the most accessible place for a vacation is my own back yard that is totally accessible with gardens, screened in porches and woodlands out back. The next best place is New York City. Museums, Broadway shows, Restaurants and sports venues are easily enjoyed by wheelchair users. Curb cuts are on every corner. In conclusion, leisure continues if one is ready to overcome a number of unforseen obstacles.

Anyone who’s ever had a pet or worked with animals knows that they can add to a happy, healthy life by being great companions and sources of hours of fun and enjoyment. Those with debilitating mental and physical conditions can get a lot out of working with animals as well, from playing fetch with a dog to spending time in the ocean with dolphins. But how does this process work? In what ways to animals help those who most need it to feel better? Here are a few of the many:

1. They reduce stress. Living or working with animals can provide a great way to reduce stress and to relax the mind. Stroking their fur, playing with them and enjoying their reactions to things around them can offer a kind of release that many other things simply cannot. Studies have found that animals can make a big difference in lowering blood pressure and reducing the effects of depression, making them ideal partners in therapy for those who cannot have their own.
2. They provide unconditional love. For people who are struggling with feelings of worthlessness, depression, and anxiety, the love and affection of animals can be a welcome respite from the fears caused by human interaction. They can offer a kind of reassurance and comfort that others may not be able to, and foster a trust that can later be translated into other situations. Even better, animals will give anyone who is kind the same opportunities, no matter what differences or disabilities they may have.
3. They break down obstacles. There are many ways in which animals can help their human counterparts overcome obstacles in their lives. Those who are incredibly introverted can use the animal as a talking point and a way to ease uncomfortable social situations. Additionally, many patients who do not believe they can accomplish things, both physically and mentally, can do so with the help of an animal—a huge confidence booster.
4. They provide a focal point. Those who have trouble focusing, suffer from depression or even who just can’t seem to sit still can benefit from interactions with animals. Most animals require a good deal of care and attention, and this provides a valuable and enjoyable focus that can calm and center patients. Larger animals like horses require a lot of work and dedication, a price many are willing to pay to be close to them, and one they might not seek out in other activities.
5. They connect us with nature. In today’s world it can become easy to feel disconnected from the natural world and our more primal beginnings. Animals help restore that balance, reminding us what a big role animals have played in our survival for thousands of years. Patients of all kinds will feel an instant draw and appreciation of animals as they are a source of curiosity and reverence alike.

This post was contributed by Tara Miller, who writes about the pharmacy schools. She welcomes your feedback at TaraMillerr00 at yahoo.com