Occupational Therapy: My Greatest Success Story

I am a Certified Occupational Therapy Assistant. At the time, I was working in the Houston, Texas area. My supervisor sent me on a home health assignment for a patient who was about three months post stroke. I will call him Pete for this blog.

I first met Pete at his home. I knocked on the door and his wife answered. She said that they were expecting me, and led me to the living room. Pete was sitting in his chair, his walker sitting in front of him. I introduced myself and sat down to discuss his particular circumstances. I always like to get to know a client a little bit before getting right down to business.

Pete told me that he was depressed most of the time, which is not uncommon for stroke patients. He said that he was unable to do a lot of things, but most of all, he missed driving his dirt track race car with his son on weekends.

After talking with Pete, I perceived that he had lost his drive, his will to keep going, and for the most part I believe that Pete had just about given up.

We sat down at his dining room table so I could assess his gross motor skills to see what our baseline starting point would be. He could barely move his affected arm, much less grasp a cup. So I set out to help Pete improve his movements and strength, per my supervising OT's Plan of Care.

For the next three weeks Pete and I worked on gross shoulder movements, elbow movements, balance, walking with his walker, and so forth without much improvement.

Then one day Pete asked me to go to his garage with him. He wanted to show me something. We had developed a bit of rapport by then and Pete was starting to be more comfortable with me. We went into his garage and there sat his race car that he was so proud of. He needed to talk about it and I just let him lead the discussion and I listened. Sometimes people need to talk things out. Out loud. Then Pete showed me his wife's car engine hoisted up in the air on a A-Frame. He said that he was working on the engine when he had his stroke. Just then the light turned on. I thought that I had just discovered something that might motivate Pete.

I asked  Pete to go back into the house with me. I told him and his wife that I needed to go to the clinic and pick up something, and that I would return shortly. I went into the therapy room and picked up a large plastic jug full of different sized nuts and bolts. I told my supervisor that I needed a little more time with Pete that day. He said that would be fine. I returned to Pete's house with the nuts and bolts and asked Pete to sit at the dining room table for a little experiment. I put some of the nuts and bolts down on the table and Pete immediately took his affected arm and placed it on the table to hold the bolt still while he put the nut on the bolt. That was the motivator he needed! The simple nuts and bolts was the answer!

Fast forwarding three more weeks, Pete was so motivated that he came out of his depression, took joy in the activities that we did, and worked hard to regain some motion in his affected shoulder, elbow and hand. He started coming to the clinic and working with therapy balls, actually throwing them with both hands. He began to progress more and more, and by then end of six weeks, his doctor took him off his anti-depressant meds.

Just a simple turning on of the light is sometimes all it takes to find the right motivation for someone to want to work hard at getting better, and that is my greatest therapy success story.