Creating Open Environments in Long-Term Care Settings: An Examination of Influencing Factors

Mounting critiques of the "total institution" (Goffman, 1961) have resulted in the emergence of alternative philosophies and approaches to care, approaches that are focused on providing more open environments within long-term care facilities. Staff responsible for recreation and leisure services can play a key role in the creation of more open environments through the introduction of more and varied community access recreation programs. Yet, our understanding of the extent to which such initiatives are being adopted in long-term care settings is quite limited. The purpose of this study was to examine the provision of community access recreation programs in long-term care settings in Canada and to identify factors that might limit the provision of these programs. The results suggest that the diversity of opportunities for recreation in long-term care facilities may not be achieving a level expected in truly open environments. Resident-focused constraints were the most critical factor influencing the extent to which community access recreation programs were being offered. A number of recommendations are provided to assist recreation professionals in the development of more open facilities.