More Love to Celebrate

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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.

Falls Management: Collaboration is KEY

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By Tamala Sammons, M.A., CCC-SLP, Senior Therapy Resource

Part 1: Fall Reduction: Focus on Strategies for Prevention
How do we identify who is at risk for a fall? Generally, we assess a resident’s physical and cognitive performance to determine who is a fall risk. However, many residents score as a fall risk, so how do we really sort it out? Do we really know who is most likely to attempt to move and why? That is a key difference.

The Challenge: Identify fall risk residents by finding out who is motivated to move and then find out what that motivating factor is. Give the residents a voice … give the CNAs a voice. Ask the resident and CNA about any changes, challenges and unmet needs.

Complete fall rounds on the floor, not in a meeting room! Assess the environment. How is the resident room set up? How is the bathroom set up? Where is the bed in relation to heating/cooling systems? How is the closet designed? What is lighting like at night? Ask the resident about their environment: how it is set up, temperature preferences, access, lighting, etc.

Provide the nurses with a tool kit based on activity prescriptions: Complete a thorough evaluation, determine who is motivated to move, determine what activities they enjoy being engaged in, determine what they can do alone and with caregivers, create activity-based prescriptions based on eval and treatment findings. Have this information and the supplies in the tool kit for nurses to easily access.

Create a Falls IDT with Nursing, Activities/Rec Therapy, RNA, and Therapy. Re-think how to really identify who’s at risk (motivated to move). Do rounds together. Have daily huddles to review the 24-hour report. Share interventions. Keep building the tool kits.

Part 2: Fall Reduction: Focus on Strategies Post-Fall
Partner with clinical to determine the cause of the fall. Ask the resident what they were doing/wanting. See if they can re-enact what they were doing prior to the fall. When reviewing a fall, ask: Is it cursory, perfunctory with the same approaches/interventions? Or are we creative, thorough and using great detective work to truly develop individualized interventions?

Complete a comprehensive evaluation. If currently on caseload, consider a re-evaluation … head to toe! Engage all therapy disciplines. Leave nothing out of the investigation to the root cause. It may take a few days to figure it all out.

  • Vital signs: Review blood sugars and check orthostatic BPs
  • Standardized tests: Assess strength and muscle performance; aerobic capacity; gait and locomotion; range of motion; ADLs; cognition; pain scales; vital signs!; sensory impairments; footwear; seating and positioning/support surfaces; modify their environment — remove hazards, modify the bathroom, modify closets; review medications
  • Toileting/Incontinence: Was the resident attempting to toilet? Were they incontinent at the time of the fall? How is the bathroom set up? What adaptive equipment is in place/needed?
  • Positioning: Does the resident have difficulty maintaining good positioning and is it different in bed versus in a wheelchair? Were all positioning devices in place at the time of the fall? What is needed now?
  • Pain: Were they motivated to move due to pain? Was there a pain treatment in place prior to the fall? Does there need to be one now?
  • Cognition/Communication: Is there any difficulty using the call light? Any difficulty expressing needs? Can they understand and follow requests? Can they explain what happened and why they fell?
  • Strength/Balance mobility: What are the safety concerns with physical movement or use of current devices? Was there sudden weakness or dizziness reported? Can they demonstrate what they were doing when they fell? Complete muscle and sensory testing.
  • Low vision assessment: Can they see the things they need? How is the lighting? Does there need to be color contrast in the room or bathroom?

Provide skilled interventions to address:

  • Difficulty with transfers in/out wheelchair/standard chair/bed
  • Inability to accurately position wheelchair when transferring
  • Inability to safely reach objects in near/far proximity
  • Difficulty crossing midline
  • Losing balance when challenged outside base of support
  • Inability to lift/carry objects
  • Difficulty with ambulation while multitasking (e.g., walking and talking)
  • Losing balance with overhead activities
  • Poor body alignment or losing balance when bending
  • Gait deviations when ambulating
  • Loss of balance with direction change or varying surfaces when ambulating
  • Shortness of breath with increased mobility distance/ambulation distance
  • Confusion or misuse of assistive device(s)
  • Difficulty climbing stairs/curbs
  • Poor recognition of safety hazards with mobility tasks
  • Impaired mobility
  • Impaired vision/hearing/sensation
  • Impaired cognition
  • Modify the environment: lighting, grab bars, raised toilet seats, bedside commodes, add color for low vision or other visual impairments; what about the closet?

Additional Resources

Fall Reduction Preventative POSTetteDownload
Fall Reduction Post Fall POSTetteDownload

Outpatient Success Story at Patriot Heights

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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!

Putting Theory into Practice with Activity Cards

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By Carly Peevers, SLP and Andrew Folmar, OT Rosewood Rehabilitation, Reno, NV

You’ve done the assessments, sensory profiles, interventions, accumulated all this information about your residents to create a specific maintenance program within their Allen Cognitive Level, but what now? How do we effectively share and educate the caregivers to create a successful functional maintenance program and have a place where they can reference this information as needed? This was a question we had early on in the Abilities Care Approach, and that’s when our facility implemented activity cards.

Activity Cards are a summary of the information collected throughout the intervention which may include:
• Stage specific recommendations within different environmental and activity demands, personally relevant activities with modifications and strategies for this patient,
• Pertinent life history and
• Sensory information that may assist in engagement and/or management of behaviors
in order to increase meaningful engagement, quality of life, and maintenance of cognitive and/or communicative function.

What does the Activity Card look like on paper? We use a tri-fold pamphlet to present our information. The front has a color outline corresponding to their ACL level (red, orange, yellow, blue). On the inside there are three columns.
• The first provides a list of activities/interests and modification recommendations.
• The second column is a summary and description of current abilities in cognition (attention, problem solving, sequencing etc.), communication, physical strengths and limitations during ADLs, and possible barriers in their cognitive function.
• The third column is a running shopping list that incorporates this patient’s personal interests and functional needs (grooming/hygiene supplies, sensory stimulation tools, clothes, etc.). We attach this pamphlet to the patient’s life history board with Velcro so it is easily accessible to all caregivers and support staff for a quick reference.

We hope this information helps others with their caregiver engagement for dementia residents.

Giving a Reason to Live Through Music

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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!

Cloverdale is Hiring a Physical Therapist!

JB Jobs

The Cloverdale Healthcare Center for skilled nursing and rehabilitation overlooks the beautiful Alexander Valley in Sonoma County. Large panoramic windows open up the facility to brilliant sunlight and illuminate living spaces. You’ll experience spectacular views of the rolling hills and manicured gardens where you can view beautiful flowers, plants and wild life during the day, and the city lights of the quiet city of Cloverdale in the evening.

Intrigued? Cloverdale is currently offering an amazing career opportunity for a Physical Therapist. With this position, we will be listing a choice of options for the candidate to choose one form that is more customizable. Those options include:

–Student Loan Assistance of $500 per month as long as employed at the facility (up to $15K)

OR

–Full time schedule of up to 40 hours a week including three 10 hour shifts with the option of at home documentation or drive time.

OR

-10K sign on bonus

If you’re interested in this job, please reach out to: PMedvene@ensignservices.net, or find out more about this amazing opportunity and browse our complete list of therapy job opportunities.

Welcome Skyline Transitional Care!

JB Jobs

We are excited to welcome Skyline Transitional Care to our network of affiliated facilities!  Skyline is a charming 80 bed skilled nursing and post-acute rehabilitation facility with a ton of potential.  Our therapy leader, Kristin Ryther, is a transfer from one of our Texas affiliates, and has been part of our organization for two years.  She has always been a natural leader in all aspects of her life and when she had the opportunity to become a therapy program manager, she jumped at the chance to be a multiplier and rise by lifting others.  As a leader in our organization, Kristin has been able to facilitate many dreams for both patients and her team members.  She is a fierce believer in CAPLICO and building facility level culture as well as encouraging her team to build something great in their own community.

For Kristin, Idaho is home.  Boise specifically, is a beautiful location and offers hiking, skiing, and a growing local cultural scene.  It is a scenic and friendly place to raise a family and offers a relatively reasonable cost of living.  When not working, Kristin loves to spend her time doing Pilates and other work outs, as well as hiking and otherwise enjoying the outdoors.  Her favorite dining experience in Boise is Bardenay, hands down – it was the one place that she would always go to when visiting the area after moving to Texas.  

Kristin is inspired to build the program at Skyline from the ground up. As a new acquisition, it is a clean slate and the team will be able to create and define the treatment approaches, specialized programs, community outreach and culture that fits the facility team and needs of the residents in the best possible way.

Skyline is currently offering amazing career opportunities for an Occupational Therapist and a Speech Therapist. Find out more about these amazing opportunities and browse our complete list of therapy job opportunities.

The Thoughtfulness Of The Coronado Therapy Team is Unmatched!

JB Jobs

An amazing display of love from Coronado Therapy to the hard-working CNAs!

It’s so cool to see this thoughtfulness towards a fellow department by supplying dessert trays and a love-up card 💪🏼🙌🏼.

Coronado Healthcare is currently offering amazing career opportunities for an Occupational Therapist, Occupational Therapist Assistant, Physical Therapist Assistant, and a Speech Therapist. Find out more about these amazing opportunities and browse our complete list of therapy job opportunities.

Join The “Island Life” With Bainbridge Island

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History of Pickleball: Created in 1965 in the backyard of Joel Pritchard with a friend (Bill), the goal to have an activity the whole family could participate in. They created it on an old badminton court and since they didn’t have badminton rackets, they used ping pong paddles. Over the weekend they created rules and lowered the net from 60” to 36”, since the plastic ball they were using bounced so well on the court. Now it’s one of the fastest growing sports in the US! This took place at Joel Pritchard’s home on Bainbridge Island, WA just a ferry ride away from Seattle. This ingenuity and drive for living an active lifestyle is still a driving force on Bainbridge Island and especially at Bainbridge Island Health and Rehabilitation Center. They have a team of therapists and nurses that are here to help you get back to life! They enjoy the “Island Life” in the beautiful Pacific Northwest, home of amazing outdoor activities and weekend getaways (including Pickleball at the Founder’s Court). We are looking for therapists to join this awesome team. Come see us at the facility and then take an afternoon to play some pickleball!

Bainbridge Island is currently offering an amazing career opportunity for a Occupational Therapist. Find out more about this amazing opportunity and browse our complete list of therapy job opportunities.

Northern Oaks Makes An Impact!

JB Jobs

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 Northern Oaks for over 2 year 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 2 seater, but he called a former NE senator from Lincoln 2 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 3 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. 

The love and encouragement the team at Northern Oaks shows to their patients is unmatched. If you’re interested in learning more about how you can join this amazing team, you’re in luck! Northern Oaks is currently offering career opportunities for an Occupational Therapist Assistant, Occupational Therapist, and a Physical Therapist. Find out more about these amazing opportunities and browse our complete list of therapy job opportunities.