Misericordia's Commitment to Wholeness: On-Campus Therapy

by Ernie Stark, in conjunction with Jenna Colangelo, MS, OTR/L, Beth Muckler, PT, DPT, Jill Sparacio, OTR/L, ATP/SMS, ABDA and Sam Sexton, Therapy Manger and McAuley QIDP

An educative experience for a visitor to Misericordia, be they parent/sibling or friend, would be to be present on campus during the "morning rush hour." The person would see the hustle and bustle of the residents as they make their way to their various destinations. Some are on their way to community day services; others are reporting to their various campus work opportunities; some are on their way to therapy…

In witnessing the parade of residents the observer might notice the variety of the their mode of travel: some may appear to be progressing independently; others are walking in a group accompanied by a staff member; others are ambulating with the assistance of a device such as a walker; others are in wheelchairs being pushed by a fellow resident or staff member; others may be zipping along in their power wheelchairs.

They are all on the go as they have things to do!      

While all the cherished residents of Misericordia are unique persons, all are bound together by some degree of developmental disability. Many of them are an aspect of their uniqueness, experience some degree of an additional disability as well. The astute observer of the morning scurrying about might take notice of some of these additional challenges to some residents.

What the visitor to the campus would not see is the depth and breadth of the commitment of Misericordia to assist each resident to maximize their individual potential and minimize the limitations imposed by whatever disability challenges them.

 A key component of carry out this commitment to the resident community is providing for on-campus physical, communication and occupational therapy. Each of these therapies address a wide range of issues challenging residents with multiple disabilities.

Simply described, physical therapy aims to improve a person's ability to move and position their body. The focus of occupational therapy is to enhance a person's ability to participate in the things they want and need to do throughout their day. Communication therapy focuses on the enhancement of communication through improvement of speech and language; development of augmentative/assistive communication; swallowing skills and monitoring of hearing ability.

To ensure that each resident has their particular therapeutic needs responded to, all residents (with the exception of those residing in Shannon Apartments and CILAs) over the age of 21 are evaluated at least every five years. Those under 21 are evaluated at least every three years. In between times, evaluations are administered on a "as needed" basis. These evaluations determine a treatment program and goals for each resident.

Examples of physical therapy goals are; decrease the progression of deformity, facilitate the acquisition of early development milestones, and manage chronic pain. Examples of occupational therapy goals are: facilitate the use of adaptive equipment, modulate sensory input, and improve arm and hand function for specific tasks.

Examples of communication therapy goals include: improvement of expressive and receptive language skills; enhancement of speech production and social skills; maintenance of oral motor skills and the expansion if the use of assistive communication devices.

Services are provided based on a resident's individual needs. Services include the provision of one-to-one therapy, group therapy, and aquatic therapy. Other services include consultation and in-services with staff and family members.

There are other sites throughout the rest of campus where in a recent year over 6,000 1:1 treatment sessions were received by residents These treatments may be related to an injury or related issue (short term intervention). Other 1:1 services may be carried out by a therapy aide (example therapeutic bike riding or gait training). There are multiple therapy treatment spaces and sensory rooms across campus. Sensory rooms provide a multi-sensory environment where residents can engage in calming or alerting tasks that can help regulate their systems and prepare them for success in other activities. Another favorite locale for therapy is the Moore Aquatic Center, where in-pool aquatic therapy occurs. In any given year, there may be over 500 1:1 treatment sessions in the water. Individuals that are non-ambulatory require 1:1 assistance while in the pool.

In addition to individual therapy, group therapy also plays an integral role in meeting the needs of Misericordia residents. When a therapeutic activity can be done in the company of others, it adds a social dimension to therapy for the residents and provides for efficient use of therapist time and space. There are approximately 25 different groups ranging in membership from 4 to 20, the average size being 6-10. Examples of group therapy are music and motion, water walking, balance, bike, gait, cooking, gardening, signing, fluency/stuttering, and communication devices. (Note: Misericordia has made appropriate adjustments in all therapy, especially group therapy, with regard to the pandemic.)

Complementing individual and group therapy are there clinics conducted on campus. The spasticity clinic typically occurs once a month. The resident would be seen by a visiting physiatrist in concert with a physical therapist and nurse from Misericordia along with Misericordia's therapy manager. A resident would be referred to the clinic if there are concerns regarding the resident's musculoskeletal problems, functional abilities and/or in need of an orthotic assessment. If a resident would need orthoses, or has orthoses in need of repair, they would be referred to the on-campus orthotics clinic. The wheelchair clinic, staffed by an occupational therapist and a certified rehab therapist, addresses referral for new wheelchairs, seating components, or recurrent problems, such as seating fit and comfort.

The final piece of the mosaic of Misericordia's commitment to resident physical wholeness and wellbeing, maximum independent functioning, and ability to communicate to the best of their ability, is the staff. All individual treatment sessions, group therapies, and clinic services are serviced by a cadre of fully qualified and appropriately credentialed professionals. The roster of therapists, their assistants and aides and their length of service to Misericordia:

Physical Therapists:

Rich Conti, PT 31 years

Megan Glaser, PT, DPT 8 years

Lisa Hirchle, PT, MPT 18 years

Beth Muckler, PT, DPT 13 years

Allison Rubio, PT 1 month

Occupational Therapists:

Jenna Colangelo, MS, OTR/L 4 years

Leah McDonald, MS, OTR/L 7 years

Jill Sparacio, OTR/L, ATP/SMS, ABDA 29 years

Speech Language Pathologists:

Constance Allen, MA, CCC-SLP 32 years

Kathleen Ruppert, MA, CCC-SLP 18 years

Heather Hogan, MA, CCC-SLP 13 years

Lindsey Tamulonis, MS, CCC-SLP 8 years

Pat Politano, PhD, CCC-SLP/L, ATP 8 years

Therapist Assistants:

Stephanie Husbands, COTA 32 years

Jesse Adams, PTA 2 years

Therapy Aides:

Maria Ahumada 27 years

Schalom Akakpo 6 years

Bathsheba Evans 15 years

Cilenen Fair 15 years

Patricia Flores 4 years

Sue Grund 30 years

Diana Hernandez 7 years

Barbara Jefferson 36 years

Kerry Roach 26 years

Ana Roman 13 years

Julianne Toates 4 years

Danijela Veljkovic 7 years

Therapy Manger:

Sam Sexton 8 years

Services and spaces in which to provide those services are essential, but the quality of the staff that occupy those spaces and deliver the services are the key determiners of the quality of care provided. Misericordia's therapists, their assistants and aides, who have accumulated 421 years of combined service, are at the core of the exceptional therapy programs provided on-campus to Misericordia's residents. Their skill, their dedication, their ability to relate personally to residents animate and inspire not only the residents they serve, but also the residential staffs whom they assist by in service and suggestion. To all of you, to each of you: thank you! Thank you!