The BCAT Recreation Program

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We use the term “resident” throughout this program to refer to any participant. So, the resident could be in a nursing home, assisted-living facility, at home or anywhere else.

INTRODUCTION

The opportunity to have a purposeful life is a basic right we all should enjoy, regardless of physical or cognitive
disability. Research on life satisfaction tells us that pleasurable and meaningful activities are important to our senses
of well-being. Planned activities for those residing in facilities or at home in the community, but who have cognitive and physical challenges, can improve life satisfaction, reduce problems of mood, and add meaning to life.

The BCAT Recreation Program is designed to assist you in helping residents meet these goals by creating a person-centered approach to recreation. Rather than generating lists of activities that may or may not be appropriate for
residents, our program determines proper “fit” between each resident and recreation features. This is accomplished by integrating a resident’s interest in participation with her actual capability to participate. Cognitive skills are melded with participation motivation.

Our program integrates the BCAT Test and the Recreation Interest Inventory. One of the strengths of the BCAT Test
is that it measures attention, memory, and executive functions – three cognitive skills that can determine a resident’s ability to engage and complete an activity. Performance scores on BCAT items indicate different levels of resident capability. The Recreation Interest Inventory consists of eight items that measure how interested or motivated the resident is in participating in activities. It is important to measure both motivation to participate as well as ability to
participate if one wants to create recreation that is person-centered.

Once BCAT scores are entered and the Recreation Interest Inventory is completed, the “cells” indicated below is selected to match the resident:

		High interest in participating Low ability	High interest in participating Moderate ability	High interest in participating High ability
		Moderate interest in participating Low ability	Moderate interest in participating Moderate ability	Moderate interest in participating High ability
		Low interest in participating Low ability	Low interest in participating Moderate ability	Low interest in participating High ability
		LOW (DEPENDENT)	MODERATE (MODERATE SUPPORT)	HIGH (INDEPENDENT)
		CABABILITY LEVEL

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These nine cells describe nine recreation “types.” One of these nine cells will represent the most appropriate fit for your resident. Our program will generate very specific approaches to choosing specific activities based on which cell is appropriate. For example, you will see that for residents with low interest in activities and low capability, information is provided about how long activities should last, how much social stimulation is optimal, and how to present activities.

DEALING WITH PROBLEMATIC BEHAVIORS

For those of you who have experience working in recreation with residents who have cognitive impairments, you are likely aware of two common behavior problems. One problem is disinterest, which is sometimes called apathy, boredom, or lethargy. Typically, disinterested residents are asked to participate in activities beyond their cognitive capabilities, or simply do not find the activity stimulating. It is important to determine which applies. In the case of the former, a substitute activity is recommended, or try to make the current activity shorter and easier to complete. If you think the activity is appropriate for the resident’s capabilities, try persistent encouragement. If disinterest is because the activity is simply not interesting to the resident, stop it, and try another.

A more series behavior problem is agitation, which is when the resident becomes emotionally distressed, and often verbally or physically aggressive. Much of the time, agitation is the result of over-stimulation. This can occur when an activity is too difficult, when there are stressors in the environment, or when their or somatic (health) problems. Because residents with dementia often cannot tell you what is bothering them, it is important that you read the signs. When agitation begins, STOP the activity. It is time to calm things down, and lower stimulation.

You might find the diagram below helpful in understanding how agitation can occur.

REMEMBER, recreation is a trial and error process. Have fun!

To view a sample BCAT Recreation Program click here.

To begin designing a person-centered BCAT Recreation Program, please email Kristen Clark at kclark@thebcat.com.