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“Home is where the heart is” and the place where my patients heal

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“The magic thing about home is that it feels good to leave, and it feels even better to come back.” – Unknown

“Home is a shelter from storms – all sorts of storms.”- William J. Bennett

Home is where the heart is.  For many of us, our home is the place we most want to be, especially while we are recovering from surgery, a hospitalization, or experiencing a decline in our ability to care for ourselves. In-home rehabilitation services have been offered through home health agencies for years.  Patients are being discharged from hospitals sooner, sicker, and more patients are declining rehab placements after discharge from the hospital. The home health team becomes an important step in the care continuum. As an Occupational Therapist in home health, I am an important player on that team.

As an Occupational Therapist, I work on all those things that occupy your time, from getting dressing, getting up and down from the toilet, taking a shower, making a meal, doing the laundry, driving, working, and enjoying your hobbies or leisure activities. After I assess someone’s abilities, I determine the areas that need to be improved and design a program that addresses those areas. The program could involve:

  • interventions in many different areas such as, therapeutic exercise, balance training, or cognition/thinking skills.
  • addressing Activities of Daily Living (ADLs) and mobility in the home, sometimes recommending adaptive devices to improve independence.

Think of me as the “gadget girl.”  I especially enjoy seeing how the right piece of equipment can make all the difference with someone’s independence. Equipment recommendations include the trialing and training on the use of the equipment, which is an important part of the job in the home. No matter how good a simulation in a clinic is, it can never replicate their home. Trialing the equipment in the patient’s actual home ensures the appropriate piece of equipment is obtained.

Home Health OT plays a huge role in the prevention of re-hospitalization. Home health clinicians wear many hats. I am an OT but at any given moment, I may have to function as a PT, Social Worker, or RN. Some days it seems that I spend half of my time talking to physicians, other clinicians, and family members trying to problem solve what will work best for my patient.

As with anything, there are aspects of my job that I love as well as the ongoing challenges that require creative resourcefulness to complete my job to the best of my abilities.

  • I enjoy the intimacy that comes being in someone’s home, connections seem easier to establish.
  • I enjoy seeing people’s family photographs, the things they collect, from stamps, vintage Pyrex, perfume bottles, or teapots.
  • I enjoy being able to use things like pet or plant care in my treatment sessions.
  • I am happy that my personal confidence with driving, navigation, and parking has improved.
  • The challenges of my days include scheduling, finding clean bathrooms, communication with coworkers who I rarely see, traffic woes, and caring for an increasingly sick population.

I feel that the rubber meets the road in home health. I see how people actually live, not just what they or their family report. When my primary care provider and I have talked shop during my visits, I have told her that if she could make home visits it would change the way she practices medicine. Seeing patients in their home is that powerful, and for an OT, is completely natural and just makes sense.

“Home is where the heart is” and it is where my patients heal.

 

Monica Laird is an Occupational Therapist in the Home Health setting in Frederick, MD.  In her 38 years as an OT, Monica has worked in a variety of settings including subacute rehab, outpatient rehabilitation, acute care, and now home health.

Occupational Therapy Awareness Amid Stay at Home Guidelines

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During Occupational Therapy Awareness Month, therapists are asking “what does Occupational Therapy look like amid coronavirus and stay at home guidelines?”

“The philosophy of Occupational Therapy focuses on improving performance in all areas of occupation to facilitate health and promote growth through change &/or adaptation.  The ultimate goal is the achievement of health, well-being and participation in life through engagement in occupation.”  (AOTA 2014).

“Occupational Therapy has a fundamental belief that a healthy lifestyle reflects the balance between work, play/leisure, self-care and rest activities.”  (Journal of OT in Mental Health, Crist et al, Sept. 25, 2008).

A return to a balance in daily occupations can be achieved with Occupational Therapy through therapeutic exercise, therapeutic activities, activity modification and adaptation,  when one is affected by undue stress, illness or injury, and by applying a similar philosophy in one’s own self care practices.

During this pandemic, how are we occupying our time?  Everyone is currently affected by a significant amount of change, which requires the ability to adapt in a positive manner to maintain our own optimal health.  This is a good time to take stock of our physical, mental, spiritual, as well as financial health.  We have had to adapt the way that we are performing our daily routines.  And by taking good care of ourselves, we are then able to engage with compassion toward others who need it…if you have 20 rolls of toilet paper and your neighbor only has 2 rolls left…kindly share!

April is Occupational Therapy Awareness Month.  Occupational Therapy problem solves to help people adapt to change.  Currently, everyone’s lives are disrupted in one way or another and all are forced to adapt to the changes.  By now, most of us have found ways to adapt and fill the increased hours spent at home, or you may be running out of ideas.  There are many resources available online to combat the anxiety, depression, boredom, and the “couch potato” syndrome that is being experienced related to the Stay at Home guidelines.

The following are some resources and strategies to help adapt and remain positively engaged while staying at home:

  • The W.H.O is having a Health at Home Challenge on Twitter, go to Twitter.com/WHO/Status#HealthyatHome.
  • Tao-Well.com – Tai chi & Qigong fit videos, focus on mindfulness, reducing stress, while promoting strength, flexibility and balance.
  • Down Dog Yoga App – health care providers can get free access to their apps through July 1st.
  • Woebot – free app to promote positive mental health.
  • NHS.uk – sofa workout, as well as many other types of exercise videos.
  • Spotify” app – has a variety of uplifting song playlists as well as podcasts.
  • ”themodernproper” on Instagram – therapeutic and creative cooking ideas. A new recipe is shared daily on Instagram

Rather than binging on TV shows, we find ourselves coming up with other activities to occupy our time.  Utilizing social media and video games, assembling puzzles, playing games, yard work, walking, biking, running, cooking, baking, arts & crafts, board games and cards have become increasingly popular, and quality time with family has become more important. Trying to maintain a sense of humor at this time, will also help to combat anxiety and depression.  YouTube videos are a great source of humor.  Even though at times it may seem like too much togetherness at home, we should cherish every minute that we have with our loved ones.

Change the way you look at things and the things you look at change.

Contributed by Erin Winters, OTR/L, PTA

Erin Winters, OTR/L, PTA

Erin is an Occupational Therapist with Tx:Team at Putnam County Hospital.  She is a graduate of the Indiana University Occupational Therapy Program.  Erin has extensive experience in the treatment of adults with a variety of diagnoses from neurological, orthopedics of the upper extremity and hand, as well as chronic or acute conditions.