The breeze lifting the hair off my face didn’t originate from any meteorological conditions. It occurred when my wheelchair broke free of my white-knuckled grip at the top of a long ramp, consequently launching me across the parking lot. It felt like I was about to execute an imitation of one of those metal balls in a pinball machine, poised to ricochet off all obstacles in my path, but without the bells and lights.
Erin Miller, a senior occupational science major, completed an obstacle course in a wheelchair during Disabilities Awareness Day activities at Eastern Kentucky University
I managed to skid to a stop a few feet short of ruining the paint job of the nearest car. As I caught my breath, I realized how close I had come to explaining this near miss to my insurance company. How embarrassing, especially since I didn't exactly require the use of a wheelchair to navigate about in my surroundings in the first place. (But then again, that situation might have altered if I had actually crashed.)
The incident stemmed from my participation in a life-altering class. I hadn’t set out to further my education, nor was I contemplating a new career following several years of blissful early retirement. Yet the six-line blurb tucked in the community section of the newspaper grabbed my attention as firmly as a front-page headline. It announced the schedule for an Activity Director training course. Those few lines had already taught me something new; I never realized that state and federal laws require certified activity directors for nursing facilities and similar institutions.
I clipped out the square of newsprint and left it where I could reread it throughout the day, weighing how much my interest was sustained as the deadline for registration approached. I imagined offering arts and crafts to those living in facilities and the lure became stronger. This was right up my alley! I decided to pick up the phone and find out if there was room for one more in the limited-size class.
The class was held two nights a week for one semester. We met at a church classroom annexed off a gymnasium/multipurpose room that was utilized as a daycare center for adults with cognitive disabilities on weekdays.
The first evening each student was asked to explain why they were taking the class. I was already feeling out of my element. Most of my classmates (all women) were already employed in health care occupations and needed the class to become certified and comply with regulations. Others planned on a career in this field. When it was my turn, I admitted that I was there primarily out of curiosity and interest in geriatrics. The compliment of instructors and my classmates silently stared at me, the obvious misfit. While sustaining direct eye contact with me, the director made a point of saying that students could drop out that night and still get a complete refund.
Everyone received a two-inch thick binder and listened to the overview of material, assignments, and required volunteer hours at different levels of care facilities. We would be required to develop two projects which fulfilled regulations and demonstrate them in front of the class. Weekly tests covering physical and mental disabilities, as well as the state and federal regulations and corresponding paperwork would track our progress. An incredible amount of documentation, charting, and assessments are required from an activity director on a daily, weekly, monthly, and quarterly basis for each resident. Naturally, the regulations in California were the toughest in the country (at least at the time I was enrolled in the class). The huge amount of material we’d cover each night meant that if a student missed more than one class, she would be automatically dropped, but allowed to return next year and try again.
I suspected bets were already being made by the end of the first session as to how long I’d last. Truthfully, I wasn’t so sure anymore either. Who knew that just playing a game of BINGO with residents in a nursing facility could be so complex?
The point to all this is quality of life. Perhaps memories of visiting my great-grandmother at a nursing home when I was a little girl planted the seed of empathy which triggered this interest. Even though I was only six years old at the time, I can still picture the plain, institutional white walls where she spent her final months. Prior to all those regulations aimed at improving quality of life, those residents who were able to leave their rooms sat slumped in wheelchairs staring at the tiled floor for hours. They merely existed.
When my mother and I arrived for a visit, the tired faces lining the halls lit up and gnarled, arthritic hands reached out in my direction. They wanted to touch my curly brown hair and pat my round cheeks. I was extremely shy and wanted to pull away from these strangers, but my mother understood their need for contact and told me to endure the attention for a few minutes before going into great-grandmother's room. Eventually I even made friends with a few of them and we 'adopted' each other as a sort of extended family.
While far from perfect, things have changed dramatically since then. The scope of Title 22 requirements includes the following activities: social, indoor and outdoor, activities away from the facility, religious programs (with exemptions), opportunity for patient involvement, creative, educational, and exercise (with exemptions). The monthly calendar an activity director creates must cover and balance all these areas. There are also five categories of activity groupings to consider: activities of daily living, cognitive/intellectual, physical, social/recreational, and sensory. Each individual is assessed to determine limitations, interests, and needs. Personalized goals are set. Participation and progress are documented and reviewed regularly to assure that the greatest potential level of enrichment is provided.
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