Occupational therapy-led community outings in inpatient rehabilitation can provide supervised, real-world experiences that build the skills and confidence needed for individuals with brain injuries to regain their highest level of independence.
Community outings for individuals with brain injuries help bridge the gap between inpatient rehabilitation and real-world living. These supervised experiences allow patients to practice mobility, cognition and instrumental activities of daily living in everyday environments while building confidence, independence and readiness for community reintegration.
Occupational therapists’ role in community outings
Occupational therapy professionals help patients with acquired brain injuries regain skills needed for daily life. This includes basic tasks like self-care and mobility, but also more complex activities that support independence. These patients often face physical, environmental and cognitive challenges that impact quality of life and the ability to perform complex tasks.
Studies show that being able to perform complex tasks is important for independent living. Physical performance at discharge also predicts health-related quality of life and community reintegration for these patients.
Community outings are one way inpatient rehabilitation programs can support community reintegration in patients with acquired brain injuries.
Why community outings matter for brain injury recovery
This type of intervention gives patients a safe and supervised way to practice real-world skills outside the hospital. Community outings help rebuild confidence, support meaningful goals and prepare patients to return to their communities.
Additional benefits of community outings include:
- Providing patients with the chance to practice skills in a real-life setting
- Helping patients use strategies they learned in therapy
- Improving patient satisfaction and independence with person-centered tasks
- Supporting social interaction with other patients and community members
- Reducing fear or negative feelings about community reentry
How to conduct a safe community outing
Community outings can take place in a variety of locations. Ideally, the outing should happen in the environment the patient intends to return to after rehabilitation. If that isn’t possible, the patient should participate in a simulated environment.
Outings can challenge a patient's mobility, critical thinking and problem-solving. Patients may walk on uneven surfaces, perform vehicle transfers and navigate both new or familiar environments.
The process for community outings may vary by facility and region, but most successful outings include careful planning to ensure safety and efficiency. Key steps include:
- Setting goals with the therapist and patient before the outing
- Discussing the outing with the full care team to consider any potential risks or barriers (i.e., agitation, restraints, infections, drug history, modified diet, etc.)
- Getting a signed order from the patient's doctor
- Choosing a location and allowing enough time for loading, transport and actual time at destination
- Arranging transportation based on patient needs
- Checking and approving the patient's medical status with their nurse on the day of the outing
- Scheduling the outing with qualified skilled professionals who can meet the medical and clinical inpatient needs of the patient
- Bringing important supplies, such as a first aid kit, pulse oximeter, change of clothes, wipes and gloves, blood pressure cuff, catheters, etc.
- Providing the patient with the right level of support during the outing
Supporting iADLs through community outings
Community outings can be a useful way to practice instrumental activities of daily living. These are more complex tasks needed for independent living. Some examples of iADLs include money management, phone use, healthcare appointments, shopping and transportation.
During community outings, patients can practice or learn these skills with the support of skilled clinicians. Being in the community also helps patients resume the thinking skills they use in everyday life.
Person-centered outings
Outings also help patients reconnect with activities they enjoy. This many include going to the movies, bowling, miniature golf, visiting a museum or walking in their favorite park. The best outings are those that are person-centered and focused on resuming prior habits, goals and routines.
A person-centered outing focuses on an individual's favorite places or activities. Choosing a place such as their preferred breakfast spot, their barber shop or even a bingo hall can make the outing more meaningful and support community reintegration.
Possible barriers and practical solutions
Although community outings can be beneficial, there are still barriers that might make planning difficult.
Some barriers include:
- Not having access to appropriate transportation
- Distance to shopping areas (if in a rural area)
- Limited staffing
- Lack of awareness about the importance of community outings
- Budget limitations
- Accessible destinations that are ADA compliant
- Differences in ability levels when planning group outings
Even with these challenges, there are creative solutions to ensure quality community outings. If transportation is limited, consider partnering with a cab or ambulance company. With a contract, these companies will be readily available to accommodate patients at different levels and with various equipment needs.
If your hospital is in a rural setting, smaller, local shops like a sandwich shop, coffee shop or a bookstore can serve as an outing location.
Advocating for community outings
Community outings help individuals with brain injury return to their community. If your hospital is hesitant to support community outings, share the benefits with hospital administration. Include clear goals and objectives when advocating for the needs of community outings and reentry.
Planning is key for a successful outing. Research locations ahead of time. Plan for patients to have their own money or hospital petty cash for any transactions. Provide enough staff based on the number of patients and their level of ability.
With an organized plan and team support, community outings can help individuals with brain injuries learn the skills they need to return to the community and improve their quality of life.
Encompass Health occupational therapy leaders Erin Henshaw, Moriah Lewis, Cody Larue and Angel Acevedo also contributed to this research and post.
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