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Submitted by Aaron De La Torre, Therapy Resource, Keystone Borderstone Market, TX
Having a decline in health can be an extremely challenging time for the individual and their family members. Typically, individuals who are admitted to the hospital can expect to be discharged to a skilled nursing facility, where they will receive therapy and nursing care and then be discharged home, where they will be serviced by a new set of therapists at home. At McAllen Transitional Care Center, the team has specialized in helping individuals receive an excellent continuity of care to assist them in their journey to return to their prior level of function. Jennifer Ybarra, DOR, and Ediel Barrera, ED, have worked hard to create a culture where patients are cared for from the time they are referred to McAllen Transitional Care Center until they have returned to their desired environment.

Upon admission into the facility, the evaluating therapists start discharge planning from day one. Once the patient has met all of the inpatient goals and is ready to go home, the physician and team determine the need for continued services. If outpatient services are indicated, the team starts the planning to ensure continuity of care.

Every individual who serves the patient at the facility plays an important role in ensuring that the patient receives the highest continuity of care possible. The patients are excited to discharge home and continue services with the therapists they have made strides with to return to their prior functional level. Below are pictures of the amazing team at McAllen Transitional Care Center that goes above and beyond to make the outpatient dream work!

Submitted by Kai Williams, Therapy Resource, Keystone East, TX
The Copperfield team is at it again! They continue to create a bridge between Therapy and Nursing by having dedicated activities for all to enjoy together. The Therapy Department spearheaded this most recent event. Loretta Johnson provided a beautiful description of the event and why it was so very much needed.

Bridging the Gap represents a means for the Nursing and Rehab departments to bring together diverse individuals with different skills and areas of expertise to develop and generate new ideas and unique solutions to enhance team performances.

At Copperfield, we believe in the tower of strength and togetherness as we withstand many obstacles on a daily basis. By combining our physical energy, knowledge, proficiencies and skills, we take charge in maintaining consistent communication. This allows us to truly appreciate and maintain the respect we have for one another.

Our Bridging the Gap program has created a warm and supportive environment for our Nursing and Rehab team. The Therapy department presented a Hot Cocoa Bar for our Nursing department. The Rehab team was ready and served up hot cocoa, tea, apple cider and with a variety of toppings and sweets. Just as these drinks and toppings blend together in unique flavor combinations, we see Nursing and Rehab working together to develop new ideas and solutions for success.

We have a truly great Rehab team at Copperfield. We work tirelessly to support the needs of our residents and our team members. We know team building takes work, and we take great pride in our commitment to remain the best team ever!

By Jon Anderson, DPT, Senior Therapy Resource

We truly have heroes working in every department, making miracles happen each day despite tremendous odds. Here in Keystone our Therapy Resources decided that one way to give back is to spread joy with our Happy Bar!

Happy Bar Concept
As healthcare experts, we give a “prescription” for health and happiness along with sweet treats, coffee, tea, or any other goodies.

On the prescription, we can have 10 things:

1. Take a few deep breaths. We all know that a deep breath helps us relax. No surprise, then, that decades of research have demonstrated that by taking slow, deep breaths, we calm the body and mind by activating the parasympathetic nervous system; when this happens, stress markers, heart rate, and blood pressure all decrease. That’s why taking deep breaths throughout the day can help keep us calmer and more balanced.
2. Call an old friend. Research suggests that social connections’ impact on mortality is on par with blood pressure, cholesterol and obesity. The benefits likely come from the immediate activation of prosocial emotions and the long-term benefits of social support. This might be particularly helpful for my patients who are facing challenges with their physical health.
3. Give someone a hug. Hugging releases oxytocin that helps build social bonds and lowers levels of the stress hormone cortisol. When hugging, we also release endorphins that lead to a sense of well-being and relaxation. But does anyone really need a scientist to tell us that hugs are good?
4. Help a friend in need. Helping others allows us to meet some important psychological needs, such as developing our senses of agency and competence as we strengthen social relationships. When we act on our values by being a good friend and helping those in need, we foster a sense of purpose, which is foundational to a meaningful life. In fact, recent research suggests that those providing help may get more benefits than those receiving it.
5. Write a thank-you note. Many studies over the last two decades have found that people who express gratitude are happier and less depressed. While one thank-you note is not the kind of gratitude practice that leads to lasting, positive cognitive change, I tell my patients that their notes should be the beginning of a habit of counting their blessings in writing.
6. Sing in the shower … or anywhere. Making music, and in particular singing, just makes us feel better. And this happens through several mechanisms. We release endorphins when we sing; given this, it is not surprising that singing reduces pain. Stress hormone levels fall, leading to improved immune function. We make meaning as we embody the lyrics. I often add that people should join a choir, as singing surrounded by others greatly magnifies the benefits of singing.
7. Dance to your favorite song. We all know that moving our bodies improves our health, but moving to music has additional benefits. The mood boost from dancing lasts much longer than from exercise alone. And dancing often has social benefits. There is even data suggesting dancing prevents cognitive impairment in the elderly.
8. Go on an awe walk in a beautiful place. Awe is the feeling we get in the presence of something vast or beautiful that challenges our understanding of the world. It is something we depend on to keep life fresh. Awe makes us feel more alive, but, importantly, it also makes us more humble, more generous, and less self-centered. The purpose of an awe walk is to move more slowly and look carefully at the surroundings for wonder and beauty.
9. Forgive someone. First off, forgiving someone doesn’t mean denying we were wronged; it means we let go of our anger and other unhealthy cognitive processes. Forgiveness requires some hard work, but the benefits are profound: Those who have learned to forgive live longer. This occurs from less stress, less depression, and better sleep and relationships.
10. Talk to yourself in a kinder voice. We are often our own worst critic, and when our health goes bad, we can cast an unhealthy amount of blame upon ourselves. Self-compassion helps us heal ourselves rather than hurt ourselves. Talking to ourselves in a kinder voice is the key to this practice.

(Photo of June with therapists Joseph Zaldua, OT, and Camille Navata, OTA)

Submitted by Donald Millares, TPM, Glenwood Care Center, Oxnard, CA
Today, we celebrated with one of our outpatients who successfully drove herself to the facility, something she could have not done in the last six months. Our Occupational Therapy Assistant who mainly has her for sessions cried in joy with our patient, celebrating her achievement. Words cannot describe the emotion that was seen as the whole rehab department clapped in joy.

Our patient June has been coming to our facility for Occupational Therapy Outpatient Services to work on both of her hands to regain function and take her life back into control. Prior to coming, she was one of our in-person residents who then discharged out of our facility and became our very first outpatient. During her stay, she developed a strong bond with the nursing staff, housekeepers, and our amazing Occupational Therapy Assistant Camille Navata and Occupational Therapist Joe Zaldua. She regained her ability to do her daily routines while wearing a soft cast that covered all the way up to her PIP joints of her fingers. Once the soft cast was removed and she was cleared for discharge, she declined to attend other outpatient clinics in the area that were recommended by her MD and decided to work with Camille and Joe once again for our outpatient services.

June knows how they work and established a great client/therapist relationship and entrusted their expertise on her road to recovery. Working together, they were able to break down scar tissue to allow her to regain strength for functional grasp patterns and increased ROM for both hands and upper extremities. With the constant intensive Occupational Therapy sessions, June was able to complete her main goal of driving her car again – something she could have not done ever since her incident that left her hands immobilized for quite some time.

Now with the regained ability, June has the freedom to go places and not have to rely on others to drive her. Camille and Joe’s dedication shows exactly why we do the things we do and celebrate the achievements of our patients – to better our patients and guide them on the healing path of independence.

By Marci Woehler, TPM/CTO, Wayne Country View Care & Rehab, Wayne, NE

I’ve been meaning to share with you one of the most amazing couples I will ever have the pleasure of knowing and treating. Meet Clair and Lura Stoakes. Clair is 101, and his wife, Lura, is 96. They celebrated their 80th(!) wedding anniversary back in August. This amazing couple has been with us for over two years, and we try to honor their anniversary in a special way each year.

When Clair and Lura were dating, Clair drove a Model-A car that he would shine up for his dates with Lura. Being in a small town, we knew someone with a Model-T, and we reached out to see if he would be willing to give the couple a ride for their anniversary. His was only a two-seater, but he called a former NE senator from Lincoln two hours away who has a “touring Model-T.” Our local Ford dealership then got involved and arranged to have that vehicle trailered here for Clair and Lura to take a tour around town.

While Lura is quite mobile, Clair requires a little more assistance. After measuring thresholds, we found out the step to get into the vehicle was 29’’with a running board at 19’’off the ground. For weeks prior to the anniversary, our therapy team worked with Clair to be able to manage a 10’’ step all while keeping the secret of their anniversary surprise; at times he thought we were crazy.

When the day came, Clair was able to manage the steps to get into the Model-T and take a drive with his sweetheart while driving off to their song “Too Young” by Natalie Cole. There were three news stations and our local town paper that showed up for the event to interview our amazing couple and watch them drive away. The look on their face when Clair saw the car was priceless as happy tears were shed. If you have a moment, see this news article.

Submitted by Alyssa Santamaria, Rehab Aide, Patriot Heights, San Antonio, TX

In the late months of 2020, Gracie contracted the virus, COVID-19, which changed her life completely. From being very socially active and full of life, her life was turned upside-down. She was in the fight of her life and recalled hearing “Echale Ganas! Echale Ganas!” which is Spanish for “Give it your all!”

That was what Gracie kept hearing throughout her fight. And, she did. With time, she was cleared of the virus but continued to have symptoms. Because she was continuing to have symptoms, our Therapy team at Patriot Heights worked with the approval of Dr. Ramon Reyes, to create a plan to help her recover. That plan included getting her back into doing the activities and groups she loved, such as playing the accordion, participating in her church, and always helping all those around her.

Since Gracie has been a part of the community here at Patriot Heights, it was easier for her and our team to create a unique plan to try and get her to the best version of herself. With all odds against her, she did not give up. Gracie worked long and hard with our Physical Therapist, Occupational Therapist, and Speech Therapist to get back to a normal life. Our team worked together on different aspects of her body and muscles, cognitive memory, oral motor skills, balance, and giving her the support she needed. They were able to get Gracie back on her feet and become the best version of herself, even better than where she was before.

“They are the best. They helped me a lot and now I am able to move again. I can move my fingers to play my accordion and move my arms and legs to participate in fencing. Therapy went the extra mile. They are my extended family. They are professional and work hard to help me achieve my goals. I am independent, confident on my feet, and happy to be able to live my life how I’m supposed to. Dr. Reyes, thank you for approving my therapy. They helped get me to where I am now, and that is something I did not believe I’d be able to achieve,” Gracie says.

Gracie has now graduated from all three therapy programs. Since gaining her independence back, she has been able to play her accordion and has added fencing as one of her hobbies, which she started doing as soon as she was able to walk and move again. Not only our Therapy team, but our whole family here at Patriot Heights are ecstatic about being able to work together to give Gracie her independence and confidence back, giving her the opportunity to keep living and enjoying her best life. With all she has accomplished, she has inspired and motivated many others to keep pushing forward. She also recommends therapy to her friends and those around her.

Gracie, we are so proud of you for what you have been able to accomplish. Sigale echandole ganas!

Submitted by Kelly Schwarz, Therapy Resource, Bandera, AZ
Johnathan Kingsley, DPT at Horizon Post Acute and Rehab in Glendale, Arizona, has enjoyed sharing his musical talents of song writing, guitar and singing with residents at work and has been able to touch the residents’ lives in many ways with his creativity. Recently, the team found it challenging to motivate a particular resident (Alex). Johnathan was inspired to not give up on Alex and really wanted to give him a reason to live.

Johnathan came up with the idea of helping Alex find a reason to give back to the facility and the other residents to help motivate him. After spending time together, it was discovered Alex really wanted to learn to play guitar; however, due to loss of function of his left-hand s/p CVA, this was not a feasible goal. Johnathan started having Alex sing along with him as he played guitar, and Alex started writing lyrics to songs. Whenever Johnathan practices singing/lyrics with him, Alex is in the standing frame, which is a difficult task for him. However, he often comes to the gym on his own now, asking to work on standing and singing.

Alex spent time on songwriting and made new lyrics to the song “Islands in the Stream.” The plan was to play/sing the song to the facility after much rehearsal. With Halloween approaching, Johnathan had the idea of taking the plan one step further. The therapy band, which consists of Johnathan (vocals and guitar); Kayleen Bennett, OT (vocals); Zakk Montgomery, PTA (drums); and Alex (vocals), dressed up as famous musicians. They made sure Alex was dressed for the occasion as well, and the whole facility was entertained!

By Dominic DeLaquil, PT, Therapy Resource, Pennant Idaho/Nevada

#PIVOT is the rally cry for Summit, which comprises the markets in Utah, Idaho, Nevada and Washington. It stands for Proactively Identifying Vital Opportunities in Therapy, and in September, the DORs in Idaho/Nevada decided to apply #PIVOT to support their Nursing partners. Here are some of the ways Therapy has been helping Nursing:

Monte Vista — Therapy is “donating” one hour per day to Nursing to answer call lights, pass trays, train on hoyer lifts, decorate the halls, etc. and it rotates among the Therapy staff, which helps the nurses and aides get to know the Therapy team better.

Owyhee — Therapy is doing the showers for skilled patients and they are also doing the assisted feeding in the RNA dining section at breakfast and lunch two days each week. They are also helping by doing larger groups, even with many non-skilled patients, so that the aides have that me to actually take their full breaks.

Meadowview — Therapy is lending their Rehab Tech to nursing to work on the floor and the Therapy team is giving more attention to call lights.

Rosewood — They are helping nursing to pass trays at mealtimes.

Creekside — Therapy has a PT assisting with ADLs on the COVID unit, and Therapy is doing resident showers on the skilled side of the building.

Bennett Hills — Daily Post-Stand Up Huddle with floor staff, led by Therapy to discuss admissions, discharges, appointments, room changes, and family visitation schedules. Monthly CNA meeting led by Therapy Program Manager to discuss opportunities for collaboration, education, ways to better support one another, and develop trust. Monthly recognition of specific CNAs that embody the CAPLICO culture, awarded with plaque and T-shirt.

The response has been extraordinary so far, and these are just the starting points! The DOR clusters are having an ongoing dialogue to share ideas and inspire each other to continue to find more ways to support their Nursing partners. Great job, Idaho/Nevada DORs. #PIVOT for Nursing!

Submitted by Devin Bodily, PT, Cedar Health & Rehabilitation, Cedar City, Utah

During the month of August, Cedar City received a large amount of rain within a very short span of time, including over 6 inches during a 24-hour period in the mountains above town. A frightening amount of muddy water, logs and boulders came crashing down Coal Creek, out of the canyon, and right through town. This eventually clogged a main floodwater-diverting channel, which caused the water to rush into, and overflow, the canal in the western part of town. Many homes were flooded and surrounded by several inches of water and mud without warning.

Our Director of Nursing, Trent Nielsen, has a home in this area and had been keeping tabs on how the flooding was going throughout the morning. To complicate matters, Cedar Health and Rehabilitation was undergoing state survey, which made it difficult for Trent to adequately prepare for any flooding at his home.

Just before noon, Trent was made aware that the water had crossed the road and was quickly traveling across the field toward his house. Without knowing how much time there was to spare, Devin Bodily, PT; Jake Holm, OT; and Braden Wiscombe, AIT, quickly rearranged their schedules and left to help Trent and his family. They were able to quickly obtain sandbags and shovels to create a wall to divert the floodwaters from reaching Trent’s home. If they had arrived minutes later, Trent’s home would have been flooded and permanently damaged.

They stayed for several hours into the evening to help maintain the wall. Community members eventually came along with skid steer loaders and mini excavators to build a dam and divert the water around the neighborhood. Ty Liston, COTA, and Eric Brown, Director of Maintenance, joined later in the evening and late into the night to help with the efforts of having an adequate water pumping system in his backyard. Having these pumps in place was instrumental to saving his home as heavy rains returned that night and broke the dam, pushing floodwaters within inches of Trent’s home before they finally subsided.

The effort to save Trent’s home was bolstered by the many facility staff members, regional nursing resources, and Executive Director, Spencer Eaton, who helped fill in for Trent’s duties during the state survey process so he could focus on saving his home through the night and into the next day.

The response to help Trent and his family was automatic as several employees demonstrated the core values of “Love One Another” and “Customer Second.”

By Cara Koepsel, M.S. CCC-SLP, DOR/CTO, Golden Acres Living and Rehabilitation, Dallas, TX
Golden Acres began a partnership with this ALF at the beginning of March 2021. It all started with a cold call from the DOR to the facility, in which the administrator agreed to a Webex with her team and me. I was able to really sell the services of what my team has to offer and show why a partnership would benefit their facility.

We started day one with two screens that turned into PT/OT/ST evaluations. Pictured is my team that accompanied me on day one! We came prepared to be flexible and assess as many patients as they wanted. I sat on the couch in their dining room and communicated with my BOM to run payer sources, check for home health, find primary MD to obtain orders, etc. These items were certainly a barrier, but all things that, with patience and persistence, we were able to work through.

Since day one, we have established six to seven patients on caseload for all three disciplines, and we visit the facility with a team that is there all day to treat these patients three days a week. We are a part of their daily routine, and they absolutely love our presence there. Also pictured is our group therapy we have initiated with the patients as well, which they love! Currently, we are working on partnering with this ALF to host an event at their facility to assist them in building their census after COVID. They are pleased to be able to tell prospective families and patients that Golden Acres’ rehab team will be a part of their loved one’s stay at their facility and their potential new home.

There may be hiccups and barriers as you start these partnerships, but once you get in the door and show these facilities what your team is capable of, I guarantee you they will want to partner with you for life! Keep pushing that flywheel even when it seems tough, because an ALF partnership is so worth it.