Occupational therapy helps people regain independence after major health issues
Occupational therapists help patients relearn basic self-care tasks and cope with emotional and cognitive problems
St. Luke’s offers many ways to master tasks, from driving simulators to mock apartments
For occupational therapist Dana Loft, an average day at work can be filled with inspirational stories. Take one of her patients, a young man with a severed spinal cord injury from an ATV accident. When he arrived at St. Luke’s Rehabilitation Institute in Spokane, Washington, he was incapacitated to the point that he needed help just to get out of bed in the morning, not to mention completing the simple activities associated with daily living. But by the time he left, he had gained mobility through the use of a wheelchair and independence by re-learning how to do those self-care tasks. The story is an uplifting one, but it also speaks to the determination of the young man, as well as the hard work put in by him, Loft and the other members of his patient care team.
“It was an amazing experience as an occupational therapist to be a part of the process of educating, training and guiding this young man as he learned to manage a new life independently as a person with a spinal cord injury,” she says.
It’s all in a day’s work for Loft, who says she “helps people after an illness, injury or surgery to be as independent as possible with self-care tasks - bathing, toileting, dressing, eating - and get back to doing the things they love and need to do.” The job can include practical tasks such as helping patients use St. Luke’s driving simulator in order to eventually get out and do things such as grocery shopping, as well as less tangible undertakings such as supporting patients emotionally as they cope with the changes they are facing.
Loft is a float occupational therapist, which means she works in the inpatient rehab facility as well as in adult and pediatric acute care and pediatric outpatient care. Her responsibilities vary depending on each patient’s individual needs and where the patient is receiving care, but generally each case starts with an evaluation.
“We determine what level the patient was at before they entered the hospital or rehabilitation, and from that evaluation we establish goals with the patient to help them become as independent as possible with their daily routine and self-care tasks,” Loft says.
St. Luke’s offers both inpatient and outpatient occupational therapy services to help patients achieve those goals. At the institute’s main campus is a 2,200-square-foot facility called St. Luke’s Community. That’s where patients can master everyday activities - in addition to that driving simulator, there is also a grocery shopping simulator so people can practice loading up and steering grocery carts; therapy kitchens to practice cooking; a cross-section of an airplane to try boarding and seating; and a mock gas pump.
There is also plenty of adaptive technology and equipment to help people with limited hand function be able to move their hands again. And to prepare for life outside the inpatient rehabilitation institute, there is an independent living apartment where everything from the lights to the TV can be operated via tablet or controls on a wheelchair. Loft adds that there are several different kinds of bathrooms set up so patients can practice in one that closely models the tub or walk-in shower they have at home. Once patients are at home, they can participate in the Providence Home Health therapy services program. And patients’ families can also get training to support their loved ones after they return home.
Occupational therapy isn’t limited to physical tasks, Loft says. “A patient’s emotional side and coping with a change in his abilities has a huge impact on the recovery process. We strive to meet people where they are at and help with the coping process if there’s been a change in their ability to do their daily activities and live their lives. There’s a lot of listening, reflecting and acknowledging the patient’s feelings; establishing that rapport with patients so they feel comfortable and are able to work through those feelings while in therapy is really important. And there’s the cognitive side we work on with patients - we help them learn how to do money management, manage medication and make a grocery list.”
Loft and St. Luke’s other occupational therapists work closely with the other members of a patient’s care team. “We regularly communicate with nurses on what is the safest way for a patient to use the toilet, for instance - how much assistance they need, or if they need to use a lift,” she says. “We communicate with the doctor about how a patient responded to their therapy or if there are concerns about a discharge plan. We also communicate with the doctors about certain restrictions a patient has or precautions we have to follow. We communicate a lot with the rest of the rehab team, be it speech, recreational, physical or respiratory therapy. It’s a very interdisciplinary profession.”
Loft says that, for her, the importance of the therapy process was illustrated in the case of a child who had a spinal tumor removed. “He was fearful of anyone coming in the room that first day, so we had to make moving fun for him, make therapy not scary,” Loft says. “That first day the only thing we could do was go from his bed to a wagon and go see what fun things there were in the hallway.” But as he progressed, the boy who had a hard time walking and couldn’t get his pants on or off regained his childhood enthusiasm and was running and jumping by the time he left the hospital.
“He really thrived in the therapy setting,” Loft says. “We had goals to achieve but we had to make it fun for him and he was able to participate. I don’t think he had any idea he was doing therapy; I think he just thought it was fun. We would play different games and he was very creative so we had to be creative with him. It was exciting the first day we got to see him run because he felt comfortable and confident enough to run and go find the toys we had hidden in the gym - to see him light up and excited to play like a kid should was exciting.”
For other patients, successful therapy is the excitement of using a restroom on their own, or being able to make a meal for themselves. “Seeing patients be able to get themselves dressed and walk into the bathroom by themselves is very gratifying,” Loft says. “They go home and live their life and get back to doing the things they love. They just might be doing them a little differently.”
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.