Alive, But Are We Living?

The Crisis of Meaningful Living and Why Therapeutic Recreation Matters

Imagine an older man living in residential care. His medications are administered on time. His meals are provided. His personal cares are completed. Every box on his daily care record is ticked. But spend an entire day observing his experience.

He sits in his chair, watching television. Occasionally, someone comes in to assist him. There are greetings, instructions and brief exchanges. Perhaps twice that day, someone has a genuine conversation with him. Someone asks about his life, listens to his stories or shares a moment of laughter.

For the remaining hours, he waits.

His care needs have been met. But have his human needs been met? This is an illustrative scenario, but it feels very familiar and reflects a serious question facing aged care in Aotearoa New Zealand: Are we measuring the completion of care tasks, or the quality of the life being lived?

For Bernie, a Registered Diversional and Recreational Therapist and E tū union representative, this is an important concern about what quality care really means.

“Sometimes, a resident can have every care task completed and

still spend most of the day waiting for someone to sit down, listen

and genuinely connect with them. That is the part of care we

cannot afford to overlook.” – Bernie

Her perspective highlights something fundamental: meeting someone's physical needs is essential, but meaningful living requires more. It requires opportunities for connection, purpose, identity, choice and belonging.

When one Recreation Therapist supports more than 70 residents

At the 2026 National Conference for Diversional and Recreational Therapy in Christchurch, a workforce survey undertaken in partnership between the New Zealand Society of Diversional and Recreational Therapists and E tū revealed concerning pressures across the profession.

Practitioners reported challenges involving inadequate staffing, limited resources, workload pressures and a lack of professional recognition. One respondent reported responsibility for more than 70 residents. Consider what that means!

A Diversional and Recreational Therapist is expected to understand each person's interests, abilities, culture, identity and aspirations. Their work involves assessment, individualised planning, therapeutic programmes, cognitive stimulation, movement, social connection, documentation and evaluation.

Now imagine delivering this for more than 70 people within an eight-hour working day. Even before planning, documentation and other responsibilities, eight hours would allow fewer than seven minutes per resident. Meaningful relationships cannot be reduced to seven-minute allocations. Neither can therapeutic care.

This is not a criticism of dedicated practitioners or care workers. It is a warning about what happens when systems expect meaningful outcomes without providing sufficient resources.

When therapeutic recreation disappears, people miss out

The survey also highlighted practitioners' observations of reduced mobility, cognitive decline, increased responsive behaviours, loneliness and social isolation when therapeutic recreation staffing was inadequate.

These findings do not establish direct causation, but they raise important questions about what residents lose when meaningful engagement is not adequately supported. A cancelled walking group is not simply a cancelled activity. It may mean someone loses an opportunity to maintain mobility, build confidence and connect with others.

A missed one-to-one visit may mean someone who rarely leaves their room spends another day without meaningful companionship. And a person living with dementia may lose an opportunity to reconnect with familiar music, memories, movement or relationships.

Therapeutic recreation is not entertainment added after the important care is finished. It is part of the important care!

We need to rethink what quality care means

Physical care, clinical safety and regulatory compliance are essential. But they are not the complete measure of wellbeing. Quality care must also protect opportunities for purpose, identity, choice, connection and joy.

That requires appropriate funding, needs-based staffing, professional recognition and an understanding of the contribution Diversional and Recreational Therapists make alongside other health and care professionals.

As Aotearoa considers the future of aged care, we must ensure that meaningful living is not treated as an optional extra. Because the real question is not simply how many people our care system can look after. It is how many people our care system genuinely enables to live.

Meaningful life is healthcare. Therapeutic recreation is part of the solution!