When Sandie Gorecki starts helping patients, she uses common sense and focuses on what’s practical for each person.
“A lot of our patients, they tell me they hate the exercises we give them, so what we do is try to make their exercises and movements creative and functionally based. This way it’s practical for them and we can have some compliance. I think sometimes we try to force people into things, but I think what ultimately happens is that we’re wasting our time. That’s what I try to avoid. I try to find things that bring passion for them. When I find things that mean something, then the patients are much more motivated,” Gorecki said.
Gorecki is an occupational therapist (OT) at Exempla Lutheran Medical Center in the Denver area. OTs fill an important role for many people recovering from a stroke, or dealing with complications brought about by conditions like Parkinson’s disease or multiple sclerosis. People with these conditions may have arm weakness and have to learn how to dress themselves or cook with only one hand. An OT helps people adapt to doing these activities a different way with new techniques. Often just putting on shoes or socks can be an exhausting chore. To keep her patients encouraged, Gorecki listens to them and finds out what they like to do. Then she creates her therapy plan around those answers.
“I had a patient who had all these pictures of her past and her grandchildren and I was able to work with her and her family to do scrapbooking. Another patient really loved doing artwork so I got her a set of pastels. I figure out what’s important to them. If it’s sitting up in a chair and reading a book, we work on that. We don’t waste energy on things that aren’t important for them,” Gorecki said.
“I think most OTs are really great problem solvers. They think outside of the box,” said Wendy Moline, Director of Physical Medicine and Rehabilitation at Lutheran. “An OT can come into someone’s house and problem solve and teach them how to maximize their environment and do the most they can for themselves.”
The goal of all this therapy is to help a patient become as independent as possible. This is why professional caregivers work closely with OTs while providing elder home care services. The idea is to create a safe environment for each person where they feel comfortable instead of helpless. When a person realizes they do not have to depend on another person for everything, that with some modification they can do it themselves, it is very rewarding. This also avoids frustration on both ends. When both the client and caregiver know what the goal is for each activity, it keeps the relationship about support, not dependency.
“I try to be the person that says, ‘The caregivers will help you, but in order to stay at your high-functioning level, here’s what you need to do.’ I tell that to the caregiver too,” Gorecki said. “I’m very honest with patients. I don’t play games, I don’t sugarcoat it, because then they trust me. And whatever I tell them, I tell the family.”
This honesty is often a comfort to those dealing with a new challenge, such as a disability brought about by a stroke or Parkinson’s. Many patients who start working with an OT are afraid of the unknown. When therapy begins, they don’t know just how much they will be able to do. The honesty of an OT prepares them for what to expect, and then if – and when – they exceed those expectations, it’s a larger encouragement.
Much of what an OT does is about taking each step during the day and making it simpler. They focus on energy conservation and pacing techniques. A person with a new disability cannot do daily activities automatically like they did before. OTs help them understand how and when to slow down and take breaks. If a patient overextends themselves, they can become tired and raise their risk of falling and incurring a serious injury. An OT helps each patient learn a greater sense of awareness and check in on how their own body is doing.
“A lot of our patients have a lot of anxiety. I help them by walking them through deep breathing techniques – in through the nose and out through the mouth. I have them picture their favorite flower and blowing out their favorite smelling candle. That helps ground them in the moment. It calms them down and gives them more energy,” Gorecki said.
It all comes back to doing what’s practical and what’s most important for each patient. Instead of focusing on lifting a 20-pound weight, the focus can be getting them to a point where they can pick up their dog again. Instead of bending down to put on slippers, it can be bending down to put food in a cat’s dish.
“Their goal is going to be to try and help a person be as independent as possible. Doing a task might look different than it looked before, but just because it looks different, it doesn’t mean there’s not a way to get the job done,” Moline said.
“When I can walk in a room and I can offer something and I know it’s going to make an impact to change something, to make a patient more empowered, more independent, and happier – I love that. That’s what makes me feel alive,” Gorecki said