OT Stories

Submitted by Ana Nagata, Occupational Therapist

My journey as an occupational therapist began in 2019, when I graduated from Universidade Federal de São Carlos, SP-Brazil, with a great passion for the profession and a desire to help people overcome their challenges. After graduating, I had the opportunity to travel for work in Japan. There I used to work in car supplies and other factories to save money for my Especialist Course at CLASI in Brazil. After my daily work, I was a volunteer for a Brazilian project named Sakura's Project, where I helped Brazilian families who live in Japan with health issues who are not fluent in Japanese to have access to mental health support in NOGs and Brazilians Consulate-General of Brazil in Tokyo, and treatments in their language. Working there I learned about different approaches to occupational therapy in other countries; this international experience was crucial for my professional growth. Then in 2020, I saw the start of COVID-19 in Japan, and I was facing this new context of worldwide life. By engaging with the practices adopted in other contexts, I was able to see patients' difficulties from a new perspective, understanding them as opportunities for development rather than just as obstacles to be overcome. This broader and more flexible outlook on the rehabilitation process helped me refine my clinical reasoning. I began to see each case as unique, adapting my interventions to the specific needs and particularities of each individual. Concurrently, I dedicated myself to studying and delving into the international occupational therapy literature at AJOT and AOTA publishing. Access to publications and texts in English was essential for expanding my understanding of the profession and improving my writing and communication skills in this language. I decided to move back to my country. To save money for this, I needed to quit the volunteer job to save money and move to another province in Japan—from Gunma Ken to Kanazawa Ken. This journey of personal and professional growth has made me the occupational therapist I am today—someone who sees difficulties as opportunities and constantly seeks to enhance their practice to provide the best care for their patients. Now in Brazil, I do my CLASI course, and I recently got my Certificate in Ayres Sensory Integration. I'm thankful for all the learning and sharing we have in this OT community worldwide, and now I'm very proud to be an AOTA member even If I don't live in the USA; being a member is a plus.

Submitted by Nancy Marin, OTR/L, C-NDY, IYT

With this being the last few days of OT Month, I wanted to share a few of my thoughts of how I feel and continue to be INSPIRED as an Occupational Therapist (with over 41 years experience).

I’d say these are my top 10 (or 12), but obviously could go on and on about why I am passionate for the field of occupational therapy: Here you go!!!

1. Inspired by having my own company, Occuplay, Inc. for the last 24 years

2. Inspired by my amazing coworkers and interdisciplinary team that I have the pleasure to work with daily at Beaches Speech Therapy, Intentional Play, Inc., Up Beat Music Therapy, Pediatric Partners of Ponte Vedra, and so many other fabulous professionals in our community

3. Inspired by all of my incredible families and hard-working (playing) clients over the many years who bring me such joy, where I get to witness their accomplishments and successes every single day

4. Inspired by the students that come from various universities to complete their internships as they embark into this profession

5. Inspired by the student volunteers who are just seeking out and learning about the field of OT

6. Inspired by my previous mentors and previous coworkers at Pediatric Therapy Associates who shaped the therapist I am today

7. Inspired by having advanced training in NDT, SI, Integrative Yoga Therapy, The Listening Program, and so many other excellent continuing education opportunities from other incredible professionals in the field

8. Inspired by the opportunities to teach for CIAO Seminars for over 20 years

9. Inspired by the opportunities to learn, coach, and mentor for The Listening Program and Vital Neuro through Advanced Brain Technologies

10. Inspired by continued advancements in neuroscience, neuroplasticity, and new technology that enhance the lives of those we work with

And two more for good luck

11. Inspired by my own family who supports me every step of the way and to witness the beauty of pure pleasurable play with my own grandsons who teach me many lessons daily

12. Inspired by my mother who sadly has dementia and in memory care where being an OT has given me the emotional and creative tools to cope on the daily and to bring some joy to her and the other residents in her memory care facility

I am forever grateful for choosing a profession where I can make a difference and be a part of so many on their journey to wellbeing, where we always presume competence, and have true connection at the deepest level.

I hope in some small way I have INSPIRED you. I'd love to hear your stories of what inspires you and/or how you have benefited from the field of OT.

Submitted by Roger Lo, occupational therapy student

I am an occupational therapy student in the States and used to be an OT in Taiwan. Before I resigned and came to the United States, I worked with a child who was two years old. He was diagnosed with developmental delays, significantly lagging in actions, social interactions, and play, and was very timid. At the beginning of the therapy sessions, it was pretty challenging for me because if his mother participated alongside him, he would become overly reliant on her and unwilling to try exploring or practicing on his own. However, if his mother didn't accompany him, he would start crying almost as soon as he stepped into the therapy room and would continue until the end of the session. With his mother, I tried to identify what triggered his emotional responses. I experimented with different games and interactive approaches each session, but none kept him consistently happy and engaged in this playful environment. Although I consulted with colleagues and discussed the situation with the mother, I still couldn't find the reason. So, every Tuesday afternoon became the time when I felt most powerless and frustrated because I didn't know how to get this child to open up and accept me. I asked a female colleague whether she could take over the case, thinking the situation would be different.

Around the eighth session, as I crouched by the therapy room door, I could hear familiar crying in the distance because the child knew it was time for his session. That day, the child's mother had to rush to pick up her daughter from school so she couldn't accompany him inside. I looked at the tear-stained little boy sitting on the floor by the therapy room door and felt like I had run out of ideas. I slowly picked him up and began to walk around, and gradually, his crying seemed to diminish. Knowing he loved cars, I held him and looked out the window at the cars passing by on the street. He began to point at the cars with his fingers, and then there was this joint attention that we could work on: the colorful array of vehicles of all sizes on the road. Thus, a solid therapeutic relationship was slowly established.

Gradually, I developed a shared language with this child. Regardless of whether his mother was present, he began to explore and interact more, sometimes trying out new toys and games, although he still had a strong attachment to toy cars. I arranged for him to have sessions with another therapist's client, which helped him engage more socially. As I approached my resignation, he finally started playing simple pretend games and cooking games. Perhaps what I learned from him outweighs what he gained from me by far. During our time together, I often question myself and wondering if I was truly suited to be an occupational therapist. However, I persisted until the end, and the child made significant progress. His mother made cookies and wrote a card to me, thanking me for my patience and care. She also acknowledged the progress her child had made over the past six months. And I knew I can still be a good OT and change people's lives.

Submitted by Shivani Vij, OTD, OTR/L

John (Pseudo-name), a retired engineer, had always been passionate about art. However, a stroke left him with limited mobility in his dominant hand, making it nearly impossible for him to paint—the one activity that brought him immense joy and fulfillment.

When John was referred to occupational therapy, he was skeptical about how much could be done. However, I was determined to help him regain his artistic abilities. I started by assessing his hand function and understanding his goals. Using a combination of adaptive equipment, such as modified paintbrushes and easels, and therapeutic exercises to improve hand dexterity, I worked with John to develop a personalized rehabilitation plan.

As the weeks went by, John's progress was remarkable. He regained enough strength and control with guidance and support to hold a paintbrush and create basic strokes. I also introduced John to adaptive splinting, a technique in which a custom splint is designed to support his hand in a functional position, allowing him to hold the brush steadily. With this newfound support, John's confidence grew, and he began experimenting with different painting styles and techniques.

His second chance at art was his remarkable journey to recovery. Each painting was a testament to his resilience and the transformative power of occupational therapy. Today, John continues to paint and inspire others with his story. He credits occupational therapy for allowing him to create art and a renewed sense of purpose and passion for life.

Submitted by Yung Hsin Chang, Post-professional Master's of Art in Occupational Therapy student

"Do I still want to be an occupational therapist?" I asked myself when I was writing my personal statement to apply for the post-professional master's program in occupational therapy at USC. At that moment, I had been working for a year in Taiwan. I needed a reason to stick to occupational therapy and travel away from home to devote myself to a graduate degree program. This story is the reason that I chose occupational therapy again.

I worked in a public hospital during my first year as an occupational therapist in Taiwan. I mainly worked with patients with neurological conditions. I worked with post-acute patients, inpatients, and outpatients. One day, a new patient was referred to the rehabilitation department. She is the typical patient with a stroke, right side hemiplegia with the motor control ability at Brunnstrom stage II, activities of daily living needed moderate assistance, and was taken care of by her husband. I approached her just like I approached other patients with the occupational therapy lens. I did the evaluation, understood her occupation history, and designed a treatment plan according to her priorities. I also noticed she looked tired and discouraged. I tried to explore things that were important to her and help her achieve them. For instance, I taught her how to wear a jacket by herself since she did not want to bother her husband to help her every time they went outside. I also provided feedback on her small movement progress. As days went by, I saw her face start to lighten up. One day after our session of practicing to balance herself when standing so she could stand by the window to look at the scenery outside safely, she held my hand, looked straight into my eyes, and said, "thank you." The sincerity in her voice hit me like a wave. I thought, "this is why I am proud to be an occupational therapist."

It was moments like this that proved to me the value of occupational therapy. I can never guarantee patients that they can recover to where they were. However, with the occupational therapy perspectives and skills I have, I can help the clients establish a life that is meaningful to them that they did not dare to dream of. I saw hope shined in this and many other client's eyes after occupational therapy. Occupational therapy is a profession that strongly supports people to live meaningfully.

Submitted by Christie Briskey, OTR/L, MOT, CBIS, CSRS

(This was written by a client and from his perspective)

In late March 2022, I woke up one morning very confused. Everything felt wrong, and I felt disconnected from everything. As the fog of sleep wore off, I realized everything was wrong and I really was disconnected. I was in a strange room and I could only move my right arm. A short time later, my wife entered the room. She explained I had been in an accident and survived traumatic brain injuries. The reality of what happened and the state I was in set in, I lost all hope and thought I would be a burden on my family.

The next day I was moved from the trauma unit at the hospital to the rehabilitation center. After I was settled in a new room, I met some of the occupational and physical therapists who would be working with me. At that time, I had no hope of recovery. I felt broken and could not see how I could ever be fixed.

The first day of therapy, an occupational therapist convinced me to get out of bed and try. She and my wife helped me sit on the edge of the bed. Then using a board, slid me from the bed to a wheelchair and buckled me in. She wheeled me to a large room known as the gymnasium, where many patients and therapists were working. The session that morning was to work on my left arm and hand. Due to the brain injury, I could not move them. This was devastating, as I was left-handed. I tried and tried, but it was no use, no movement at all. Even with my loss of hope, the therapist’s positive encouragement kept me motivated. Where I was unsuccessful in causing any movement, the therapist put several sticky pads with wires on my arm and hand and connected the wires to an E-stim unit or electrical stimulation unit. At first there was just a tingling sensation in my hand, but as the intensity grew the feeling increased to what felt like a spark. With that spark feeling, we saw movement. I was not controlling it, but there was movement. Was the spark that gave me the first glimmer of hope.

In the following sessions, we continued working on my left arm. Again, we used the E-stim unit to stimulate movement, and then me trying to move my hand. In one session it happened, I thought, and my hand moved. The rest of the morning and into the afternoon I kept thinking and moving my hand. Later in a session with another therapist, I noticed the therapist from the morning walking towards me. I raised my hand and waved. Her excitement about what I was doing was magical. Seeing someone else as excited as I was about that small accomplishment changed the glimmer of hope into undeniable hope. I had a long road ahead in my recovery but at that moment I was convinced I could and would complete the journey ahead back to my life.

Each session we made progress, even if it was just a tiny bit. It was all progress towards me recovering. As movement and control progressed, we added in exercises I didn’t fully understand, like weightbearing tasks with me in quadruped and lateral leaning positions to help elicit neural recovery. All I cared, was that the therapist knew what was needed and I was making progress. We soon progressed to a lot of task practice, such as intentionally using my left-hand during tasks like dressing, shoe tying, brushing teeth, and any everyday task we could think of.

At the end of my inpatient stay, I had not fully recovered, but I was well into the journey of recovery. I could feed myself, dress myself, and do any other basic task. I no longer felt broken, and I knew I could be fixed. I was not ready to return to my life, but I was ready to go home and continue the journey. I had put in a lot of work to reach that point, but I could not have done it without the Occupational Therapist who convinced me to get out of bed and try the first day. She and the other therapists motivated me through the struggles and were there with me celebrating every achievement no matter how large or small. As I prepared to leave the rehabilitation center, I knew it wasn’t just a big day for me, it was a big day for all of us. For me I was heading home with the skill and hope I needed for the journey ahead, but for the occupational therapists it was a day they had graduated another patient, having helped them get a start on returning to their life.

After returning home, I started outpatient therapy with occupational and physical therapists. Outpatient therapy built upon what we had achieved when I was an inpatient. Now, where I had the basics under my belt, we concentrated on the fine motor skills I would need. We worked on moving and stacking coins, drawing, writing, memory skills, and following directions to complete complex tasks. A side effect from my brain injury was double vision, so we worked on eye exercises like pencil pushups. After time and a lot of pushups, the double vision went away.

As my abilities progressed, the occupational therapists talked to me about support. They had been supportive of me all along, but this was about support after I graduated from therapy. They introduced me to support groups. The support groups provide a safe space to talk with other people with similar injuries and who are going through or have dealt with issues like mine. It is a space where people truly understand what I am experiencing. It helped tremendously to hear that I am not alone and the others are there to support me through whatever I face.

One support group had a meeting in December 2022, and it was held at the Rehabilitation Center, so I was very excited to attend. It was my first time returning since my inpatient rehabilitation ended. One of the members in the group remembered my inpatient rehabilitation was there, so she suggested I walk around the halls. As I walked, the realization how far my recovery had progressed overwhelmed me. In my excitement earlier in the evening when I left my house, I forgot my cane. I was walking completely unassisted in the same place where 8 months earlier I had no hope I could recover. I still had the hope the occupational therapists helped me regain, but that night realizing what I had achieved made the hope grow stronger. It was another incredible moment in my recovery I will never forget.

After months of hard work, and a lot of memorable times, I graduated from therapy, with the skills and hope I needed for the next step, returning to my life. The day I graduated was a very happy day, but at the same time there was a little sadness. I had worked with incredible occupational therapists and I would miss them. They are much more than therapists, doing a job. They are some of the most caring people I have known, and they are doing what they are passionate about, helping others heal. That passion is what returned hope to me and returned me back to my life. I will be forever grateful to the occupational therapists I worked with.

Submitted by Susanne Giannitti, OTR

I write a monthly "newsletter" on OT Hacks. The theme for April was OT Month: Promoting OT on a Budget

Whether you are a new grad or a seasoned therapist; OT month rolls around and there is the collective “what are we going to do?’, “I’m not into it”, “I don’t have the time or energy” etc. I get it, and I have been there. I just wanted to share over the years what I have done to promote our profession with very limited resources.

• If food is your departments’ desire, try having an OT Tea break: dOnut holes (munchkins) and T(ea) Finding the OT in food.
• If you order pizza get one round one and one Sicilian one and place the squares in the shape of the letter T. Now you have an O T pizza party.
• Dessert—cookies, there are cookie cutters in the shape of hands.
• Posters:
  • Find OT memes, copy and pin them to a bulletin board.
  • Create a bulletin board with members of your OT department’s baby pictures and have a contest to see if other staff members can guess who you are. At least they can now identify you as OT and not PT.
  • Another bulletin board idea could be having OT staff members write a paragraph about why they wanted to become an OT. It will give other staff members insight into you and our profession.
  • Pick a day and have OT staff members wear a pin or OT Tee shirt.
• Have your OT “badges” put on your email closing or your favorite quote as it relates to OT:
  • “It is neither wealth nor splendor; but tranquility and occupation which give you happiness.” — Thomas Jefferson, Personal letter to his sister
  • “Man, through the use of his hands, as they are energized by mind and will, can influence the state of his own health.” — Mary Reily, OTR, EdD
  • “You treat a disease: you win, you lose. You treat a person, I guarantee you win-no matter what the outcome.” — Patch Adams
• Give you OT besties post it notes
• Plant OT seeds—When my daughter was in the 2nd grade, the school had a career day and I felt it was important to represent OT. I brought in a hip kit and did demonstrations, an artist friend of mine made a ‘coloring page’ of an OT showing a person with hemiplegia how to dress (I will try to find it and share it with you), and a word search with OT content. Three years later a received a phone call from a mother who asked if I was the person who “helps people do things that they can’t?” The school was having an “Invention Convention”, and her daughter was trying to make a device to help her grandmother cut her nails independently. I was truly touched that the child remembered me and what OT could do.
• Many years ago, I left an OT Practice magazine in an airport waiting area, as I was finished with it and thought someone else could pass the time with it. This was before cell phones and identity theft. I received a letter (because I inadvertently left the mailing label on it) from a woman who stated that she did not know what OT was and really would seek out a referral due to reading this magazine. This gave me the idea of leaving my OT Practice magazines in doctors’ offices. The pediatrician got the one on play, the oncologist got the cancer issue, my GP got the aging edition, etc.
• Get involved in a community/church/civic/school/board activity and you’ll see how much OT you bring to the table.

Submitted by Heather Burakowski, COTA/L

This story is about inspiration, dedication, and of course occupational therapy. However, it is not about me. This past year I have watched my friend and co-worker recover from a life changing event. Next month, it will be one year since she suffered a stroke. Every day since this incredible woman has proven over and over again that she can not be stopped. Her stroke left her with left side hemiparesis in which she has gained back much of her movement. Through out her stay in the hospital and rehabilitation she shared videos of her therapies so her friends and family could be a part of her journey along the way and one thing remained the same, she never stopped smiling. She will forever be the strongest woman I have ever met. She returned to work 5 months after her stroke because as I said before, she's just unstoppable.

Since returning, I have watched her continue to make gains. At first, being driven to work and using a wheelchair. Now to independently driving and no wheelchair, experiencing adaptive skiing and loving it, and has now discovered a bioness unit which allows her to walk more independently. Of course this is only a short synapsis of what she has overcome and what she continues to gain. This woman exemplifies occupational therapy in not only her job but her life.

She is an inspiration to...well...everyone. Especially me. I continue to be awed by her, learn from her and admire her determination to heal and her determination to continue to give to our profession. Throughout everything she continues to be a mentor and motivator for her coworkers, her students and peers.

She has taken her knowledge of OT and her passion for life and proven that no matter the obstacle there is hope, people are unstoppable, and goals are achievable.

So to you K.R OTR/L, YOU are an everyday inspiration and I am forever proud of you!

Submitted by Nikki Beatrice, OTD

I like to think of our work as not always being about the interventions themselves, but the process along the way. My work in Mental Health OT, is to meet patients where they're at in the moment, despite how challenging it may be for them.

RC was a patient, who had been on our inpatient psychiatric unit, for about 2 years, while awaiting a bed at the MA State Hospital. Through his time on the unit, he attended many OT groups, with his favorites being, task/art groups, music therapy, and pet therapy, with our hospital facility dog, Bob. Over the years, our OTs were forced to get creative, in order to provide new, creative, and engaging groups for BC to participate in. He baked a homemade pie from scratch in our unit kitchen with OT, to prepare for a Thanksgiving meal on the unit. He wrote poetry, and sang songs, for our musical talent shows. He also began tapping into his creative side, with learning how to paint with watercolors.

RC recently reached out to me, to let me know that he is doing very well, has left the State Hospital, and is applying for jobs in the community. He has written and illustrated a children’s book that is available on Kindle, and gave me permission to share it with the team. He began working on this project while he was on our psych unit, and often worked on paintings during OT groups. He let me know that he is grateful for everyone who was on his team, and has learned self-worth along his journey. All of the proceeds from his book will go back to supporting mental health programs in the Boston community. I was amazed to find, that within the first few pages, he had dedicated the book to me, and other OTs who have helped him along his journey!

An excerpt RC writes, "A couple of years ago I had what used to be called a "breakdown." I spent some time inpatient and experimented with watercolors and sketching. I eventually got better. I began writing this story in the psych ward at Tufts Medical Center and continued the artwork at Tewksbury State Hospital. After release, I continued the illustrations with a firm completion date of December 31, 2023. I came across a quote by Noah Hill, "A goal is a dream with a deadline." Sometimes you can make dreams come true."

Submitted by Nicole Plutino, MS, OTR/L, BCP

I love working as a pediatric occupational therapist and helping children reach their boundless potential each and every day. One of my clients with cerebral palsy who I have been treating since he was 2 years old was able to enter kindergarten in a typical classroom this last Fall with minimal supports and the parent expressed her thanks by saying, "Thank you for helping us prepare for this day. I would have never dreamed 6 years ago we would start kindergarten on time. I appreciate you more than you'll ever know!" And it is messages exactly like this one that makes me work harder and think bigger as an occupational therapist for my clients and to me, is the epitome of the boundless potential of the profession.

Submitted by Isabel Salazar, OTR/L

What I love about OT is that I really am just helping individuals do things: do things again, do things they have difficulty doing, find an alternate way of doing things. It's really about helping individuals do things that are meaningful. I work with infants, school-age children, and adults with physical disabilities.

Submitted by Kaori Nakamura, MS, OTR/L

Please read my story, "The Gift of Independence" in Colgate Magazine: https://news.colgate.edu/magazine/2022/11/16/the-gift-of-independence/

Submitted by Megan Nicholas, OTR/L

I work with children with Dyslexia and wanted to help encourage them. My son also has Dyslexia and when looking for a children's book about dyslexia, he found one that focused on struggles and hardships. So, we wrote an encouraging one that highlights the strengths that often accompany the dyslexic brain. We've heard from families all over the world who have been encouraged after reading the graphic novel that I authored. Because I am an OT, work with children with dyslexia and also a parent of a dyslexic, I have several reasons why I felt like I needed to write this for children and families.

Submitted by Diana Hess

I am the Chief Communications Officer for a non profit disabilities services organization in NY called Jawonio (Jawonio.org). Please read an interview with our amazing and extraordinary children’s OT, Ilene Goldberg.

Submitted by Amy Moss, MA, OTR/L

As an occupational therapist, I’ve been fortunate to leverage my training, experience, and skills to drive innovation and product development to enhance patient lives. It all started a few years back when I met Dylan Law, a pediatric patient with upper extremity tremors. Dylan challenged me and his pediatric neurologist, Dr. Sharief Taraman, to create a novel upper extremity device tailored to meet his and other pediatric users’ needs.

Dr. Taraman brought Dylan’s challenge to biomedical engineering students at the University of California Irvine (UCI) and together with Children's Hospital of Orange County (CHOC) and Innovation Lab, La Palma, CA together, Dylan and I, embarked on a journey with the team to develop and bring to market a solution to stabilize pediatric upper extremity tremors.

After months of team brainstorming, prototyping and monthly consultations with my patient Dylan emerged Move-D; a device engineered to not only stabilize tremors but also adjusts for a natural range of motion for Activities of Daily Living. It’s easy to clean, lightweight in construction, adjustable in length and circumference to accommodate a child's growth stages. Most importantly, it improves the performance of ADLs, and its device pediatric users are willing to wear.

How did the name Move-D come about? The “D” in Move-D stands for Dylan himself. He not only provided invaluable insights into user needs that informed the design process, but he also provided our team with continued inspiration and drive. You can now see Dr. Taraman, Dylan and me, Amy Moss, on the Move-D website www.movedbrace.com. My patient Dylan continues to play a central role in the project. I am thankful for this opportunity to work alongside him and the rest of the team to positively impact children and adults coping with upper extremity tremors.

Submitted by Beth Bostrom, OTR/L

I have 3 adult children and raised them as a single mother. This is challenging in and of itself, but my one son has ASD. There were times friends would ask me out to dinner with my children and I couldn't go even though I needed it more than anyone. I didn't want to tell them what my son's behavior would be like. They didn't and couldn't understand. This was in the early 2000's and people didn't understand as much as they do now about ASD. I was alone and lonely. I felt like I was hiding a family secret. I had no support and was just trying to hold it together. There were some very dark days.

Advance 20 some years and I have made my career working with pediatrics. My heart and soul, my passion is working with parents and their kiddos. When a parent comes in and I see in their eyes how lost they are, I can't help but share my story with them. Sometimes they cry. Sometimes they just exhale and feel like the weight has been lifted. There is strength in numbers. There is hope in sharing. There is no shame in feeling lost, guilty, sad, depressed. There is no judgment when you find someone who has been there. Your can't tell a friend " I wanted to jump in front of a bus", "I sometimes wish I didn't have my child". "I wonder how different my life could have been". "I don't feel bonded to my child sometimes". These are all normal feelings and need a safe space to be said if felt.

Part of my goal for the rest of my career will be to show these people unconditional love. The love and acceptance I wanted and needed but didn't have. Support groups are invaluable. Support is crucial. We can help kids but without a solid home life it will always fall short. Helping caregivers is helping kids.

Submitted by Gail Gabriel, OTR/L

In the journey of rehabilitation, each client brings a unique story, and the path to recovery often requires not just skill but also innovation and adaptability. One particularly inspiring case involved an 85-year-old individual diagnosed with a complex array of conditions including chronic kidney disease stage 3, diabetes mellitus type 2, hypertension, hyperparathyroidism, gout, dementia, hypothyroidism, syncope, atrial fibrillation, and depression. This patient's life was significantly impacted following a syncopal episode that resulted in a fall, highlighting the urgent need for a tailored occupational therapy intervention.

The occupational therapy strategies deployed for this patient were multifaceted, aiming to address both physical and cognitive challenges. The initial focus was on assessing and modifying environmental barriers to reduce the risk of future falls, a critical step given the patient's history of syncope and the resultant fall. This involved strategic placement of support aids and ensuring clear pathways within the home environment to facilitate safer ambulation.

Functional activity tolerance was another key area of focus. Through the use of therapeutic exercises and neuromuscular reeducation, we worked on enhancing the patient's strength and endurance, crucial for the performance of daily living tasks. The therapy sessions included seated overhead pulleys and the use of an upper body recumbent bike, activities selected for their efficacy in improving upper body strength and overall physical resilience.

Cognitive challenges due to dementia necessitated the incorporation of strategies aimed at improving the patient's ability to follow directions and engage in tasks with greater independence. Simple, one-step directions were used to facilitate comprehension and execution of tasks, fostering a sense of achievement and encouraging engagement in therapy.

A pivotal aspect of our approach was the integration of Everbility AI into the treatment plan. This innovative tool was instrumental in tracking the patient's progress, allowing for real-time adjustments to the therapy regimen based on the patient's evolving needs. Everbility AI's insights into the patient's performance and response to various interventions enabled a highly personalized therapy experience, ensuring that each session was optimally tailored to the patient's capabilities and rehabilitation goals.

The journey of rehabilitation is a testament to the resilience of the human spirit when supported by compassionate care and innovative technology. Through a combination of skilled occupational therapy interventions and the strategic use of Everbility AI, we witnessed remarkable progress in this patient's ability to navigate daily life with increased confidence and independence. This case serves as a powerful reminder of the profound impact occupational therapy can have on enhancing the quality of life for individuals facing complex health challenges.

Submitted by Preetee Gokhale, MS

This story is written in retrospection and is about a client when I was practicing as a Neuro-Occupational Therapist in 2021.

It is an ethical dilemma for issuing a fit note to young stroke survivors for return to their previous work roles with hidden symptoms of stroke. It is further a challenge for an occupational therapist to design vocational interventions for such a client to enable successful ‘return to work’.

This is a story of Mr. A (name has been changed to maintain the confidentiality of client's identity), who was at the peak of his career as a medical representative in a multinational Pharma company. At the age of 25, he was working as a Team leader with habits of occasional smoking and drinking alcohol.

He experienced sudden onset right sided weakness in 2019 and was diagnosed with left fronto-parietal intradural haemorrhagic stroke. He underwent a surgical intervention and became a young stroke survivor with mild motor deficits on right side of his body with motor aphasia and stroke related cognitive impairments.

He received an early referral to occupational therapy and the main objective of my therapy was to support him get back to his work role. Being the only earning member of his family, client had a goal of retaining his job and regaining his work position. Along with the targeted therapy for motor impairments, the focus of occupational therapy was remediation of cognitive function.

Being in his early twenties, he would often get very irritable and frustrated every time he failed to complete a cognitive task during his occupational therapy sessions. He expressed feelings of anxiety and depression and had almost lost hope of being a medical representative again. It took us two years of collaborative and interactive occupational therapy intervention to enable a phased return to work for Mr. A. It tested his patience. However, he enjoyed his OT sessions and in one of the sessions he said' OT sessions are very much focused on my problems. You know what I would like to do in future and that's what keeps my motivation in therapy'. We, as a team of occupational therapists working in an acute setting planned a set of work simulated activities for Mr. A under my leadership. We made Mr. A practice nomenclature of different drugs, their uses and side effects. We made him practice developing power point slides and presenting it to one of the OTs on a monthly basis. We worked on his handwriting skills by prescribing an adapted gripper to accommodate his dominant hand weakness. Mr. A's progress was reviewed every six months using the standard validated procedures within the setting. This objective assessment of Mr. A's neurological impairment helped the employer's understanding of Mr. A's renewed abilities and strengths after surviving a stroke.

Regular communication and negotiation with Mr. A's employer and discussions around reasonable adjustments at work for Mr. A helped a relatively easy transition into work.

Mr. A is now working as an office-based medical representative within the same Pharma company as he was working pre stroke (unfortunately, he can't take up any outdoor duties now!) and making his way forward towards a healthy and successful life with the help of occupational therapy!

Occupational therapy has definitely added life to his years after surviving a stroke.

Submitted by Joshua Smith, PT, DPT, MDT

In April 2023, NASA announced that aboard the Artemis II mission, Christina Koch will be the first female astronaut to ever land on the moon. Pictured here are two amazing Bayhealth Occupational Therapists, Beth Roros, OT, CHT and Sasha-Gay Steward, MSOT, OTR/L, who helped to build and implement an injury prevention program for the team responsible for creating the first female-specific space suit. Occupational therapy is literally out of this world!!