In order to begin shadowing I was first required to pass a background check and give a copy of my fingerprints to the police department. This is normal for anyone going into healthcare occupations for internships or employment. I also was required to read thoroughly through the confidentiality agreement of Stonehenge of Cedar City.
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After the paperwork I was immediately introduced into the work that went on. The therapist introduced me to assessments used to determine a client's ability to retrieve information, assess balance, strength, and cardiovascular endurance. No two clients are treated the same, even if they have a similar problem. I only saw two of these initial assessments for incoming clients, both had back issues. Regardless of the similarities, each client had different goals they wanted out of therapy for when they returned home.
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One of the first lessons given to me was that occupational therapy gives treatment that with help the whole person. This means that aside from physical improvements, clients are advised by occupational therapists on how to perform necessary tasks everyday. Showering, dressing, moving in and out of a car or wheelchair, and picking things up are just a few examples. Some people are severely limited in what they can do, but these therapists give them handy devices that can be used to pick things up from the floor, or clean themselves in the restroom.
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Most clients leave after a few weeks due to insurance limitations. I still learned how to help someone out of bed by putting them in proper positions and I was allowed to retrieve equipment for the therapist to use. My favorite was the putty with hex nuts in it. It's an effective tool for building hand musculature as well as for conditioning the digits to make fine motor movements.
Much of the time I was just following and paying attention to the diagnoses of each client, but I was attentive to hearing about treatments too. A client with heart disease might have to walk around the clinic while I shuffled behind with a wheelchair. Occasionally there would be checks for edema or swelling of the legs due to poor circulation. Almost everyday I would be standing near the shower room and observing the instruction for how to move safely around the room or to get on and off the toilet. Only once did I actually observe the shower instruction for real. Even though I felt awkward being in the room, I learned that this practice is very important in therapy and the therapist bears the responsibility of ensuring the client is safe to go back home.
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I noticed how much therapists rely on communication with each other in order to assist each client at reasonable times of the day. They collaborate every day so they can make a schedule block in which to fit in the names of people days in advance. Sometimes the therapists go back to back with a client for various forms of therapy, or they split treatments into morning and afternoon sessions. Each time they pass in the hall they'll say things like "I got room 9 just now. Were you able to see that client about their question form yesterday?" They are general in what they share in passing for the sake of privacy, but in their offices they can be more open and give each other updates. However, they are careful about information floating around on paper. If paperwork about a client is being used in a room that is shared the paper is face down. Otherwise it is on the person of the therapist and out of sight.
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The actual therapies were designed to provide optimal results based on each client's goals. Cardiovascular exercise used a portable arm cycling machine since many elderly patients don't have the endurance in their legs and because the facility wasn't meant for running. Sometimes just standing in place was good enough for cardio.
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Balance exercises were often done with two long bars around four feet up from the ground and parallel to the floor. Clients could practice moving cups from one desk to another using the bars to stay up. There was also the range of motion loop, a rubber arch with rings around it that could be moved while standing if the client was n good enough condition to try it. In occupational therapy the shower bars are probably the most practical tool though because mobility in a shower is essential yet can be dangerous.
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Clients come into Stonehenge and are often weak form surgery or hospitalization of some kind. The are given tools to build physical strength and to reprogram the nervous system to fire signal when appropriate. Resistance tools like elastic bands, dumb bells, and the putty are utilized so that every activity a client does when they leave will be more feasible for them.
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Occupational therapists work with clients until they refuse to receive treatment or they feel confident and more independent with less pain. Everything the therapist does has a purpose driven towards meeting the client's goals and helping to regain some more sense of self-efficacy.
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