Here’s How to Integrate Outdoor Activity into Your Billable Therapy Sessions

I think we all know that spending time outside is beneficial to our health and wellbeing. There are lots of studies around these benefits in older adults and individuals living with progressive illness. There’s hard data to support that increased physical activity outside can decrease instances of obesity, type 2 diabetes, cardiovascular disease, mental illness, stroke, depression, and fear of falling, while improving/increasing life expectancy, quality, and sense of self-functioning.

As the warm weather becomes more and more consistent, here are my favorite ways to shift my therapy sessions outside.

Sit out in the Lawn.

In other words, just do the session outside. If there’s a porch or deck, a little lawn space, courtyard, garden, even a shady out-of-the-way section of the parking lot, get out there. Bring some equipment, and hold your planned session outside. I’ve done this numerous times, working on upper body strengthening, standing balance and/or tolerance, cognition, and even eating skills. The only thing you can’t really do out there is an ADL session – otherwise, the sky’s the limit! And, you can bill the session the exact same way you would otherwise.

Advocate for Indoor Groups in an Outdoor Setting.

When I was working fulltime, the facility would do this all the time. Once the weather broke, at least half of the regularly scheduled activities moved from the recreation room to the back deck. Exercise group, singing/music group, dance class, art class, even meals were held outside. Sun hats and SPF provided and encouraged. And it was great! Some Residents who wouldn’t normally participate in group activities would happily sit outside with everyone just to breathe the fresh air and sit in the sun.

If you’re hosting a group treatment, you can just as easily shift the setting to an outdoor space. If you’re advocating for scheduled activities to move outside, you can bill for a session with the focus strictly on the task at hand (such as “engaged in gross motor exercises using ‘x amount’ of weight for ‘x amount’ of reps…”), or you can bill for community engagement and socialization opportunities (“to improve cognitive and emotional function…”).

Identify the Resident’s Favorite Outdoor Activity.

Some Residents just love the outdoors naturally (ha, get it?). Tap into that! If they love to garden, use that to work on balance, reaching, sequencing, whatever. If they’re an avid golfer, play golf in the yard. If they love to grill, work on some *safe* meal prepping and cooking tasks. As long as you’re using your activity analysis and skills to directly relate the task to the goals you’ve set (or are working under), you can integrate just about any activity that the Resident finds fun and meaningful.

Assess and Address Outdoor Mobility/Equipment Management.

One of my favorite things to work on is wheelchair mobility. For a lot of reasons that we can get into later, but listen. If you’re Resident thinks they’re great at wheelchair propulsion, have them try a lap around the parking lot. There are so many more factors to consider, and the challenge is definitely greater. The same goes for ambulation at any level. In your documentation, make sure to account for cues needed, balance grades, devices used, brakes taken, cardiopulmonary measures, distance, and posture. Practicing outdoor mobility within a therapy session also allows for greater confidence on family outings or group trips.