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Occupational Therapy is rehab for life skills - Medically Speaking, Volume Three, Number Three, 9/10/15

Alan Ward came to San Juan County ten years ago to join his older brother Richard as the lone Occupational Therapist in the organization that became Precision Rehabilitation with offices in Blue Mountain Hospital.

Ward completed his undergraduate degree in Family Science at Brigham Young University and received his Master of Occupational Therapy Registered and Licensed (MOTR/L) at the University of Utah. After graduation he plied his trade in his hometown of Bountiful, Utah, for a time, until he got a call from his older brother recruiting him to come to Blanding, in 2005. He's been here ever since. Alan explains that he's frequently asked what an Occupational Therapist does, as compared to a Physical Therapist.

"Occupational Therapy is the branch of rehabilitation that deals more with functional skills; the things which occupy a person's time are considered their occupations. A job is an occupation but so is brushing your teeth, being able to dress yourself, wash yourself or drive a car," Alan explained. "It's the functional skills, the stuff we do in everyday life that we just take for granted. When an illness or an injury, or an accident of some kind, has removed your ability to do those functional things in life, an Occupational Therapist is there to help you rehabilitate those things. Here, we also specialize a little more in some of the hand therapy side of Occupational Therapy."

Danelle Shumway graduated from Salt Lake Community College in 2011 as a Certified Occupational Therapy Assistant (COTA). She started working with Alan right away. She said she didn't even know the job of COTA existed before she went to school, but it was the perfect fit for her. Alan explained that it was hard to recruit Occupational Therapy Assistants in Blanding, so the decision was made to find someone locally who wanted a career, who was honest had a good work ethic and was trust worthy. Once they found Danelle, Alan and Richard Ward and Alon Pugh (Physical Therapist Assistant with Precision Rehabilitation) offered to pay for her schooling if she'd come back to Blanding and work once she finished school. She has completed her obligated work time with Precision Rehabilitation, but said she has no plans to leave Blanding. She said she loves her career and notes the emphasis on hand therapy is important because in most of the things people do they use their hands.

"You feed yourself, dress yourself, comb your hair and turn on shower knobs. We are raising their quality of life by increasing their safety and independence," she said.

Alan explains that patient safety is a primary compliment to a patient's Activities of Daily Living (ADL) and Basic Activities of Daily Living (BADL).

"BADL's are just mobility, toileting, grooming and hygiene, self-feeding, that basic stuff we do for ourselves every day. We find ourselves going into a home where there needs to be grab bars in the shower, or hand rails or a riser for the toilet so that's it's easier and safer," he said. "A lot of falls among the elderly or those who have an injury occur getting in and out of a shower, or on a toilet. So the safety side of that will frequently involve grab bars or making a recommendation about which shower seat to get and getting a shower hose. We still want you to be independent but let's do it in a way that you won't fall."

Danelle said seventy-five percent of what she does involves going into homes to do treatment with people who are homebound. OT in the home setting involves helping patients to make home safety modifications, do exercises, and getting them to be able to do the things they were doing prior to their illness or accident.

Alan and Danelle provide outpatient services in the UNHS Blanding Family Community Health Center, UNHS Montezuma Creek Community Health Center and the clinic in Monticello. They provide inpatient services to patients in Blue Mountain Hospital and San Juan County Hospital, in Monticello. They also provide Occupational Therapy services to Rocky Mountain Home Care.

Another area in which Occupational Therapists are making a significant impact is in hand therapy. Alan and Danelle see patients with injuries of the forearms, elbows, wrists and hands. One of the conditions they see a lot of is Carpal Tunnel Syndrome, which may be the problem if people start to feel numbness and tingling in some of their fingers.

"They wake up at night with numbness and tingling in their hands or their hands start to go to sleep while they're driving, and a lot of people kind of live with it and assume it's not a big deal," he says. "But it can develop into something serious and it is very treatable. A lot of people are told they have carpal tunnel by a doctor and they think their only treatment option is to go have surgery and that's just not true.

"We see people all the time and we help to resolve all their carpal tunnel problems with no surgery, no injections. With just therapy and some of the specialized splints and procedures we have that can help those conditions," Alan added. "These work as well as surgery, if not better in many cases, but there are cases where the condition is serious enough that it does need to be referred to a surgeon. When that happens we send them to the specialist they need to see, but I would say over 90% of the carpal tunnel cases we see we are able to help them resolve their conditions without ever having to go see a surgeon. Almost always there is something that can be done to resolve it and the earlier we catch it the better. There are times when patients will wait to come in until it's just excruciating and I think it's because they just don't know help is available."

In talking about the methods used in Occupational Therapy, Alan explains, there is definitely, at times, a dynamic process. It often involves seeing a need and trying to think outside the box.

"Sometimes we have to say to a patient, okay, if you really want to be able to do this task again, we can help you figure out a way to do that. And it may not look like the way you've done it for the last forty years of your life but for the time being let's try it this way until you're able to do it the way you did before," Alan said.

The goal for the Alan and Danelle is to work themselves out of a job by helping patients to become as self-sufficient and able to take care of themselves as possible.

"That's what I tell patients. I either have to stop coming because you're not progressing, or I have to stop coming because you're to the point you don't need me any more. I'd much rather have the second option," Danelle stresses.

According to Alan, the two questions that define the focus of occupational therapy are:

One, how do we rehabilitate and restore normal function?

Two, if it's not able to be restored through rehab, how do we adapt a task in a way that makes it so you can still do it?

"If we can help you or if we can help an aging parent who might need to be safer in their home with the way they are getting around in their home, please come see us," Alan added.

With the one-two punch of Occupational Therapy and Physical Therapy, Precision Rehabilitation offers a wide variety of services to help the residents of San Juan County through their aches and pains and injury rehabilitation.

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