Volunteering at the VA Nursing Home

    This month, on Thanksgiving break, I decided to volunteer at the VA nursing home. While I enjoyed working the Crisis Text Line as I had done in previous months, I wanted to have an in-person volunteer experience, given our time off during break and the spirit of the holidays! I was able to volunteer with my friend's mom, Tricia Lauf, who is an occupational therapist at the VA nursing home in Reserve (just outside of La Place). I thought it would be especially interesting to volunteer in her line of work because most of the patients she sees are patients who have had strokes, and strokes are something that I see and treat on a daily basis as an EMT. Whenever we are called to someone who is having a stroke, we look for signs such as arm drift, gaze to the left or right, slurred speech, dizziness, and difficulty producing speech. I'm very accustomed to seeing these symptoms, recognizing that they are likely indicative of a stroke, and then following stroke protocols for the patient such as drawing blood and obtaining a blood pressure before bringing them to a specialized stroke center (in our case, usually West Jefferson Medical Center, Ochsner Main Campus, or Tulane Hospital). However, in EMS, it's rare that we are actually able to follow up with our patients to see if they come out with deficits or even what their quality of life is like post-stroke. This is why I wanted to volunteer with Tricia: to actually see the deficits that stroke patients struggle with on a daily basis, and how to help these patients achieve a better quality of life through occupational therapy.

    First, since Tricia works in a nursing home, we had to gather all of the occupational therapy patients together in the therapy room. I helped bring patients from their rooms to the therapy room, and fixed patients' morning coffee as I got to meet each of them and find out their therapy goals. The majority of the patients were in wheelchairs, with one or two able to walk. The patients who were able to walk either suffered from limps or had contractures to their hands limiting movement. Tricia explained to me that her goal as an occupational therapist is to assess the deficits of the geriatric patients and work towards improving range of motion of muscles and improving activities of daily living. Most patients see her for around 2 years, and she mostly sees stroke patients, but other patients have disabilities attributable to other conditions such Down's Syndrome and diabetic neuropathy. Tricia will use techniques such as electrotherapy to stimulate muscle contraction -- using a machine hooked up to electrodes on the patient's skin -- where small electric shocks cause the muscles to contract so that the patient can regain sensation in the affected muscle. I also watched Tricia splint patients suffering from contractures, and she will size the splint and then gradually increase the angle of the splint (in the arm for example) causing the patient to be able to slowly but surely extend their arm and increase their range of motion in this muscle. This looked like it was very painful for patients, but it was really cool to see how they are slowly able to use an extremity that would otherwise be completely immobile. 

    One main activity that I helped with was assisting patients with using their wheelchairs. A huge cause of injury for disabled or nursing home patients is accidents with their wheelchairs, so we went over the steps of how patients can safely get up and sit back down in their chairs. This is a super important skill when patients need to stand up to use the bathroom, or stand up to pick a shirt out of their closet. I helped patients first lock their wheelchairs, grab their arm rest, lean forward while engaging their triceps and focusing on their center of gravity, and slowly standing up. Another main activity that I helped with was bouncing a medicine ball to and from patients, as this helps with balance, hand-eye coordination, and reaction time. I also assisted Tricia in group exercises such as using small weights to do shoulder presses, marching in place, leg kicks, and "wheelchair pushups" (lifting the body off of the chair). As Tricia led everyone in these exercises, I was able to walk around and help any patients that were having trouble. 

    An activity that I particularly enjoyed was helping patients write. Many patients had trouble with their grip due to conditions such as neuropathy or contractures to their fingers, so I was able to help them pick out the correct sized grip to place on a whiteboard marker. With the grip assistance, these patients were able to grip the marker and write their names, my name, Tricia's name, and many other things. This activity was very wholesome because one patient in particular told me that she wanted to start write letters to her grandchildren, but had been having trouble gripping her pen and actually writing legibly on a piece of paper. She told me that she was working towards writing letters and had been practicing! Other patients were used to using grips for activities such as gripping their toothbrush to brush their teeth, and gripping their comb to brush their hair. I hadn't thought much about how difficult life would be without the ability to grab things -- forks, toothbrushes, pens, coffee mugs, clothing hangers, etc -- so it definitely opened my eyes to how beneficial occupational therapy truly is.

Time: 2 hours

Semester Total: 12 hours