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Strategies for Success: Stories From the CommunityTopic links:
Occupational therapy professionals say that the rewards of volunteering with Rebuilding Together are connecting with the community and making a difference in the lives of individuals. A significant part of the work involves helping the people they meet become aware of occupational therapy and of the knowledge those in the field bring to home modification. The following stories of occupational therapy practitioners working in their communities with Rebuilding Together provide models for success and encouragement for others who would like to get involved. In Howard County, Maryland, occupational therapists from the county Office on Aging volunteer to preview the homes selected by Rebuilding Together (RT) for repair and revitalization. Before any work on houses is undertaken, the volunteers form a "mod squad" (coined by Pittsburgh participants) to speak with homeowners, look at accessibility and safety issues in the homes, order equipment, and supervise the installation of home modifications. Mary Becker-Omvig, MS, OTR/L, says that the most important things she and other occupational therapy volunteers bring to the equation are a holistic approach for the client and knowledge of community resources. "We bring an integrated role of assessment and referral that never existed here before in Rebuilding Together, and connect homeowners with assistance from county agencies and services. The Board of Directors embraced this; we help them access support for people after we leave on National Rebuilding Day." Each year, RT staff members integrate these services more and more. Becker-Omvig is the regional home modification consultant for Rebuilding Together for Washington, DC, Maryland, and parts of other states. Her job includes promoting home modification, connecting occupational therapy professionals with RT, and answering questions from the various affiliate organizations. She has served on the Board of Directors of her local RT affiliate for 2 years. She thinks the most effective role for an occupational therapy practitioner is to be a member of the RT board to understand the role of the organization and the nuances of priorities and decision-making before trying to suggest a focus on home modifications. Her advice is to "try to set a foundation that is viewed as valuable by the Board, then build up the numbers [of occupational therapists and students]." The goal of the Pennsylvania Occupational Therapy Association (POTA) in Pittsburgh has been to have an occupational therapy practitioner conduct a home safety assessment of every home to be repaired on National Rebuilding Day. The district association got involved initially when Pamela Toto, MS, OTR/L, BCG, saw a report on the local news about Rebuilding Together, telephoned the organization for information, and presented the idea as a project for OT Month. Beginning with a core of four volunteers, the district has added people to their RT team each year. Practitioners attend house-captain meetings to discuss and explain exactly what occupational therapy practitioners can do. They have modified RT’s home preview form to move the slant from being construction-focused to homeowner-focused, and assisted in putting together the house captains’ binders, including more information on home safety and placing adaptive equipment catalogs in the binders to encourage captains to consider buying items the client may need but cannot afford (for example, a cart to transport items around the kitchen, telephones with extra large number buttons, etc.). The district’s other goal is to have occupational therapy representation at every house on National Rebuilding Day. Recruitment is conducted primarily through the five schools of occupational therapy located in the area and among district POTA members. The POTA is working to keep up with Pittsburgh’s very active Rebuilding Together community; one of last year’s houses will be featured on television host John Walsh’s new show, American Heroes. "Personally and professionally, Rebuilding Together thinks O[ccupational] T[therapist]s are wonderful. We get a lot of positive reinforcement," says Sharon Glover, OTR/L, who has been involved with the collaboration from the beginning and now sits on Rebuilding Together’s Pittsburgh board of directors. She adds that some of the construction professionals they’ve met have started to learn the value of occupational therapy practitioners, too, seeking advice from district association members when working on low-income housing. Glover suggests that occupational therapy practitioners and students who want to apply their skills get involved with RT’s house previews. That way, they can make suggestions to house captains and give them options for home modifications. "You’re not evaluating and treating as a OT, but you’re using your skills," Glover says. "Rebuilding Together keeps the focus on making homes warm, safe, and dry." She adds that volunteering doesn’t have to be a huge time commitment, but that the best feeling is being there on event day to see everything come together. This year marks the sixth year of occupational therapy practitioners’ partnership with San Francisco’s Rebuilding Together program. In 1996, Fran Post, OTR/L, suggested volunteering with RT as a way to celebrate OT Month. Since then, the Golden Gate Chapter of the Occupational Therapy Association of California (OTAC) advertises through chapter venues and member workplaces to recruit occupational therapy practitioners and students willing to conduct home safety evaluations leading up to National Rebuilding Day. This winter, 20 people, including three students from Dominican College’s School of OccupationalTherapy, reviewed 31 homes. "O[ccupational] T[herapist]s customize. We have the skills to evaluate each homeowner and make customized recommendations," says Sarah Eggen-Thornhill, OTR/L, volunteer coordinator. "Two years ago, we found one woman with terrible bed sores who should have been recovering from a stroke. She had been completely bedridden for six years because there was no way for her to get around her house. She was even unable to access the bathroom. We widened doorways, put equipment in the bathroom, got her wheelchair fixed, and educated the woman’s daughter on available resources. Rebuilding Together took our advice to replace the mattress. How would a construction captain have known what kind of mattress to order, to get a gel mattress?" Eggen-Thornhill makes sure to tell participating occupational therapy practitioners to introduce themselves as Rebuilding Together volunteers. The emphasis is on interviewing and observing clients and families, not hands-on treatment and therapy. The Golden Gate Chapter developed home safety tip sheets and evaluation forms, and tailored them to RT’s funding and capacity. The feedback from RT has been that the house captains and the construction supervisors find the worksheets, and practitioners’ help, very valuable. BevVan Phillips, OTR/L, of Omaha, Nebraska, has a unique perspective on her contribution to the city’s Rebuilding Together program. She owns her own company, Home Access Solutions, which provides residential accessibility planning. She got involved with Rebuilding Together three years ago when the local program organizer approached her to donate her expertise. Phillips volunteered her time for National Rebuilding Day, and RT found that the occupational therapist’s input enhanced their work. They have since employed her throughout the year to develop plans with professional contractors for additional home modification activities. Next autumn, she is bringing an occupational therapy doctorate (OTD) student intern into her company specifically to write a grant proposal that will fund occupational therapy professionals to provide more help to RT. Phillips is currently working with an OTD student, setting up goals for an internship that will include grant writing specifically to fund local Rebuilding Together accessibility projects. Each year as Rebuilding Together gears up for April’s event, Phillips conducts an orientation for team captains, briefing them on the things they should look for with each homeowner. She gives them enough information to feel comfortable with their layman’s evaluation. "I tell them to observe the homeowners, see how long it takes them to get to the door, do they hold onto furniture, and see if they have trouble getting up from a chair because that probably means they have trouble with personal things, too, like getting up from the toilet and tub," Phillips says. "Rebuilding Together knows they can call on me to help their team and the homeowner identify good solutions. What I do reduces the pressure on volunteers so they don’t feel like they have to do things they don’t know. Home safety requires a body of knowledge." Phillips feels that her mission is to make people more aware of home accessibility issues and solutions. She does a lot of public speaking, and each time she has the opportunity to talk about her work even informally, she is able to introduce more people to the profession. "It’s important for people to add these terms to their vocabulary: accessibility, environment, occupational therapy. This is the stuff that keeps me excited in my work." Philadelphia, one of the first cities with Rebuilding Together affiliates, has a vast network of volunteers and homes ready for repair. Phyllis Ehrlich, MS, OTR/L, CHES, works on RT homes in the north part of the city. She previews homes that have been earmarked for adaptations and modifications, shops with house captains, and helps put together the house kits that go to each home for National Rebuilding Day. A former executive officer of Pennsylvania’s District 5 Occupational Therapy Association, Ehrlich suggested to her board of directors last year that they take on the volunteer opportunity as a district and get others involved. She solicited occupational therapy practitioners by putting information on the association Web site and sending out group emails until she got 15 volunteers. The experience was so satisfying that the district is working with RT again this year. "We absolutely make a difference," Ehrlich says. "A lot of these homeowners would not get adaptations if we weren’t there. The Rebuilding Together executive officer for Philly is a contractor by trade, and he had no clue before last year what occupational therapists do. But you talk to a lot of people—family, friends—and the word spreads." Ehrlich told two stories that particularly touched her during last year’s event. At one home, the owner had Parkinson’s disease. A volunteer occupational therapist was so concerned about the family’s ability to get the proper help that she made a resource book for them so they would know how to access services and care. Another homeowner was a legally blind woman. She wanted to be able to continue to cook, but she needed a special stove to could detect the height of the flame when the burners were turned on. RT was able to buy the stove for the woman—because an occupational therapist was able to tell them that such a stove existed. Ehrlich has specific advice for occupational therapy practitioners who want to get involved with RT: Don’t be intimidated. Go to RT in your community and say you’d like to get involved. Be prepared to explain what occupational therapy is. Be willing to go to meetings and answer questions. And wear a shirt that identifies you as an occupational therapist. Last year on National Rebuilding Day, Philadelphia RT prepared a booklet that was handed out to members of the press. The booklet had a whole page devoted to the contribution of occupational therapy professionals, illustrated by a picture of Phyllis wearing a T-shirt that clearly read, "OT." At Rockhurst College in Kansas City, Missouri, in 2002, the School of Occupational Therapy offered students academic credit for service with Rebuilding Together. Approximately 18 first year, first semester students in the Occupational Performance: Health and Wellness class worked on two houses in December to satisfy part of their requirement for screening and community contact fieldwork. This participation was the first contact with occupational therapy for the Rebuilding Together Kansas City affiliates. Kim Vemmer, OTR, Academic Fieldwork Coordinator at Rockhurst, heard about RT at last year’s AOTA Annual Conference and contacted the RT’s local affiliates when she returned home. She located an affiliate director in the town of Liberty whose wife is a social worker and who understood occupational therapy. He invited Kim to meet the house captain in charge of Liberty’s home modification efforts and the professional relationship took off from there. Initially, the director asked for help in designing a wheelchair access ramp. So many enthusiastic students volunteered that Vemmer and fellow faculty member, Janis Davis, MA, OTR, split the group and worked with RT on two different homes. "We didn’t want to overstep our bounds the first time," Vemmer says, "But Rebuilding Together has a new appreciation of occupational therapy and we have a great relationship. They were thrilled to work with OTs." Davis and Vemmer made the event a service learning project and debriefed the students afterward. One group of students worked with married homeowners, one of whoom had a progressive disease requiring the use of a wheelchair. In addition to their recommendations for design and their assistance with construction of the access ramp, Davis tested students’ knowledge by asking them to identify home modification solutions to guard against falls and other mobility and safety concerns of the couple. At the other house, students cleaned, painted, repaired ceilings, and redesigned electrical outlets to increase safety features in the home of a family dealing with many health issues. Vemmer reinforced students’ observations by having them think of ways to interface with the family and meet their needs if these were ongoing clients. Students were given five contact hours for the on-site work. Vemmer acknowledges that the on-site participation was very early in the students’ academic career, but sees positive results that she feels couldn’t be generated by in-class time. Students who worked on the home modifications are planning fundraisers to help buy assistive equipment for RT homes, and are looking forward to volunteering for National Rebuilding Day. Vemmer cautions colleagues that developing a relationship with an organization unfamiliar with occupational therapy is a "time intensive issue." Success requires the dedication of a faulty member willing to make a concentrated effort on the students’ behalf. "Pick a Rebuilding Together chapter that’s most open to occupational therapy and what OTs can do," she advises. "Find one willing to work with you, take your suggestions, and willing to expand the partnership and grow." The AOTA-sponsored Washington, DC house was designated the 2003 National Rebuilding Day media showcase house. AOTA has sponsored a house every year since 1997 through staff fundraising and organizational efforts led by Karen Smith, OT, Regulatory Associate in AOTA’s State Affairs Group. Smith, AOTA’s house co-captain, sits on the DC board of RT and has broadened the efforts of the organization to include occupational therapy practitioners citywide. "We want to spread the impact," Smith says. "Rebuilding Together is a great organization. I think OT practitioners can help make it even better." Smith has taken her passion for the partnership with RT to hospitals and health organizations to inform occupational therapy practitioners about RT. She shows them how occupational therapy practitioners fit into the organization, recruiting interest and volunteers for the 100 houses sponsored in DC. With the RT house captains, Smith has worked to integrate occupational therapy and accessibility issues by informing staff and volunteers about occupational therapy’s expertise in home safety and home modifications, and pairing occupational therapy practitioners with house captains who could benefit from their assistance. She also has helped bring about an institutionalization of accessibility and home modification information in the organization’s materials and home preview forms. She sees the role of occupational therapy as important, the contribution of small changes that can make big differences. "It is incredibly meaningful to me to help people adjust to aging and disability in their own homes," Smith says. "The match up between Rebuilding Together and occupational therapy is getting more OTs connecting to the community so that it becomes second nature. We can point the way and say you’re needed, but it’s up to OTs to fill that need."
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