Share

by Jill Schuette, OT –

It’s a hodgepodge of plant life: petunias, tomatoes, squash, rosemary, ferns. To the casual observer, it may seem like landscaping with a lack of direction. But to the therapy team at Pocatello Care and Rehab, it is a garden with a clear sense of purpose. In the facility’s small courtyard, a very special program is in full bloom. This is where patients practice therapeutic gardening as part of an interdisciplinary array of therapy techniques.

Working with plants is helpful to patients with emotional and physical challenges. For example, stroke victims can work on upper extremity function as they turn soil in a planter or water flowers. Gardening helps strengthen muscles, improve fine motor skills, increase endurance and enhance dexterity. Patients with depression or other mood disorders can increase their activity level and self-esteem.

The courtyard garden has a wide path for patients to practice safe maneuvering with walkers or wheelchairs, and features sitting and standing-height planters. Future plans for expansion include benches and conversational seating areas for therapeutic rest breaks and socialization.

Our Simple Garden Recipe:

1) Cement blocks: we stacked ours at different heights to allow both standing and seated therapy

2) Sturdy wood frames with bottom supports

3) Garden box inserts: ours are heavy black plastic, but we would recommend you choose something deep enough to allow for root expansion. We are limited to shallow root plants such as strawberries and culinary herbs

4) Wine casks or whiskey barrels: we bought ours from the local nursery. Be sure to drill holes in the bottoms to allow for proper drainage of soil.

5) Gourds: we selected these because they allow for a longer cultivating/harvesting season

6) Sensory plants: herbs are great for the senses –touch, smell and taste

7) Multi-pick plants: strawberries and tomatoes allow multiple harvests for patients

8) Visual stimulation: low maintenance flowers like petunias and sunflowers pack a visual punch

9) Water: Be sure to include watering your garden when doing daily planning. Patients manage our watering six days a week, nursing staff handles the seventh day.

Your garden project doesn’t need to be expensive or fancy. Sometimes simple really is best. Our garden setup changes each season, based on what works and what doesn’t.

Be sure to get the most out of your therapy garden by choosing plants that have multiple uses. Have your patients harvest fresh herbs for cooking activities, cut flowers for a dining table arrangement,and paint gourds for fall and winter table decorations. Use your imagination to get your patients actively involved in their garden. Give them ownership and see what blooms!

Draper Rehab needed a fun activity for our skilled patients, and a cooking group fit the bill. Our first cooking group consisted of a patient’s secret family recipe for whole wheat waffles along with a fresh fruit salad. Not only was it delicious, but it provided eye hand coordination, upper extremity strengthening, standing balance while stirring and doing dishes, and cognition through the ability to follow a written recipe. We recruited one of our high level patients to do the cooking.

Our rehab cooking group is now a highlight of the building and looked forward to by all. Most of our Part A’s participate because they love to be there. Sometimes our activity person, Pam, joins in on the fun and the CNA’s can be found coming and going lured by the smell of wonderful food. Pam also was kind enough to embroider bib aprons with a cute little design for each participant. Along with hairnets and rubber gloves they all remind me of “lunch ladies”. Every seat is filled at our big rehab table on cooking day, usually 8-10 patients and residents. We discuss the next week’s menu with the patients and encourage them to provide their favorite recipes.

Some of the other cooking group menus have included:

• Ruth’s amazing potato salad
• Potato bar
• Chef salad
• Pancakes w/watermelon
• Cinnamon rolls with frosting
• Tacos with handmade tortillas
• Scones with homemade fresh strawberry freezer jam

The kitchen provides some of the ingredients and we buy the rest. We have compiled all the recipes from the past groups, took pictures and will publish a “Draper Rehab Cookbook” sometime early next year with hopes to use it as a fund raiser.

Who said rehab isn’t fun…and tasty.

Having a physical disability doesn’t mean you can’t get out on the green! In fact, many people with all kinds of disabilities have found that golf is a great way to overcome physical challenges while having fun!

Golf can be a driving force in the physical recovery of stroke “victors,” which is why the American Stroke Association, in partnership with local golf courses and the Northern California Professional Golfer’s Association, created Saving Strokes, a Golf Fitness and Training Program for Stroke “Victors.” Saving Strokes empowers stroke victors by illustrating that disabilities need not stop them from playing – or learning – golf. Indeed, golf can improve their strength, flexibility, coordination and balance and provide a valuable social outlet for them and their caregiver. Working in conjunction with the local PGA and holding these events on community golf courses have created new venues for stroke awareness. As a result, local government entities have embraced the concept as part of their disabled sports strategy, and widespread media attention has been created (www.savingstrokes.com). The program is for stroke survivors in ALL stages of recovery.

Orem Rehabilitation and Nursing had the opportunity to help in the planning and execution of the first Utah County Saving Strokes event at Thanksgiving Point golf course in Lehi, Utah, who donated the use of their course to our event. Thanksgiving Point was recently named the number one public golf club in Utah by Golf Digest, and one of 15 “hidden gems” in the country by Links Magazine.

Orem’s role was to provide PTs for evaluations and assistance to the golf pros in maximizing each participant’s functional success on the course. Sam Baxter, DOR, and Kelly Alvord, Therapy Resource, were the PT volunteers from Orem who assisted in the event. Orem also provided nursing staff for prescreening and blood pressure checks. Orem’s own Justin Steinquist (Marketing) was the driving force behind the event with the full support of our administrator (Aaron Earnest, ED). Orem Rehabilitation and Nursing set up a booth for those in the community to see the specialized treatments we are able to provide at Orem with training in Neuro-IFRAH. BYU Golf provided the coaching staff and The Courtyard at Jamestown provided the “comfort green” that included massage therapy, beverages and snacks.

The event was a huge success and a wonderful opportunity for Orem to network in the community. It was rewarding to work with and associate with so many wonderful “Stroke Victors” and other community members involved in the event. I believe friendships were forever forged and relationships and trust forever created. We will be involved next year and are excited to see this event continue to grow.

Linnea Laufer and Laura Hessig, COTAs at Park View Gardens, joined their creative talents to create an OT treatment game that we frequently use with our patients. They created the game about two years ago in response to a request that the department increase the use of group treatments. Not only did they come up with a great idea, but they managed to include the patients in the creation of the game itself, which added to the overall experience!

The game is played as a board game with up to four players. Each player has a marker for the game board, and there is one large die. The spaces on the game board include a wide variety of tasks that the players are asked to perform. If a player lands on a task that they are unable to perform due to their level of disability, they are asked to pick an alternate card, which typically defines a cognitive/social task to perform. Some of the tasks included in the game are: changing a pillow case, picking up five bean bags with a reacher, donning a hospital gown, stacking cones positioned at a therapeutic distance, and doing exercises with a weight bar or stick. The activities can be graded in difficulty by having them perform from a seated or standing position as appropriate. The alternate questions that are used when a task seems inappropriate include memory questions like naming the other players at the table, telling what they had for breakfast, and stating the date. There is also a card that asks them to give a compliment to the person on their right, and one that asks what they are to do with the wheelchair before standing.

We keep the supplies all together so there is no time spent gathering items when a therapist wants to use the game. The supplies for the tasks we use in the game are a dressing stick and reacher, theraband, hospital gown, empty pill bottle and beans, five cones, two towels, five bean bags, a pillow and pillow case, ball, and a cane or weighted stick.

To create the game, Linnea and Laura had patients help with tasks while working on fine motor skills and standing activities:

Cutting out the shapes for the game board spaces and alternate cards
Gluing the shapes on the pages
Hole punching the pages.
Tying the pages together

The pages were laminated and tied together to create a game board that folds down to the size of a single piece of paper. When the board is laid out on a table, it is large enough for all the patients to reach it, and the therapist can turn it to face whichever patient is having their turn.

The patients have great fun and encourage each other during the game. The socialization and camaraderie are also a great benefit to our patients!

At Desert Terrace, we began doing groups for 3 reasons:

1. Increase patient motivation with therapy;
2. Improve efficiency on days with meetings;
3. To have more fun at work!

We perform several groups. On Fridays, our occupational therapy department has cooking groups. Each patient has a preparation task and a clean-up task to perform. They typically do a cooking breakfast group starting at 6:30 a.m.; although, we have also had groups making salsa, cookies, and salad.

The physical therapy department has multiple physical activity groups. We play volleyball, have obstacle courses, basketball toss, static and dynamic balance, and gait groups. Because we are an inner-city facility with many patients who use public transportation, we coordinate real-life community integration groups. The building gives each patient participating $5. We use public transportation and go to a nearby Wal-Mart or pharmacy to practice real-life community interactions.

We have discovered that our groups, especially the volleyball and basketball toss, motivate patients to stand and participate at a higher level than they would with traditional 1:1 therapy. We give prizes to the winners, which is another great motivator!

One idea we have for a future group is to obtain some fishing poles since we have a canal that runs behind our building. Our plan is to put weights on the fishing lines and just let folks “fish” for relaxation, balance, standing endurance, and upper extremity strength and mobility. In the next 90 days, we are also planning on starting a gardening group and a diabetic group. The diabetic group will include nursing, dietary, and physical therapy to discuss the importance of following a diabetic diet, and weight bearing and skin care orders to prevent and help heal diabetic wounds.

We have also found a book with some games that will help us come up with even more groups. Future plans include putting (as in golf), bowling, dart ball, and ring toss. Speech therapy has discussed beginning a card group on Friday afternoons.

We are excited to begin looking for other ways for our patients and for ourselves to have fun in therapy. We would love to hear what others are doing and will be glad to share information anyone may need.

.