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Amanda Wilde (Host): Occupational therapists help patients recover and maintain daily living and working skills. We're talking today about exactly how occupational therapy works with Ashley Kwasniuk, Occupational Therapist with Eisenhower Health Rehabilitation Department.

Thanks for being here, Ashley. And just to make sure we're on the same page, how would you define occupational therapy?

Ashley Kwasniuk, OTR/L (Guest): Thank you for having me. Well, I want to start off by saying happy OT month, and it's a great time to share about this amazing profession. So occupational therapy, we help people do the things that they need to do and want to do, regardless of disease, disability, lifestyle, or injury; through the therapeutic use of occupations and meaningful activities. We work with many different types of patients over the entire lifespan, from birth to geriatric. OTs, we're very up to date on our research and we ensure our practice is always evidence-based. I pride that OT is staying very client-centered. Each treatment of ours is a plan that's very unique to each patient. So our aim is to help our patients become as functionally independent as possible.

Host: So can you give me an example of a kind of patient, even though it's a broad spectrum, someone who would be in need of occupational therapy?

Ashley: Sure. So for example we treat patients with multiple sclerosis. And these patients it's a progressive. disease. So we kind of meet them maybe in the early stages or we may work with them in the later stages. A lot of multiple sclerosis patients need assistance with endurance through their activities of daily living. So we help them adapt their activities so they can be more independent.

Host: So you're saying occupational therapy, you mentioned multiple sclerosis, then there's the geriatric patients. So anyone needing help maximizing their daily, practical living and working skills.

Ashley: Exactly. Yes. So I kind of look back on why I became an OT and that helps me answer that question a little bit better too. You know, what really drove me to OT is how it's so holistic and I'm a firm believer in treating the patient as a whole. I also love that perfect combination of both the art and the science, so both areas that OT runs really deep in. I absolutely love the sciences, the human body, the brain, psychology, research, but I love the arts. And as OT we get to be so creative. So with these patients with multiple sclerosis, for example, we're very client-centered and we look at their life and what components are important to them. So if this patient, for example, they have their mom and they're caring for their children. We help them in ways that they can do that safely, easier, more independently.

Host: Well, what do you mean when you say occupational therapy is holistic and an art? What are examples of how that plays into what you do?

Ashley: So we look at the whole person. We take in everything about our patients and what's important to them. So we treat their mental, emotional, spiritual, and their physical wellbeing because all of these aspects are factors into their recovery. Right? So we, don't just look at their range of motion and their strength. And we're not just helping our patients get dressed or go to the bathroom. It's so, so much more than just that. We look at how patients are going to live out the days of their life.

Host: So you really help people maximize quality of life.

Ashley: Exactly.

Host: But you must have to have tons of qualifications. I mean, you're not just doing physical therapy, then you, as you just mentioned you're sort of, you're a therapist, like a mental health therapist. You're like a physical therapist. I mean, it sounds like a lot of disciplines in order to get to the goal.

Ashley: It is, we do a lot. I think a lot of people don't realize that we do work in that mental health realm. But often like you were mentioning, physical therapy, the two fields are often confused.

Host: What is the difference between occupational therapy and physical therapy?

Ashley: Well, very simply put a PT focuses more on mobility and strength and OT focuses more on function. So we work hand in hand, and we're constantly consulting with one another, but I think that PT, they generally are more focused on treating large muscle groups, and a patient's lower extremities, as your legs are the basis for walking and mobility right along with other many other things PTs do. And then therefore, OTs, we focus more on the patient's upper extremityies while adding that holistic realm of care, which is unique to OT.I think so that it's often misconstrued. And I really want to clarify that OTs, we don't only treat the upper half of the body.

Host: Yeah. And that you treat the mental and emotional states as well. It sounds like.

Ashley: Yes. Yeah, exactly.

Host: So who is a good candidate? Who should be looking at signing up for occupational therapy, who would it most benefit?

Ashley: Well, a person can qualify for OT if there is a deficit affecting their daily function or quality of life, and then based on their needs, we may only see them maybe for a few visits or they may require more intensive care and frequent sessions. So questions that you might ask are, is the patient having difficulties in their ADL's, their activities of daily living. Are caregivers stressed, and, are they in need of training and support? Are there safety concerns related to the performance of their occupations? Would the patient benefit from adaptive equipment or modifications to their environment? Does a patient have visual loss, pain, physical limitations that may be impeding their independence? So all of these qualify a person for OT, but then there's children. too. We were also working with pediatrics and they qualify if they maybe have developmental delays, deficit's in their gross or fine motor. They may have problems in things like visual processing, oral motor, sensory processing, social skills, or a child's number one, occupation, play.

Host: So you work with all ages and stages of life. When you say occupational, it does sound like it's job related. Does occupational therapy help someone keep a job or find a job?

Ashley: That famous question, right. Everyone is always asking well, are you going to help me find a job? And I will acknowledge the name of our profession is very misleading. Isn't it. So let me clarify by defining the word, occupation. Occupations are meaningful activities. Occupations are the things that we do every single day. And many of these occupations we take for granted, such as cooking a meal, brushing our teeth, caring for our children, paying bills, or even giving a hug. And these occupations are not just something you do. They give you a sense of identity. It's something that makes you who you are. So for a minute, Amanda, think about this. How would you describe yourself? Right. I would say personally, I'm an OT. I love the outdoors and hiking and I love cooking a good meal for my family. These are all the things that are important to me, that I value and they make up who I am, my identity. So we come in, OTs when something disrupts your participation in these activities.

Host: And with certain diseases or aging process, can a condition be too far advanced for OT or is OT always going to be there to help improve whatever stage you're at?

Ashley: We are very creative, like I was saying, and we really break down an activity and look at all the different components. So we really can meet the patient where they're at. We can work with them at that advanced stage and break it down to the simple components of that activity and even help with that caregiver support and training so we can help their loved ones better support them and take care of them.

Host: So I don't hear any drawbacks. Are there any downsides to occupational therapy?

Ashley: I don't think I would be able to think of one. I think it's just an amazing profession.

Host: Well, the past two years have been a significant challenge because of COVID. How did the occupational therapy profession deal with COVID or contribute to COVID care?

Ashley: Yes. What a last couple of years. So OTs, along with the rehab team, physical, speech, respiratory therapist, we're all a huge component of COVID care. We have been working with these COVID patients from the very beginning and our treatment includes many of those same components as a regular treatment. The patients have the same goals, but the therapist has a very different approach. So treatments often include a greater emphasis on energy conservation. Within our typical session, we focused on specific breathing exercises and positioning so we can maximize their respiratory function. For example we may be working on getting a patient sitting edge of bed to wash their face and this task may seem so simple, but for the patient, it may feel like the hardest thing they have ever done. So in doing that, we're working on sitting balance, we're working on strength and endurance all while we're working on function. So you know, there's this great need for therapists to be in there working with these COVID patients.

That's evidence really shows that dire importance of early mobility and getting these patients up and moving. And, and then there comes, you know, with there is that great need to help these patients be even more independent because when they return home, they often had to quarantine and maybe they didn't have that same assistance from their loved ones. So we hone in on that energy conservation and those adaptive techniques, so they can be safe and they can be independent when they're home.

Host: Yeah. How do you maintain those changes once somebody is at home and doesn't have you right there?

Ashley: Well, I think it depends on the patient or sometimes, unfortunately they're not safe to go home and we would recommend rehab. But we really, we try to recommend certain assistive equipment like bedside commode, reachers that can help make them more independent and safe so they can still do all those things that they need to do when they get home.

Host: So now that we've taken a look back on these COVID years, looking forward now, what shape do you think the future of occupational therapy will take?

Ashley: The future of OT, I think is very, very bright. I think we're just getting started and OT, we have such a distinct value. Our profession has a very special lens that sees things much differently. So I think that OT you know, we have a bright future ahead of us and hopefully we can chat with you all sometime soon on some of those specialty areas of OT.

Host: Yeah. What are some of the specific areas where OT comes in?

Ashley: Well, for example, lymphedema. We work with lymphedema patients in one of our outpatient, facilities at Eisenhower. Eisenhower's also working in our newly opened NICU. We work on hand therapy, neuro rehab, pediatrics. We are just all over the place. Even outside of Eisenhower, OTs are working in settings like psychiatric hospitals and within the schools and within corporations.

Host: So OT is really growing, it sounds like?

Ashley: I would say yes, we're growing. We're really branching out into a lot of different specialties and different areas. There's a need kind of a niche and with so many different types of patients that we can address for them.

Host: Well, you mentioned that you had your personal reasons for going into this field and how exciting you found it. I think it does sound like it takes a special person who can incorporate lots of disciplines and who is sensitive and compassionate to really be a superior occupational therapist. Would you agree?

Ashley: I definitely agree. Shout out to my colleagues because I think that the OTs, I think you know, they're very special people. It's, it takes a special person to do it and to be empathetic and you know, while being, it's an art form. So being creative and having that mind of science it's such a, an amazing, amazing profession and group of professionals that work with us.

Host: I just learned from you that April is OT month. So, how do we celebrate?

Ashley: Oh, well I think this is a start. This is a great, celebration. As I was saying occupational therapy is often, confused with finding a job. And you know, people often don't know what we do. So what would mean a lot to me is spreading the word and letting others know what occupational therapy is to help us advocate for this beautiful profession.

Host: Well, Ashley, thank you for the meaningful insights and for your work in occupational therapy.

Ashley: Thank you so much. You're welcome.

Host: For more information about Eisenhower Health's Rehabilitation Department, go to Eisenhowerhealth.org/rehab. If you found this podcast helpful, be sure to share it with friends and family and subscribe as well. Thanks for listening to Living Well with Eisenhower Health, health care as it should be. I'm Amanda Wilde. Stay well.