Category: Therapy

Connecting to Other Disciplines

Blog provided by Krista Covell-Pierson, Owner of Covell Care & Rehabilitation, LLC.

If you start a private practice, or a business in general, it’s time to start thinking about your community. You will develop marketing plans and networking opportunities but I recommend you also become an expert knowing who does what in your community. You need to make referrals with confidence for your clients and developing strong community relationships is key to client, and business, success. I meet too many healthcare workers that do not make enough referrals for their clients and have little awareness of additional services and experts in their area that could improve their clients’ lives. This seems like a big injustice to those we serve. All of us need to get our boots on the ground to meet fellow community members. People worry more about people stealing their referrals than they do about collaboration and service. 

A great way to develop relationships is remembering that you are still a student. This will never end, even if you hit the 30 year mark as a therapist. Start asking questions and get curious. Pick up local publications and visit places your clients visit. It is easy to focus on what you need for your professional licenses and meeting your annual CEU requirements. Remember that this is just the bare minimum recommended for people to maintain competence in their skill set. As business owners and leaders, we should look to grow our minds beyond the bare minimum, shouldn’t we? I encourage you to reach past your own discipline and learn about topics regardless of the CEU benefits. Dive into the big world of learning. You won’t regret it. 

Here are two examples of how I embrace learning outside of my world of OT in the home. 

  1. I primarily work with older adults and knowing that so many people fear aging I decided to go to an anti-aging seminar in Las Vegas. I was blown away. So many things on the market that I had never heard of, doctors helping clients stay young in every way and a line that looked a mile long for people to get a “free” treatment for hair loss. Things I learned at that conference did not directly impact my day-to-day therapy provisions. But, they expanded my awareness about the aging process and I gained an increased empathy for the overall experience of growing older. I am better for it. 
  2. I sign up for various companies’ emails and watch for educational opportunities. For example, our payroll company does 20 minute tutorials online about an array of topics from how to organize your HR files and what to do at the end of the year with your payroll reports. I try to hop on their webinars as often as I can. I usually sign off with a new little golden nugget of knowledge that helps me run my business with more confidence. It also helps me get to know who works in our payroll’s office and when they pick up the phone I can initiate a conversation with them about the great job they did and what I learned. 

More than likely you live in (or near) an area that is full of ways to plug in educationally. If you look at community center calendars, your local Small Business Development Center or subscribe to a listserv for your city’s events you will likely see plenty that peaks your interest! Often times events are low cost or even free. The point is to get out there and connect. 

On top of getting out in the community, I encourage business owners or managers to consider starting their own education focused group to bring the community to them. I know as a practitioner how hard it is to stay on top of a caseload of clients as well as stay up on all the services in the community. Transitioning from a setting where I saw other practitioners everyday at the SNF to a lonely road warrior doing home visits, I knew my exposure to others’ talents was few and far between. I wanted to continue learning from people in my community so I started bringing folks in to present to my team of contractors and staff. We only brought people in for education and didn’t look at it as an opportunity for people to come in just to plug their business. We wanted to grow as practitioners and as people that could provide quality resources to our clients. 

As time went on, I decided we could serve our community in a bigger way by opening the group up to anyone wanting to learn and expand their awareness of services available in our own backyards. So, four years ago, “Clinicians and Comrades” was born. We meet every month for one hour. Our speakers volunteer their time and we request that none of them use it as a platform for direct referral recruitment. This is simply a place to geek out on what they’re really good at like low vision strategies, diabetes management, making homes accessible, hospice care, mental health assessments and other important topics. 

If you want to start your own group here are some suggestions: 

  1. Find a location that will allow you to use their space on a regular basis free of charge. Senior housing facilities like the foot traffic and exposure and may be happy to host your group. Or, churches and rec centers may offer space for free. 
  2. Set a routine time and stick to it. 
  3. Start an email list of people to invite. Build on the list every month by using a sign-in sheet for attendees. Send a reminder a day or two before the meeting. 
  4. Name your group. 
  5. Ask people to present in advance. We typically have our entire calendar for the year built out before the end of February. 
  6. Send thank you notes to presenters. They are giving their time away for free so definitely show your gratitude. 
  7. Request speakers stick to the clinical information and don’t launch into a sales pitch. 
  8. End on time. 
  9. Take pictures with permission and share!   
  10. Send certifications of attendance to your audience members.

The sky’s the limit with all you can learn and apply to your practice. Do your best to stay fresh and up to date on industry and community trends and changes. Our clients and patients need us to stay committed to being the most well-rounded and capable clinicians we can be. Plus, staying connected and energized helps prevent burn-out and compassion fatigue. 

If you started a community group of any kind, I would love to hear about it! Send me an email about it to krista@covellcare.com.

Incorporating Mental Recommendations in Your Professional Practice

Blog written by Madeline Gardner, Occupational Therapist, specializing in mental health.

Mental health affects all clients, and regardless of your discipline, it can impact the therapeutic process. Mental health is not simply a lack of mental illness, so it’s important to consider if your clients are mentally flourishing.

Truly listen to your clients. You may be able to provide recommendations that are within your scope of practice, or a referral may be necessary.

  • What are they saying that may be indicative of their mental well-being?
  • Do they speak of feeling lonely or isolated?
  • Lacking motivation?
  • Anxious about managing their health condition?
  • Are they having difficulty adjusting to life with a disability?

Some examples to address mental wellness include:

  1. Incorporating stress management or relaxation techniques
  2. Mindfulness practice
  3. Gratitude journaling
  4. Learning healthy coping mechanisms
  5. Or just providing a listening ear

If mental health seems to be a significant barrier or if you suspect an undiagnosed mental illness, a referral to a mental health professional (counselor/LCSW) or PCP is necessary. Also consider a referral to occupational therapy, as OTs can be a great resource to address daily routines, health promotion strategies, and activity modification to improve participation and enhance quality of life. 

*If you have concerns about the safety of your client, get help immediately. National Suicide Prevention Lifeline phone number: 1-800-273-8255

Find helpful resources at https://suicidepreventionlifeline.org/help-someone-else/ about how and when to help others who may be going through a crisis.

5 Tips for Finding the Right Mental Health Therapist for Seniors

Thank you to guest blogger, Holly Clark, Freelance Health Writer.

Mental health is essential. No matter what age you may be, staying mentally healthy is extremely important, not just for your mood or happiness, but for the health of your body as well. Poor mental health may cause poor overall health, which is never a good thing. It’s not shameful to need help sometimes, and seeing a therapist is the best way to get the help you need. However, seeing a therapist as a senior may seem a bit daunting. This is especially true when it comes to finding one. Fret not, because it is possible to find the right therapist for you. Some tips to find the right therapist as a senior are:

Ask Your Doctor

If you’re comfortable asking your doctor, they’re the best place to begin. Your doctor may be able to refer you to a therapist that matches you. Many people will ask their doctors for a referral, so it’s not something that they’re unfamiliar with. Explain to your doctor some of your issues, and then ask if they have any recommendations, you just may be surprised at how helpful asking your doctor may be.

Use Internet Resources

The internet is a powerful tool, and it comes with a lot of sources for help. Do a few internet searches for therapists in your area, there are many online resources that list therapists and their locations, as well as specialties. Doing some shopping around also allows you to look at all of your options before choosing which therapist you’d like to try first. Remember, you may not like the first or even the second therapist you see. It’s okay to end the relationship and move on to another choice. Sometimes you’ll need to try a few different therapists before finding the one you feel most comfortable with.

Look For Your Insurance

It’s important to remember to look for a therapist that accepts your insurance. To do this, you can look through directories online, or even call your insurance company for a list of therapists in your area. Some will even let you filter your results by age and gender, allowing you to specify what sort of person you’d feel more comfortable seeing. If you have Medicare, this insurance does cover therapy, as well as many other insurance companies do.

Ask Around

It’s not shameful or even odd to ask your friends and family if they have any recommendations. You may be surprised at how many people you know that have a therapist. Asking those you trust and like most allows you to get recommendations that match your personality better, it may also ease some tension and fear when trying to choose someone who works best for you.

Consider Teletherapy

If you can’t drive, or you don’t have dependable transportation, it may be worthwhile to consider a form of teletherapy until you could figure something else out. Services such as TalkSpace cost, but they may ease one into the process of therapy, and they also provide an option for those who are unable to travel to a local therapist’s office. However, you may be able to have your insurance company transport you to your appointments at no extra cost, so it is definitely worth calling and inquiring about those services.

Jane Byrne, project coordinator at a nursing home in Kildare, notes that, “Seeing a therapist may seem scary, especially as a senior citizen, however, it’s not as terrible as you’d believe. Many people see a therapist and are much better off for it. Remember that it’s okay to need to talk about your problems, and doing so is a great way to become happier and healthier.”

Low Vision and Children

Guest Blogger, Melody Bettenhausen, Development Director with Ensight Skills Center.

Visual cues are central to most early childhood education systems. Consider the number of school lessons that revolve around students writing on the whiteboard or reading off of photocopied handouts or even tiny text in books! Every subject, from math to spelling and even geography, requires reading and writing.

That’s why whether visual impairments are moderate, severe or profound, they often interrupt a low vision student’s ability to participate in regular classroom activities.

What is low vision? Children and adults with low vision are not considered legally blind, they simply have reduced vision at or lower than 20/70. Students who are blind have vision that is at or lower than 20/200. Nonetheless, only 15% of students with visual impairments are considered to be completely blind, with no light or form perception ability. That means even legally blind children may have some useful vision.

Low vision in the classroom
In a school environment, visual impairments can cause difficulties when it comes to traditional reading and writing activities, reading at a distance, distinguishing colors, recognizing shapes and participating in physical education games which require acute vision, such as softball and kickball.

Children with visual impairments often start off learning to read and write with the assistance of low-tech solutions, such as high-intensity lamps and book stands. Sometimes screen magnification and computer typing and reading programs are used. In other cases, low vision students will learn to read using the Braille system over text, or a combination of the two.

Typically, children work within the school district using teachers for the Visually Impaired (TVI) who introduce tools and skills that will benefit them in the school environment. Outside of the schools, these students work with a low vision rehabilitation team to access tools and skills that will benefit them in their home and work environment.

There are many modifications and assistive technologies that can allow children who are visually impaired to thrive in their education and personal endeavors. If you have any questions about programs or resources, please contact the Ensight Skills Center at 970-407-9999 or email at info@ensightskills.org.

Why Should All Healthcare Providers Ask About Low Vision?

Blog post written by Krista Covell-Pierson, OTR/L, BCB-PMD & Owner of Covell Care & Rehabilitation, LLC.

As an occupational therapist, my job is to look at how functional things are for people. I don’t care so much if your shoulder lacks 24 degrees of range of motion as I do if you can wash your hair, reach into your cupboards and do your daily routine without hardship. I might measure your range of motion so I can track objective changes in your arm but I am primarily concerned with your quality of life. 

Because I focus on function, function, function I am often frustrated when healthcare providers of many different disciplines don’t take people’s vision into consideration for their interventions. Every single one of us from pharmacists, doctors, counselors, activity coordinators, etc need to understand different eye diseases and how they impact people we work with. An ophthalmologist or optometrist are not the only people that should ask about our eyes.  

For example, I worked with a client that told me she had seen a physical therapist months prior and was given a hand out of exercises. I said, “Perfect, let’s review those exercises.” The client referred me to her fridge where the sheet was hung up so she wouldn’t lose it. I handed her the paper asking her to show me some of the exercises. She responded, “Well, I haven’t done them in a while and I’ve forgotten a lot of them. And… I can’t see what’s on here. The pictures are too little and the writing is way too small.” 

Such a simple solution might have improved this client’s ability to maintain, or return to, her exercise program. If only the PT had enlarged the print and pictures and ensured the client could read the paper!

During my years working in a rehabilitation center I met countless residents and short-term patients with low vision and eye disease. Many times I would hear a nurse would report that a patient refused to go to meals and was isolating themselves in their room. I would often look into this with clients from an OT perspective. One particular client said, “I am so embarrassed by how I spill in the dining room. I knock things over, I can’t pour my water from the pitcher on the table and I don’t even know what I am eating until I take a bite. I can’t even tell who is sitting at the table with me because I can’t see their faces and I feel awful asking people when I should know who they are. I don’t want to ask for help because the staff is so busy already. I would rather just eat alone.” Simple modifications like contrasting plates with her place-mat and food, strategies to help her accurately pour water and see people with the remaining peripheral vision she had solved this issue. 

I could go on and on with examples of how vision impairments get overlooked and need to be a regular part of healthcare professionals’ assessments. When was the last time your doctor asked you about your eyesight? 

If a healthcare provider finds that a client struggles with vision, or lives with eye disease, not only should the client be referred to an ophthalmologist but also to an OT for an evaluation. At our practice, we provide mobile, outpatient services and can see clients in their homes rather than making them come to our office for an assessment. This is huge when it comes to low vision training! If a provider can’t find a mobile provider (and they are hard to find), a referral to a traditional outpatient clinic may suffice. Some eye doctors have OT’s on their staff which is always refreshing and supportive to comprehensive care for patients. 

For the best outcomes, therapists and patients should work together beyond the evaluation and focus on the recommendations. Leaving clients to figure out devices or integrate new ideas into routines greatly reduces the likelihood of positive carry-over. Using magnifiers, learning how to use their preferred retinal locus (PRL), problem-solving with new strategies requires SUPPORT. If you are a patient and feel like you aren’t doing well with recommendations, go back to your therapist or find a new one that will take the time to help you master your new skills. 

In order to get folks thinking about things that can help with low vision I put together a simple list of things I have used many times with clients. This is just the tip of the iceberg!

  1. Lighting: Try different light bulbs–both style and wattage. Different light affects the eyes differently. I keep a box of various light bulbs in my low vision kit. Remember that what works in the kitchen may not work in the bathroom. (And it’s ok to keep the lights on during the day if it’s helpful!) 
  2. Contrast: An onion on a white cutting board is difficult to see for someone with low vision. Buy a cutting board with a dark color on one side and a light color on the other. Cutting the onion? Use the dark contrasting color! Cutting open an avocado? Use the white side! 
  3. Establish tactile cues to help with matching clothes: For example, take tiny safety pins and pin one on the tag of all the black shirts, pants and skirts. Then take two tiny safety pins and put them on everything that is navy blue. Work together with someone to set up the system that works and then be confident that you are wearing the colors you want to! If you know you like to wear certain outfit combinations put them together on a hanger so you aren’t searching or wondering if you have the right clothing items.  
  4. Reduce strain and stress by converting to large print calendars, playing cards, books and magazines. 
  5. Buy a talking watch or clock. 
  6. Reduce glare. Bright lights can reflect off of granite counter tops or shiny floors and cause distorted or irritated vision. Older adults can tolerate 2.5 times less glare than a young adult. 
  7. Use a 20/20 pen to write in large, black ink that is less likely to leak through your paper than a Sharpie. 
  8. Integrate a large print and/or high contrast keyboard to the computer. 
  9. Use a goose-neck lamp with built-in magnifier and spotlight in order to read, see medications, and keep up with hobbies. 
  10. Paint or put high-contrast tape on the edge of steps in and out of the garage to help with depth perception.
  11. Sign up for you state’s Talking Book Library. In Colorado, people receive an electronic device and books on tape to play. It makes it really easy to navigate the buttons on the device and hear what you enjoy. Plus, it’s all free!  
  12. Add high contrast to light switches to make them easier to locate. 
  13. Keep things in the same place so people with low vision know where they are. Don’t move furniture around! 
  14. Check out different scanners that can read labels, price tags, medication bottles and differentiate between denominations of dollar bills.

Share your low-vision tips, equipment, ideas with me! We will take all of the tips and share them together before the end of the month! You can message me at krista@covellcare.com