Occupational Therapy Team Members Share Some of Their Most Memorable Cases
April is National Occupational Therapy Month—a time when we recognize the essential work that VNS Health occupational therapists (OTs) and Certified Occupational Therapy Assistants (COTAs) do in addressing the practical functions involved with activities of daily living. Whether it’s training a stroke patient how to get dressed on their own again or teaching a knee-replacement client how to shower safely, their mission is to help patients regain the independence they need in order to live safely and comfortably in their homes and communities.
To get an inside look at the miracles—big and small—they perform every day, we asked a few VNS Health occupational therapy team members to share a time when they made a difference in their patients’ lives—and vice versa.
“Every time I see her, she’s made some improvement.”
—Anne Chen, Occupational Therapist, Manhattan
“It’s very fulfilling when a patient progresses and you see some return in function. I have a client who had a stroke that affected her left side. Because she’s left-handed, she lost the ability to write. We’re still working on it, but she’s always excited to show me her progress. The other day, she was just starting to write her name again. It’s not legible yet, but you could begin to make out the letters. It was a huge milestone for her, and it was wonderful to see how excited she was about it. Every time I see her, she’s made some improvement. That’s what makes my work so rewarding.
“A lot of what I do involves working with the patient’s family as well. If a person has a stroke or is otherwise incapacitated, everyone around them is affected. It can be very frustrating for them, and they often feel helpless. It changes the family dynamic. I help them get acclimated to their family member’s new level of functioning and figure out ways for them to be involved in the recovery process, which in turn helps them feel less helpless. In my work, one of the privileges is seeing the love that families really have for each other.”
“We’re the MacGyvers of rehab—we have to get creative.”
Kelly Guich Occupational Therapist, Westchester
“I always tell people that, as OTs, we’re kind of the MacGyvers of rehab—we have to get creative. I recently had a patient in her 50s who was recovering from cancer. Because of the placement of the skin grafts on her legs, she had a very difficult time using the toilet. It was painful to sit down the usual way, so she had to kind of squat, which was also a challenge because of weakness in her legs. Understandably, she didn’t relish having to ask her husband or children for assistance.
“My background is in oncology—I worked at Memorial Sloan Kettering for 13 years—so I’m familiar with these types of issues. In this case, we got her a commode and adjusted the height properly for her, and then we placed a scored cushion on the top. The cushion made of an egg-crate type material that I manipulated to alleviate the pressure on the area where the skin grafts were, so she was able to use the toilet comfortably for the rest of her recovery. I wanted to highlight this case because using the toilet is something that we all take for granted. Most of us can’t even imagine something that routine might someday become a challenge for us, but when it does, it changes our world a little bit.”
“I see myself as a stepping-stone to the next level.”
Julia Sonya Hewitt, Certified Occupational Therapy Assistant, Queens
“I have a patient in his late 40s who had a stroke. He did a short stint in a rehab facility but didn’t regain much functionality there. When he got home, he wasn’t able to dress himself. He had never been through anything like that before, and now he was relying on his wife for everything. It was a real wakeup call for him, and completely changed his whole perspective on life. As the breadwinner, he is eager to get back to his job at the airport. He also has a six-year-old son—the same age as mine!—which is also pushing him now.
“At the beginning, we worked on strengthening his arm, which was most affected by the stroke. We focused on improving his range of motion and repeating ADLs [activities of daily living]. I also designed a home exercise program that he’s been very diligent about. He’s extremely motivated and really follows through, which makes my job much easier. He’s made terrific progress in a matter of weeks, relearning to dress himself and steadily regaining movement in his hand. He’s so grateful and thankful, and he often has cookies and pastries waiting for me when I arrive—but he’s responsible for much of his progress. He still has a way to go, but I’m confident that he’ll get there. I see myself as a stepping stone to the next level, getting him to the point where he’s ready for outpatient treatment at a facility where he’ll get more intensive therapy on machines.”
“He’s so proud—and he should be!”
Stacey Mislavsky, Occupational Therapist, Nassau
“I’ve been an OT at VNS Health for a little over a decade, and I’ve definitely noticed a trend in the last few months of younger people—meaning people in their 50s and 60s—who really need support to return to work. As an OT, my typical patient had always been quite a bit older and more infirm, and my goal was just to make them safe in their home environment. The pandemic really changed that dynamic. Now, many of my patients have long COVID, which can make recovery much harder—even for things like minor surgery. For many of my recent patients, it’s about getting them beyond their front door and back into their work environment. And that takes a lot of thinking outside the box!
“Not long ago, I had a patient in his early 50s who was an operating room nurse, a job that requires you to be on your feet all day. He’d had COVID and had been hospitalized. When he came home, he had a difficult time even standing. He was so fatigued that when he was done showering, he often had to rest for the remainder of the day. He was his household’s breadwinner and now he had to rely on his family for everything, and he felt like a burden. I worked with him for six weeks, teaching compensatory strategies: Instead of lifting a pot of water, slide it across the table; instead of plopping into a chair, shift your weight to take the pressure off. I also taught him ways to efficiently conserve his energy—instead of waiting for that pot to boil, set a timer and use that time to rest. And I gave him a challenging exercise routine. As he got stronger, we moved on to simulating work situations. He’s made terrific progress in a matter of weeks, and is no longer reliant on other people. He’s so proud—and he should be!”
“As he progressed, the change in his attitude was amazing; he was so excited.”
Mary Amatya, Occupational Therapist, Manhattan
“I once had a patient going on 100 years, who was recovering from a stroke. He was using a walker, but the stroke had affected his mobility to do daily tasks that he used to enjoy. He seemed depressed—he would just sit in his chair and didn’t want to involve himself in any activities. I asked his home attendant what he enjoyed doing on a daily basis, and she told me that he used to go to the kitchen to make coffee. Now, though, he was afraid to stand. He was worried about falling, and also about being able to hold the cup or stir with a spoon. He was from the Dominican Republic and made his coffee the traditional way, with condensed milk. So that became our goal, and my mission!
“We worked on standing endurance and dynamic balance, gradually building to the point where he could walk to the kitchen and stand without support for five minutes. A lot of what I do involves teaching new ways or modified ways to approach tasks. I would tell my patient to think of his hip bones as headlights, and to point those headlights in whichever direction he was heading and then approach his destination straight on. Strange as it might sound, that really helped his stability, steadiness and confidence. As he progressed, the change in his attitude was amazing; he was so excited. The first thing he’d say in the morning when I got there was, ‘poquito café?’ He was making us coffee! And I’d laugh and say yes, but not yet—we have to get through our activities first. Through my teaching him the compensatory skills he needed, he was able to get back to an activity he loved—drinking cafe con leche!”