The Most Comprehensive Manager - Responsibilities of the Recreation Director in Long Term Care

All the world's a stage,

And all the men and women merely players:

They have their exits and their entrances;

And one man in his time plays many parts,

William Shakespeare

All the world's a stage (from As You Like It 2/7)

Many activity professionals enter the field of therapeutic activities and recreation to enhance the quality of life and functional status of the individuals they serve. Most activity assistants, aides, coordinators, and therapists spend the majority of the day hands-on with the residents, facilitating one to one and group activities. The interaction between activity professionals and residents is beneficial to both parties. The residents are engaging in meaningful, therapeutic activities that greatly enhances their quality of life and overall functional status. Recreational activities often provide opportunities for self-expression, independence, decision making, coping skills, solace, socialization, improved emotional well-being, self-esteem, a sense of purpose, enhanced physical status, and much more. The activity or recreational professional finds great satisfaction and joy in knowing that they are an instrumental part in enhancing the lives of those they serve. In addition, leisure professionals learn a great deal of knowledge in regards to history, ways of life, culture, social graces, religious beliefs, traditions, and valuable life lessons.

When a person first enters the field of therapeutic activities and recreation, they have to obtain a variety of leisure skills and knowledge ranging from arts and crafts, music, dance, drama, poetry, sports, exercise, word games, cooking, gardening, table games, competitive activities, and more. Most of these individuals have one or two areas that they are particularly interested in and good at, but then have to learn the rules, benefits, strategies, methodologies, and techniques, for each activity provided. Not everyone can sing, but all activity professionals have to be able to lead a music group or a sing-along. Not everyone can cook or bake so they often depend on the residents' guidance and experience. In addition, a great deal of effort and time if often put into planning and preparing a variety of recreational activities by means of communication tools, phone calls, lists, verbal reminders, etc.

Next, activity professionals have to be aware of a variety of diagnosis', illnesses, precautions, contraindications, diets, symptoms, etc. so that the programming can be adapted to meet the clinical needs of each resident. Activity professionals are responsible for assessing, care planning, monitoring and evaluating the residents' responses and involvement in activity programs; therefore they must have quality writing skills.

Activity professionals also play an important role in enhancing the environment through the use of plants, animals, seasonal/holiday decorations, bulletin boards, calendars, personalization of resident rooms, and more. It is a busy day for an activity/recreation professional, but one that is rewarding and gratifying, for the residents are truly appreciative of the activity programs and their established relationship with the activity professionals.

"A new position of responsibility will usually show a man to be a far stronger creature than was supposed."

William James

When an activity assistant or recreation therapist decides to take the next step and become a recreation director, they are faced with many new challenges, responsibilities, and obligations. The role of the recreation director in long term care is one that is multi-faceted and ever-changing. Less time is spent in the implementation aspect of programming and more time on the assessment, planning and evaluation phases. The greatest challenge is being able to balance the responsibilities of being a manager and the intrinsic desire to be with the residents.

Often times, like their interdisciplinary peers, recreation directors are knowledgeable about being a provider of their particular area of service, but less familiar with the responsibilities and skills needed to be an effective manager. The recreation director has to learn how to manage, lead, motivate, empower, train, supervise, recognize, schedule, evaluate, and discipline their employees. The process of performing an employee performance appraisal, providing constructive criticism, meeting with a union representative, or even having to deny a vacation request, is often very difficult for the new manager. Dealing with varying degrees of education, certification, work ethics, skills, and knowledge, as well as conflict resolution, cultural diversity, problem solving, and time management, also serve as obstacles the recreation director must overcome on a daily basis. The new manager must utilize the skills and knowledge they have learned previously, and become a teacher and mentor to the recreation staff, as well as the facility staff

The recreation director should demonstrate effective communication and writing skills. Policies and procedures have to be written in accordance with regulatory agencies, corporate standards, standards of practice, and any other guidelines. Memos, emails, letters, training materials, press releases, reports, medical documentation, etc. should be written clearly, and professionally. Recreation directors also create flyers, posters, and newsletter, as a method of communication. Computer efficiency is a plus!

The recreation director must be an active participant in a variety of scheduled and non-scheduled meetings including: daily morning meetings, monthly department- head meetings, quality assurance meetings, care plan meetings, and various committee meetings such as the fall committee, restraint committee, and so on. Recreation directors are usually not very comfortable spending so much time in meetings because they would prefer to be interacting with the residents. Unfortunately, the reality is that since activities are fundamental to the quality of life and care of the residents, then a representative of the department must be present. The clever recreation director offers the recreation assistants the opportunity to attend care plan conferences, or become members of various committees. This is beneficial for many reasons. First of all, the activity assistants are the ones who know the recreational status of the residents for their unit better than any one else, and their information is instrumental to the care planning process. Secondly, involving the activity assistants in meetings and committees affords them empowerment and learning opportunities. However, there are certain meetings that only the recreation director should attend, such as the department head meeting. Lastly, delegating recreation personnel to attend various meetings, give the recreation director an opportunity to facilitate groups, provide one to one interventions, or catch up on required office time.

Most recreation directors in long term care are also responsible for managing the Volunteer Program. Volunteers are a much needed resource and offer a wide variety of services including: group facilitation, one to one visits, administrative work, fundraising, religious/spiritual support, transporting residents to/from activities, feeding and meal distribution, mail delivery, and special projects. Volunteers require the same orientation, training, supervision, recognition, motivation and support that the Recreation personnel require. Much time is also spent on recruiting volunteers, matching their needs and schedules with the needs and interests of the residents, and providing endless encouragement and appreciation. In addition, creating partnerships with community groups is also an important task of the recreation director. Developing relationships with schools, colleges, universities, churches, clubs, synagogues, and other community program, enhances the activity program even further. Activity professionals are highly acclaimed for their resourcefulness!

Another task usually assigned to the recreation director is that of the Resident Council. A Resident Council is a group of long-term care residents that meet on a regular basis to review services provided by the facility. Resident Council members are encouraged to be as independent as possible, but often request assistance from the facility. The recreation director assists in the formation, implementation, and communication aspects of the meeting. Minutes are taken, typed in a particular format, and distributed to the appropriate department heads for review, who then report back to the council on their plans of correction. In turn, the recreation director becomes a strong advocate for the residents at the monthly meeting and on a daily basis. A tremendous amount of time and effort goes into advocating for the residents, therefore, it is recommended that recreation directors keep a log of resident concerns and actions taken to assist with those concerns.

Recreation directors must posses the ability to multi-task and plan ahead. Each month a calendar of events is created which includes a variety of activities that should be designed in accordance with the residents' care plan, population analysis, and individual interests. A variety of Quality Assurance survey tools and audits may be utilized to collect data to effectively formulate the activity calendar. Many special events requires months of planning and preparation i.e. the ordering of food, scheduling of entertainment, purchasing necessary supplies, equipment, and decorations, assigning tasks, communicating with other disciplines, notifying residents, family, and staff, and, so on. It is amazing how much time and effort goes into planning a one hour event! Recreation directors also lend a hand in developing, and planning daily activities such as cooking programs, arts and crafts, theme days, discussion groups, educational programs and other activities.

Activity professionals are a great resource for the other disciplines as well. Recreation and activity interventions should be found on most resident care plans. Some care plans of special importance include: behavior concerns, pain management, falls, restraints, nutrition, psychosocial, mood, cognitive loss, communication, ADL's, and palliative care. These interventions provide support to many departments such as nursing, social services, food and nutrition, and rehabilitation services. The marketing director may also take advantage of the public relations opportunities of specialized dementia programs, horticultural therapy, music therapy, resident council, intergenerational programs, special events, pet therapy, etc. Finally, recreation directors often coordinate programs with other disciplines, assist in writing grants and press releases, develop marketing tools, and assist in planning, and implementing employee appreciation celebrations.

Recreation directors often have difficulty in balancing their time between residents, managerial duties, and personal life. To be an effective manager, recreation directors must be able to balance all three. Most recreation directors work more than eight hours a day, do not take breaks, lunch, days off, and even bring projects home with them. They feel a sense of guilt for not being able to spend more time with the residents, therefore, overcompensate by working additional hours (without overtime!). Recreation directors need to know it is alright to say "no" sometimes, take personal time, and designate "office time". They will be a better manager for it.

It is apparent that recreation directors, activity professionals, and recreation therapists truly are multi-faceted, talented individuals whose contribution to long term care and the residents is invaluable. The recreation director is the leader of the department that is often referred to as "the heartbeat of the facility". Please take a moment to thank the facility's recreation director and the entire department for their dedication, resourcefulness, and interdisciplinary support. The recreation director truly is the most comprehensive manager in long term care.

The Most Comprehensive Manager:
Responsibilities of the Recreation Director in Long-Term Care
By Kimberly Grandal, CTRS, ACC
Executive Director, Re-Creative Resources, Inc
recreativeresources.com recreativeresources.com

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. She is a recipient of the Kessler Institute of Rehabilitation 1997 Triumph of the Human Spirit Award.

Kim is a member of NJAPA, NJ/EPA-TRA and NAAP and serves on the NJAPA board as the Chairperson for the Legislation Committee. She is an NCCAP reviewer and is an active member of the NCCAP and NAAP Government Relation Committees.

Kim is a speaker for various national, state and local activity associations, the Society of Licensed Nursing Home Administrators of NJ, colleges, and community groups. She also 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 Activity Directors Today newsletter, and has contributed articles to Creative Forecasting Magazine, Current Activities in Long Term Care Magazine and The Continuing Care Insite newsletter. For more information visit recreativeresources.com recreativeresources.com