Beyond 'Busy': Meaning making and engagement in therapeutic activities
Finding a way to engage in the world, make connections, and feel that we are contributing meaningfully is a key function in life for all of us. In our homes, we create meaning through day-to-day routines such as going to work, spending time with loved ones, and participating in the community.
These daily rituals are how we create feelings of consistency and safety in our lives; they provide us with opportunities for choice and autonomy, self-determination and connectedness. Through work, family and community, our lives garner meaning and purpose.
This lifetime dynamic is vital in a long-term care community. Therapeutic activities in long term care must ensure the focus is on engaging and providing opportunities for connection and meaning-making rather than simple entertainment. One must consider whether the focus is to “occupy time” or to build meaningful, if momentary, connections. The former yields little while the latter delivers rich results.
At the Hebrew Home at Riverdale, the Therapeutic Activities department provides opportunities for residents to find interesting, fulfilling new routines that encourage autonomy and meaning-making. The team engages our community members as each redefines and creates a new definition of home. We emphasize meaning-making through a diverse offering of creative arts therapy, lifelong learning, physical, cognitive, social and spiritual group activity programs.
For example, in our Group Drumming music therapy group, drumming and rhythm are used to create group connections and self-expression. Through the process of co-creating music, the therapist and residents produce a powerful therapeutic environment in which the modality of music bonds the group together. Verbal reflections on this process are made throughout the group by the music therapist who encourages self-expression. The physically embodied process of drumming supports the group's psychosocial experience, and the verbal exchanges give that work meaning.
During therapeutic activity programs, the facilitator's focus is on meeting each resident where he or she is, recognizing his or her current level of functioning and emphasizing his or her strengths. Ensuring that the emphasis is placed on abilities still present, rather than abilities lost, is one key to meaningful engagement.
Another essential facet in the provision of meaningful therapeutic activities is the context of relationship. A sense of partnership, created by the facilitator and present with the resident, may also grow between residents in the group. Group work provides an opportunity for increased socialization and peer-to-peer relationship building. The relational aspect of therapeutic activities (facilitator to resident and resident to resident), is where the goals of engagement are made manifest.
As a field, therapeutic activities is seen as critical to providing the highest possible quality of physical and psychosocial care. Reflecting on a therapeutic activity program one Hebrew Home resident shared: “The activities here… give you purpose.” This feeling of purpose is indeed the goal. Through engagement in a myriad of therapeutic, social, recreational and spiritual activities, residents at the Hebrew Home find opportunities for meaning-making, self-expression, and autonomy, that move beyond “busy” schedules into meaningful lives.
Mary Farkas is the director of therapeutic engagement at The Hebrew Home in Riverdale.