OCCUPATIONAL THERAPISTS TEACH INDEPENDENCE

Renelda McClarney, left, a registered occupational therapist at St. Francis Rehabilitation Services in Cape Girardeau, worked with Mary Moit of Chaffee, who's recovering from a nerve injury in her arm, to thread some pegs in a coordination test to improve hand function.

Janet Drozd, an occupational therapist at Southeast Missouri Hospital's pediatric speech, physical and occupational therapy program, helped Travis Jones, a 5-year-old from Cape Girardeau, to lasso a column from a swing. Drozd said the roping therapy helps Travis, who has cerebral palsy, with his balance and forces him to extend his arms from his body.

Kathy Yallaly, left, director of rehabilitation services at the Cape Girardeau Nursing Center, helped Ella Costello, who is recovering from a broken hip, to stand and brush her hair in an occupational therapy session.

Whether it's a baby with Down's syndrome, a child with cerebral palsy, a teen-ager with a spinal injury from a car accident, a middle-aged man with one arm after an industrial accident or an elderly woman convalescing from a stroke, the occupational therapist participates in their recoveries.

Therapists work on basic life skills with patients to help patients achieve their highest level of independence, said Ellen Holcomb, a registered occupational therapist who's worked 4 1/2 years at St. Francis Rehabilitation Services in Cape Girardeau.

For Maribeth Ruder and Janet Drozd, both certified occupational therapists at Southeast Missouri Hospital's pediatric speech, physical and occupational therapy program, their work may look like play, but that's what infants and youngsters are supposed to do that's what they are teaching.

"We may help them to reach for things, crawl and sit," Ruder said about infants who receive treatment in the hospital's therapy program.

Ruder said the therapy with an infant may be aimed at helping the child control his body and head while he uses his hands for another task, such as reaching for a rattle or holding a bottle.

Late development of skills or birth defects are common among premature babies and children with cerebral palsy, Ruder said. She also works with autistic children and those with genetic disorders.

Some of the goals for children might include getting them to sit up, to crawl to a ball, to use their hands correctly when grasping something, to dress themselves and get ready for school or to improve their writing or attention in class. The purpose is to help them function at home and in school, Ruder said.

The type of therapy depends on what skills are needed, Drozd said. The physical therapist and occupational therapist may use the same type of activities, but the focus is different. The occupational therapist is trying to adapt patients' skills so they will be functional, she said.

Holcomb said treatment from occupational therapists at St. Francis can start while a patient is in the intensive-care unit. Transitional care is available to a patient followed by acute rehabilitation before they are ready to leave the hospital. Occupational therapy can then be provided on an out-patient basis.

The occupational therapists make home visits to check what's needed for the patient to get in, out and around their homes, Holcomb said. Therapists deal with all the family members so everyone knows what is needed and possible.

Therapists can make suggestions on modifying bathrooms, kitchens, bedrooms and doorways if a patient is still in a wheelchair or has some other handicap. The therapists may also help patients with their interactions in the community, such as transacting business, shopping or using an automatic teller machine at a bank.

Occupational therapists can provide very intense care for patients with head injuries, back injuries or neurological disorders, such as those suffering from strokes, aneurysm, heart attacks or spinal cord injuries, Holcomb said. Therapists also work with arthritic patients to help them limit the effect of their condition, she said.

Sometimes, it's a case of showing a patient various ways to compensate for the loss of a particular function, Holcomb said. Coordination exercises may help a patient to put toothpaste on a toothbrush. There might be peg activities to improve movement and coordination. Computers are sometimes used to test response times.

Kathy Yallaly, an occupational therapist and director of rehabilitation services at the Cape Girardeau Nursing Center, works primarily with elderly citizens, average age, 75.

She said occupational therapy plays a role for those residents who come to the center for short-term care and rehabilitation, such as those with hip fractures or those who have had a heart attack or stroke. More and more residents are able to return home with training to accommodate their limitations.

For those who stay, therapy helps them to be as independent as possible in taking care of themselves. It might be as simple as the ability to feed themselves or to go to the bathroom without help, Yallaly said. The therapists work a lot on transfers -- from a bed to a wheelchair, from a wheelchair to a commode.

"That means less work for the nursing home staff and it's better for the residents because it helps with their self-esteem," Yallaly said.

Therapists work on the basic things essential to living and also include leisure activities when possible, Yallaly said. She's helped patients relearn how to shop, cook, feed and care for themselves, all necessary for someone to return home. She once helped a stroke victim learn some one-handed techniques so he could again enjoy fishing as a pastime.

For rehabilitation, an occupational therapist tries to simulate life skills to help a patient reach his maximum potential, Yallaly said. A therapist looks at how a patient functions in his environment and considers the whole person and other family members in arriving at a potential solution and training program.