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StandUp for Kids – Denver Chapter – Some of the members of the Sloan’s Lake Rehab therapy team hosted a Sunday meal for about 40 homeless teens last weekend. Organized by Meghan Ricketson, PTA. What a great team building and humbling experience it was for everyone!

Julia Temple supports breast cancer awareness!

October is breast cancer awareness month… Show us your PINK!

Spring is in the air, and many SLP graduate students are breathing a sigh of relief as they finish their theses, pass their oral exams and start to look for their CFY positions.

What is a CFY? Clinical fellowship year is the full meaning. It is a residency of sorts. The CFY/SLP is hired and employed but still requires supervision by a more experienced (and licensed) SLP. There are important rules regarding the hiring of CFYs that come from the American Speech-Language-Hearing Association (ASHA). In addition, there is often a separate set of rules for your own state licensure. In California, for example, a newly hired CFY might have to wait up to two months to process paperwork and be able to start treating patients. As a Director of Rehab, if hiring an SLP is on your to-do list this summer, here is some basic information to help you decide if a CFY is right for you and your department.

• A CFY is a paid employee.
• The CFY is 36 weeks of full-time (35 hours per week) experience (or the equivalent part-time experience), totaling a minimum of 1,260 hours.
• The initial hourly rate is slightly lower than a licensed SLP. Their rate is adjusted when they receive certification and licensure.
• It is best to interview more than one candidate if available.
  • Need to have potential CFY supervisor participate in the interview process
  • The SLP supervisor needs to be current with his or her ASHA CCCs and state licensure
  • Make sure the potential supervisor has the skill set to mentor a CFY
  • In California, the SLP needs six hours of supervision training
  • The CFY will have his or her own caseload immediately
  • They may be placed in their own facility with a supervisor off-site
  • The CFY will be introduced to colleagues and patients as a staff SLP
  • They may need some guidance and training
  • They may need added time to learn some aspects of the position
  • The CFY supervisor must supervise a minimum of eight hours per month for a full-time CFY and four hours for part time
  • CFY candidate who will work in facility without supervisor needs to have the personality and capability to take on this challenge
  • The supervisor needs to be given the time to provide the necessary supervision
  • It is clear that there are pros and cons to hiring a new-grad SLP. The supervision time and need for added training may be considered a negative. However, often these new grads are bright and energetic with a strong willingness to learn and grow into the position. With this information on hiring CFYs, DORs and SLPs can decide what is right for you and your department.

    By Elyse Matson, M.A., CCC-SLP, Carmel Mountain Rehabilitation & Healthcare, San Diego, CA

Sonny Gonzalez, DOR, and Jennifer Daniels, SLP of Oceanview Healthcare and Rehabilitation in Texas City, Texas, have been participating in a national grant project of the Eden Alternative called Creating a Culture of Person-Directed Dementia Care. The Eden Alternative® is an international, nonprofit 501(c)3 organization dedicated to creating quality of life for elders and their care partners, wherever they may live. Through education, consultation and outreach, we offer person-directed principles and practices that support the unique needs of different living environments, ranging from the nursing home to the neighborhood street.

Both Sonny and Jennifer have each shared poems they’ve penned in response to what they’ve learned. Sonny’s poem, Alone, echoes the message behind Eden Alternative Principle Three, which acknowledges that companionship is the antidote to the plague of loneliness. Click here to read Alone. Jennifer shares Night and Day with us. Her poem reflects the essence of Eden Alternative Principle Five, which names spontaneity and variety as the antidote to the plague of boredom. Read Night and Day.

(Sonny Gonzalez shared the above from the Eden Alternative site at http://www.edenalt.org/inspired-words-make-worlds/)

North Mountain Medical and Rehab Center in Phoenix, AZ has continually had an increase in respiratory patients over the years, making it well known to the community as a premier respiratory facility. The goal of almost every resident coming through our doors is to return to the community, and the Therapy Team chose to implement a Pulmonary Rehab Program designed with specific interventions for these residents, which often means taking a different approach to rehab due to their lower level of activity tolerance. A patient must first meet the criteria to participate in the Pulmonary Rehab Program, and once admitted into the program, we have select guidelines for assessments, treatment plans, educational material, and involving community resources to continue to help our respiratory patients thrive while in our facility and then discharged home.

After a successful 1^st quarter kick-off, the team continues to grow the program with new goals. Shannon Dougherty, PT, is working towards a specialized PT Certification in Pulmonary Rehab. Kelly Schwarz, DOR, is getting involved in community education programs through Breathe Easy Arizona. The team has researched the use of different standardized tests to add to their assessments, and will implement the use of manometers and inspiratory muscle trainers to their treatment sessions.

At North Mountain, we are truly taking an interdisciplinary approach to helping our residents “Breathe Easy” on the road to success!!

By Kelly Schwarz. DOR, North Mountain Medical and Rehab Center, Phoenix, AZ

Prior research has indicated that older adults treated with four weeks of reminiscence-structured activities to target specific personal memories showed fewer depressive symptoms, less hopelessness, improved life satisfaction and retrieval of more specific life events (Allen, 2009). Toward that end, we wanted to provide rehab patients and/or their caregivers with a value-added service — one that emphasizes a celebration of life and identifies the patient’s volition, rituals and habits through the use of a client-centered legacy-building intervention.

Through legacy-building activities, such as engaging with family members, creating slideshows, creating scrapbooks and creating videos, the patient and family improve existential awareness of their past, present and future. The goal is to improve activity tolerance, facilitate out-of-bed activities and address underlying deficits that influence ADL performance skills.

Partnerships and Collaborations

Our partnership with the Loma Linda University Occupational Therapy department, as well as other higher education institutions, allows us to recruit graduate-level fieldwork students to participate in our legacy-building project. By the end of week 12 (the end of fieldwork rotation), the FW II student presents a facility in-service regarding implementation and outcomes of the legacy-building program.

A Case Study in Legacy-Building

One patient, an 87-year-old woman, was admitted to Sea Cliff Health Care after a hospitalization secondary to generalized weakness, decreased functionality and decreased oral intake that revealed UTI, dementia, dehydration, coronary artery disease, anemia and urosepsis. The patient was evaluated by physical and occupational therapists for intervention once a day, five days per week, from March 24 to May 18, 2015.

Plan-of-care goals had to be modified throughout the process to address the patient’s increased aversive behaviors, outbursts and anxiety with therapy requests. We introduced behavioral modification techniques and legacy-building interventions, such as scrapbook making, a quote book and an interview for personal needs.

Thereafter, the patient met several functional goals and showed increases in other areas of ADL function, including BUE strength, seated balance, UB/LB dressing tasks and hygiene/grooming tasks. With the help of behavioral modification techniques and legacy-building interventions, the patient was able to demonstrate decreased aversive behaviors, confabulations, outbursts and anxiety and increased socialization (she sang more) without the use of psychotropic drugs.

Conclusion: a FW II Student’s View

Is the legacy-building project a valuable interpersonal teaching exercise? Why?

The experience during my level 2 fieldwork with the legacy-building project has allowed me to be a part of making a difference in the life of a patient that otherwise may have not had the means to advocate for their own care or means of participating in meaningful occupations at a vulnerable time in life.

What characteristics should future FW II students possess to be successful in this program?

It was important to be able to use therapeutic use-of-self in order to shape therapy sessions based on the patient’s needs and desires. Patience and empathy were also important characteristics for building rapport necessary to facilitate patient honesty, thoroughness and willingness to reveal personal anecdotes and experiences.

Did the program meet its objectives? The program reached its objectives to create mementos and informative aids for facilitating increased communication between patient and family/caregivers, while creating a product that is meaningful and can be used to maintain the patient’s legacy.

By Kristine Lewis MOT, OTR/L, Sea Cliff Health Care, Hungtington Beach, CA, In partnership with Loma Linda University OT Department

 

At Southland Rehabilitation & Healthcare Center in Lufkin, TX, we have found success in using a “Therapeutic Use of Self” method of treatment. Defined as “the use of oneself in such a way that one becomes an effective tool in the evaluation and intervention process” (Mosey, 1986), Therapeutic Use of Self consists of a planned interaction between a patient and another person in order to:

• Alleviate fear
• Provide reassurance
• Obtain and provide information
• Give advice
• Assist the other individual to gain more functional use of inner resources

We implemented the Therapeutic Use of Self method with Mr. K, using various techniques to engage the patient, including patience, rapport, trust, humor and honesty.

Since the use of Therapeutic Use of Self, Mr. K. is a changed man! Today he actively participates in occupational and speech therapy, inquires about other ideas to improve his health, smiles more often and enjoys his therapy. We look forward to using Therapeutic Use of Self with many more patients in the future and seeing the benefits firsthand.