Transcription:
The Role of Recreation Therapy in Rehabilitation

Shepherd Center offers a comprehensive continuum of care from evaluation and medical treatment to rehabilitation and lifelong support programs. As part of our service to our community, we present Shepherd Center Radio.

Deborah: People hear the word rehabilitation, it can conjure up many scenarios. But is recreation one of those scenarios? Today, we'll talk about the role of recreation therapy and rehabilitation. I'm your host, Deborah Howell. And today, our guest is Jenny Dilaura, a certified therapeutic recreational specialist and lead health and wellness therapist here at the Shepherd Center. Jenny, welcome.

Jenny Dilaura: Hi. Thanks.

Deborah: Wonderful to have you today. Why is recreation therapy an important part of the rehabilitation process?

Jenny Dilaura: So recreation therapy is super unique to rehab. And as a recreational therapist, what I get to do is I get to work on all of their rehab goals if it's from PT, OT, and even speech and apply it to everyday real life activities that they would be doing at home or at their job or at school. So we get to take what they're doing inside the gym and cater it to them to make it unique so they can do it when they leave.

Deborah: Well, that sounds very rewarding and actually kind of fun. So what does recreational therapy typically entail?

Jenny Dilaura: So it ranges. We do a lot of things in leisure skills. And those are those activities that you find enjoyable. So returning to maybe hunting or camping or painting, then we also do sessions that are called leisure education. And those are more educational base, and that has information that could talk about how are you going to go to the beach with a mobility device, how are you going to travel, fire safety and nutrition.

And then a big part of our program and as a professional is doing it outside of the hospital setting. So in the community, taking those skills and practicing it real life, like if you need to go to the grocery store or if you're going to go try on clothes at the mall and practicing those skills in real life situations.

Deborah: I love it. Now, it's been quite a year as we all know. So how has in-person therapy shifted to accommodate COVID-19 protocols?

Jenny Dilaura: So for in-person therapy, we're able to do a lot of it still. And we can do all of our leisure skills and all of our education still with hardly any modification and changes. Returning to community has been a little bit more difficult with COVID, but we've done a really good job here with simulating environments that represent the community even without leaving the center.

Deborah: So quick question about that. You said you helped people with their skills, maybe learning how to dress again. How can you do that with the protocols if you have to be six feet away and masked and all that?

Jenny Dilaura: So with the protocols, with the six feet away, as long as we have proper PPP on, we're allowed to be closer to the patient for a safety standpoint. So if the patient is trying to do wheelchair dressing and at some point they become unsafe, we can still step closer and help them hands-on as much as we need to.

Deborah: Got it. Okay. That clears that up. Now, tell us about the virtual health and wellness programs you're involved with.

Jenny Dilaura: Yeah, absolutely. So with COVID a lot of people weren't able to do what they normally did from going to a gym, going to the grocery store. And we wanted to make sure individuals with neurological injuries and illness weren't getting shut out. So we took a lot of our hands-on clinic and we turned them on to online clinics. So still doing those activities, but all online via Zoom and then through constant communication with email, we're able to do leisure skills, fitness, and then also education.

Deborah: And if a person is not connected to the internet, can you still help them?

Jenny Dilaura: I can I'll help them. It's a little bit more difficult. The Zoom sessions would probably go away, but instead of doing email sessions, we would be doing it over the phone and I would be then mailing their resources.

Deborah: Got it. It sounds like you have everything covered. So tell us more about the speech therapy.

Jenny Dilaura: So a lot of times with speech, you want to make sure, especially if they have a brain injury, that they're following the directions and all that. So with rec therapy, we're making sure that they're doing that as well, which is something that they find enjoyable.

Deborah: At what point is a patient referred to you, Jenny?

Jenny Dilaura: So for inpatient, they are referred upon admission. Every client that comes through the Shepherd Center and gets a referral to rec therapy from day one. To come to me for health and wellness, I meet with their primary CTRSs and then that's how they get involved through health and wellness here. And then I also reach out to local community programs and say, "Hey, I've got this going on. If you have clients that meet our registration requirements..." then they pass that information along to me, and that's how I get involved if they were not a prior Shepherd Center patient,

Deborah: Okay, got it. Now, there's an emotional component in all of this. You know, maybe somebody has had a car wreck and now they're in a wheelchair. How do you deal with the emotional part of a person's recovery?

Jenny Dilaura: Yeah, so we let them vent it out. They need to be able to get that out in the open to start accepting what's going on with them. But then really being there and kind of handholding them and showing them, "Look, I know this is not a good time, but you still can do the things that you find enjoyable. And I'm going to show you how," because that's the part of a rec therapist job is to say, "Look, we're going to do this a little differently. And if you can't return to something, how else can I show you different leisure skills, so you can find something just as enjoyable.

Deborah: How important do you think the recreational portion of rehab is?

Jenny Dilaura: Huge. It is hugely important. There's actually been some studies that have shown that if you spend more time in recreation therapy in your initial inpatient rehab stay, that there is decrease of secondary complications such as skin issues or depression and anxiety, because they feel more comfortable about doing those things since they did it while they were in inpatient.

Deborah: Yeah, because you're giving them back the skills to do something that brings them joy.

Jenny Dilaura: And then once you're a happier person, you're most likely going to be able to do something that was more challenging, like a transfer. If you're happier, you're gonna want to be able to do that.

Deborah: So this is in conjunction with OT and other forms of rehab?

Jenny Dilaura: Yeah. This is in conjunction with OT, PT and Speech. We do a lot of co-treatment sessions and then we also do individual sessions.

Yeah, we do make rehab fun. We do, we get it. We get to say a lot that we get to do the fun things and we get to play. But in real life, you're not just sitting around at your house doing nothing.

Deborah: That's the thing. You really have to stick with it. What can you tell patients to make them stick with it?

Jenny Dilaura: A lot of times, like I'll remind the patient that, "Yeah, it's terrible that this has happened to you, but you are still the same person that you are, and you need to show your friends and your family that you haven't changed. Especially from a spinal cord standpoint, the only thing that has changed is that now you're not standing and you're seated and your wheelchair does not define who you are."

So if you are a hunter before, there really should not be too many limitations as to why you should not hunt now because that's what made you who you are. You are who you are because of those activities that you find enjoyable. And it's my job to help you modify those activities so you can still do it.

Deborah: How long is the usual course of rehab in your situation with your patients?.

Jenny Dilaura: it varies. It can be from four weeks to 12 weeks, sometimes even up to many months.

Deborah: Is there anything else you want to say about your position and your relationship with your patients?

Jenny Dilaura: No, just we have a good time. There's always lots of smiles.

Deborah: Okay. And that's it in a nutshell. Thanks so much for being on with us today, with all your good information and for putting the recreation back in rehabilitation.

Jenny Dilaura: Yeah, absolutely. Thanks for having me.

Deborah: Thank you, Jenny. For more information or to book an appointment, please visit www.shepherd.org. And for more health tips and updates, follow us on your social channels.

That's all for this time on Shepherd Center Radio. I'm Deborah Howell. Have yourself a terrific day.