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PRT 5828Goodwin House Bailey’s Crossroads

By Kate Ward

+Summary This summer I completed my 560 hour internship in Washington, D.C. at

retirement living facility called Goodwin House Bailey’s Crossroads. The population served was the elderly.

I worked with the Therapeutic Recreation Supervisor (CTRS), and Therapeutic Recreation Coordinator (CTRS) to assist with the development and implementation of a comprehensive recreation program for the Health Care Center, Assisted Living and the Terrace. I provided therapeutic recreation programs and interventions, as well as diversional recreation services, through implementation and/or supervision of structured and unstructured group and individual leisure programming.

I worked primarily in the Health Care Center (HCC), providing a variety of programs each day including exercise, sit-n-stretch, social, reminiscing, relaxation, special events, concerts, games, arts & crafts, sing-a-long, cognitive training, outdoor activities, field trips, pet visits, sensory skills practice, etc. I also assisted with art and music therapy sessions.

I also was responsible for assessments, quarterly & annual notes, documentation, evaluations, care plans, MDS, and two ongoing special projects.

+Goals & Objectives Goal 1: Will plan, develop and coordinate recreation programs and interventions

specifically for a geriatrics population. Objective 1: Work with recreational therapy team to determine the purpose and

outcomes of the intervention/program, as well as document the specific steps that the intern will follow to implement the program effectively.

Objective 2: Will help facilitate or co-lead at least 25 individual and/or group sessions throughout the course of the fourteen weeks under the supervision of a CTRS.

Goal 2: Will document changes in functioning of the individuals served at the Goodwin House facility. Objective 1: Assist with the completion of the documentation requirements for

both the state and federal government, including assessment, MDS, care plans, progress notes and Hospice-related documentation after reviewing the protocols for assessment with the supervisor.

Objective 2: Will record individual behavioral observations and progress at the end of each TR session and input into individual’s care plan for referral by supervisor.

Goal 3: Will become familiar with the assessment process at the Goodwin House. Objective 1: Will observe CTRS complete an assessment and a 1:1 interview

with an individual. Objective 2: Will research three different means of assessments to facilitate with

secondary sources (i.e. family members, friends, other disciplines).

+Goals & Objectives, cont.

Goal 4: Will gain professional development by working with a treatment/service team. Objective 1: Will attend weekly interdisciplinary meetings related to the

therapeutic recreation services offered at the Goodwin House, such as, but not limited to Stand-Up, Falls Intervention Meeting, Department Meetings, Plan of Care, etc. under the supervision of CTRS.

Objective 2: Will observe communication between recreational therapist and team members on progress of person served (behavioral changes,

functional status) by attending weekly care plan meetings for individual residents.

Goal 5: Will become familiar with TR program organization at the Goodwin House. Objective 1: Will assist with the development and advertisement of event

information via calendars, flyers, mailings and newsletter articles. Objective 2: Will assume primary responsibility for creation of daily slideshow of

events on HCC as well as daily completion of the Point of Care Participation Tracking for each individual resident.

Objective 3: Will monitor recreation supplies and equipment on a daily basis to ensure adequate availability and proper functioning.

+Facility Goodwin House Bailey’s Crossroads – Retirement Community

Located in Falls Church, VA 2 buildings housing 450 + Residents All Levels of Care

Senior Living Assisted Living Health Care (Where I primarily worked- 65 residents) Memory Care Rehabilitation (Physical, Occupational)

Mission: “The mission of Goodwin House Incorporated is to support, honor and

uplift the lives of older adults and the people who care for them through a faith-based, nonprofit organization affiliated with the Episcopal Church.”

+Intern Responsibilities

Develops and coordinates recreation programs including in-house entertainment, birthday parties, trips, educational programs and classes, special events, etc.

Assists with the completion of the documentation requirements for both the state and federal government, including assessment, MDS, care plans, progress notes and Hospice-related documentation.

Assumes primary responsibility for creation of daily slideshow of events on HCC as well as daily completion of the Point of Care Participation Tracking for each individual resident.

Monitors recreation supplies and equipment to ensure adequate availability and proper functioning.

Encourages resident and volunteer participation in programs.

Actively participates in interdisciplinary meetings, such as, but not limited to Stand-Up, Falls Intervention Meeting, Department Meetings, Plan of Care, etc. under the supervision of CTRS.

Works on special projects associated with Creating Home on the Healthcare Center.

Assists and/or works with other staff members on special projects/programs.

Assists with the development and advertisement of event information via calendars, flyers, mailings and newsletter ard

Attends all required trainings, in-services and meetings. Provide in-service trainings as assigned by supervisor.

Solicits resident feedback during designated meetings and

spontaneously for quality improvement.

Serves as an advocate for resident rights.

Projects positive professional image.

Exercises discretion and independent judgment.

Develops and maintains resource information for programming and documentation.

Contributes toward achieving departmental goals and objectives.

Provides individual therapeutic recreation services based on individualized needs.

+Daily Routine There are usually 3-4 programs a day on the Health Care Center (HCC). I

attended each activity every day. We would arrange the residents in a circle to begin the group. We also mentioned the date and the schedule for the day as a constant reminder.

• To start of the day, I would facilitate a 30 minute social or reminiscing activity, for example: discussing the news, trivia, quotes, “on this date” food tasting, etc.

• Once a week, instead of the social activity, we would either have a special morning concert or an arts & crafts group.

• I was primarily responsible for the 30 minute exercise program in the morning. It was low impact, easy exercise because 95% of the residents on the HCC are in wheelchairs. I also facilitated 1:1 exercise room visits.

• In the afternoon, I would facilitate a group activity to get the residents thinking such as crossword puzzles, bingo, or board games. I also would take the residents outside, have refreshments & chat.

• Many times a week, I also had to complete assessments when residents arrived in the HCC. I completed an initial assessment interview, MDS (Form F) and created a care plan for each resident under the supervision of a CTRS. All of this information need to be gathered within 72 hours of their arrival and available for all staff to view on the computer.

+Example of Weekly Event Calendar on Health Care Center

+ Special Programs at Goodwin House Bailey’s Crossroads that I Assisted With Development & Implementation:

Throwback Thursday: 1950s Dinner

Ice Cream Social

HCC Art Show

Lobster Dinner

Birthday Parties

Themed “Days”

BBQ Cookout with Country Band

Field Trip to National Arboretum in Washington, D.C.

Classical Music Concert

Magic Show

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One of the Friday Arts & Crafts Groups I Facilitated for

the Residents in the Health Care Center: Pucker Up

Printmaking!

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Art Show & Reception in the

Health Care Center that I helped plan &

organize for the residents and their

families!

+ Special Projects Life Histories

I completed 5 life histories over the course of the summer. A life history is essentially a biography of each resident’s life. The goal for a life history is to gather and present the history of each resident in order for staff and those who serve the resident have a useful understanding of the background and uniqueness of each resident that we serve. I developed a creative presentation (using power-point and audio/visual) for each resident after completing an interview with them. I also gathered information from family members, as well as collected personal pictures for the presentation. When the presentation was completed, we would show it to the residents in a special viewing.

Music & Memory

I was lucky enough to be involved with the Music & Memory project designed for those struggling with Alzheimer’s, dementia and other cognitive and physical challenges to be able to reconnect with the world through music-triggered memories. During my internship, one of my main responsibilities was to complete music & memory assessments on residents in HCC, create a personalized playlist based on the findings, upload the playlist onto an iPod and deliver it to each resident so that they can enjoy it whenever they desire. I was astounded by the drastic changes of resident's moods, behaviors, and emotions. Many of them were moved to tears when they heard a specific song, or they began to sing or smile. It was a very rewarding experience, and has really shown me about the therapeutic benefits & healing power of music. 

+Challenges

Gathering Information Sometimes I would have difficulty gathering information during the life history

interviews or music & memory assessments because the resident would have trouble recalling personal information. I would often have to communicate with family members to ensure accuracy.

Communication I often had to repeat myself many times during group programs, and speak very

loudly to ensure that each resident could understand me and follow along. Loss

Unfortunately, many residents in the HCC passed away over the 3 month period that I was there. It was always difficult to lose someone who I interacted with on a daily basis.

Resident’s Level of Functioning Sometimes the residents would become agitated or aggressive during a program.

Residents often needed several reminders or hand over hand assistance to complete activities. Residents had a difficult time interacting during a program, would fall asleep, become confused, couldn’t hear/see, etc. The residents also were not shy of voicing their opinions or feelings about a group openly. It was also difficult to see some of the resident’s intellectual deterioration, for example they would ask to go home, where their family was, confusion about their location etc.

+Overall Experience I had an amazing three months here at Goodwin House Bailey’s

Crossroads. I was exposed to all levels of care, and had the opportunity to work with so many wonderful residents and develop relationships with them.

Both of my supervisors were extremely knowledgeable and I really feel like I learned so much about the therapeutic process in a clinical / long term care based setting. They trusted me to facilitate programs, provided emotional support during difficult times and showed me all of the tips and tricks to ensure resident participation, quality care, and program enjoyment.

I feel much more competent in my abilities as well as more prepared for the NCTRC exam now that I have been able to put my classroom experience into real life practice. I went into TR to work with the older population, and this internship reassured me that this is what I should be doing.