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Home and community-based programs include a number of activities within the community to augment and enhance rehabilitation, thereby enhancing the quality of life of an individual. These programs are recommended to be included in a life care plan and can be located in religious and non-profit organizations. These activities help educate the individual with skills in communicating with non-medical personnel. The programs help to simulate work situations when it is not probable for the individual to return to a paying job. Most importantly, the use of these activities is a bridge for an individual to begin to reinvolve themselves in the community. This is an opportunity for the individual to help develop self-esteem.

Therapeutic aquatic programs provide opportunities for children and adults with varying needs to participate in programs of rehabilitation, recreation, and instruction. Under the supervision of registered physical therapists and specifically trained adapted aquatic specialists, the program can include water exercise classes, adapted swimming instruction, hydrotherapy, and therapeutic recreational swimming. 

Many doctors agree that swimming and water-based activities are beneficial in treating a variety of medical and pre- and post-surgical conditions. Since water is buoyant, the reduction of the gravitational pull allows for reduced trauma and stress to weight-bearing joints while its resistance helps strengthen muscles, increase flexibility and range of motion, and improves the circulatory system of the body, all valuable elements within a life care plan. 

Each person is treated on an individual basis, although a person may participate in group sessions as well as privately. However, the following specific common physiological and psychological gains can be evident:

    • Increase in kinesthetic awareness through stimulation of joints and muscles 
    • Re-establishment of cognitive sensory-motor perceptual patterns 
    • Reduction or prevention of atrophy through increased muscle action 
    • Faster absorption of inflammation 
    • Increase in skeletal strength and proper body alignment 
    • Improvement in cardiovascular functioning, circulation, and respiratory function 
    • Improvement in independent movement ambulation and range of motion 
    • Stimulation of new cognitive functioning 
    • Reduction of psychological stress and tension 
    • Enhancement of self-image and increased satisfaction with accomplishment 
    • Avoidance of isolation and increased ease of re-entry into the community 

It is obvious that a therapeutic aquatic program has an impact on the rehabilitation process for many different types of cases. Unfortunately, not every community has such a program available. However, with increasing evidence indicating the value of a therapeutic aquatic program, there are several available options, such as local YMCAs/YWCAs have pool time available and generally have relationships with other organizations, such as hospitals, Red Cross, rehabilitation centers, physical and occupational therapists, and arthritis foundations. 

Life care planners should consider inclusion of therapeutic aquatic therapy, recreation and community-based programs as a part of a life care plan to enhance the quality of life and integrate the individual into the community.