FOX Rehabilitation's Lanie Hefferly, MS, OTR/L explains five simple ways an occupational therapist can promote healthy living with an older adult patient. The key, as you’ll soon discover, is to keep things sustainable and achievable.

Jim: Welcome to The FOX Five, the series that explores FOX Rehabilitation through an original list created by a FOX colleague. Today, I am joined by FOX Rehabilitation occupational therapist, Lanie Hefferly.

Lanie: Hello.

Jim: Lanie, how are you doing today?

Lanie: Good, always good to be here.

Jim: Is your dog around today?

Lanie: Oh, he has wandered out.

Jim: How old is your dog?

Lanie: Sixteen weeks.

Jim: He's not even three months yet, or is he?

Lanie: No, he is three months.

Jim: See, my math is terrible.

Lanie: He's going on four months, so he's a still a puppy.

Jim: Maybe we'll flash a picture of your puppy before this FOX Five is over, but anyway, Lanie, what is your FOX Five today?

Lanie: My FOX Five is Five Ways That I Promote Healthy Living as an OT.

Jim: I had a couple of questions about this, but I'm not going to ask them because I want to see how you dive in. So, what is number one on your FOX Five?

Lanie: Number one is education. On the very low end of things, I might just educate somebody on their specific diagnosis and how they can promote a healthy lifestyle within that diagnosis. On the large end of things, when I have people who have diabetes, a decreased activity tolerance, or overall poor general health, I'll actually give them a health promotion plan. It's a part of my home activity plan and it has things on there like exercising daily, eating fruits and vegetables, drinking water, and getting plenty of sleep. I use the American Heart Association guidelines and it has a little chart with checkboxes and I use it exactly like a home exercise program.

Jim: Your FOX Five is aimed toward your patients, which I assumed, but when I saw your notes, I thought maybe you were going to promote the importance of having a healthy lifestyle amongst clinicians. Today, it’s all patient-based. Alright, so what is number two on your FOX Five?

Lanie: Number two is cooking. As an occupational therapist, it is the best thing that you get to do with your patients—well, for me, because I love cooking and I love learning new recipes, and who better to teach you recipes than the [older adult] population of the South? I mean, come on! I like to cook with them and a lot of times I'll have them cook a recipe that they like and then I'll bring a recipe that I like, and when I bring a recipe, I always bring in vegetables or fruits that they don't eat, or ways of cooking that they don't usually participate in. I've definitely air-fried, done a sheet pan, or stir-fries with patients. I always incorporate a vegetable when I bring the recipe and I try and do vegetables that they haven't been exposed to before. When you live in the south I cannot tell you the amount of patients, that when I ask them how many vegetables they're getting in a day, it's maybe one, and then if you ask what vegetables they're getting, it's like, “lettuce and tomato.” One person told me, “butter beans and cornbread.” I was like cornbread is not a vegetable.

Jim: All those greens down in the south, you got to get them eating those greens!

Lanie: Yes.

Jim: What people may not realize is that there's so much function in cooking a meal—standing up, twisting, moving, motor skills.

Lanie: Yeah, usually my cooking goals are in relation to activity tolerance, so a lot of times people can't stand long enough to cook a healthy meal. Usually, that's what my goal is when I am cooking with someone.

Jim: What is number three on your FOX Five?

Lanie: Number three is the low-hanging fruit, building a sustainable home exercise program. You want to get [patients] in a level activity that they can achieve. I'll start my exercise programs with two minutes a day or they might have a five-minute stretch a day, and then I work them up to hopefully about 10 minutes a day. That’s what we try to get to by discharge, and then they have an exercise program to follow.

Jim: I like that you use the word “sustainable,” because if it's not sustainable then they're like, “Oh, the heck with this, I can't do this,” but if it's sustainable, then they can do it.

Lanie: Yes, and I think the key is giving them a little bit at a time because if you start with 15 exercises, they’ll look it at and throw it in the trash.

Jim: Yes, that was a good one. Lainey, what is number four on your FOX Five?

Lanie: Well, I just realized I kind of went into it, but creating achievable goals. One of the ones I use all the time is the back scratch test which is arm range of motion. When I do that goal, I have a two-minute stretch program that I want [my patients] to do every day, and then when they do their stretching program and I measure them again, and they've gained two to three inches, they're like, “Okay, I'm going to stick with this.” I think having really measurable goals and small measurable goals really motivates people.

Jim: Yes, I agree, and then that brings us to number five on your FOX Five.

Lanie: So, number five is an OT specialty. OTs love routine and roles and so the routine is so important. If I feel that somebody has a really dysfunctional routine, I will have them write down what they’re doing every minute of the day so then I can look at it and say, “You know the reason we're not making the progress that you want to make is because you are sitting 23 hours, and you're standing and doing something one hour a day. We have to have you moving more than one hour a day if you want to make the progress that you want to make.” I think building in sleep routines, building in when they eat; I think that's one of the really good things about assisted living because they help get people into a routine. It's so important for our digestion and it's so important for our overall health routine building.

Jim: Definitely. Would you say as an occupational therapist, you’re part motivational speaker, part life coach?

Lanie: Yes. I had to make a purpose statement whenever I was in OT school and I can't remember it exactly, but I know mine was “to encourage others,” because I feel like that’s 99% of what I'm doing—just educating and encouraging.

Jim: Right, because it's one thing if you can pump them up when you're there, but to keep a patient going while you're gone, that's a whole other step.

Lanie: Yep.

Jim: Well, thank you Lanie and I guess Mills, your puppy dog, never made an appearance?

Lanie: He’s in the other room chewing something.

Jim: Alright, maybe next time.