A Lakeland resident works with an occupational therapist to assess whether the splint is helping protect the resident’s hand.

Lakeland’s Occupational Therapy team helps residents achieve more independence


Contact: Lisa Pemberton, DSHS Office of Communications lisa.pemberton@dshs.wa.gov or 360–902–7844.

Story and photos by Lakeland Communications Consultant Colette Buck

Occupational therapy is a health care discipline that combines art and science with the ability to completely transform the lives of people, and it’s quietly practiced at DSHS’ Lakeland Village residential habilitation center in Medical Lake.

According to the American Occupational Therapy Association, the complex discipline “focuses on the things you want and need in your daily life” and uses everyday activities to promote health, well-being and the ability to participate in life. Not being able to follow your routines or habits can prevent you from being you, said Occupational Therapist Mike Maynard, who supervises Lakeland’s OT team.

“If a disability deprives a resident of their independence or even causes a significant delay in their independence that multiplies and disrupts their flow through life,” he said. “It’s going to change how the residents live, and what’s going to happen eventually without intervention, it’s going to impact the resident’s independence negatively. As part of a team, occupational therapists provide treatment to heal or adapt for disability to help residents achieve their greatest level of independence possible.”

Five people in front of a group building. They are smiling, and four of them are holding items used in occupational therapy, such as plush toys.
Lakeland’s Occupational Therapy Team, from left: Susan Krohn, Occupational Therapy Assistant 2, Krystal Moreno, Occupational Therapist 3, Mike Maynard, Occupational Therapy Supervisor, Valarie Beecher, Occupational Therapy Assistant 2, and Leann Springer, Occupational Therapist for the Intermediate Care Facility for individuals with intellectual and developmental disabilities.

Lakeland offers a certified training center and skilled nursing facility for people with intellectual and developmental disabilities. Maynard, along with Occupational Therapists Krystal Moreno and Leann Springer, and Occupational Therapy Assistant Susan Krohn, completed rigorous annual evaluations, quarterly evaluations and 99 evaluations at the request of staff last year.

Using the data collected, the OT department completed 350 treatments using inventive solutions, and placed or fabricated 682 pieces of equipment to increase resident independence that they track and monitor quarterly.

Each piece of adaptive equipment or therapeutic solution is individualized to the 150+ residents living across campus, and often, adjustments or complete overhauls are required over the lifetime of a treatment to achieve the best results. To reduce the need for changes, occupational therapists consider design’s complexity, the type of material used, and they even analyze the cost and benefit of the support.

Any piece of equipment or process recommended by the occupational therapy team is created and applied using evidence-based practice from across the occupational therapy discipline to achieve the best patient outcome. Sometimes that includes implementing therapies or supports that a resident only just started demonstrating a need for now to prevent injuries in the future.

One example the OT team cited is the introduction of shower chairs to aging residents who show minor balance problems in the shower. While a resident might be able to stand without a chair in the present, they could be at risk of falling in the future because of the progression of physical and mental disabilities and the aging process. By allowing them to acclimate to the chair while they have a low risk of falling, Krohn and Maynard said this allows the resident more time to accept the device while providing the least amount of disruption in their activities of daily living.

“Making some changes to their routine is way more difficult with a person who is older, sick or has an injury than to start the process with a shower chair or a hospital bed when they’re well,” Maynard said. “(This way) you kind of front load or preload it so the person can get used to doing it and you don’t have a problem later on.”

A collection of about five soft items that resemble braided knit balls used for occupational therapy. They are different colors — red wine, sage green, medium blue, white and light pink.
Occupational Therapists use a variety of sensory items in their work to help people build independent skills.

After spending anywhere from six to seven years completing their post-secondary education, occupational therapists are required to earn a license before they’re able to practice. They must also keep up with the evolving science of human physiology, neurology, anatomy and psychology in order to create the best treatments possible for each individual resident.

Like any other medical discipline, the principles and practices used by Lakeland’s OT team are not absolute, especially when accounting for the unique needs of people with developmental or intellectual disabilities.

Sometimes it requires therapists to get creative in how to address needs and complications, and sometimes a therapist can try everything they can think of without the patient making progress. While that can be difficult to experience for an occupational therapist, the ability to be creative in therapeutic approaches and watch a patient thrive because of those interventions keeps our practitioners coming back day after day.

“You don’t just come to work and do the same thing each day…it’s a lot of puzzle-solving out here…which can sometimes make you want to pull your hair out, but when you do get it…when you figure out how to fix a problem or help a resident, it can be extremely satisfying,” Maynard said. “You trade off the routine of going through everyday being planned out step wise for a little more chaos here, and it can be very satisfying.”