Share

By Brian del Poso, OTR/L, CHC, RAC-CT, Therapy Resource

Through this difficult time, all of us are doing what we can to pitch in while at the facility, or remotely for those of us who can’t go to our facilities at the moment. With the stress of our jobs, schools being closed, scavenging for groceries, etc., it’s easy for us to forget about taking care of ourselves or make excuses for why we can’t take care of ourselves right now. We tell ourselves “I’m too tired from my crazy day”; “I have to find something for my kids to do”; “The gyms are all closed”; “If I don’t read all of Mary’s COVID-19 emails right at this moment, I won’t be prepared for tomorrow” (yes, people, it’s sarcasm) … well, STOP IT! Yup, a Bob Newhart reference, and if you don’t know what I’m talking about, check out this clip here. I promise, it’ll brighten your day! https://www.youtube.com/watch?v=Ow0lr63y4Mw

As therapists, we know that exercise is one of the best ways we can take care of ourselves, relieve stress and increase our happy hormones! Just STOP IT, and create 15 to 30 minutes for you and your well-being to do some exercise while at home. Here are samples of some simple, basic routines you can try (a quick Google search will give you an idea of how to do the exercise if you’re not sure):

No Weights … No Problem! Body-Weight Circuit It Is!
Perform each exercise in the circuit for 45 seconds at your own pace, with 15 seconds of rest between each exercise. You can increase progression simply by increasing the number of reps you can perform in the 45 seconds or by increasing your work time/decreasing your rest time.

Routine 1
– Squats (modify by how deep into the squat you go)
– Push-ups (modify by performing on your knees or against a wall/table)
– Walking lunges (modify by how deep you lunge)
– Plank
– Side lunges (modify by how deep you lunge)
– Mountain climbers (modify by how high you bring your knee toward your chest)
– Standing scapular retraction (3-5 second holds)

Routine 2
– Diamond push-ups (modify by performing on your knees or against a wall/table)
– Glute bridges
– Crunches
– Triceps dip on a chair (modify by bending your knees in your start position)
– Single leg Romanian deadlift
– Leg raises
– Door-frame rows (modify by body angle)

Feeling frisky? Perform two to three sets of the circuit with two to three minutes of rest between circuits, or grab some of those cans and bottles you bought from the grocery store and add some weight to the routine! (Pro Tip: You can use HeartMath with quick coherence in-between sets to concentrate and slow your breath, re-clarify and refocus for the next set … I know, MIND BLOWN)

But Wait, I Only Have 5 Minutes to Spare … Perfect, Tabatas Only Take 4 Minutes!
Tabata Training is a form of High Intensity Interval Training (HIIT) that requires 20 seconds of high intensity exercise (going all out!), followed by 10 seconds of rest, for eight rounds. This 4-minute method is a fat-burning, metabolism-boosting, sweat-drenching workout that is the equivalent to doing 20 minutes of normal cardio.
– High knees
– Burpees
– Jumping jacks
– Mountain climbers
– 20 seconds of all-out work, 10 seconds of rest between each exercise, repeat for a total of 8 rounds

Not into these types of exercises? Some other things you can try: March in place while you’re reading that book or watching your favorite show; take a few laps up and down your stairs if you’re in a multi-story home; chase that dog of yours around your home for a few minutes; you get the drift. Also, if you are already part of a local gym/fitness club, check in with them. Many companies are offering their members online home training options. The main thing is, don’t concentrate on what you can’t do anymore because of the restrictions in place, but focus on all of the things we can do, and just keep yourself active!

We invite anyone who is able and interested to join us with HeartMath at 8:30 a.m. Pacific daily during this time. Totally optional! You can join for one minute or join for longer. We would like to use the “Global Coherence App” that is available for free to download if you are able! Here are the instructions:

1. Download the free Global Coherence App
2. Click “JOIN NEW GROUP” at the bottom of the screen
3. Our group is called CAPLICOwell
4. Enter the ACCESS CODE: IndigoOcean06
5. You don’t need a sensor! You can join with or without a sensor.

When you start the session and click on “map,” you can see everyone around the organization using the app!

Once in the group, I invite you to follow our steps to get your neurological system in balance as you regulate your autonomic nervous system:
1. Slow your breathing down to a comfortable rhythm of four to five seconds in and out.
2. Close your eyes if you are able.
3. Shift your awareness to your heart. It might help to imagine a warm light in the center of your chest, or place your hand on your heart.
4. Imagine your breath as flowing in and out of your heart.
5. Make a sincere attempt to bring up a positive renewing emotion such as gratitude, appreciation, maybe hugging a loved one or pet, maybe the feeling after an invigorating run, or the feeling looking at a sunset. Try not to think about the emotion, just feel it in your heart. It gets easier the more you practice!
6. Radiate this feeling out to our facilities and teams, our leaders and our patients.

Submitted by Jennifer Raymond, Therapy Resource — Northern CA

In January, Elyse Matson, MA CCC-SLP, Speech Language Pathology Resource/Ensign Services, provided an onsite half-day training course for the Flagstone NorCal Market Speech Language Pathologists and DORs.

The training content focused on how PDPM has changed SLP practice, including review of PDPM and SLP case mix, use of group and concurrent therapy, clinical documentation for both skilled and LTC patients, coding/goal writing, standardized testing, Medicare Part B utilization, dementia treatment utilizing Abilities Care, and the latest evidence-based practice and treatment techniques.

Since all of the SLPs in the NorCal market work independently in their facilities and many of them are geographically far apart, these therapists rarely are able to collaborate with each other in person. The course was an opportunity for them to meet face-to-face (some for the first time), share a meal, ask questions and discuss best practices with their colleagues, and update their learning together.

The course was enthusiastically received by our SLPs, as demonstrated in their comments below:

• “I feel more confident in documenting skilled services, great use of resources”
• “I have more tools now for providing abilities-based care”
• “I have learned new coding and documentation skills”
• “I feel more comfortable treating patients with dementia”
• “Now I really understand the increased role of SLP with PDPM”
• “Going forward, I know how to make my goals more specific on my POC”
• “Wonderful learning and networking afternoon; can we please do this at least every six months?”

In addition, by inviting the non-SLP DORs, it provided an opportunity for our OT and PT leaders to have a better understanding of the broad range of available ST clinical services, documentation requirements and processes specific to PDPM and LTC interventions for their SLP programs.

JB Chua, PT/DOR for Summerfield, shared:

“Attending the SLP training course gave me tools on how to support my SLP in growing our program. It gave me insight on what to look for during our Daily Technical Meeting. Triggers that will make me ask my SLP to screen a particular patient to help us capture an accurate clinical picture of our patients. Lastly, it also helped me understand words/phrases that SLPs use that a PT seldom or never uses in their documentation. Overall, this training course is highly recommended not only for our awesome SLPs, but most especially for DORs without an SLP background.”

Thank you, Elyse, for this opportunity to exercise our Passion for Learning in NorCal!

By Julie Uychiat, Clinical Market Lead – Arizona

Discovering running at a much later stage in life has been the greatest gift life has given me. It came at a perfect time when I needed a lift, to be reminded of my life’s purpose and overcome my self-imposed limitations. Running has given me everything … my renewed self-love, my self-confidence, my fearlessness, my grateful attitude and my purpose. It has inspired my new direction and outlook. It has taught me to push forward when things get difficult. In return, I am giving it my heart.

I come from zero running background. I hated running. In late 2015, my sister started running with my best friend. I remember asking her how she is able to run when I can’t even run from my house to the next stop sign without getting short of breath. She told me to just slow down my pace and keep going … further saying, “You won’t die.” Her words stuck with me as I attempted to give running one more shot that afternoon. I ran my very first 2.5 miles that day and remembered how incredible that feeling was. It gave me the confidence to join our Bandera Ragnar team in 2016, but I still wasn’t serious about running at that point.

In March 2017, I ran my first individual race, which was a half marathon with my sister. We decided to follow the 2:30 pacer. I wasn’t serious about it at first, conversing with her while running, answering texts during the race until around mile 8-9 when I saw how serious and competitive other runners were and thought to myself that maybe I should take it more seriously, too. I started giving it my best and got ahead of the 2:15 pacer to the finish. This race gave me a glimpse of the possibilities, although a full marathon was still out of the picture at that time.

In May 2017, two months after that race, I was at the Service Center for a meeting. There were about seven or eight of us in the conference room. Jess Dalton had his laptop open and told me that he wouldn’t be starting the meeting until I signed up for the St. George Marathon with him that October. I quickly refused and told him to give me at least a year, but he insisted. I made a deal and told him that if there was another person in the room who would sign up with us, then I would commit to doing it. The first person I asked was Rebecca Higbee, whom to my surprise said yes without hesitation. I didn’t know then that she was a runner, so I was committed.

Marathon training presented opportunities to discover the deepest parts of me at age 44. I didn’t know I had the discipline, passion and commitment to endure the hard work in spite of my very hectic work schedule and weekly travel commitments.

I Boston-qualified my first race that year, and that opened things up to a whole new exciting world for me. I am currently chasing the 6 Major Marathons in the world and since 2018 have completed four of six (Berlin, Chicago, Boston and New York). From these races, I have earned a respectable world ranking and received an invite to run the Wanda Age Group World Championships inaugural race in London this April. This is where I will be competing against 84 other top world runners in my age group.

I recently surprised myself when I ran my best race at the Phoenix Marathon on Feb. 8. I got very emotional when I crossed the finish and saw my time, 3:19:30. It exceeded our expectations (coach and I), and my heart was full once again.

I believe in Hal Elrod’s Miracle Equation:

Unwavering Faith + Extraordinary Effort = Miracles.

My marathon journey is a true testament to this. In fact, this equation applies to every other area in our lives. We just need to first believe that WE.ARE.LIMITLESS and put forth the effort to see the miracles happen.

By Dennis Baloy, OTR/L, OTD/DOR, St. Elizabeth Rehabilitation, Fullerton, CA

It’s 5:05 a.m.

You’ve already hit the snooze button twice. You get up, fix your coffee and open your laptop. You check the assignment board and check patient projection and staff scheduling. You take a sip of your coffee. You open your email, read your email and reply accordingly. You take another sip of your coffee. You are now more awake and you’ve started planning your day.

You take a shower, brush your teeth, and wake up your kids and get them ready for school. You finish dressing up and you drop off your kids, and now you are on your way to work. By this time, you have already replied to five people (both coworkers and family members). You might have taken or made a phone call or two. By this time, you’ve probably browsed some daily news, greeted some friends on social media and read some inspiring quotes to start your long day. You are ready. Well, sort of. Still, you feel like there’s a lot of things not accomplished, but you come to work as prepared as you can be.

Then your eight-hour workday commences.

You are done with the day. You’ve tied up loose ends. Made a lot of people smile. You feel productive, though there’s a couple more pending items that you are left to do. You did your best, and there’s another day waiting to finish it all up. You get the job done and another one awaits. “I can do this,” you say to yourself.

On your way home, you pick up your kids, run errands, fix dinner and help them with their homework. You take them to shower, read them a book and you finally have a few more minutes (sometimes when you are lucky, an hour or so) for you and your spouse to spend.

Then 5:05 a.m. strikes, and it’s back to the daily grind.

If this routine sounds familiar, then we are all in the same boat. Truly, we are creatures of habit, bound to do things over and over again. And it’s all good! After all, we try to manage our time in the best possible way, expecting the best possible productive result.

So where did my running affair start?

I am an average joe. I hated running and could barely run a mile. My knees would start hurting, and it just didn’t feel right. I know as a therapist, there are countless full-body workouts I can do to achieve the physical fitness that I want. But one thing I know about myself is I am always up for the challenge — physically and mentally. There is an inner adventurer in me wanting to experience life to its fullest. I love sunshine, the oceans and the outdoors. I can be a very laid-back person, yet I can switch it on to be a very competitive one.

So why do I run, and why run an ultramarathon?

1. The ultra “high”: Studies have shown that running and other physical activities release endorphins and decrease cortisol levels. Running definitely has a positive effect not only on your body, but also in your mind. A good run will leave me a clear mind and calmer self. Every time after I run, I come home a completely different person — more positive, understanding and caring. It’s definitely a mood changer. The lasting effects are definitely noticeable by your family, friends, coworkers and loved ones.
2. Empowering, develops resilience (and humility!): The feeling of accomplishing a goal, whether it’s buying a new pair of shoes, having your kid graduate from school, cooking a new dish, learning a new language or perhaps running your first 5K, will leave you feeling like a champion. There is no better satisfaction knowing you are able to accomplish the personal goals you’ve set. Conquering distances, facing hardships and dealing with pain during runs translate to life in general. Knowing you can push through these obstacles allows you to do the same in life. Not all runs you will finish, and not all life’s struggles you can face, thus running is also a very humbling experience.
3. Happily disconnected: It’s rare that we get disconnected in this technological world that we live in. We are always on our laptops, phones and TVs— so much so that being “disconnected” is a blessing. It is also by all means a choice. Being outdoors, may it be with or without music, and running give you this wonderful experience of being one with the world. It’s a religious experience that connects you and everything else that you see, feel and hear (the sights of nature, the sounds of wildlife and the drizzle of rain). It’s equally soothing, stress-relieving and euphoric.
4. You vs. you: As competitive as I can be (most of my close family and friends can attest to this <insert emoji of choice here>), I always believe in the Ironman mantra, “You vs. You.” Oftentimes you want to go faster, you want to go longer and you want to be the athlete you idolize. In the end, you are always reminded that the best part about this journey is just to be a better version of yourself. You want to be stronger, wiser and better than you were yesterday. This is more than enough.
5. Community: Lastly, running brings people together. Runners are such happy people in general. You all undergo the same painful yet satisfying experience. The community of runners helps each other finish their goals. There were numerous times when a running buddy helped and carried me ‘til I finished, and I’ve done the same — motivating and physically assisting them to the end. No wonder there are tons of running charities out there that aim to bring awareness of all different sorts (health, socio-civic, for-a-cause, running-tributes, etc). You get the above benefits, but more importantly, you are helping make this world a better place to live in. How cool is that?

My Journey kicked off way in 2017. I started with the Angels Stadium 5K, then completed all the Spartan Races, the 70.3 Ironman in Arizona last year and recently the 50K ultramarathon. I hope this story resonates with all runners or non-runners. We can all break our routine and try out this spiritual experience that not only yields physical gains, but also emotional, mental and psychosocial benefits.

….and before you know it, it’s 5:05 a.m.

Are you ready to lace up?

By Erin Huddock, PT, DPT, DOR, Vista Knoll Specialized Care, Vista, CA

When looking at what programs haven’t been tapped into, my ED and I decided to focus on outpatient and what we could do differently to get our program back up and running again. Outpatient at Vista Knoll Specialized Care has always been something that was never really focused on and was getting by with minimal referrals over the past few years. To start, we looked at our outpatient census and how we could gain more referrals. With that, we decided to make our rehab tech, Diana, the outpatient champion.

We first looked closely at our referral sources. A great way to start was to look into those referrals from patients who are currently in-house. We are already developing a great rapport with the patients and family members; they are comfortable with our therapists and it would provide a smoother continuum of care. And guess what? We can also keep a look-out for our patients who may be struggling or potentially be at risk for readmissions to the hospital and let our admissions coordinator know. It’s a win-win.

Next step, do they have insurance that we can accept? My rehab tech, Diana, will run the common working file on each patient who is here under Medicare or Managed Medicare that we contract with for outpatient. From there, we would discuss those patients who are appropriate to transition to outpatient during our weekly rehab meeting and would have Diana speak with the patients and discuss the benefits of returning to Vista Knoll for outpatient. Those who are appropriate and are interested, we let our case managers and social worker know to encourage the patient to transition to outpatient upon discharge. The biggest barrier that we have run into has been the lack of transportation for our patients who do not drive and do not have family. We do our best to assist those patients with finding options for transportation at the lowest cost possible.

It has been quite the team effort, and I really could not have done this without Diana, who has really taken to heart the care for our systems and the well being of our patients. Prior to starting this transition, we were averaging about four to five outpatients per month. To this day, we have been able to successfully maintain, on average, 17 outpatients per month with 55 percent of those referrals coming from our inpatient population.

Submitted by Amy Pot, PT, DOR, Escondido, CA

The sound of light drumming and laughter filters down the hallway as the residents and patients start to assemble for drum circle. “I like chocolate cake, that’s the beat we’re going to play,” instructs Amy Pot, Director of Rehab, and Lulu Matos, Director of Activities, to a group of residents and patients at Palomar Vista Healthcare Center. They are drumming along on Turbano drums to I Love Rock and Roll by Joan Jett.

Pot and Matos are passionate about providing opportunities to improve the lives of the residents at Palomar Vista and worked together to build a wellness program using music as a vehicle to address many health aspects. The drum circle was a perfect medium to bridge the goals of each department. “It’s so simple anybody can do it and have a good time. We really wanted to work together to provide a dynamic program that would include everyone,” said Pot. Every week, the drum circle continues to grow. Residents and patients who were hesitant to participate become involved because the buzz is so infectious and the experience can be tailored to address their individual needs.

There are many benefits of senior drum circles, including: decreased anxiety, stress and depression; sense of community and new social connections; improved ROM, posture and coordination; muscular endurance stress relief; decreased effects of senile dementia; and building thought process self-esteem and confidence.

The construction of each drum and drum stick promoted a sense of ownership as each were customized and built by each resident to fit their needs. Some of the residents have limited movements from severe arthritis or Parkinson’s disease or may be wheelchair bound. The drums were built at varying heights to accommodate limitations in ROM, and drum sticks were provided to residents who did not have the muscular endurance to complete a song and promote grip strength. “We had hoped the residents would enjoy it. The feedback from residents and family has been overwhelming. The drum circle has been so positive in promoting a sense of community and being able to bring residents together to create something wonderful. The outcome has been amazing,” says Matos.

The drum circle is strictly driven by residents’ needs. At the request of the residents, they recently performed a Christmas concert for family and friends and are currently working on an 80s music performance for the spring.