Week 1: Pro Ro, Let’s Go

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New Friend #1: “How old are you? Ya look like you’re 17 years old.”
Me: “No… I’m actually 26, but I’ll take that as a compliment!”
New Friend #1: “You’re 26? Do you have children?”
Me: “No… “
New Friend #1: “Oh no! It is time! It is time!”
Me: *shakes head profusely*

The conversations I have with my residents¹ make me laugh everyday. There’s just something about working with a population where filters are for the most part…defective. I knew before OT school that I had a heart for the elderly and that I wanted to hear their stories and learn from them, but not wanting to ‘pigeon-hole’ myself, I tried other practice settings as well and have just continually found myself yearning to work with this special population.

Here I am in the last 12 weeks of my life as an occupational therapy student and what better place to spend my time in than a skilled nursing facility?! I absolutely love the place I am working at–the therapy team is wonderful, the facility is beautiful and well-kept and the residents are so gosh darn sweet.

The purpose of this final rotation is to explore an area of practice we enjoy in a more in depth fashion, or even try a practice setting that is unconventional or more specialized. I have four learning objectives for my time at my facility and they are as follows:

  1. During my 12-13 weeks at selected facility, I will learn about occupational therapy’s role in long term care (LTC) and care for individuals with dementia. I will learn about the role occupational therapy has in providing education to caregivers.
  2. Develop a sensory program using the space designed by a previous Creighton University student. Determine cognitively appropriate activities that would sufficiently stimulate various aspects of sensory system for individuals with dementia.
  3. Over the span of 6-8 weeks at selected facility, I will implement Memories in the Making (MIM) as an intervention for individuals with dementia. Memories in the Making is a painting program geared towards reminiscing with a focus on the therapeutic process and art as a form of communication as opposed to the product, learn more about it here: http://www.alz.org/co/in_my_community_art_program.asp
  4. Provide direct patient care 1st 6 weeks of rotation to learn more about specific interventions used with residents in long term care and billing.      

As mentioned above, my first six weeks on rotation will be spent providing interventions to my patients, performing evaluations, and becoming more efficient with the documentation system. So far, I have helped with a few evaluations and provided one-on-one care with patients and some co-treatments with physical therapists and physical therapist assistants. My patients are here for a variety of reasons, but some of the diagnoses include: status post (s/p) stroke, s/p congestive heart failure, cancer, COPD, general weakness, or even transitioning from being hospitalized with pneumonia and needing therapy prior to returning home. Some of my patients are here for just a little while, and some become long term residents at the home and graduate from therapy to a restorative program to maintain their strength and overall wellness.

Some patients enjoy therapy and it is somewhat of a social outlet for them or they recognize the benefits of participating. More often than not, I find myself getting creative with how I approach patients when asking if they would like to come to therapy, because asking directly would certainly guarantee a big ole, ‘n. o.’ One of the beautiful parts of OT is you can make so many things therapeutic. Need to brush your teeth? Perfect! We will work on your activity tolerance while standing at the sink and I can assess your sequencing skills and safety awareness using your walker. Need to go to the bathroom? Even better! I can assess your current ability to manage your clothes, transfer to the toilet, perform thorough toilet hygiene and proper hand hygiene afterwards. Many patients don’t see the value in pumping iron in their golden years, but when I can focus on promoting independence in performance of activities of daily living (ADLs) or functional mobility, that’s a win in my book, as well.

The last topic I will address today is the sensory room. I cannot tell you how excited I am to get a program started with it! To give a little background, sensory rooms a.k.a. Snoezlen rooms or Multi Sensory Environment (MSE) rooms have been utilized to promote relaxing or stimulating/activating experiences to promote quality of life for individuals with dementia and adults with intellectual disabilities. Through the use of lights and images, scents, sounds, textures, tastes, different movements, etc individuals’ senses can be stimulated or relaxed. The amount of stimulation one needs is based on if they are a sensory seeker or avoider. This can be assessed through observation and formal assessments like the Pool Activity Level Instrument for Occupational Profiling (PAL). I will be using both in developing individualized programs for my patients. Use of sensory rooms have been shown to decrease agitation and wandering, increase communication, and even help to maintain the ability to complete daily activities helping individuals to stay as independent as possible. With proper education for caregivers in their use of sensory rooms with people with dementia, the benefits are numerous! My site has invested a lot of time and money into creating the beautiful sensory room we have and I feel so blessed to be a part of getting this program going in the facility 🙂

I am so excited for my adventures with my new friends and to share my experiences with you with my weekly blog! I would love to answer any questions you may have about the work I am doing, so please don’t be shy if you would like to learn more.

Until next week

Amanda

¹ I will use resident and patient interchangeably throughout my blog–these are one in the same as to not confuse. 🙂

Sources:

Jakob A., Collier L. (2015). How to make a sensory room for people living with dementia. Unpublished manuscript, Kingston University, England.

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