The Baker Beacon

Posts Tagged ‘Occupational Therapy’

Stroke Recovery: How Therapy Can Help

Posted in The Baker Beacon

Nearly 800,000 Americans suffer from a stroke each year.[1]

That leaves many survivors with the tough task of relearning. They have to start parts of their life over as they work on walking, talking, and even processing and remembering as they once did. And, it leaves many family members and loved ones with the challenge of taking this journey with them.

The good news, though, is that there are many caring and capable people willing to help. Physical, occupational, and speech therapists all play an important role in the relearning process.

The damage suffered from a stroke can vary from patient to patient. Each stroke looks different based on how much damage occurred and what part of the brain was affected.[2] Stroke survivors face a variety of problems including pain, numbness, or muscle weakness. These can lead to difficulties with sense of touch and difficulties with swallowing and eating. Problems with language and thinking are very common as well.

Therapy helps patients regain their independence and their ability to take care of themselves. Here are a few ways in which the individual therapies can help recovery after a stroke.

Speech Therapy

Stroke survivors may develop aphasia. They’ll have difficulty speaking, finding words, and understanding what others are saying. Speech therapists use repetition and reading and writing exercises to help survivors learn how to communicate.[3]

Physical Therapy

Physical therapists help with any movement problems. They use exercises and activities to help survivors regain strength, coordination, balance, and control.[4]

Occupational Therapy

Occupational therapists help survivors relearn self-care skills. They focus on daily activities such as bathing, getting dresses, eating and cooking.

The biggest key to success: don’t give up hope! Recovery from stroke is often a long process. Some skills come back quickly and others take more hard work and more time. But, improvements and growth can come even years into the recovery process.

 

 

[1] Strokecenter.org/patients/about-stroke/stroke-statistics/

[2] Webmd.com/stroke/tc/stroke-rehabilitation-overview?page=2

[3] Everydayhealth.com/stroke/guide/recovery/

[4] Stroke.org/we-can-help/stroke-survivors/just-experienced-stroke/rehab

It’s OT Month All Year!

Posted in The Baker Beacon

Sue Paul COO,OTR/L has been the Chief Operating Officer of Baker Rehab Group since 2002. Ms. Paul has held certifications in geriatrics through the American Occupational Therapy Association and served as AOTA representative for the End of Life Practice Recommendations for the National Alzheimer’s Association in Washington D.C. She is the author of the Head, Hands, Heart Dementia Assessment System, which is a healthcare provider tool for assessing and treating persons with dementia.


Well here we are at the end of OT Month 2015 and we’ve had some great insights and lessons shared by some of our colleagues.  But not everybody got the chance to share.  Not only was April #OTTakeover Month, it was also annual compliance month, and let’s-install-a-new-electronic-medical-record-month, and spring break month… and a month filled with a ton of work and growth and “stepping up” at BRG.  Our therapists have been pushed to the max this month so we’ve decided to spread the love out over the rest of the year.  So watch your inbox and the Baker Beacon for additional nuggets of OT wisdom.  It’s good stuff.

 

But since it is still technically OT Month, allow me to share with you my own recent “a-ha” lessons.  I’ve been an OT for almost 25 years, which means I pretty much know what I know, and I know what I don’t know.  But it turns out, what I thought I knew is really something I used to know, or maybe I still know, but I lump in with other things I know into a fuller body of knowledge.  Such are the fruits of maturity and experience.  However, it seems I’ve been neglecting to put into practice some key principles that are really important in the delivery of quality occupational therapy services.  Even more eye-opening is that I learned these valuable lessons from a new grad.

 

I have been covering patient treatments for one of our younger, newer therapists while she is on vacation.  I have been pleasantly assured by all of her patients that her skills and aptitude for home health OT is top notch… they all love her.  The one thing that they each have mentioned to me, and that they really appreciate, is how she has been able to break down the parts of task into smaller components.  By reviewing each step of a task, they are able to hone in on each weak link and work on corrective actions.  I keep hearing the same feedback over and over, “She really breaks it down for me.”

 

In occupational therapy lingo, this is called task analysis.  We spend a lot of time in OT school breaking down functional tasks into components that consider movement patterns, cognitive processes, and environmental and psychosocial elements.  It’s OT 101.

 

When you’ve seen the same task performed hundreds of different ways over the course of 25 years, you tend to take a more macroscopic view of issues.  Or you tend to assume that the problem is obvious to everyone, because you’ve seen it so many times before.  I have been reminded lately how crucial it is to explain task analysis to our patients.  I had forgotten how much they appreciate understanding our reasoning behind treatment approaches, even the most obvious detail, and how important it is to show them the weak link in a sequence.  I may know what the problem is and how to fix it, but may not bother to break it down into smaller steps for the sake of better compliance and participation.  I tell them to trust me. When did I become such a know-it-all?

 

So I’d like to thank Rachel Hensberger for her stellar contribution to the OT community and for reminding me how valuable our basic guiding principles are.  She has done her patients, her profession, and her “boss” a great service.  I am humbled and grateful.

 

Kudos, girl.

Happy OT Month

Posted in The Baker Beacon

Some of our occupational therapists are BRG employees.  Some are independent contractors who run their own businesses.  Regardless of their relationship to BRG, we need to celebrate their amazing contributions to the Occupational Therapy profession.

In years past, we’ve celebrated OT month with cupcakes or pins, but giving the therapists a little appreciation isn’t quite the same as giving them recognition.  And what better way is there to recognize their skills, talents, and passions than giving them a platform on which to share them?

All through the month of April, we will be recognizing the occupational therapists affiliated with BRG by letting them tell you their views, opinions, strategies, and tips through our blog, The Baker Beacon.  They will be the authors of topics from home modifications to dementia to stroke to driving.  Tune into The Baker Beacon throughout the month of April for the latest installments, and don’t forget to follow us on Facebook for up to date postings.

The Low Vision Low Down

Posted in The Baker Beacon

How Occupational Therapy Can Help

By Mary Schwartz, OTR/L

“We just can’t make your glasses any stronger.” To many individuals with low vision, this is a frequently heard statement from eye care professionals. It is estimated than one in four people over the age of 80 are affected by low vision. As the population ages and life expectancy increases, low vision has become the third leading cause of disability in older Americans. Most of us know someone whose life has been altered by severe vision loss. But few people know that there is something that can be done about it.

Low vision is defined as a visual impairment that cannot be corrected by eye glasses, medicine, or surgery that interferes with the ability to perform everyday activities. The most common conditions are macular degeneration, diabetic retinopathy, glaucoma, and vision loss from stroke.

People with severe vision loss have difficulty performing simple daily tasks that many of us take for granted. Reading medication bottles, writing checks, or setting the dials on the stove can be nearly impossible for someone with low vision, even with the use of corrective glasses.

While many of these conditions are irreversible, this does not have to mean a loss of independence or quality of life. If you are experiencing vision loss, the first step is to contact your eye care professional.  An ophthalmologist can diagnose and treat eye disease and may prescribe medications or surgery to address vision related conditions. An optometrist can diagnose eye disorders and prescribe glasses, low vision devices, or vision therapy. It is important to find an eye care professional that specializes in low vision. Your doctor may then recommend that you receive additional low vision training through a vision rehabilitation teacher or an occupational therapist.

Why Occupational Therapy?

Occupational therapists are rehabilitation professionals who are uniquely trained to help clients achieve the highest level of independence despite disability or impairment. Many occupational therapists now have specialized training in low vision. A low vision occupational therapist (OT) can evaluate the home environment, provide treatment, and teach compensatory strategies so that the client can use their available vision.  Recommendations may be made for assistive devices that can enable the person to remain in the home and perform daily activities independently. Low Vision OTs can also provide information on the many services and organizations available in the community.  Because occupational therapy is a skilled rehabilitation service, these services are typically covered through Medicare and other third party payers.

Most seniors have a strong desire to remain independent in their own homes, even with declining vision. With the appropriate modifications, this is a viable option for many. Increasing lighting, contrast, and improving organizational strategies are a few simple things that may enable someone to remain independent at home. Training in orientation and mobility can allow individuals to remain active in the community as well.

When standard glasses are no longer an option, optical devices can provide the needed magnification so that an individual can continue reading. High powered magnifiers and electronic readers now are able to magnify print up to 20x the original size. Additional devices such as talking glucometers, color identifiers, and large button cell phones are also available to those with low vision.  If vision loss has impacted you, remember that you are not alone and there are many options available to improve your quality of life.

 “Obstacles don’t have to stop you. If you run into a wall, don’t turn around and give up. Figure out how to climb it, go through it, or work around it.” - Michael Jordan

10 Simple Low Vision Tips:

  1. Use full spectrum or natural daylight bulbs to reduce glare and imitate daylight
  2. Remember to light up stairs, pathways, and walkways
  3. Consider goose neck style lamps which are best for reading
  4. Use a black felt tip pen on white paper when writing
  5. Avoid too much pattern on placemats and tablecloths
  6. Label buttons on appliances with bright stickers/raised dots
  7. Label medication bottles with large bold letters on top
  8. Color code household documents and papers
  9. Ask you bank about large print checks
  10. Consider audio books when reading is no longer an option

Mary Schwartz, OTR/L is a low vision occupational therapist with Baker Rehab Group in Frederick, Maryland and sees clients both in the home and within many local assisted living facilities.

Three Ways to Improve Patient Follow Through

Posted in The Baker Beacon

By Brittainy Wierzbicki, OT

One of the hardest things about being an Occupational Therapist (OT) is getting our patients to follow through with our recommendations. This includes home exercise programs, adaptive equipment recommendations, adaptive equipment recommendations, and anything else we ask our patients to do. It doesn’t matter how awesome our interventions are or how well we know how to improve a person’s function. If your client won’t follow through when you’re not around, then their progress will be limited. So take a look at the following recommendations and try them out next time you have trouble getting a patient to follow through with your recommended plan of care.

  1. Don’t assume that your patient understands what you said/wrote. As health care practitioners, we are educated and knowledgeable. We know how to use fancy medical terminology to sound smart, and we know what happens when people don’t take care of themselves. We understand why exactly high blood pressure is bad. We know why holding onto towel bars for stability is a recipe for disaster. But just because we know doesn’t mean our patients do. Hopefully we’ve all heard the term “health literacy”. Health literacy is “the ability to read, understand, and act on health information” (Eaton, 2004). According to the American Occupational Therapy Association, as OTs, we should “provide health education that is understandable, accessible, and usable by consumers” (Barnekow-Pizur & Darragh, 2011). In fact, nearly half of all adults have inadequate health literacy, meaning that they cannot appropriately interpret health care information (Vanderhoff, 2003). What should we do? Provide home exercises in both written and picture form. Use plain language: instead of saying “shoulder flexion”, say “raise your arms up overhead”. Even better, use their wording. If your client knows what “arm raises” or “toe touches” are, then write that. When using the teachback method to check your patient’s comprehension, avoid asking “do you understand”?, as this can elicit embarrassment or anger if the patient is confused. Instead, say something like “I’m really bad at explaining things. Why don’t you show it to me so that I can see if I did okay?” This way, if your patient doesn’t understand your instructions, you’ve placed the blame on yourself, inviting them to request further explanation.
  2. Make sure your goals are their goals. We’ve all done it. You spend a few therapy visits working to improve a person’s independence in dressing (bathing, meal prep, etc) without much progress or follow through, only to find out that your patient doesn’t really care if they can dress themselves. It seems important to us. Why would anyone not want to dress themselves? Maybe because they live with an adult child who dresses their aging parent as an act of  love and respect. And maybe that adult caregiver would prefer you focus your therapeutic efforts on improving their parent’s bed mobility in order to give the caregiver’s aching back a rest. Whatever the reason, we have to be sure we’re all on the same page. Our clients and caregivers are much more likely to do their exercises or purchase the recommended adaptive equipment if it helps them achieve their goals.
  3. Give it meaning. Your clients need to understand how your specific interventions will help them reach their goals. For example, when I see someone who is having difficulty with upper body dressing I always look at their shoulder internal rotation, which is frequently limited. Home exercise program time! But telling a person to lean forward in their chair and try to touch the back of their belt, then repeat 10 times, twice a day, may seem silly to them. So be sure you explain that it will help make putting on jackets and button down shirts easier for them. Our clients will be more willing to complete their home exercises if they understand that those exercises were chosen specifically to meet their needs, rather than just “busy work”.

References:

Barnekow-Pizur, K., & Darragh, A. (2011). AOTA’s societal statement on health literacy. The American Journal of Occupational Therapy,65(6), S78-S79. doi: 10.5014/ajot.2011.65S78

Eaton, J. A. (2004). Low health literacy seen impacting costs, compliance, outcomes. Physicians Financial News, 22(1), 1.

Vanderhoff, M. (2003). Patient education and health literacy. PT: Magazine of physical therapy, 13(9), 42-46.

Changing Lives Through More Than Just Occupational Therapy

Posted in The Baker Beacon

As home health therapists, we stumble into all kinds of circumstances.  When occupational therapist Erin King met a family living in dire conditions, she took action.

“This is a family who is doing everything right, but can’t get a break,” Erin explained.  “They are a lovely couple with an adult son who is developmentally disabled.  Neither parent can work as both have had strokes.  They were evicted from their apartment when the husband got sick and could no longer work, and put what few items they had into a storage unit.   They moved into a shelter where he got sicker and was eventually hospitalized.  He had a stroke while he was in the hospital and their storage unit was repossessed.  They are now living in this apartment and have no belongings.  There is one chair and they literally take turns sitting on it.”

Erin provided the family with resources and is working as part of the home health team to help the husband get back on his feet.  But the urgency of the situation compelled Erin to do more.

Erin took to her Facebook account and reached out to her friends and family.  The response was amazing.

“I got an overwhelming response right away.  One person I know went to Wegman’s and bought an entire week’s worth of groceries.   Another lady I know who lost her son about three years ago donated a bunch of things.  She even donated her son’s last shirt that was hanging in the closet- she had been hanging onto it for sentimental reasons.  She told me it was time for that shirt to go to a gentle soul who needs it.  It was incredibly touching.  I feel like Oprah driving all this stuff to them.”

Erin has managed to find furniture, clothing, shoes, kitchen items, and gift cards for this family.  But on a larger scale, there is much more to be done.

“The husband is eager to return to work, but he is limited by severe complications from his stroke.  I am not sure what else we can do long term.”  Erin says.

In the short term, Erin plans to deliver more donations and collect whatever else the family may need.  Erin’s generous heart has inspired the entire crew at Baker Rehab to be on the lookout for families in need.  Her example has shown us how a simple gesture can make a huge difference in someone’s life.

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Spotlight on Excellence: Connie Mulloy, OT

Posted in Spotlight on Excellence, The Baker Beacon

Client Care Facilitator (CCF) in Montgomery County, Maryland

Friends of Baker Rehab Group, here’s a therapist you just have to meet.

Connie Mulloy is an occupational therapist and serves as a Client Care Facilitator (CCF) for Baker Rehab Group in Montgomery County, Maryland. Connie brings nearly 30 years of clinical expertise to our team, and is an invaluable resource for training, mentoring, and supervision to our newer staff members.

Connie has earned specialized expertise in the concept of aging in place, also known as CAPS (Certified Aging in Place Specialist). Her CAPS qualification ensures our clients that Connie is current on the latest home modifications and equipment available to maximize safety and independence in their homes despite age, illness, or disability. She is also a valuable resource for contractors, builders, and project managers who need input into design and function during new construction or remodeling.

Here at Baker Rehab, we frequently call on Connie’s wisdom to trouble shoot processes that could run more smoothly and to help develop new, evidenced-based practices that enhance the skills of our therapists. She is beyond generous with her time and talents, and every one of her patients would agree.

Check out Connie’s blog where she shares tips for aging in place at Aging in Place Tips for Caregivers. You can also call our office if you’d like to reach Connie for consultation or regarding an educational event.

Thank you for being so awesome, Connie. We think you’re the best!

Connie provides occupational therapy in the home throughout Montgomery County, Maryland. If you’d like her to come work with you or your family member, please email us or call our office at 866.727.3422.

Spotlight on Excellence: Theresa Davis, OT

Posted in Spotlight on Excellence, The Baker Beacon

You know her… everybody does. She has been in and out of so many homes in Frederick County over the last 13 years that it is very likely that if she wasn’t in your home, she was at your neighbor’s, and she passed you on the street. And she waved. She’s like that.

Theresa Davis is our October Spotlight on Excellence therapist because, well, she’s excellent.

Theresa has been an occupational therapist for 18 years, spending her entire career working in geriatrics and the vast majority of it in home health.

“I love home care because it’s true Occupational Therapy – working in a client’s home and focusing on improving their safety, mobility, and independence. I love the elderly and making their days brighter just by talking with them and showing interest in them. Sometimes a hug and a smile will really make their day better.”

Theresa is proficient in environmental modifications and dementia care. She is a huge resource for Baker Rehab Group in providing training and management of our newer therapists. She is a staple at many area assisted living facilities, and is skilled in joining forces with their management teams to integrate rehab into each facility’s structure.

Many would describe Theresa as “sunshiny” due to her love of the beach and infectious laugh. She is a talented multitasker- juggling her busy work life with two active sons and a wonderful husband who she adores.

“I love the other therapists I work with and feel lucky to always have such a collaborative relationship to improve the lives of our patients.”

We feel exactly the same way about you, Theresa!!!

Shine on!

Theresa provides occupational therapy in the home to much of Southern Frederick County in Brunswick/Jefferson and Washington County, Maryland. If you’d like her to come work with you or your family member, please email us or call our office at 866.727.3422.

Spotlight on Excellence: Mary Schwartz, OTR/L

Posted in Spotlight on Excellence

This month’s spotlight on excellence shines on Mary Schwartz, occupational therapist, and her tireless dedication to her low vision clients.

Low vision is broad term used to describe anyone who has a primary eye condition or visual deficits caused by other diseases. The most common causes of low vision include macular degeneration, glaucoma, cataracts, and diabetic retinopathy.

Mary enjoys many aspects of low vision rehabilitation, using low vision aides or compensatory techniques to maximize remaining usable vision.

In Mary’s own words, “I love helping clients get back into reading with the use of the right magnifier or optical device. I also enjoy teaching clients the skills they need to remain independent in their own homes despite severe vision loss. I get so much out of improving the quality of life for someone who has given up on all leisure activities because of vision loss. There is so much that can be done.”

Mary also educates the community on the numerous resources available to the blind and partially blind. She sees clients at BRG’s Senior Rehab and Wellness Outpatient Center located at 5800 Genesis Lane, Frederick and in their own homes.

Mary was instrumental in developing the EyeSee Low Vision Program for Baker Rehab Group, which is a framework for professionals to use when educating clients and caregivers about low vision therapy.

If you would like to contact Mary or get more information about low vision services, email us at lowvision@bakerrehabgroup.com.

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This is Sue Paul, and This is an Unauthorized Blog Post.

Posted in The Mind Of John

I am brimming with such pride and admiration that, being without a platform or mountaintop to holler from, I felt had no choice but to hijack John Baker’s blog while he is on vacation.

I’ll ask his forgiveness later.

But for now I must share with you some warm fuzzies- the kind that leave a mark on this world.  I have the dubious responsibility of completing annual supervisory visits with the occupational therapy staff at Baker Rehab Group.  It is a mechanism to ensure quality care and compliance with our staff, and is used as a framework for important feedback and suggestions to help us all grow as clinicians.

Though not designed to be an ambush of sorts, I usually end up stumbling across an OT in one of our assisted living facilities, whipping out my paper, and observe a treatment session there on the spot without warning.  It’s purely out of convenience on my part due to my slippery schedule, but it can be genuinely surprising and slightly disconcerting to the unprepared therapist.

Today was one such day.  I ambled down the hallway at a facility and overheard one of our OT’s talking with a resident and staff caregiver.  The OT described the purpose of the task to both parties (check!).  I peeked through the crack in the door and watched her demonstrate instructions to a patient with cognitive impairment (check!).  I listened to her providing cues, educating the caregiver, and rearranging the environment to make the patient more successful and safe (check, check check!!!).

Then I listened to the feedback from the caregiver, thanking her for the wonderful suggestions and impact that therapy is having on the resident’s quality of life (there is no check box for that, but there should be!).

Only a few rooms away was another of our stellar OT’s.  I listened through the door for a bit, mostly just to gauge if it was an appropriate time for me to enter.  I heard easy banter and a few laughs coming from the bathroom.  I knocked and entered the room, asking the patient if it was ok for me to observe.  Standing slightly behind the patient and mouthing to me over her shoulder, the OT whispered, “I love her” to me and gave the patient an affectionate rub on the back.

I watched them work on activities at the bathroom sink- where to park her walker, where to place her hands, in what sequence to perform tasks, where to place the items.  The OT told me that the patient is highly motivated to be able to complete all bathroom tasks without help from the staff- and together they would make this goal a reality.

Feeling any warm fuzzies yet?

The OT then set her up with some exercises to strengthening her weak, arthritic hands, so that she would be better able to open the containers at the bathroom sink.  And then she reviewed the things they had worked on, what else they would still work on that visit, and what they would address during the next visit.

It goes without saying that these OT’s follow procedural policy flawlessly.  I can check off competency in all skills related to this setting without hesitation.

But what I was most struck by was the compassion… and the incredible desire to improve the lives of their patients.  Before they were even aware of my presence, I could hear the patience and kindness in their voices.  I witnessed excellent communication coupled with gentle, non-threatening body language.  Their presence was calm and confident.  They were easy to understand and easy to trust.

I then went in search of assisted living staff, looking for feedback and opinions about these therapists and the work they do with the residents.  They were so genuinely appreciative of these therapists, and others that work in the building, and told me that their expectations had been exceeded beyond measure.  I was humbled by the success stories and puffed up my chest like a proud mother hen.

I am so honored to work with these therapists, and all the others at Baker Rehab Group, who show the same commitment to excellence and beyond-job-requirement effort in everything they do.

It may sound cliché to be so positively affected by a group of coworkers, but they truly inspire me.  They are difference-makers.

You can have your blog back now, John.

I’ve said my piece.