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CREATING A RECREATION INTEGRATION PROCESSAMONG OLDER ADULTS WITH MENTAL RETARDATIONM. Jean Keller aa University of North Texas , DentonPublished online: 09 Jul 2006.

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CREATING A RECREATION INTEGRATION PROCESS AMONGOLDER ADULTS WITH MENTAL RETARDATION

M. Jean KellerUniversity of North Texas, Denton

More persons with mental retardation are living to later life than ever before.Federal legislation mandates interagency collaboration between the networks ofservices for older adults with developmental disabilities. Research demonstratesolder persons' lives can be enhanced by recreation experiences. However, mostagencies serving older adults indicate that they are unprepared to serve theaging mentally retarded population. A strategy is presented for community-based social service and aging-related agencies to integrate older people withmental retardation into generic recreation programs serving elderly adults.This strategy represents a comprehensive interagency approach to offeringolder persons a variety of recreation experiences utilizing the expertise of ag-ing, recreation, and mental retardation professionals. Eight steps are includedin this integration process: (1). Defining the target population. (2). Discoveringrecreation integration needs and interests. (3). Creating staff awareness andunderstanding. (4). Preparing consumers. (5). Designing and adapting recre-ation experiences for successful integration. (6). Empowering consumers. (7).Providing a continuum, of recreation services. (8). Evaluating consumers, expe-riences, and outcomes.

This integration strategy provides older adults with mental retardation theopportunity to progress to interdependent recreation functioning, in less re-strictive environments, with maximum integration, and less intensive services.

The American population is growing older; likewise, more personswith mental retardation are living to later life. Although the life expec-tancy of this group is associated with degrees of intellectual function-ing, related health problems, and other demographic characteristics,most people with mental retardation can now anticipated life spanscomparable to those of the nonretarded population (Lubin & Kiely,1985). Seltzer and Seltzer (1985), using a 2.4 to 3% prevalence rate ofmental retardation, estimate that there are between 1,104,000 and1,400,000 mentally retarded persons over 55 years of age. The actualnumber of older persons with mental retardation reported in the litera-ture varies; however, " . . . the finding that mentally retarded elderlyadults represent a significant and rapidly increasing segment of ourpopulation has earned universal support among investigators" (Sison &Cotten, 1989, p. 153).

Educational Gerontology, 17:275-288, 1991 275Copyright © 1991 by Hemisphere Publishing Corporation

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Research conducted with this growing segment of the elderly popu-lation has focused on various physical, medical, emotional, behavioral,social, biological, and psychological characteristics of the aging processwith the findings suggesting more similarities than differences withrespect to a need for services similar to those received by nonretardedolder adults (Cotten, Sison, & Starr, 1981; Walz, Harper, & Wilson,1986).

In the last 25 years, deinstitutionalization toward the least restric-tive environment has been mandated. Hence, many older adults withmental retardation are living in local communities and are eligible forservices like other older adults. Additionally, such federal legislativeinitiatives as the 1987 amendments to the Older Americans Act (P.L.100-175) and to the Developmental Disabilities Act (P.L. 100-146) in-clude mandates for interagency collaboration between the network ofservices for older persons and developmental disabilities service sys-tems. However, Roberto and Nelson (1989) found that most agenciesserving older adults indicated they are unprepared to serve the agingmentally retarded population or can serve them only if they "fit in."

This article describes a strategy that can be used in senior centers,congregate living facilities, adult day care centers, nutrition sites, andother community-based social service, aging-related agencies to inte-grate older adults with mental retardation into generic recreation andleisure programs serving elderly adults. This strategy is a comprehen-sive interagency approach to offering older persons a variety of recre-ation experiences utilizing the expertise of recreation, aging, and men-tal retardation professionals.

THE NEED FOR RECREATION INTEGRATION

Recreation integration is a developmental process that allows individu-als with disabilities access to recreation programs and leisure experi-ences that correspond to their personal needs and interests (Richard-son, Wilson, Wetherald, & Peters, 1987). Participation in recreation isan important aspect of life in later years (Ragheb & Griffith, 1982).When recreation activities meet the needs of individuals, they can pro-mote physical health, mental alertness, social interaction, and emo-tional support (Janicki & Wisniewski, 1985). An ultimate purpose ofrecreation and leisure services is to enhance the quality of life duringfree time.

Numerous studies and authorities have stressed the benefits of inte-grated recreation and leisure services (Gold, 1983; Schleien & Ray,1988). Unfortunately, very little of the literature has discussed the ac-tual integration of nonretarded older people with mentally retarded

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older adults in recreation and leisure settings (Rancourt, 1989). Thus itappears appropriate to be proactive in the area of integration of olderadults with mental retardation into existing aging and recreation ser-vices.

CREATING A RECREATIONINTEGRATION PROCESS

Because no one recreation activity is always appropriate for any el-derly population, a recreation integration process can be used as ameans of creating and designing recreation activities to fit the uniqueneeds of older adults. Eight steps are included in the integration pro-cess (see Figure 1):

1. Defining the target population.2. Discovering recreation integration needs and interests.3. Creating staff awareness and understanding.4. Preparing consumers.

Defining theTarget Population

(Consumers and Staff)

Evaluating Consumers, DiscoveringExperiences and Recreation Integration

Outcomes Needs and Interests

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5. Designing and adapting recreation experiences for successful inte-gration.

6. Empowering consumers.7. Providing a continuum of recreation services.8. Evaluating consumers, experiences, and outcomes.

Step 1: Defining the Target Population(Consumers and Staff)

Determining the constituency that will participate in an integrationprocess is a logical place to begin planning. This assessment of con-sumers and staff members (recreation, aging, and mental retardationprofessionals) is one of the most fundamental aspects of a successfulprogram of integration; however, it is often neglected or addressedcasually. A recreation program that is to be integrated should be care-fully matched to the needs and interests of a defined segment of theelderly population. No attempt should be made to integrate all recre-ation programs or to attract all older adults or staff members.

Older people are heterogenous, as are those with mental retardation(Janicki & Wisniewski, 1985). Older adults will vary in age, gender,race, religion, ethnic and cultural background, education and life expe-riences, socioeconomic status, interests, needs, attitudes, skills, abili-ties, and disabilities. Likewise, recreation, aging, and mental retarda-tion staff members working with older adults will vary depending ontheir age, education, background, experiences, and attitudes. Takingthe time to carefully identify and select staff members and consumerswho will participate in a recreation integration program will assist inpromoting a successful experience. There will be consumers and ser-vice providers who will demonstrate interests and possess skills thatwill enhance integration of older adults with mental retardation intorecreation and aging programs and services.

Step 2: Discovering Recreation IntegrationNeeds and Interests

After the target population has been identified, the needs and interestsrelated to integration in recreation programs and activities should bedetermined. Stroud and Stutton (1988) in their text, Expanding Op-tions for Older Adults with Developmental Disabilities, summarized,"On the whole it is impossible to generalize about the recreation activi-ties of the older population. Individual differences prevail. Investiga-tors find that those who remain active also remain comparativelyhealthy and satisfied with life" (p. 24).

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A project conducted by the University of Akron, entitled ACCESS,explored the leisure and recreation participation patterns of olderadults with mental retardation (Stroud & Murphy, 1984). The findingsof this study revealed that most respondents ate out, went for carrides, attended parties, sporting events, and movies, shopped, bowled,traveled out of town, watched TV, listened to music, visited with fam-ily and friends, and had picnics during recreation and leisure time.Similar leisure and recreation activity patterns have been exhibited inthe older adult population as well (Ragheb & Griffith, 1982). Stroudand Murphy (1984) felt that those older adults with mental retardationwho had skills and interests comparable or similar to other older adultswere most likely to be successfully integrated.

Emphasis during this step should be placed on assisting older indi-viduals to explore their own recreation needs and interests. Informa-tion is lacking on older adults' recreation attitudes, values, capabilities,behaviors, and the benefits they wish to obtain from an integratedrecreation experience. Once recreation needs and interests are deter-mined, staff members are better prepared to work with consumers tocreate successful recreation programs and services that will promoteintegration.

Step 3: Creating Staff Awarenessand Understanding

Staff members from aging and mental retardation agencies have ex-pressed a need for staff training in working with older persons withmental retardation (Roberto & Nelson, 1989). In order to prepare per-sonnel from aging, mental retardation, and recreation agencies, train-ing needs to be conducted across disciplines to educate and dissolvemany of the fears and stereotypes each group may hold. Though devel-oping staff members' awareness and understanding of older adultswith mental retardation and older adults in general is important, staffmembers should also develop an awareness of the principles of integra-tion in recreation and the role of recreation in the lives of older adults.Table 1 summarizes five integration principles for working with olderadults in recreational settings.

The principles for integration in recreation focus on individuals andtheir success in recreation experiences. The basic principles are (a)respect the dignity and worth of older individuals, (b) recognize olderadults as whole and complete persons, (c) reduce personal disabilitiesand accentuate personal abilities, (d) eliminate or reduce communityand agency barriers to participation, and (e) provide a continuum of

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TABLE 1 Integrating Principles in Recreation Services with Older Adults

Principles of integration Implications of principles

Respect for the dignity andworth of the individual.

Recognition of individual as awhole and complete person.

Reduction of personaldisabilities and accentuationof personal abilities.

Elimination or reduction ofcommunity or agencybarriers to recreationparticipation.

Provision of a continuum ofrecreation services.

Each individual is respected as ahuman being with potential tobecome the best he or she can bethrough recreation experiences.

Each individual is viewed as acomplete person with social,emotional, mental, and physicalneeds and abilities. Recreationservices are developed based onneeds and individual preferences.

Maximize personal abilities andpromote interdependent recreationfunctioning.

Communities and agencies arereadied so that they are flexible,adaptable, and responsive toindividual needs.

A wide scope of recreation servicesare designed to help olderindividuals reach their potentialthrough participation.

recreation services, so that older individuals can be integrated whenand where it is appropriate.

Staff members can develop an appreciation for integration processesas means of helping older adults with mental retardation become con-tributing individuals who can enjoy recreation with others. Also, staffmembers can gain insight into the role of recreation in the lives ofolder adults and how they can use recreation as a tool to foster physi-cal, mental, social, and emotional development and enrichment. Staffmembers should be trained and prepared to work together as a team,focusing on individuals' functional abilities and using these strengthswhen integrating older adults with mental retardation into older adultrecreation activities. For instance, an older man with moderate mentalretardation has played for years on a softball team in an institutionalsetting. His softball skills are exceptional, though his interpersonal andsocial skills are marginal. Rather than focusing on his weaknesses, therecreation staff introduced him into a senior adult softball team pro-gram. He gains acceptance and recognition for his contribution to theteam as he learns from staff and fellow team members how to appro-

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priately interface and interact with others. Staff members will alsoneed training on how to prepare their agencies for recreation integra-tion and promote continuous support and encouragement in this area(Richardson et al., 1987). No one recreation activity or program willmeet the needs of all. Staff members will need training in how toprovide a wide scope of recreation activities and services by adaptingand modifying current activities and services to meet the individuals'needs of these two somewhat diverse populations.

A complete understanding of the target populations, their needs,interests, and preferences, and the techniques and procedures for im-plementing recreation integration programs will be needed by recre-ation, aging, and mental retardation staff members (Rancourt, 1989).The staff should be committed to educating and preparing older peopleto recreate together; planning and modifying recreation programs sothat all benefit from these experiences; and working with groups tofacilitate cooperative interaction and exchange in order to promotesuccessful recreation integration.

Step 4: Preparing Consumers

Preparing consumers really means preparing the general public, olderadults already participating in recreation programs offered by variousagencies, and older adults with mental retardation. Since aging, mentalretardation, and recreation agencies exist within community settings,it is important to educate community members about older adults withmental retardation and demonstrate the reasoning behind integrationof this population with other older adults. Using the various media,working with churches, speaking at social and civic clubs are someways of sharing information about recreation integration with olderadults.

Acclimation, integration, and acceptance are slow processes thatrequire patience and perseverance. The process of integration cannotbe rushed, and older participants' personalities, abilities, backgrounds,and goals must be recognized, understood and accepted. Educationabout and exposure to older adults with mental retardation whohave the ability to socially interact and communicate in nonthreaten-ng environments are essential to preparing the general and older adultpopulation to accept and integrate with this subpopulation (Thurman,1985).

Older adults with mental retardation must likewise be prepared forrecreation integration. Recreation integration is not merely placingtwo groups together and doing an activity; it is the process of concernfor the dignity and worth of individuals and the development of hu-

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man potentials using a wide variety of recreation experiences duringleisure time in an environment that is as culturally normative as possi-ble. Preparing older adults with mental retardation will differ in sev-eral ways from preparing older adults already participating in recre-ation experiences. Older adults and staff members alike haveexpressed the need for those with mental retardation to fit in withother older adults (Rancourt, 1989; Roberto & Nelson, 1989).

Figure 2 highlights possible steps in preparing older adults with men-tal retardation to be fully integrated into recreation experiences. Thesteps may need to be individualized or delivered in small groups(Schleien & Ray, 1988). Initially, individuals' physical, mental, social,and emotional abilities are assessed, and then recreation professionalswith aging and mental retardation staff members help them determineappropriate levels of recreation activity. For example, a 65-year-oldman with mental retardation has been living in a group home in a smallcommunity for more than 12 years, and during this time he workedbagging groceries at the local grocery store. He recently retired. Hewas fully integrated into a senior center recreation program that heldexercise, arts, and crafts classes in the morning, shared noon mealstogether, and socialized in the afternoon. He had participated in theclasses at the group home and mental retardation service center; heknew nearly everyone there by name, because he saw them regularlyat the grocery store; and he had social skills appropriate for eating andconversing with other participants. Very little special training wasneeded to successfully integrate this person into an older adult recre-ation program.

The following illustration demonstrates the need for partially inte-grated recreation services. An older man was recently placed in agroup home in a large metropolitan area after his parents, who hadcared for him 56 years, died. He had excellent social skills, table man-ners, and enjoyed being around older people. He was unfamiliar withthe games, arts, crafts, and exercises available in a local senior center,because he had lived and worked on a farm his entire life. He partici-pated in the noon meals and afternoon socializing sessions at the seniorcenter successfully. In the morning, he attended a small group witholder people of similar abilities, learning new recreation skills and howto take part in small- and large-group activities such as exercises,games, arts, and crafts. By providing a partially integrated recreationexperience, older adults with mental retardation are able to grow anddevelop to their potential and learn recreation and social skills in acommunity setting that may lead to further integration, interdepen-dent recreation functioning, in a less restrictive environment with lessintensive services (Taylor, 1988).

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Integration intoExisting

Recreation Services

Dependent for Interdependent forRecreation Functioning Recreation Functioning

Minimum Individual Maximum IndividualAbility Ability

More Restrictive Less Restrictive

Environment Environment

Most Intensive Service Least Intensive Service

Least Integrated Most IntegratedFIGURE 2 Steps in providing recreation services leading to integration ofolder persons with mental retardation.

Step 5: Designing and Adapting RecreationExperiences for Successful Integration

After staff members have prepared both groups of consumers andthemselves for integration, it is time to deliver meaningful recreationexperiences that foster integration. Yet, which activity is best forwhich group? Older consumers must be involved in planning, design-

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ing, and adapting recreation activities if they are to feel ownership. Ifthe activity is developed for older consumers rather than with them,the likelihood of full integration is reduced (Taylor, 1988).

Consumers and staff members can use their own creativity and pref-erences to design meaningful recreation experiences. The majority ofrecreation programs center around 14 areas: arts, crafts, music, drama,dance, educational experiences, sports, games, volunteer services, out-door and nature activities, aquatics, hobbies, social recreation, andtour and travel events. All program areas can be relevant to olderadults' well-being. The activities within each of these recreation pro-gram areas are numerous and can be adapted or modified to meet theneeds, preferences, and abilities of consumers.

The content of a recreation program is important for older con-sumers, and so is the format. How recreation programs are conductedcontribute to achieving desired outcomes and promoting integration.Staff members should gain information from older consumers on theirpreferred methods of delivery, convenient times and locations, trans-portation problems, costs, and other barriers which affect participa-tion. Once these barriers are determined, alternatives and modifica-tions can be created. Recreation integration activity formats shouldencourage participation, increase self-esteem, promote social interac-tion, enhance self-satisfaction, and stress the importance of interde-pendent recreation functioning in a less restrictive environment withless intensive services.

During recreation integration experiences, staff member shouldstrive to build an esprit de corps among consumers. A strong "we"feeling has the added advantage of successful integration. Older con-sumers could be encouraged to serve as a support system for eachother during and after recreation activities (Gold, 1983).

Step 6: Empowering Consumers

The process for creating recreation integration experiences presentedhere involves a participatory approach designed to empower older con-sumers with mental retardation and those nonretarded older con-sumers. To empower older consumers, staff members will be chal-lenged to tap their competence, nurture confidence, createacceptance, and give them a strong sense of ownership in recreationprograms and their outcomes. Empowerment is an enabling processwhich promotes shared responsibility among older consumers and staffmembers. This approach fosters the identification and clarification ofneeds, interests, abilities, and preferences; the promotion and encour-agement of accepting attitudes; the development of new skills related

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to recreation and integration; and the facilitation of attitudinal andbehavioral changes within and among consumers. Older consumers,with or without mental retardation, may need ongoing assistanceand monitoring from staff members so that they gain skills neededto function as interdependently as possible in recreation integrationprograms.

Step 7: Providing a Continuumof Recreation Services

A continuum of recreation services envisions a series of activity op-tions ranging in terms of restrictiveness, integration, and normaliza-tion, with a preference for the least restrictive, most integrated, andnormalized setting (see Figure 2). A key to a successful continuum ofrecreation services is to provide an array of options that can addressrecreation and integration needs, abilities, and preferences for olderconsumers and promote the uniqueness of individuals, assist individu-als become the best they can be during recreation, and enhance theirdignity and worth.

It is important to note that acceptance of this continuum concept ofrecreation integration does not mean that it will be possible to provideall older persons automatically with age, culturally, socially, mentally,emotionally, and physically appropriate recreation experiences. Accep-tance of this notion, however, emphasizes the creation and placementof older adults in recreation experiences best suited to meet theirneeds, abilities and preferences, which promotes involvement in com-munity life and cultivates relationships between older people withmental retardation and nondisabled older people. As recreation pro-grams are created to help older persons with mental retardation be-come more interdependent, they can better determine their own levelof recreation involvement and integration. A continuum of recreationintegration services and programs is also sensitive to the needs of non-disabled older persons and their preferences for recreation and inte-gration experiences.

Step 8: Evaluating Consumers, Experiences,and Outcomes

The last step in this process is evaluation; however, evaluation in thisrecreation integration process should be viewed as ongoing and de-signed to strengthen each phase of the process and provide informa-tion for rational decision making about the process design, implemen-tation, and effects on consumers. Each phase needs to be thoroughly

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reviewed and critiqued as it occurs and after it has been completed.Each agency and group of staff members will need to evaluate anintegration program based on their missions, purposes, goals, and fu-ture plans.

Consumers, staff members, and administrators should be involved inevaluations. Throughout a recreation integration process, staff mem-bers should evaluate and monitor group dynamics and develop a sensi-tive posture to how participants are perceiving the experiences of rec-reation and integration and when needed, adjustments should bemade.

After an evaluation is completed, the findings should be translatedinto changes in the appropriate phases of the recreation integrationprocess. Additional phases may be necessary or some steps may bedeleted depending upon agencies, staff members, and consumers. Inthis way, evaluation becomes a useful part of the process of creatingrecreation integration experiences that enhance older adults' lives.

SUMMARY

Bogdan and Taylor (1987) said integration only makes sense in the con-text of a segregated society. The recreation integration process is ameans to help society get from one place to another, to move closer toa vision based on such enduring human values as community, hetero-geneity, equality, dignity, and acceptance (Taylor, 1988). The process ofrecreation integration can play a vital role in meeting the recreationneeds of older people in a least restrictive environment and most nor-malizing form. The recreation integration process helps older adultsbecome as interdependent as possible in their recreation functioning asit maximizes their individual abilities and potentials with the least in-tensive services (Rancourt, 1989). Recreation, aging, and mental retar-dation personnel are challenged by legislation as well as a commitmentto integration and interagency cooperation to discover their roles andrelationships. Someday recreation integration may be unnecessary be-cause society will have moved away from a segregated stance. Untilthat time, however, the recreation integration process can be a meansto creating meaningful recreation options and alternatives with thegrowing number of older adults with mental retardation.

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Received January 12, 1990Accepted January 30, 1990

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