Occupational Therapy’s Role in Reaching Independence

Additional Info

• Audio File:uab/ua195.mp3
• Doctors:Griffin, Bailey;Hodges, Alex
• Featured Speaker:Bailey Griffin | Alex Hodges
• CME Series:Clinical Skill
• Post Test URL:https://cmecourses.som.uab.edu/mod/quiz/view.php?id=4665
• Guest Bio:Bailey Griffin is an Occupational Therapist. 
  
  Alex Hodges is an Occupational Therapist. 
  
  Release Date: March 25, 2021
  Expiration Date: March 25, 2024
  
  Disclosure Information:
  
  Planners:
  Ronan O’Beirne, EdD, MBA
  Director, UAB Continuing Medical Education
  
  Katelyn Hiden
  Physician Marketing Manager, UAB Health System
  
  The planners have no relevant financial relationships with ineligible companies to disclose.
  
  Speakers:
  Bailey Griffin, OTR/L
  Occupational Therapist, Rehabilitation Services
  
  Alexandra E. Hodges, OTR/L
  Occupational Therapist, Rehabilitation Services
  
  Bailey Griffin and Alexandra Hodges have no relevant financial relationships with ineligible companies to disclose.
  
  There is no commercial support for this activity.
• Transcription:Melanie:  Welcome to UAB Med Cast. I'm Melanie Cole, and I invite you to listen as we examine occupational therapy's role in reaching independence. Joining me today is Bailey Griffin and Alex Hodges. They're both occupational therapists with UAB Medicine. Ladies, thank you so much for joining us today.
  
  So Bailey, I'd like to start with you. Tell us about the field of occupational therapy. What's exciting in your field right now that other providers would want to hear about?
  
  Bailey Griffin: So in occupational therapy, we focus on helping people across the lifespan to do the things that they do throughout their day. So we call those things occupations, which is why we get our name. We focus on adapting the environment and helping them gain the skills to do things like dressing, feeding themselves, getting in the shower, brushing their teeth, simple things like that, even up to helping them with higher-level skills like cooking, cleaning, doing laundry. So we look at the person as a whole and try to figure out what they need to work on in order to be able to do those things as independently as possible.
  
  Melanie: And really, Bailey, your field has shifted a bit over the years. Can you tell me how you feel it has shifted? When you mentioned occupations, it's really not only that anymore, right? So it's kind of shifted and working hand in hand with physical therapists and all kinds of specialties. Correct?
  
  Bailey Griffin: Yes. So when OT first became a thing, they worked a lot on knitting and crafts and that kind of stuff. And now, especially in the setting that Alex and I work on, we work very closely with physical therapy, with the physicians because we're in the inpatient rehab setting. So we really work more on the strengthening, their cognition, balance coordination, vision, all of the more medical side of things to allow them to do those things. Anything from, like I said before, dressing to cooking, to cleaning. So it really is a large span, which I think is one of the greatest things about occupational therapy as we hit on such a wide variety of skills.
  
  Alex Hodges: I agree. And you know, we work with a lot of people. We really have physical therapy and OT teams, so we can talk every day and see what the patient really needs to work on. We collaborate with also like speech language pathologists, the physicians and nursing, the case management, neuro-psych. We look at all different areas of the patient to see what they kind of need the most from all of us.
  
  Melanie: Well, that's certainly true. And it's an exciting time to be in your field. So, Alex, what does OT look like in the inpatient setting? You guys just touched on it briefly, but tell us a little bit about it. And what diagnosis do you work with at Spain Rehab? Tell us about your team and really what this looks like when you're working with inpatients.
  
  Alex Hodges: So in inpatient rehab, each patient gets at least three hours of therapy a day. That's an hour and a half of occupational therapy and an hour and a half of physical therapy. And they may also get speech if they need it. We work on skills, like Bailey said physical and cognitive, dressing, toileting, bathing, showering, things that they might want to do at home. But we also work on, you know, strength, balance, cognition, neuromuscular reeducation, anything like that.
  
  But the one great thing about working in inpatient rehab is that we can do things like cooking because we have a kitchen in our rehab gym, and we can also go on patient outings too, so they can kind of get out in the community and practice doing things outside of rehab.
  
  Bailey Griffin: I'll elaborate on the types of patients that we work with. So at Spain Rehab, we have four medical teams. We have one doctor that specializes in traumatic brain injury, one that specializes in spinal cord injury, and one that specializes in stroke. We also have a fourth doctor that does all the general medical conditions, general debility, car accident patients.
  
  And each therapist is tied to one of those teams. So I'm a primary therapist on the spinal cord injury team. So I primarily work with patients who have had spinal cord injury, working on adapting tasks and kind of meeting them where they're at to make them be able to be more independent with their daily activities. So we all kind of focus on our one diagnosis, that way we become more confident and specialize in working with that particular patient population.
  
  Alex Hodges: Yes. And right now, I'm actually on the traumatic brain injury team. And depending on the severity of the brain injury, we might work on just simple things like alertness, attention, behavior, memory, motor function, or we could do higher level things like paying bills, medication management and cooking activities.
  
  Melanie: How cool. And it really speaks to the innovation and the way you have had to be creative with your patients, right? So tell us a little bit first how COVID has affected what you do. And I'd like you to start, Alex, in just how has the pandemic kind of interrupted what you do. Have you been able to use telehealth with families? Have they not been able to be with you with the patient? Tell us how COVID has impacted occupational therapy at UAB Medicine.
  
  Alex Hodges: Well, I think when COVID first started, we all had to do therapy in the patients' rooms. We couldn't use our gyms anymore. The patients were allowed one time caregiver with them, so that way, they could be hands-on to help the patient when they get home. But now, lately, we've been able to go back in our gyms and we just have to social distance. And I think they just passed that two caregivers are allowed to come and be with a patient at one time. So it's definitely been different and, you know, doing therapy in a small patient room has made us have to become more creative, but it's getting better.
  
  Bailey Griffin: And we don't get any COVID-positive patients, but we've actually seen a lot of the after-effects of patients who have had COVID. So they come to us after they're finally medically stable and able to get physically stronger to go home. And it's really been eye-opening to see how COVID has affected people so bad.
  
  You know, people are very weak. Many of our patients have been in the hospital for two, three, up to six months fighting COVID. And these patients are just so grateful to be alive. Their families are so grateful that they're alive. And it's been really cool to see how much progress they can make from where they started and eventually get to go home. It's been rewarding despite how horrible COVID has been.
  
  Melanie: Well, I love that positive attitude. So tell us how you prepare patients' families and the patients themselves to be discharged home from inpatient. How do you work with the families so that they can be prepared to do what they need to do at home?
  
  Bailey Griffin: So the end goal for all patients that come to inpatient rehab is to go home safely. One of the biggest things that we work on is training their family members to be able to help them and to feel comfortable and safe when they get home. So we do a ton of hands-on training, especially right before the patient discharges.
  
  We have the family members help them with everything, help get them dressed, help them get out of bed, help with, you know, anything that they might have to do once they get home and make sure that they feel really comfortable with that. We also help with getting them the right equipment, shower equipment, dressing equipment. We work with PT to get them the correct wheelchairs, trying to address anything that they may need once they get home.
  
  One of the big things that we love to do that Alex touched on earlier is take our patients on outings, which we haven't been able to do as much of since COVID, but it's really important to try to get the patients out into the community. Here at the hospital, they're kind of in a safe place. You know, everything's accessible, but going out into the community, to restaurants, the grocery store, to a movie theater or something like that will really allow us to help the patients in a more natural environment and figure out what they need and how they can still do the things that they enjoy doing.
  
  Alex Hodges: Yes. And like Bailey said too, we can also prepare them by kind putting them in touch with other patients that are going through the same thing. So we've had a lot of patients that will call some peer mentors and talk to them and they just give them pointers about, you know, car transfers or the kind of car that they got or what kind of adaptive sports that they're involved in, just many different things, so they can feel comfortable talking to someone that's already gone through this.
  
  Melanie: Bailey, what misconceptions do people often have about occupational therapy?
  
  Bailey Griffin: Once I became an OT, I realized how many people do not know what occupational therapy is, even people in the medical profession. Somehow it's just kind of overlooked and blended in with a bunch of different things. So a lot of our patients will go in and they'll say, "Say, Oh, I already have a job. I don't need occupational therapy." And we're like, "Well, that's not exactly what we do, you know. The long goal would be for you to get back to work, but we're really here to help you do just your simple daily activities."
  
  The other misconception is that OT only works on the upper body and PT works on the lower body, which it's a lot more to it than that. We're thought that we only work in the hospital setting or only work with arts and crafts. You know, there's a ton of different things that people think we do. So we spend a lot of our time educating patients and families and even other medical professions of why we do what we do and why our job is important and how we can help them get back to their full independence.
  
  Melanie: It's definitely interesting. And I know as an exercise physiologist, people don't always understand the field anyway, and everybody knows what a physical therapist is, but not so much OT. And so thank you for that. I want you each to have a last chance for a final thought. So, Alex, why don't you start? Tell other providers referring physicians in the community and beyond what you would like them to know about occupational therapy's role in reaching independence for inpatient at UAB Medicine and why you feel they should refer.
  
  Alex Hodges: Well, I think they should refer because it helps us really to be able to practice the day-to-day activities that they use in everyday life. So they're more comfortable before they're going home, their caregivers are more comfortable with helping them before they go home. And I just think, especially having three hours of day of therapy just gives them so much more than just going maybe straight home and then going to outpatient or home health. They just really get intensive therapy from us.
  
  Melanie: And Bailey. Last word to you. What do you enjoy most about being an occupational therapist? And if you were speaking to medical students, specifically students, what would you like them to know about the rewards and the rewarding feeling that you get being an occupational therapist?
  
  Bailey Griffin: So my favorite thing about being an occupational therapist, especially in inpatient rehab setting, is the relationships that we form with our patients. We see our patients for an hour and a half a day from anywhere for two weeks up to two months. So we see them through the hardest point in their life, all the way to where they're finally getting to go home and are becoming more independent. And the relationships that we form with our patients is really incredible. I mean, we just truly get to learn about these people and their families and get to know them. And it's so rewarding to see them make progress and to finally get to go home and have more confidence in themselves. So it's just very rewarding and we work with a lot of great people and a lot of great patients. So it's a great job.
  
  Melanie: Thank you both so much for joining us today and telling us about occupational therapy, because as you said, not everybody knows what you do. So thank you again.
  
  A community physician can refer a patient to UAB Medicine by calling the MIST line at 1-800-UAB-MIST.
  
  That concludes this episode of UAB Med Cast. For more information on resources available at UAB Medicine, you can always visit our website at UABMedicine.org/physician. Please remember to download, subscribe, rate, and review this podcast and all the other UAB Medicine podcasts. I'm Melanie Cole.
  
  
• Hosts:Melanie Cole, MS