Senior Living Today
Welcome to The Ohio Masonic Communities' podcast Senior Living Today! In this podcast, we will be discussing all aspects of senior living. From debunking myths about senior living to caregiving tips and health and wellness advice for seniors, we are here to answer all of your questions, and what life is like at our communities. We are excited to share our expertise on a variety of senior living topics, with a new podcast every two weeks. We will have a wide variety of guests ranging from experts in the field to those living their best life in one of our communities.
Senior Living Today
Maintain Independence as an Older Adult with Occupational Therapy
Occupational therapy has many benefits at every stage of life. For older adults, it can even help maintain independence. Cindy, an occupational therapist, joins us to discuss how OT can help older adults.
Hi everyone. Welcome back to another episode of Senior Living Today. On today's episode, we will be discussing the benefits of occupational therapy for older adults. With us today is Cindy Hudson, director of clinical compliance at Arbor Rehabilitation. Cindy, thank you so much for joining us today. Absolutely. Thank you so much for having me. So why don't we start by you telling us a little bit about yourself, how you got started in your career and how long you've worked in the occupational therapy setting? Sure. So I have actually been an occupational therapist for over 35 years. So how much over I'm not going to say, but it's been a while. So my first exposure to OT was really back in the day. We had candy stripers in hospitals and I was a candy striper. They sent me to the OT department. And at that point, it's our OT was able to help a person not only physically, but emotionally and mentally, move through their rehab, process. And I thought, well, how wonderful is it that they can help and all these different aspects? It's not just physical, it's not just emotional. It pulls it all together to make day to day life, a little bit easier for the people that are living through whatever injuries or illnesses they've had. So that dual approach really appealed to me, and that got me started on my journey as an OT. That's amazing. I didn't realize you had been in the field for that long, so I'm sure you're going to have lots of great information to share with our listeners today. Before we dive into what the benefits of occupational therapy are, let's go ahead and start with the definition and explanation for our listeners. So could you go ahead and explain what occupational therapy is to them? Sure. So occupational therapy overall we help people learn or sometimes relearn how to do what it is that they need or want to do to take care of themselves. And this can be anywhere from helping children, have better control over their bodies if they're born with certain challenges. Because children their job is to play. With adults our job is to be able to engage in our hobbies again, live a little bit more independently, take care of ourselves and in a variety of ways. So we are going to help people do those activities of daily living or ADLs, and help you do what you want to do every day in a way that's going to be safe and easy. So when you're meeting with someone for the first time, how do you kind of build that rapport with them and make them feel comfortable about starting occupational therapy? I think it's really important to start with something as basic as what do you prefer to be called? Do you want to be addressed as Mr. or Mrs.. Do you have a nickname that you prefer? I think when we start with that, that's going to set the tone for a respectful relationship. And I think that that helps people understand we're really on your team. You know, people have been through a lot of challenges with the medical field and, and with insurance and that type of thing. And I think that we want to set the tone for a positive, respectful interaction. And we start by asking, you know, what do you prefer to be called? From there, I think it's helpful to understand their background a little bit, what their home situation might be like, who they live with, if they live with anybody, and what their goals are for being in therapy. And because I think that it's important for our clients to know that we're all going to row in the same direction, but we need to understand what direction you need to go. So I think that that's, you know, when we start with those basic questions that helps people understand we're really on your team. We want to help you make the most of your rehab process. But we are not the experts in your life. You need to tell us a little bit about your life so that we can, help you with that in the best way possible. Absolutely. So one of the things you mentioned was goals. And we're actually going to dive into four common areas of occupational therapy and, and how that works in the first one we're going to talk about is setting goals for occupational therapy. So I know one of those specifically since we're talking about, you know, older adults, is helping them maintain their independence. So can you talk a little bit about some of the goals that are associated with that? Sure, absolutely. And that and that depends on the individual. That's where we have to get that backstory to know what might be appropriate for them. Because if they don't have stairs, for example, in their environment, if they don't have to cook in their environment, you know then that those things would not be relevant for that individual. So we need to know what areas are important for them, what areas are a challenge for them, and then why those areas are a challenge. I think that sometimes as we set the goals, we need to understand the root cause of those challenges, and then we can kind of work to resolve that and maybe once you have your strength and your balance, then everything else can get a little bit easier. So we really have to start with understanding what's important to them, what the deficits are, what the root causes are, and then work together to find a way out of those challenges and develop those kind of goals. So those are really unique to each person and their specific situation. Absolutely. Yes. Wonderful. So what can patients expect out of occupational therapy? How does the process work. Right. So we're going to use a variety of approaches, and modifications and so forth to make the day to day tasks easier. So after we do the evaluation, when we find out what's difficult, what that person wants to achieve, then we set up a plan of care with those goals specific to that individual. And then from there, people can expect that we might, look at different equipment to make daily life easier. Like a bath tub bench, maybe a sock aid to make it easier to put on socks. There's a lot of adaptive utensils out on the market to make it even easier to feed yourself. Sometimes arthritis makes that a little bit difficult, but again, we need to address the root cause, which can be the balance, the strength, the coordination, the sensory skills so that we can make the most of those functional skills. And I think in light of our goal to enable independence, we don't always want that person to use that adaptive equipment. You know, there's a lot out there on the market, but do you really want to evaluate is that the best thing for that person, or are we going to enable dependency or weakness? And we don't want to do that. So again, sometimes we're pretty selective in our recommendations for that equipment. And then again after we do that assessments to figure out their physical strengths, their cognitive strengths, what they're going through, what their resources are, then we can instruct the person on specific exercises, upper body, maybe even lower body. Working on balance, working on safety education, working on ways to help them save energy. You know, ideally OTs like to use functional tasks, over wrote exercises to help a person function a little bit better. So lifting a weight is fine doing those exercises. There's a time and place for that certainly. But it can also be exercise, putting cans up on a shelf, you know, unloading a dishwasher. All those things are kind of sometimes a little bit more functional. And I think sometimes people understand those challenges a little bit more than I just want to do boring exercises, you know? But for them, they see the relevance of putting cans up on a shelf, and yet they're still getting exercise. So I think that that's a good thing as well. Also, in terms of what to expect, you know, we have two different levels of occupational therapists as well as physical therapists. So there's occupational therapists who would do the evaluation and oversees that plan. And then oftentimes we hand off the day to day treatment to an occupational therapy assistant who works under that plan and consults with us. And we consult with them to advise them on the best approach to help that person achieve their goals. So there's actually two levels of therapist that somebody might be exposed to, when they're getting therapy in a clinic. And when might someone need or benefit from occupational therapy? Sure. I think that, certainly somebody who is struggling to maintain themselves in their home environment, they might benefit from occupational therapy. If getting a bath or getting dressed or getting a meal together has become a challenge. Shopping for food or planning is getting to be a little bit more difficult in terms of either thinking through the process or just the energy to do all those things. Again, occupational therapy can definitely help. Those who notice maybe some cognitive changes can benefit from some compensatory strategies with OT. We've got a lot of ways of helping people with memory besides just writing things down. But we can work with memory. We can work with strategies again to help the person make the most out of their energy. I think that one of the concerns that I have is that, you know, there's, a high risk for people falling. And, you know, when you go to see your doctor, they're going to ask you if you've had any falls in the past year. And if a person has fallen, their odds of falling again, do go up and so we want to be careful to address that. And I think that there's a lot of reasons why people fall. And I think occupational therapy looks at a lot of those reasons where we're well versed and looking at those potential issues that could lead to that fall. So it might be in the environment like throw rugs or poorly fitting shoes. And we always recommend people not wear flip flops, but wear sure that has a heel to it. You know, something behind the back of your foot. We look at again the environment. We could look at vision changes. A lot of them do get macular degeneration, and that can impair their ability to see things on the floor right in front of them. But that could be a trip hazard we want to help them learn how to avoid. Some cognitive changes; people that are becoming a little bit more confused might have decreased attention span. They might have slower reaction time. We would want to help make sure that we've got a safe environment for those individuals. There's something also called cognitive vision. And that's when we, when we have a lot of things that we need to focus on. Like if you're driving down the road on a snowy, icy day, you're pretty much focused on that snowy, icy road. You're not noticing the snowman off on the tree line. Yes, absolutely. You right. So we can only put so much attention on one thing. And then for driving conditions, we have to focus on the road. We don't notice the snowman. It's a little bit similar that somebody who's having a cognitive decline can only focus on so much visually. And so we want to make sure that they're in a safe environment, and don't have a trip hazard or any other risks as well. So all those things can contribute to a fall and contribute to decreased safety. And occupational therapy wants to look at those areas and make sure that we're doing the best we can for the folks that we're working with. So once again, coming back to finding the root cause of the issues and addressing those directly. Exactly. Yeah, exactly. I know we've talked a lot about how occupational therapy is used with older adults, but just for our listeners’ knowledge, is that something that can be used with the younger generations as well, such as kids and teenagers? Absolutely, absolutely. Because OT as I said, it helps people do what they need or want to do for themselves. And it can take place in a school with, you know, elementary or teenage children, hospitals, community based, like home care. Many people have heard of home care. We also help those who are struggling with mental illnesses. And in fact, OT originated right after World War one. Veterans came back and they were what we called then, shell shocked. Now we know that that's PTSD. But occupational therapy engaged those veterans in purposeful activities to help rebuild their skills and help them recover both physically and emotionally. So our roots go back actually with mental illnesses. One of our OT influencers now is we would call an influencer. Her name is Mary Riley. And she said that man, through the use of his hands as they are energized by mind and will, can influence the state of his own health. And I think that that quote shows our belief in the link between the physical with the mental, with the emotional. And so that really spans all generations, whether it's children with autism that need to learn how to navigate their environment perhaps a little bit more effectively. Children who are born with perhaps down syndrome that need to learn how to have control over their body and how to interact appropriately, all those kinds of things. What do you need or want to do to help yourself through life? That's where we can help. So I know we've already touched on some of them, but what are some of the main benefits that you feel occupational therapy can help with? Well, that's a good question because it's like, what can't we help with? Like it's almost everything. You know, it's everything. And yet we have our roots in it being functional and relevant for that individual. So, you're right. People who have again, issues with struggling with depression or struggling physically with after having had a stroke or with Parkinson's or, just for long hospitalization and now their body is super weak. Those who may be having some cognitive changes, we can find ways to make adaptations so that they can navigate more safely in their environment again and still be successful. I think having a sense of purpose and a sense of fullfillment in life is critical to all of us. And occupational therapy can help any age, any, any level of challenge to find more fulfillment and more meaning in life. And that's the reward that that we can all benefit from. Absolutely. So I think a lot of people will think of occupational therapy in a senior living setting, when they hear about it. But where else can occupational therapy take place? Sure. And that that really is across the continuum. As many people are aware that we do home care. Occupational therapists are in the home making recommendations for that home environment to be safer, easier to navigate. Working on some rehab for somebody who doesn't have the stamina yet to go out into the community for outpatient therapy. It can also happen in, for example, schools and hospitals. I've had friends that worked in prisons. You know, it's because, again, that core theme of what does a person need to do to, be able to reengage in life again. And so pretty much any environment, is is fair game. And I will say in order for insurance typically to pay for that occupational therapy, if, if a person has insurance, we do need a physician's order. But in many environments we also can support licensure laws. We have direct access. And that means we do not have to have a physician's order, but that payment might need to come through other means. And typically insurances want that order. But we don't have to have one to function in a in a school system, for example. Okay. Yeah. That kind of led into my next question. Which is if an individual can just choose to ask for occupational therapy or is a doctor's referral required for that? Absolutely. They can ask for it. If it's going to be covered by insurance, it needs to be medically necessary. So there's a lot of other hoops that we have to be careful about for insurance to cover it. If people want to privately pay. That is an option as well. Yes. Yes, yes. Wonderful. So I'm sure you've spent a long time in this field. We talked about that at the beginning of the episode, and I'm sure you've seen a lot of success stories as your time as an occupational therapist. So would you mind sharing 1 or 2 of those with our listeners? Sure. So back in the day, I worked with a woman and her name was Theresa, and she was maybe about 84, 85 years old at that time. And she had a brain bleed, like we would call an aneurysm a stroke, they’re all called a brain bleed. And that, you know, that definitely impacted her body and her mind. And she was pretty sleepy. She was pretty shut down when we first started working together. And she really wasn't able to do much because she was so tired all the time. And she just sit there with her eyes closed and her head hung down and really wasn't doing much. So every week in the setting I was in we did standardized testing where we would, for example, have them maneuver certain items, looking at how quickly and how accurately they were maneuvering those items. We’re looking at coordination and speed and that type of thing. So I did that testing every week, and the one week I did it, she was a little bit better, not much, but a little bit. And the rest of the therapy team felt, you know, she's really not making gains. We need to take her off of therapy because we're just kind of at a standstill with her right now. But I disagreed because I saw those little tiny gains in the tests that I was doing. And I said, you know, can we give her another week because she's just ticking up a little bit for us? Well, during that week, they ran some labs for her. Found out that some of her lab values were way out of whack, and they were able to make some changes to her medications to where she significantly changed. She rounded that bend, and she started moving and walking and getting herself dressed, and was able to leave the facility and go home with her husband of 50 plus years. And so, you know, I think that sometimes we give people that little bit of extra time, a little bit of extra boost, and see their potential. I think that makes all the difference. That was a very rewarding situation. No, that's amazing. And I think it just shows the extreme benefits that occupational therapy can have. Absolutely. You know, across a variety of situations and instances. Right. right. So before we close out today, is there anything else you can think of that our listeners should know about occupational therapy or anything else you'd like to share with them? Oh, boy. You know, I could go on about OT, like I said, this is my my career of 35 plus years, and I absolutely love it. You know, it could be simple and low tech anywhere to high tech. You know, as more and more technology comes out there's more and more ways that we can help people stay safe, stay in their home environments. But it can be low tech as well. And so don't overlook some of those suggestions when, if you have the opportunity or have the need for occupational therapy, sometimes it's a simplest of things that can make a huge difference. With safety, with energy. We know when people get tired, any of us when we're tired, we're more likely to take a stumble and nobody wants to fall. So again, looking at ways to kind of save your energy can be a huge, huge benefit to keeping people safe in the home, and again doing what you need or want to do and to have that fulfilling, meaningful life. And that's my final words, I guess. Awesome. Well, thank you so much for joining us today, Cindy. You shared some incredibly helpful information about occupational therapy. I know I learned a lot today, so I'm sure our listeners did as well. So just thank you again for joining us. Thank you for the opportunity, Alexandra. Appreciate your time as well. Of course. For our listeners, be sure to like and subscribe to the Senior Living Today podcast wherever you listen to your podcasts, so that you never miss a new episode. And we will be back again with a new episode in two weeks.
