Presentation
HE7 - Design Considerations in Enhancing Recreational Therapy in Long-Term Care - Literature Review
SessionPoster Session 1
DescriptionBackground
Recreational therapy is increasingly recognized in long-term care (LTC) homes for its significant role in enhancing residents’ well-being through non-pharmacological methods. By facilitating engagement in meaningful activities, recreational therapy fosters social connections, alleviates feelings of boredom and loneliness, and provides numerous additional benefits. While recreational therapy relies on designed tools, environments, and services, the relationship between design and recreational therapy in LTC is not well-defined. This literature review sought to collect articles describing designed elements in recreational therapy in LTC, and to analyze them in a way that better defines this relationship.
Methods
A scoping literature review was conducted to explore the role of design in recreational therapy within LTC facilities. An analysis of 27 articles investigates the interplay between design — as both a process and outcome — and recreational therapy in LTC. To meet the inclusion criteria for consideration, articles 1) were conducted in a LTC home, 2) involved older adults, 3) related to a recognized form of recreational therapy, and 4) related to a recognized form of design. The findings, including case studies from all around the world, were thematically analysed to create a framework that shows how different forms of design influence recreational therapy in LTC settings on different levels.
Results and Discussion
Several key themes emerged regarding the influence of various design disciplines. The applications of design varied in scale and tangibility, ranging from products and spaces to services and systems. Central themes identified in the literature included the creation of comfortable and inviting spaces; accessibility, tools and equipment; equity, diversity, and inclusion; individualization; and development of novel therapeutic activities. Insights were drawn from various design disciplines, including product, industrial, and textile design, which contribute new tools including sensory items, assistive equipment, and emerging technologies. Interior and environmental design help produce comforting and inviting spaces for therapeutic activities. Additionally, service design approaches offer ways to evaluate the planning and delivery of therapeutic programs. Together, these disciplines support a diverse array of recreational activities, ranging from art, dance, and music therapy to multi-sensory environments, virtual reality, and socially assistive robots.
Design can further optimize therapeutic outcomes by prioritizing the accessibility of spaces and equipment, ensuring therapy practices accommodate age-related changes. Additionally, design processes can contribute to therapeutic systems that honour equity, diversity, and inclusion, while being adaptable to the unique needs of each resident. Advancements in technology claim to pave the way for novel therapeutic activities through innovations such as virtual reality and robotics.
The review highlighted several case studies which will be shared in this session, such as the use of co-design in art therapy, where residents created ‘zines’ to illustrate the experiences of residents and facilitate social change. Another example described a railway travel simulator, allowing residents to embark on a simulated train ride with family and friends while accompanied by an observing recreational therapist. A third example described the development of a centripetal, ergonomic garden system that minimizes the need for supervision during horticultural therapy. Other case studies discussed include a digital piano accompaniment system for music therapy, the creation of a Snoezelen room incorporating textiles, and AIBO ERS, a dog-like robot that facilitates ball toss games as well as radio calisthenics.
The review concludes by examining the challenges of implementation, such as funding, space and equipment, staff and training, integration into routine, and health and safety risks. It advocates for investment into novel therapeutic approaches enabled by design by presenting evidence of the benefits. Finally, the review offers recommendations for the future. The findings culminated in a framework — Design Considerations in Enhancing Recreational Therapy in Long-Term Care — that illustrates the potential of design to enhance the quality of life for residents in LTC homes.
Conclusion
Through thoughtful and purposeful design, the impact of recreational therapy programs can be elevated by making them more accessible and appealing. The framework of themes describes the intersecting factors that contribute to successful applications of design in recreational therapy. These insights serve as a foundation for future design endeavors.
Next Steps
The presentation of this work to the Ontario Centers for Learning, Research and Innovation (CLRI) in Long-Term Care at Bruyère as well as invited LTC homes led to a partnership between our research team and a LTC home in Ottawa, Ontario, Canada in an initiative to redesign their outdoor spaces based on the review presented here and future community-based research. The participatory action research design approach will involve consulting with residents, neighbouring tenants, care partners, staff, and local schools to co-create a design proposal for a space that can be used for recreational therapeutic activities such as horticulture therapy, intergenerational activities, and more. The initial stages of this project will be shared in a second presentation under the title Designing Interactive and Intergenerational Outdoor Spaces in Long-Term Care Settings.
Recreational therapy is increasingly recognized in long-term care (LTC) homes for its significant role in enhancing residents’ well-being through non-pharmacological methods. By facilitating engagement in meaningful activities, recreational therapy fosters social connections, alleviates feelings of boredom and loneliness, and provides numerous additional benefits. While recreational therapy relies on designed tools, environments, and services, the relationship between design and recreational therapy in LTC is not well-defined. This literature review sought to collect articles describing designed elements in recreational therapy in LTC, and to analyze them in a way that better defines this relationship.
Methods
A scoping literature review was conducted to explore the role of design in recreational therapy within LTC facilities. An analysis of 27 articles investigates the interplay between design — as both a process and outcome — and recreational therapy in LTC. To meet the inclusion criteria for consideration, articles 1) were conducted in a LTC home, 2) involved older adults, 3) related to a recognized form of recreational therapy, and 4) related to a recognized form of design. The findings, including case studies from all around the world, were thematically analysed to create a framework that shows how different forms of design influence recreational therapy in LTC settings on different levels.
Results and Discussion
Several key themes emerged regarding the influence of various design disciplines. The applications of design varied in scale and tangibility, ranging from products and spaces to services and systems. Central themes identified in the literature included the creation of comfortable and inviting spaces; accessibility, tools and equipment; equity, diversity, and inclusion; individualization; and development of novel therapeutic activities. Insights were drawn from various design disciplines, including product, industrial, and textile design, which contribute new tools including sensory items, assistive equipment, and emerging technologies. Interior and environmental design help produce comforting and inviting spaces for therapeutic activities. Additionally, service design approaches offer ways to evaluate the planning and delivery of therapeutic programs. Together, these disciplines support a diverse array of recreational activities, ranging from art, dance, and music therapy to multi-sensory environments, virtual reality, and socially assistive robots.
Design can further optimize therapeutic outcomes by prioritizing the accessibility of spaces and equipment, ensuring therapy practices accommodate age-related changes. Additionally, design processes can contribute to therapeutic systems that honour equity, diversity, and inclusion, while being adaptable to the unique needs of each resident. Advancements in technology claim to pave the way for novel therapeutic activities through innovations such as virtual reality and robotics.
The review highlighted several case studies which will be shared in this session, such as the use of co-design in art therapy, where residents created ‘zines’ to illustrate the experiences of residents and facilitate social change. Another example described a railway travel simulator, allowing residents to embark on a simulated train ride with family and friends while accompanied by an observing recreational therapist. A third example described the development of a centripetal, ergonomic garden system that minimizes the need for supervision during horticultural therapy. Other case studies discussed include a digital piano accompaniment system for music therapy, the creation of a Snoezelen room incorporating textiles, and AIBO ERS, a dog-like robot that facilitates ball toss games as well as radio calisthenics.
The review concludes by examining the challenges of implementation, such as funding, space and equipment, staff and training, integration into routine, and health and safety risks. It advocates for investment into novel therapeutic approaches enabled by design by presenting evidence of the benefits. Finally, the review offers recommendations for the future. The findings culminated in a framework — Design Considerations in Enhancing Recreational Therapy in Long-Term Care — that illustrates the potential of design to enhance the quality of life for residents in LTC homes.
Conclusion
Through thoughtful and purposeful design, the impact of recreational therapy programs can be elevated by making them more accessible and appealing. The framework of themes describes the intersecting factors that contribute to successful applications of design in recreational therapy. These insights serve as a foundation for future design endeavors.
Next Steps
The presentation of this work to the Ontario Centers for Learning, Research and Innovation (CLRI) in Long-Term Care at Bruyère as well as invited LTC homes led to a partnership between our research team and a LTC home in Ottawa, Ontario, Canada in an initiative to redesign their outdoor spaces based on the review presented here and future community-based research. The participatory action research design approach will involve consulting with residents, neighbouring tenants, care partners, staff, and local schools to co-create a design proposal for a space that can be used for recreational therapeutic activities such as horticulture therapy, intergenerational activities, and more. The initial stages of this project will be shared in a second presentation under the title Designing Interactive and Intergenerational Outdoor Spaces in Long-Term Care Settings.
Event Type
Poster Presentation
TimeMonday, March 314:45pm - 6:15pm EDT
LocationFrontenac Foyer
Digital Health (DH)
Simulation and Education (SE)
Hospital Environments (HE)
Medical and Drug Delivery Devices (MDD)
Patient Safety and Research Initiatives (PS)