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With a little help from my friends: a lesson in interprofessional advocacy

Posted by Katie Cooper on 2019-04-30

I come from an administrative and human resource background, and as a late thirty-something with two kids, a husband and a full-time job, choosing to go back to college wasn’t an easy one. I needed to make sure I chose the right path to lead me to what I was inevitably trying to achieve: work-life fulfilment. I wanted a career where I was making a difference in the lives of the people I was working with. I wanted to feel a sense of accomplishment and passion in the career that I spend at least a third of my day. 

After a year of research, I knew I wanted to get into the field of community service or health care. Having a sister in the health care field, I decided she was a good sounding board to bounce my ideas off of to help determine the path that was best for me. She explained that the career I seemed to be describing was Recreation Therapy. As a registered speech pathologist, she worked closely with the recreation therapy team and explained the importance and significance of the profession with her clients. Fast forward another year, and here I am.

One of the first lessons we are taught as students in Therapeutic Recreation is about advocacy; advocating for our participants and our future profession. I will admit that I struggled to grasp the concept of advocating for a profession that I had yet to fully learn about, but the importance of the idea was a no-brainer. I had chosen this field to study, so I should be fully on board with promoting its significance in and out of the field.

One of the most prominent displays of advocacy for recreation therapy that I’ve seen to-date was my sister fighting to have patients in temporary beds awaiting long-term care in her facility receive the same care as the long-term residents. The patients in “transition beds” were not scheduled for access to recreation therapy. As a speech pathologist, she recognized the significance of what recreation therapy provided the clients and took steps to try to attain equal care for those patients in need that were not being offered the services due to budgeting demands. 

Here’s her story:

Katie: Why did you feel the need to pursue this change, to have patients who were staying in temporary beds waiting for long-term care at your facility receive the same care as the residents in long-term care beds?

Speech Pathologist: This was the second year that our facility had received funding to open temporary “transition” beds to help move people out of acute care hospitals while they waited for a long-term bed to become available. Overall, of course this is a very positive move both for the system as a whole and the patients, but what became evident last year was that these “transition patients” were bored, lonely and isolated, and at times literally stuck in their room or bed in our facility. This was not only depressing for patients, but also their families and the staff that had to witness their experience. 

We were told that our facility would be getting enough funding for nursing care and a little physio for these patients only. I asked if some of the funds could be diverted to recreation programming because that really was the gap – if these patients were in long-term care here at our facility, they would get RT. 

The answer I was first told was, “No. They can join in already existing programs in the facility.” Again, this sounds reasonable, but the fact of the matter was that these patients and their families were not made aware of programs and there was no information on our unit about activities either. There were no volunteers coming to our unit to porter people to the activities. But more than this, there was no one who took the time to get to know the patients’ hobbies or interests so that they could encourage them and connect them to activities occurring around the facility that they might be interested in.

Katie: Explain what you had to go through to make your voice heard.

Speech Pathologist: I had to be persistent. I emailed managers throughout my facility including the managers of the hospital beds, the manager of recreation and volunteer services as well. When I was ignored, I emailed again. I brought our team together to brainstorm ideas how we could help these transition patients access the activities ourselves; how we could change our own processes on our unit to help them. 

I have to say, I was quite frustrated – I’m just a speech therapist; this had nothing to do with my role in the facility and I was truly advocating for the patients because I really believed this was in their best interest and was an achievable goal. I pointed out that if our facility stands behind our mission of compassionate care, then we couldn’t just put people in a bed and house them. We had to consider all aspects of their care, which included recreation and engagement with others. 

Eventually, our team’s efforts were acknowledged, and the recreation manager agreed to allocate one recreation therapist for a little bit each week to come and engage one-on-one with some of the patients, some group activities. They also started bringing in some entertainers and external recreation programs down specifically to our unit. We now have a specific rec calendar and message board updated regularly for patients, family and staff to refer to. In the end, we got a liaison and a little bit of recreation therapy.

Katie: What are the benefits you see as a speech language pathologist to have a recreation therapist on your team?

Speech Pathologist: I work in the hospital, but I specifically work in the rehabilitation unit. With the cuts in health care over the years, what has been systematically cut is recreation therapy. We used to have a recreation therapist almost full-time in the department, then it dwindled down to part-time. On our rehab unit, the rec therapist would help patients access old hobbies and activities that they previously enjoyed but now in a modified way (due to their new disability) as well as pursue new activities, all in the pursuit of maximizing their quality of life. 

I’ve worked in tandem with rec therapists to help clients try out newly learned adaptive skills outside of the hospital setting and in a more real-life environment, such as a restaurant. Activities such as these allowed the client to gain some confidence and awareness of attaining their goals of reintegrating back into the community, and the recreation therapist would also report back to the team and to let us know the challenges of such an activity. As a result, I would alter my approach with the patient to help them better attain their goals. It was a very good way to problem solve real-life challenges outside of the hospital setting. 

From my experience, our recreation therapists looked at a person’s rehabilitation from a different perspective, and I miss having that perspective to round out our team. As someone who has been around long enough to see how recreation used to be involved in the rehab program, and to now have it completely cut, is such a shame.

Katie: What was it like to advocate for a discipline different than your own?

Speech Pathologist: I didn’t think it was that different at all. I think that speech therapy and recreation therapy are similarly cast in the same light as “non-medical” and therefore sometimes are seen as “elective” services. I think that we often have to fight and advocate for our services and the value of our services for our client. I’m constantly having to, and have been trained to, advocate that communication, for example, is a basic activity of daily living, as valued an activity as not being able to walk. For the people that I serve, it is especially important to advocate for them because they often cannot do it for themselves – literally. Sometimes they cannot speak or do not have the language skills to make their wants, needs or feelings known. 

Advocating for patients is not hard at all and I can’t see how it is ever wrong. I think when you see ways that you can make someone else’s life or experience better, regardless of what discipline it involves, you must do it. When patients, families and those in power (whether in your facility or in government) see the benefits of your services, they will also start to lend their support and advocate as well to make changes to services and systems.

I think when you see ways that you can make someone else’s life or experience better, regardless of what discipline it involves, you must do it.

The more I heard my sister speak about this issue, the more I finally understood the true value of advocacy, not just for your profession, but for the most important aspect: the well-being and quality of life of our participants. This is exactly what my professors have been trying to instill in us from day one. It just took one inspiring person and their story to finally open my eyes to what advocacy truly meant and validated that I’ve chosen the right path to walk.

Katie Cooper is a second-year Recreation Therapy student at Niagara College.