Clinical Spotlight, continued from Page 8
What does your typical workday look like?
It’s hard to describe what a typical day looks like for me, since
every session and intervention is individualized to the patient
and their specific level of injury. A lot of sessions are initially
focused around increasing independence in basic self-care ADLs.
However, some examples of other interventions involve increasing
patient knowledge and empowering them to direct their own care,
learning proper and safe transfer techniques, as well as increasing
their strength and balance. Once a patient is more independent
in their ADLs, I will move onto more IADL tasks, such as kitchen
or community mobility from a wheelchair level.
Each therapist is typically assigned four primary patients. I
will see my primary patients for at least an hour and a half each
day. Usually at least once a week, I will have an ADL session
for re-assessment of bathing and dressing to demonstrate patient
progress or reasoning for a lack of progress. This information is
especially critical to report to the therapy team and will be utilized
to provide reasoning for insurance approval concerning a patient
requiring skilled occupational therapy interventions within an
intensive rehabilitation setting.
How do you incorporate an occupation-based approach?
Almost all therapy treatments with patients with SCIs are
occupation-based in teaching adaptive techniques and/or use of
adaptive equipment. Also, durable medical equipment is used to
maximize patient safety and independence with ADL tasks. Once
improved independence is established with patients’ ADLs, we
will progress to interventions in IADL tasks. For an example, an
occupation-based approach I have used when patients are parents
involves adapting child care tasks. We have to teach them how
to care for their child from a wheelchair level. We have to teach
them how to pick up their child, or if they wish to play on the
floor with the child, how can they safely perform a floor transfer
from the wheelchair.
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In addition, we will perform activities like meal
preparation, laundry, and other household tasks, as well as go
on various community outings (i.e. Shedd Aquarium, Lincoln
Park Zoo, Millennium Park, Garfield Conservatory, etc.) to
maximize patient safety and independence with community
participation.
Are there any innovative SCI programs at Schwab?
Here at Schwab, we have a Peer Mentor program that pairs
up individuals who have lived with their injury for numerous
years to patients currently on the unit. It’s a great opportunity
for current patients to see and talk to people who have had
a SCI themselves and are out living in the community now.
This mentorship program is a powerful motivator for patients
to participate in therapy.
In addition, a newer program has started called the SCI
Social Club. Usually, there is a topic each month on an SCI
issue. These topics are picked based on patient preferences.
Some examples from the past social clubs include employment,
bowel-and-bladder programs, and travel.
The social component of the club is very important too.
We do one social outing per month to encourage and engage
patients in the community (i.e.- White Sox Game, barbeque
and wheelchair basketball). We try to encourage them to
continue to engage in the community once they leave inpatient
rehabilitation for an overall increased quality of life.
From the above interview, it is obvious that Alicia is an asset
to the profession. Her ability to adapt tasks, be client-centered,
and advocate for the client is what makes her an invaluable OT.
Alicia demonstrates excellent clinical care and enthusiasm in
identifying and addressing unmet needs surrounding the care of
patients as part of the interdisciplinary team. I hope you are able
to take away aspects from her story to strengthen and improve
your own practice.