THE MARATHON SURVIVORS From April 20 th to July 24 th, thirty-two survivors rehabilitated at SRH....
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ROLES & RESPONSIBILITIES Spouse Parent Sibling Friend Employee AREAS OF OCCUPATIONS ADLs: Independent IADLs: Independent or Shared Responsibilities with Spouse Work: Employed Full-Time or Part-Time MEANINGFUL OCCUPATIONS Spend Time with Family/Friends Walk Run Exercise Dance Shop Travel HURDLES Below Knee Amputation Above Knee Amputation Multiple Fractures Nerve Lacerations Degloving Injuries Burns Hearing Loss Visual Impairments Shrapnel Wounds PTSD THE MARATHON SURVIVORS From April 20 th to July 24 th , thirty-two survivors rehabilitated at SRH. Occupational Profile of 7 Marathon Survivors STRENGTH AFTER TRAGEDY Samantha Conley, MS, OTR/L Spaulding Rehabilitation Hospital, Boston, MA Marathon Monday, April 15 th , 2013 will be embedded in our memories forever. At 2:49 p.m., two bombs exploded within seconds of each other near the finish line of the Boston Marathon. The explosions killed three people and injured more than 200. These horrific attacks rattled the entire city and changed the lives of many innocent people forever. APRIL 15 th , 2013 “Collaboration can be a powerful force. When strong partners push toward a common goal, amazing things can happen.” 1 Communication, collaboration, and teamwork began in the acute care hospitals, continued between the acute care and rehabilitation, and persisted within Spaulding Rehabilitation Hospital (SRH). TEAMWORK Ongoing team discussions throughout the day were essential . Each survivor’s recovery varied both physically and emotionally, sometimes with hourly changes. The Communications Director and Security personnel also played a vital role in the survivors’ daily care. Teamwork created friendships. We were strong together. *References available upon request. Following one of Boston’s darkest hours, the benefits of using meaningful, occupational- based, and client-centered rehabilitation were reinforced. The Boston Marathon Bombing survivors’ strength and determination motivated me to not only become a better occupational therapist, but has improved my strength as an individual. OT STRONG This OT experience made me… • A minimum of 10 separate crews daily • 17 press conferences • Broadcasts in 70+ countries • 5,365 media hits GOAL Represent Self, Survivors , & City SURVIVOR PERSPECTIVE - Survivor excited to dress up for press conference. - Survivor apprehensive to throw out “First Pitch” at Boston’s loved Fenway Park. - Barriers: impaired balance, functional mobility, and endurance. - Fear of falling. - Fear of crowds and walking on grass at Fenway Park. INTERVENTION - Supported survivor on press day and encouraged wearing high heel instead of ballet slipper! - Practiced throwing “first pitch” with fellow survivor in grassed area of “Strength Garden”. - Encouraged and cheered as survivor walked onto Fenway with head held high, as she represented the strength and resilience of the Boston Marathon Bombing survivors. GOAL ADL Mornin g Shower SURVIVOR PERSPECTIVE - Survivor verbalized desire to wash hair to remove the smell of smoke. - Barriers: Could not visualize taking shower with recent limb loss. - Reported feeling uneasy about “seeing” the residual limb for the first time. INTERVENTION - Provided emotional support and education. - Simulated set up of shower, covering of residual limb , and various compensatory strategies during the therapy session the day before. -Facilitated a visit with AC Certified Peer Visitor. GOAL IADL Meal Preparati on SURVIVOR PERSPECTIVE - Survivor emotional and fearful of inability to care for, especially cook, for husband, who was recently diagnosed with a brain tumor. - Barriers: non-weight bearing of one upper extremity, cast in place, and severe pain. INTERVENTION - Facilitated one-handed compensatory strategies. - Kitchen evaluation in the Functional Living Apartment to simulate home environment. - Motivated survivor by shifting focus to increasing OT’s competence in the kitchen. - Played couple’s favorite music during meal, facilitating cooking and dancing. OPPORTUNITIES CHALLENGES Promoted survivor healing. Security risks were heightened. Encouraged “if they’re okay, we’re okay” healing for many Bostonians. Spaulding transitioned into a new building at the same time. Created the BOSTON STRONG presence throughout the community. Staff needed to “learn” the new facility in the spotlight. Increased communication and collaboration through the entire Boston medical community. Reporters, camera crews, photographers present during therapy sessions. Displayed our new hospital. Potentially compromised confidentiality. Portrayed the important role of rehabilitation, especially OT, in recovery. Created a “media circus” which affected Boston Marathon Bombing survivors, non-involved patients, as well as staff. Inspired amputee awareness and advocacy. “Ultimately, practitioners can help victims of disasters in all stages of emergency situations by creating realistic goals, ‘empowering them to regain their independence and move from being a victim to a survivor’.” 3 OT & RECOVERY Study of previous disasters helped to support and guide our therapeutic approach. The world began to see that “occupational engagement reduces the intensity of stressful events and helps reestablish a sense of mastery in a situation in which a person feels a loss of control.” 2 Goals were achieved through client-centered and occupation-based OT interventions. A “new normal” brought new challenges; however, OTs know that hope still glimmers in the darkest hour. ROLE OF THE MEDIA The entire world was exposed to the events and injuries that occurred on Marathon Monday. Media presence and involvement at SRH was intense: “When lights dim and cameras go away, know that our support and love for you will never waiver.” - Former Mayor Thomas Menino “America will never stand down… We are Boston. We are America. We respond. We endure. We overcome and WE OWN THE FINISH LINE…” – Vice President Joseph Biden A NEW NORMAL THROUGH OT Continuity of Care BIDMC BWH BMC MGH TUFTS Securit y Nurse Nursing Assistant Case Manager Social Worker Developme nt Office Communicatio ns Director Hospital Administrat ion Physiatrist Psychiatris t Psychologis t Therapy Department (OT, PT, SLP, TR) Marathon Survivor Home Therapy Outpati ent Therapy GOAL Community Re-Entry SURVIVOR PERSPECTIVE - Survivors were apprehensive to begin “new normal” outside the safe hospital environment. - Fear of crowds and how the community would respond to the “new normal”. - Barriers: balance impairment, poor endurance, functional mobility required use of wheelchair, walker, crutches, or cane. INTERVENTION - Obstacle course in gym, navigated crowded cafeteria, and walked outdoors through “Strength Garden” for simulated uneven surfaces. - Community outing to Boston’s North End to navigate uneven grounds, hills, and busy area. - Encouraged survivor and family outings (i.e. New England Aquarium, Boston Bruins game, local restaurant, mall) with OT and PT present for guidance and support. - Therapeutic leave of absence for survivor with family or friends to break the “security blanket” hospital and staff provided.
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Transcript of THE MARATHON SURVIVORS From April 20 th to July 24 th, thirty-two survivors rehabilitated at SRH....
ROLES & RESPONSIBILITIES
Spouse Parent
Sibling Friend
Employee
AREAS OF
OCCUPATIONS
ADLs: Independent
IADLs: Independent or Shared Responsibilities
with Spouse
Work: Employed
Full-Time or Part-Time
MEANINGFUL OCCUPATIONS
Spend Time with Family/Friends
Walk Run Exercise
Dance Shop Travel HURDLES
Below Knee Amputation
Above Knee Amputation
Multiple Fractures
Nerve Lacerations
Degloving Injuries
Burns
Hearing Loss
Visual Impairments
Shrapnel Wounds
PTSD
THE MARATHON SURVIVORSFrom April 20th to July 24th, thirty-two survivors rehabilitated at SRH.
Occupational Profile of 7 Marathon Survivors
STRENGTH AFTER TRAGEDYSamantha Conley, MS, OTR/L
Spaulding Rehabilitation Hospital, Boston, MA
Marathon Monday, April 15th, 2013 will be embedded in our memories forever. At 2:49 p.m., two bombs exploded within seconds of each other near the finish line of the Boston Marathon. The explosions killed three people and injured more than 200. These horrific attacks rattled the entire city and changed the lives of many innocent people forever.
APRIL 15th, 2013
“Collaboration can be a powerful force. When strong partners push toward a common goal, amazing things can happen.”1
Communication, collaboration, and teamwork began in the acute care hospitals, continued between the acute care and rehabilitation, and persisted within Spaulding Rehabilitation Hospital (SRH).
TEAMWORK
Ongoing team discussions throughout the day were essential. Each survivor’s recovery varied both physically and emotionally, sometimes with hourly changes. The Communications Director and Security personnel also played a vital role in the survivors’ daily care. Teamwork created friendships. We were strong together.
*References available upon request.
Following one of Boston’s darkest hours, the benefits of using meaningful, occupational-based, and client-centered rehabilitation were reinforced. The Boston Marathon Bombing survivors’ strength and determination motivated me to not only become a better occupational therapist, but has improved my strength as an individual.
OT STRONG
This OT experience made me…
• A minimum of 10 separate crews daily • 17 press conferences• Broadcasts in 70+ countries• 5,365 media hits
GOAL
Represent Self, Survivors, &
City
SURVIVOR
PERSPECTIVE
- Survivor excited to dress up for press conference.
- Survivor apprehensive to throw out “First Pitch” at Boston’s loved Fenway
Park.
- Barriers: impaired balance, functional
mobility, and endurance.
- Fear of falling.
- Fear of crowds and walking on grass at
Fenway Park.
INTERVENTION
- Supported survivor on press day and encouraged wearing high heel
instead of ballet slipper!
- Practiced throwing “first pitch” with fellow survivor in grassed
area of “Strength Garden”.
- Encouraged and cheered as survivor walked onto Fenway
with head held high, as she represented the strength and
resilience of the Boston Marathon Bombing survivors.
GOAL
ADL
Morning Shower
SURVIVOR PERSPECTIVE
- Survivor verbalized desire to wash hair to remove the smell of
smoke.
- Barriers: Could not visualize taking
shower with recent limb loss.
- Reported feeling uneasy about “seeing” the residual limb for
the first time.
INTERVENTION
- Provided emotional support and education.
- Simulated set up of shower, covering of residual limb , and
various compensatory strategies during the therapy
session the day before.
-Facilitated a visit with AC Certified Peer Visitor.
GOAL
IADL
Meal Preparation
SURVIVOR PERSPECTIVE
- Survivor emotional and
fearful of inability to care for, especially cook, for husband, who was recently diagnosed with a
brain tumor.
- Barriers: non-weight bearing of
one upper extremity, cast in place, and
severe pain.
INTERVENTION
- Facilitated one-handed compensatory strategies.
- Kitchen evaluation in the Functional Living Apartment to simulate
home environment.
- Motivated survivor by shifting focus to increasing OT’s
competence in the kitchen.
- Played couple’s favorite music during meal,
facilitating cooking and dancing.
OPPORTUNITIES CHALLENGES
Promoted survivor healing. Security risks were heightened.
Encouraged “if they’re okay, we’re okay” healing for many Bostonians.
Spaulding transitioned into a new building at the same time.
Created the BOSTON STRONG presence throughout the community.
Staff needed to “learn” the new facility in the spotlight.
Increased communication and collaboration through the entire Boston medical
community.
Reporters, camera crews, photographers present during therapy sessions.
Displayed our new hospital. Potentially compromised confidentiality.
Portrayed the important role of rehabilitation, especially OT, in recovery.
Created a “media circus” which affected Boston Marathon Bombing survivors, non-
involved patients, as well as staff.Inspired amputee awareness and advocacy.
“Ultimately, practitioners can help victims of disasters in all stages of emergency situations by creating realistic goals, ‘empowering them to regain their independence
and move from being a victim to a survivor’.”3
OT & RECOVERYStudy of previous disasters helped to support and guide our therapeutic approach. The world began to see that “occupational engagement reduces the intensity of stressful events and helps reestablish a sense of mastery in a situation in which a person feels a loss of control.”2 Goals were achieved through client-centered and occupation-based OT interventions. A “new normal” brought new challenges; however, OTs know that hope still glimmers in the darkest hour.
ROLE OF THE MEDIAThe entire world was exposed to the events and injuries that occurred on Marathon Monday. Media presence and involvement at SRH was intense:
“When lights dim and cameras go away, know that our support and love for you will never
waiver.”- Former Mayor Thomas Menino
“America will never stand down… We are Boston. We are America. We respond. We endure. We overcome and WE OWN THE FINISH LINE…” – Vice President Joseph Biden
A NEW NORMAL THROUGH OT
Continuity of CareBIDMC
BWH
BMC
MGH
TUFTS
Security
NurseNursing Assistant
Case ManagerSocial Worker
Development Office
Communications Director
Hospital Administration
PhysiatristPsychiatristPsychologist
Therapy Department(OT, PT, SLP, TR)
Marathon Survivor
Home Therapy
Outpatient Therapy
GOAL
Community
Re-Entry
SURVIVOR PERSPECTIVE
- Survivors were apprehensive to begin “new normal” outside
the safe hospital environment.
- Fear of crowds and how the community would respond to the
“new normal”.
- Barriers: balance impairment, poor
endurance, functional mobility required use of
wheelchair, walker, crutches, or cane.
INTERVENTION
- Obstacle course in gym, navigated crowded cafeteria, and walked outdoors through “Strength Garden” for simulated
uneven surfaces.
- Community outing to Boston’s North End to navigate uneven grounds, hills,
and busy area.
- Encouraged survivor and family outings (i.e. New England Aquarium, Boston
Bruins game, local restaurant, mall) with OT and PT present for guidance and
support.
- Therapeutic leave of absence for survivor with family or friends to break the “security blanket” hospital and staff
provided.
