Latest / Root Cause Conversations / Beyond Behavior: Sensory Processing, Pediatric OT & Aging in Place with Amy Marchant

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Beyond Behavior: Sensory Processing, Pediatric OT & Aging in Place with Amy Marchant · Root Cause Conversations

• 0:04
  SPEAKER_00: Hey guys, I'm Amanda Mavrokis, your host here on Root Cause Conversations, where we look beyond the symptom, ask better questions, and connect the dots between whole person health and wellness.
• 0:18
  SPEAKER_00: I'm a speech language pathologist, myofunctional therapist, and the owner behind Salt and Light Speech and Language Resources right here in Alabama.
• 0:28
  SPEAKER_00: A quick heads up: this podcast is for educational purposes only.
• 0:32
  SPEAKER_00: It's not individualized medical advice, and it's not meant to diagnose or treat anything.
• 0:39
  SPEAKER_00: So always loop in your own provider for anything specific to you or your child.
• 0:46
  SPEAKER_00: Thanks for pulling up a seat at the table, and let's get into today's conversation.
• 0:56
  SPEAKER_00: Hey guys, welcome back to the podcast.
• 0:59
  SPEAKER_00: This is where we connect the dots between wellness and whole person health.
• 1:04
  SPEAKER_00: This episode is going to be a little different today because our guest works with families on both ends of life's journey.
• 1:12
  SPEAKER_00: We're talking with Amy Marchant, the owner of Equipped Kids and LiveEquipped, about her two-part practice from play-based pediatric occupational therapy to accessibility and independence consulting that helps aging or medically complex adults stay safe at home.
• 1:31
  SPEAKER_00: Welcome, Amy.
• 1:32
  SPEAKER_00: Thank you for being here with us today.
• 1:34
  SPEAKER_00: Thank you so much for having me.
• 1:36
  SPEAKER_00: We just saw each other yesterday, so that's a great thing about working together.
• 1:39
  SPEAKER_00: We can see each other all the time and do a podcast together.
• 1:43
  SPEAKER_00: Yeah, so fun.
• 1:44
  SPEAKER_00: So can you just tell our audience a little bit about you, your background?
• 1:49
  SPEAKER_01: Yeah, as she mentioned, my name's Amy Marchant.
• 1:52
  SPEAKER_01: I am an occupational therapist and owner of Live Equipped and Equipped Kids.
• 1:57
  SPEAKER_01: My work is centered around one goal, just helping people to participate more fully and independently in everyday life, whether it's children or older adults.
• 2:06
  SPEAKER_01: We serve clients across the lifespan.
• 2:08
  SPEAKER_01: So through Equipped Kids, we provide individualized pediatric OT to help children to build the skills and confidence that they need at home, at school, and in the community.
• 2:19
  SPEAKER_01: Then through LiveEquipped, I specialize in home accessibility, aging in place, functional home modifications, combining that OT perspective with medical understanding and practical, thoughtful design solutions.
• 2:33
  SPEAKER_00: Oh, I love that so much.
• 2:35
  SPEAKER_00: And you just completely cover the lifespan.
• 2:38
  SPEAKER_00: So, what do you want to talk about first?
• 2:41
  SPEAKER_00: Do you want to talk about the kids first or do you want to talk about the accessibility of home modifications first?
• 2:47
  SPEAKER_00: Oh, let's start with kids.
• 2:49
  SPEAKER_00: So let's talk about equipped kids.
• 2:51
  SPEAKER_00: What made you decide that you were going to build a practice like around play-based occupational therapy and focus a lot on sensory needs?
• 3:01
  SPEAKER_01: So pediatric occupational therapists have always used play as our main sort of source of treatment.
• 3:08
  SPEAKER_01: That's just how children learn, develop, and engage in the world around them.
• 3:12
  SPEAKER_01: We aren't simply just playing with the child.
• 3:15
  SPEAKER_01: We work with children through play to target different difficulties that they're having and really trying to figure out what's happening beneath the surface, whether it's sensory processing, regulation, motor planning, coordination, strength, fine motor skills, or other factors.
• 3:33
  SPEAKER_01: We use intentionally play-based activities to address those underlying needs.
• 3:41
  SPEAKER_00: So, Amy, from a pediatric standpoint, you guys have created a great occupational therapy clinic in our local town.
• 3:50
  SPEAKER_00: And can you tell me what made you decide to do this?
• 3:54
  SPEAKER_00: Because I know you guys use a play-based approach.
• 3:57
  SPEAKER_00: So what kind of made you choose this approach or this model?
• 4:01
  SPEAKER_01: Yeah, and so occupational therapists use play as our means of intervention to work with a child and help them to overcome any difficulties that they're having.
• 4:12
  SPEAKER_01: And because that's how children learn to understand their environment is through play.
• 4:17
  SPEAKER_01: That's how they grow and develop and learn through play.
• 4:20
  SPEAKER_00: So I know you guys work a lot on like sensory processing and regulation.
• 4:27
  SPEAKER_00: Can you unpack that just a little bit for the parents out there and let them know like what does that look like?
• 4:33
  SPEAKER_00: What is sensory processing?
• 4:35
  SPEAKER_00: What is regulation?
• 4:36
  SPEAKER_00: And what does that look like from an occupational therapy standpoint?
• 4:40
  SPEAKER_01: So sensory processing, put simply, is how a child processes all of the sensory and environmental input they're receiving at any given moment.
• 4:48
  SPEAKER_01: So it's using your senses as well as your body awareness and positioning to understand the world around you.
• 4:54
  SPEAKER_01: Some kids are overwhelmed by all of that information at once, and others need even more input to be at their best.
• 5:02
  SPEAKER_01: But often the kids aren't able to identify what's going on.
• 5:05
  SPEAKER_01: So they're feeling this and they're not able to communicate what they're feeling.
• 5:09
  SPEAKER_01: So this often comes out as behaviors or outbursts or even avoidance.
• 5:14
  SPEAKER_01: All kids are different, so this can present in many different ways.
• 5:18
  SPEAKER_01: Often parents come to us with behavioral concerns or say that their child has big emotions.
• 5:23
  SPEAKER_01: So then it's our job to figure out what's underneath it.
• 5:26
  SPEAKER_01: So we look at where they are on the range of sensory processing.
• 5:31
  SPEAKER_01: Is their nervous system overwhelmed or is it over-responsive or under-responsive?
• 5:37
  SPEAKER_01: Are they needing more input or less input?
• 5:40
  SPEAKER_01: And we also look at their postural control and stability.
• 5:44
  SPEAKER_01: Do they have the core strength needed to support their hands effectively?
• 5:48
  SPEAKER_01: Do they have the body awareness in sense of where their body is in space to be able to do what they're trying to do?
• 5:55
  SPEAKER_01: We look at coordination, motor planning, and how the child sequences the steps of an activity.
• 6:03
  SPEAKER_01: A lot of times parents don't even realize, but their child is not able to copy what they did.
• 6:08
  SPEAKER_01: Like you could do something and ask your child to do the same thing, and they're not able to do it.
• 6:12
  SPEAKER_01: So they're having difficulty with like motor planning and coordinating all of the necessary components of that task.
• 6:20
  SPEAKER_01: So we have to break it down into smaller pieces and address each component.
• 6:25
  SPEAKER_01: Um, we also put together a little list for you as well that you can share with your listeners.
• 6:31
  SPEAKER_00: That's awesome.
• 6:32
  SPEAKER_00: Thank you.
• 6:33
  SPEAKER_00: So let's talk a little bit about motor planning because I work in the clinic with Mindy and I get to hear her talk about some of the kiddos that come in.
• 6:42
  SPEAKER_00: So can you give the parents an example of what that might look like on a day-to-day basis?
• 6:47
  SPEAKER_00: Like what might they see their kids struggling with that would indicate a motor planning issue?
• 6:54
  SPEAKER_01: A lot of times it just looks like the child isn't very coordinated, or you're like, oh, they're so clumsy, or they're just they look awkward when they run.
• 7:02
  SPEAKER_01: Little things like that to us are actually red flags.
• 7:06
  SPEAKER_01: And Mindy specifically operates from a neurodevelopmental framework, and we use those play-based activities to help the child learn to master those skills.
• 7:15
  SPEAKER_01: And she's amazing.
• 7:17
  SPEAKER_01: Mindy is a wealth of knowledge, and that's why it's so important to have an experienced clinician on your team when you're working on these on these areas, especially like sensory processing and primitive reflexes, because a lot of kids that we do find that they do have retained primitive reflexes, and sometimes once you have an activity planned and you've got this beautiful session laid out, and you go to do that, and then it doesn't work with the kid, you've got to immediately be able to pivot to the next thing in order to just achieve those desired outcomes.
• 7:50
  SPEAKER_01: So experience really matters when choosing your provider.
• 7:53
  SPEAKER_00: I spoke with Jill on the podcast at least pediatric therapy, and we talked a little bit about retain primitive reflexes too from a physical therapy standpoint, but you guys do that as well, don't you?
• 8:04
  SPEAKER_00: Oh yeah.
• 8:04
  SPEAKER_00: Okay.
• 8:05
  SPEAKER_00: Let's just say I bring a seven-year-old into your office and I have concerns that they're having a hard time getting dressed and putting clothes on.
• 8:14
  SPEAKER_00: They're having a hard time with sports.
• 8:16
  SPEAKER_00: They seem to don't like the way clothing feels on their skin.
• 8:20
  SPEAKER_00: So I come in with these issues that my kiddo is having.
• 8:23
  SPEAKER_00: Can you walk us through what an evaluation would look like?
• 8:26
  SPEAKER_01: Everything is based on play.
• 8:28
  SPEAKER_01: So we do different activities that are fun for the child.
• 8:31
  SPEAKER_01: So it's not like they're coming in and they're being drilled questions or here, do this, and we're gonna take some notes.
• 8:37
  SPEAKER_01: It's fun.
• 8:38
  SPEAKER_01: We come in and build rapport, and you've got to kind of gain that child's trust and where they want to participate and do what you're even asking of them.
• 8:49
  SPEAKER_01: So Mindy will have them like play a game or do an activity at first, and then she might have them come over and watch them jump or skip or balance on one leg or throw a ball and just kind of see how all of those activities go, and then that determines our next step.
• 9:06
  SPEAKER_01: Sometimes the first visit, they don't they don't want to participate in things that make them a little nervous, and it takes some time to really build that rapport.
• 9:14
  SPEAKER_01: So we often look at like sensory processing and ask the parents a lot of questions.
• 9:18
  SPEAKER_01: We do like a parent questionnaire as well, and use all of these pieces to guide our next steps.
• 9:24
  SPEAKER_01: And a lot of times that first evaluation is just the first step, and we're continuing to assess each visit and kind of just peel back the pieces to figure out what the underlying cause is and really get to the root of it.
• 9:40
  SPEAKER_00: And I love that it's more like a play-based initial assessment.
• 9:44
  SPEAKER_00: They probably don't even realize that you're testing them for things or looking for certain things.
• 9:50
  SPEAKER_00: And they think they're just in there playing and having a fun time and bouncing on the trampoline, and I know that's got to help the parents feel more comfortable that it's not super structured or rigorous.
• 10:01
  SPEAKER_00: Yeah.
• 10:02
  SPEAKER_00: Let's talk about some root cause issues because that's kind of why we're here.
• 10:06
  SPEAKER_00: Let's say that we're looking at some behaviors.
• 10:11
  SPEAKER_00: A lot of kiddos come into your clinic and they're exhibiting behaviors that are impacting their learning or their ability to interact or play with other kids.
• 10:20
  SPEAKER_00: If we're gonna dig down into that, like what are you guys looking for as an underlying issue?
• 10:27
  SPEAKER_01: Yeah, that's the thing.
• 10:28
  SPEAKER_01: It's it's not merely the behavior, it's a clue that there's something else going on.
• 10:33
  SPEAKER_01: And it might not be a behavior, but maybe the absence of an expected behavior.
• 10:38
  SPEAKER_01: So each child presents differently, and you really just kind of have to dig deep and figure out what's going on.
• 10:46
  SPEAKER_01: As you mentioned earlier, like a child who has difficulty dressing, maybe they throw a fit when it's time to get dressed, but we can't just assume that the child is refusing to get dressed.
• 10:59
  SPEAKER_01: What we don't know is maybe the the clothing feels uncomfortable, maybe they're having a hard time balancing to put the pants on, maybe they have difficulty with motor planning, as we talked about earlier, figuring out what's the first step to do, or maybe they're just completely overwhelmed at trying to figure out what to do, or the whole morning routine itself is stressful and they're just overwhelmed.
• 11:21
  SPEAKER_01: Like there's so much that goes into it.
• 11:23
  SPEAKER_01: We've got to to separate all of the pieces out and figure out where exactly the issue lies in order to be able to address that.
• 11:31
  SPEAKER_01: And as you mentioned, it's multiple different things, it's not necessarily one thing, it's we need to work on this and this and this all simultaneously to be able to accomplish the end goal, which is that child being able to get dressed independently.
• 11:47
  SPEAKER_00: And I know a lot of times that can be introducing supports into their environment, like a visual on the sequencing of what steps to do and how to do them, because sometimes memory and attention play a huge role in all of those things.
• 12:01
  SPEAKER_00: So it's not just one thing, it's usually multiple small things that are impacting that child's ability to potentially get dressed independently.
• 12:11
  SPEAKER_00: Okay, you had mentioned earlier when we were discussing the nervous system, and you said sometimes there can be over-responses and under-responses when we were talking about sensory issues.
• 12:23
  SPEAKER_00: Can you give us an example of what each one would look like so a parent that's listening would kind of understand where we're coming from?
• 12:30
  SPEAKER_01: Okay, and again, every every child is different, but just a few examples would be like a child who is scared of loud noises.
• 12:39
  SPEAKER_01: One of my children, when we would go to the bathroom at the mall or somewhere, the hand dryers or the toilet flushing would set them off.
• 12:47
  SPEAKER_01: They did not like those abrupt loud noises.
• 12:52
  SPEAKER_01: They couldn't handle it.
• 12:53
  SPEAKER_01: So anything something like that, or over under responsive, where they just crave more input.
• 13:00
  SPEAKER_01: The kids that are, oh, they're just a daredevil, or they're constantly pushing or hitting or bumping, like cannot sit still, cannot keep them their hands to themselves in line at school, constantly getting in trouble because they need that input.
• 13:14
  SPEAKER_01: And sitting in a desk for an hour, they're about to lose it and they're bumping in and touching everybody around them because they crave that input.
• 13:23
  SPEAKER_01: Same thing like with textures.
• 13:24
  SPEAKER_01: As I mentioned, you could either not like messy things and not want to get your hands dirty or sticky, or you crave more of it.
• 13:32
  SPEAKER_01: You want to play in all all the things, get my hands dirty, and just love playing in the dirt or whatever it is.
• 13:39
  SPEAKER_01: So it there's just two ends of the spectrum, and then each child kind of falls somewhere on that spectrum.
• 13:46
  SPEAKER_00: Yeah.
• 13:47
  SPEAKER_00: Okay, so I'm definitely like, I don't want my hands dirty, and I'm gonna eat something, and I'm gonna continue to eat it, but I need to wipe my hands after every time I touch that piece of things.
• 13:58
  SPEAKER_00: Well, you might need to come see us.
• 14:00
  SPEAKER_00: There's people out here, they're listening to us, and they're thinking, oh my gosh, that sounds like my kid.
• 14:06
  SPEAKER_00: So what would you say to that parent?
• 14:08
  SPEAKER_01: The key isn't that there's one thing.
• 14:12
  SPEAKER_01: Usually there's more than one thing.
• 14:14
  SPEAKER_01: But if there's multiple different behaviors that you're noticing, that's when we want to see you.
• 14:20
  SPEAKER_01: And we actually created a list, a little checklist for your listeners so that they can look at that as well.
• 14:27
  SPEAKER_01: If they're avoiding activities that most kids enjoy, those are red flags.
• 14:34
  SPEAKER_01: Your child's always saying like they can't or they don't want to try this or do that.
• 14:38
  SPEAKER_01: Then part of that could be that they've failed at it before and they're nervous about trying it again, or that it just makes them feel insecure or unsafe.
• 14:47
  SPEAKER_01: And we need to get to the root cause and figure out what's going on behind that.
• 14:52
  SPEAKER_00: You mentioned something about a checklist, and so we will link that in the show notes below so that the parents can go in and grab that and download it.
• 15:01
  SPEAKER_00: And I'm assuming it's a printable document.
• 15:03
  SPEAKER_00: It sure is.
• 15:04
  SPEAKER_00: That way, parents, you guys can download it and you can go through it with your kiddos and see if any of those things might apply to you guys.
• 15:13
  SPEAKER_00: So now we're gonna just kind of create a bridge in an unnatural way from kids to adults.
• 15:21
  SPEAKER_00: Let's see.
• 15:22
  SPEAKER_00: So now we're gonna talk about LiveEquipped, where you work on accessibility and independence and aging in place.
• 15:31
  SPEAKER_00: Can you tell us a little bit about what led you to focus on home accessibility and home modifications?
• 15:40
  SPEAKER_01: All right, I'm hoping to make this all come full circle and make sense for you all because yes, I get it.
• 15:46
  SPEAKER_01: It's like I have two completely different businesses all under one umbrella, but it all flows and makes sense, I promise.
• 15:54
  SPEAKER_01: But let's go way back.
• 15:57
  SPEAKER_01: So, as I mentioned earlier, I'm an occupational therapist, but as a child, I loved design.
• 16:03
  SPEAKER_01: I wanted to be an architect, I would draw floor plans and design houses for fun at like eight, 10, 12 years old.
• 16:10
  SPEAKER_01: I was sketching floor plans.
• 16:13
  SPEAKER_01: Fast forward to college, I still liked that idea, but I was like, I'm just gonna flip houses and do that for fun.
• 16:19
  SPEAKER_01: I really want to help people and fell in love with OT.
• 16:23
  SPEAKER_01: So I became an occupational therapist, and in school, we had one little class, maybe not even a full class, where we talked about adaptive equipment and like minor home modifications, clear pathways, things like that.
• 16:38
  SPEAKER_01: And I was like, ooh, what if I blend these two?
• 16:42
  SPEAKER_01: That would be really cool.
• 16:44
  SPEAKER_01: And that was kind of that.
• 16:46
  SPEAKER_01: It was always kind of been in the back of my mind.
• 16:49
  SPEAKER_01: But I graduated, I had started OT school wanting to do pediatrics, funny enough, and then somewhere along the way fell in love with working with older adults and helping them to become more independent and get their life back after like a stroke or a significant injury, something like that.
• 17:09
  SPEAKER_01: And so after graduation, I ultimately ended up in home health, where I mean that was my dream job.
• 17:16
  SPEAKER_01: That was perfect.
• 17:16
  SPEAKER_01: I was recommending minor modifications, ramps, widen the doorways, things like that here and there.
• 17:23
  SPEAKER_01: And things were going well.
• 17:25
  SPEAKER_01: That was exactly where I needed to be.
• 17:28
  SPEAKER_01: I was comfortable.
• 17:29
  SPEAKER_01: If you get what I'm saying, I was comfortable.
• 17:32
  SPEAKER_01: You know, when you get comfortable, God's like, No, I created you for more.
• 17:38
  SPEAKER_01: Like you're discomfort is not gonna last.
• 17:41
  SPEAKER_01: So yeah, get ready, Amy.
• 17:43
  SPEAKER_00: He's staying with moments.
• 17:45
  SPEAKER_01: Right.
• 17:46
  SPEAKER_01: I was right where I needed to be.
• 17:47
  SPEAKER_01: Like, I'm good.
• 17:49
  SPEAKER_01: Then, so one day I was going on a honey trip with my husband.
• 17:55
  SPEAKER_01: Honey trips happen rarely with us for with three kids, and this was actually a work-combined trip where we were getting away from the kiddos for just a little while.
• 18:05
  SPEAKER_01: He had some meetings, we'd spend some time together in the evenings, and it would be nice.
• 18:10
  SPEAKER_01: Well, on the way for our long weekend, my phone starts blowing up, and I'm getting texts from colleagues about an emergency meeting was called at work, and half of the team was called to the emergency meeting, and the other half got messages that they needed to come in for a one-on-one.
• 18:30
  SPEAKER_01: Well, next thing I know, I got that message.
• 18:32
  SPEAKER_01: We know you're on vacation, but we need you to call us.
• 18:36
  SPEAKER_01: Which lovely, right?
• 18:38
  SPEAKER_01: So I called, and of course, half the team was let go.
• 18:43
  SPEAKER_01: They cut the therapy team in half, declining reimbursement rates, downsizing, yada yada.
• 18:50
  SPEAKER_01: Rug pulled out from underneath me on vacation.
• 18:53
  SPEAKER_01: And what should have felt like the rug pulled out from under me, like fear.
• 19:00
  SPEAKER_01: I was the primary breadwinner of our family.
• 19:03
  SPEAKER_01: We had three kids, one, three, and five, I think, at the time.
• 19:06
  SPEAKER_01: And like that should have been, I should have been very upset, but I've never felt such peace.
• 19:13
  SPEAKER_01: Like in that moment, I just knew like God's got this.
• 19:18
  SPEAKER_01: I don't know what what tomorrow looks like, but I'm okay.
• 19:22
  SPEAKER_01: Like, and in that piece, there's nothing that can describe that, just knowing that everything's gonna be okay when looking at it, everything's not okay, you know.
• 19:35
  SPEAKER_01: But I was able to spend that weekend praying and planning and researching, and ultimately that led to this.
• 19:45
  SPEAKER_01: And God has guided me every step of the way, He has made every every bit of this happen.
• 19:51
  SPEAKER_01: It's all Him, not me.
• 19:53
  SPEAKER_01: I give Him all of the glory, every partnership, every opportunity, every encounter.
• 19:59
  SPEAKER_01: It has all been Him.
• 20:00
  SPEAKER_01: Like I'm a control freak and try to do things and get everything just right before I jump, or just trying to have it all figured out, and then I'll run with something, and then He'll lovingly remind me who's actually sailing this ship.
• 20:14
  SPEAKER_01: And it just it's all worked out to be better than anything I ever could have just planned on my own.
• 20:21
  SPEAKER_01: You know, it's always been there.
• 20:22
  SPEAKER_01: Like looking back, it all makes sense, but it's amazing what God has done with it.
• 20:28
  SPEAKER_01: And I guess to throw in the the kids' portion, when all of this started, or I guess after a couple of years, I mean, I was getting referrals for families who have children with disabilities who their kids are aging and the parents are aging and they can't pick their kids up and down out of the bathtub or carry them to the car anymore, and it's getting difficult.
• 20:48
  SPEAKER_01: And it's amazing the things that parents do for their children, and you just figure out a way and you do it, and you're just used to it, and you don't even know sometimes that there's a better way or something that can make it easier.
• 20:59
  SPEAKER_01: And after seeing that and working with those families, I was like, we've got to serve everybody.
• 21:05
  SPEAKER_01: And the opportunity came up to start equipped kids, and that was you, Amanda.
• 21:12
  SPEAKER_01: I mean, you offered your space, and like I said, like God has ordained every step of his mission, and so here we are.
• 21:21
  SPEAKER_01: We serve everybody, all aspects, we serve everyone across the lifespan.
• 21:26
  SPEAKER_00: Girl, I love that so much because I mean, we're very different, but we're also very similar in a lot of ways, and we're both avid planners, and I feel like we both think we need to do our part so that the Lord isn't having to do everything for us.
• 21:43
  SPEAKER_00: We need to help the Lord.
• 21:45
  SPEAKER_00: Right.
• 21:45
  SPEAKER_00: Sometimes it just doesn't work out that way.
• 21:48
  SPEAKER_00: No, that's for sure.
• 21:51
  SPEAKER_00: So modifications.
• 21:55
  SPEAKER_00: Do you do those kids and adults?
• 21:58
  SPEAKER_00: Like, what is that population?
• 22:00
  SPEAKER_00: Generally, look like for you on a day-to-day basis?
• 22:03
  SPEAKER_01: I will say primarily we do modifications for adults.
• 22:07
  SPEAKER_01: We have not grown as much as we can and hope to in the future with kids simply because I've been so busy on the other side with serving adults.
• 22:18
  SPEAKER_01: We have multiple programs that we do with nonprofits and workers' comp, and all of those things have kept me rather busy, but I'm actually hiring.
• 22:28
  SPEAKER_01: So hopefully that'll help free things up because I do want to move more into that pediatric space because there is such a need there.
• 22:35
  SPEAKER_01: And families just they need that support.
• 22:38
  SPEAKER_01: And as I mentioned, a lot of times you don't know what you don't know.
• 22:41
  SPEAKER_01: So I really want to be able to serve those families as well.
• 22:45
  SPEAKER_00: I'm so glad that you can kind of stand in the gap for people and help them understand that it doesn't have to be hard, it doesn't have to be stressful.
• 22:53
  SPEAKER_00: There's people out there that can help you and support you and like show you ways to make things easier for you because if you do have a medically complex kiddo, they're just gonna grow and get bigger, and you can't necessarily carry a 16-year-old, 180-pound kid out to the car every day.
• 23:11
  SPEAKER_00: And you know, being able to think long term, not just this is where we are today.
• 23:16
  SPEAKER_00: What does this look like in 10 years for us?
• 23:19
  SPEAKER_00: And what steps do we need to start putting in place now?
• 23:22
  SPEAKER_00: So when we get there, we haven't injured ourselves, right?
• 23:25
  SPEAKER_01: Planning ahead.
• 23:26
  SPEAKER_01: That's one thing that just as a society that we're not great at.
• 23:30
  SPEAKER_01: A lot of this is aging in place and putting in a grab bar before you necessarily need it.
• 23:37
  SPEAKER_01: Things that will prevent falls, because falls can be catastrophic.
• 23:41
  SPEAKER_01: Add a few grab bars or add a rail at the steps, things like that before it's too late.
• 23:47
  SPEAKER_01: I mean, you can prevent a hip fracture or something like that.
• 23:50
  SPEAKER_01: It's much easier to do on the front end, but oftentimes people wait until they absolutely have to address it when something catastrophic does happen, and then they're like, oh, well, we should do this.
• 24:01
  SPEAKER_01: But it's much easier to do it on the front end, I promise.
• 24:04
  SPEAKER_00: I know when me and my husband bought this house last year, we knew this was not gonna be our forever home.
• 24:10
  SPEAKER_00: We have a flight of stairs down to the basement and we have a flight of stairs upstairs.
• 24:15
  SPEAKER_00: And both working in healthcare, working with older adults for 20 plus years, we both know like you have to think ahead and you have to think, what is this gonna look like when I'm 60?
• 24:26
  SPEAKER_00: Okay.
• 24:26
  SPEAKER_00: Because we don't know what the future holds, but it doesn't hurt to put a few things in place to plan for that so nothing terrible happens.
• 24:33
  SPEAKER_00: Exactly.
• 24:34
  SPEAKER_01: And it doesn't have to look like a hospital, you know.
• 24:37
  SPEAKER_01: There's so many things out there that are aesthetically pleasing, and that's part of what I do is design it so that things are functional and tailored to their specific needs, and that it is it's home still.
• 24:50
  SPEAKER_01: It doesn't look like it's something unusual, you know, something like a nursing home.
• 24:55
  SPEAKER_01: It's it's tailored to you.
• 24:58
  SPEAKER_00: If you have a client that reaches out, and I'm just gonna toss out a few things here.
• 25:02
  SPEAKER_00: If they have a neurological disorder, let's say MS or a Parkinson's diagnosis, and they know that they want to stay in their home, and they're kind of in the early stages of this, but they've done their research and they know that 10 years can look very different than what's happening today.
• 25:20
  SPEAKER_00: What do you do, Amy?
• 25:21
  SPEAKER_00: Can you tell me, like when you go to that house, what are some things that you look at and what are some recommendations that you typically make?
• 25:28
  SPEAKER_01: Yeah, so we go through everything.
• 25:30
  SPEAKER_01: We look at how they get in and out of the home, if they're using stairs, how they do going up and down the stairs, in it getting in and out of the shower, up and down from the toilet, in and out of the bed.
• 25:40
  SPEAKER_01: We talk about their daily routines, their priorities, their desires.
• 25:44
  SPEAKER_01: I mean, it's their home.
• 25:45
  SPEAKER_01: So ultimately, that's that's what we're working for is something that they desire and helping them to be able to do the activities that they want to do.
• 25:55
  SPEAKER_01: If they love cooking, but cooking has gotten hard and now they're not able to do it anymore.
• 26:00
  SPEAKER_01: We need to fit figure out a way to bridge that gap and help them to be able to do those desired activities safely.
• 26:07
  SPEAKER_01: So we go through everything and I make the recommendations and then work with the contractor to figure out if we're doing like floor plans and everything that I walk through every step with the client.
• 26:21
  SPEAKER_01: And even when like the grab bars get installed, we look at exactly where the grab bar needs to be placed.
• 26:27
  SPEAKER_01: We're not following ADA, ADA is not required in the home, and it's usually not the best placement for a grab bar.
• 26:34
  SPEAKER_01: So we look and determine what that client specifically needs and tailor every bit of it to them.
• 26:43
  SPEAKER_01: As far as like frequently recommended modifications, of course, ramps, and if they use a wheelchair or anything like that, but there's also a way to make ramps that aren't like just a metal ramp or something, you can make it pretty, you can do like landscaping and different things around making it look like it fits rather than just sticking a ramp at your front door.
• 27:09
  SPEAKER_01: There's so much that can be done to make it pretty.
• 27:12
  SPEAKER_01: Grab bars, of course, and there's so many styles of grab bars.
• 27:15
  SPEAKER_01: They have grab bars in every color.
• 27:17
  SPEAKER_01: And depending on what's going on, if there's vision deficits or anything like that, that determines the appropriate color and different styles, making it all match and just look pretty.
• 27:29
  SPEAKER_01: We do toilet lifters, bidets, shower benches, full bathroom remodels.
• 27:35
  SPEAKER_01: It just depends specifically on that client and their budget.
• 27:39
  SPEAKER_01: Because we're also very good at figuring out what corners can be cut, or if we need to do this in stages to work with them financially, because not everyone's able to just make my home into what it needs to be.
• 27:54
  SPEAKER_01: Most people aren't.
• 27:55
  SPEAKER_01: So we're really good at putting band-aids on situations to make it safer and make it work for them to be budget friendly.
• 28:03
  SPEAKER_00: Yeah, I appreciate that too.
• 28:05
  SPEAKER_00: And I know that your families do as well because there's no money tree.
• 28:10
  SPEAKER_00: And most of them like this is pretty much out of pocket, right?
• 28:14
  SPEAKER_00: It's kind of like a home improvement.
• 28:15
  SPEAKER_00: A home modification is kind of like an improvement to help you be able to stay there longer.
• 28:20
  SPEAKER_01: Yeah, there's definitely things you can do on the back end.
• 28:24
  SPEAKER_01: There's different programs, and we're able to help with getting you in touch with the right people as well.
• 28:30
  SPEAKER_01: If finances are an issue, we can definitely help get them on the right path to figure out how to get the assistance that they need.
• 28:38
  SPEAKER_00: Okay, so you would come into the house, I'm assuming interview them, talk with about what their needs are, what their budget is, and then make recommendations.
• 28:47
  SPEAKER_00: I'm assuming like you're drawing or sketching this out.
• 28:50
  SPEAKER_01: I do everything from we kind of have different levels.
• 28:54
  SPEAKER_01: So I can make recommendations, obviously, give them a list.
• 28:57
  SPEAKER_01: I can I typically make like a scope of work for the contractor.
• 29:01
  SPEAKER_01: They can get my recommendations and just give that to their contractor and move on and be done with me if they like.
• 29:07
  SPEAKER_01: They've got something that they can tell them this is what I need and run with it, or I can stay involved and work with the contractor.
• 29:14
  SPEAKER_01: I do floor plans, I've edited other designers' floor plans to make it more suitable for the clients.
• 29:22
  SPEAKER_01: And then I really I think the biggest piece though is once everything's done, is training on it after.
• 29:29
  SPEAKER_01: If we're recommending any equipment or things like that, it's making sure that they can use it safely and teaching them how to do that and their caregiver and make sure everybody's on the same page and that we have a good plan and good support going forward as well.
• 29:44
  SPEAKER_00: So the contractor piece of this, do you have contractors that you recommend, Amy, or do you let the family kind of find somebody that works for them?
• 29:54
  SPEAKER_01: Clients will come to me and they've already got a contractor in mind, and that's great.
• 29:58
  SPEAKER_01: I'm happy to work with whoever.
• 30:00
  SPEAKER_01: I, of course, have contractors that I frequently work with, and if they do need a contractor, I'll give them a few options and tell them.
• 30:08
  SPEAKER_01: I always tell them to you do your research and you interview them and make sure it's a good fit for you.
• 30:14
  SPEAKER_01: And the people that I work with that I recommend I've had do work at my home and are the ones that I would go to if I needed something done.
• 30:22
  SPEAKER_01: So I'm not gonna refer somebody that I don't believe in.
• 30:26
  SPEAKER_01: Yes, and also someone that respects them and their space, that's a huge piece.
• 30:32
  SPEAKER_01: So I've come to really love the contractors that I work with frequently.
• 30:37
  SPEAKER_00: Home modifications, we've talked about grab bars.
• 30:40
  SPEAKER_00: What about equipment?
• 30:42
  SPEAKER_00: What about lifts or stair lifts or hoyer lifts?
• 30:46
  SPEAKER_00: Can you kind of talk about equipment?
• 30:48
  SPEAKER_00: Because I know I did home health care for 15 years and we would routinely request hour lifts and different things like that.
• 30:55
  SPEAKER_00: Is that something that you help the families with as well?
• 30:58
  SPEAKER_01: Yes, and a lot of times on those not necessarily like a stair lift or something, but sometimes there is coverage through your insurance.
• 31:06
  SPEAKER_01: So we can write to that medical necessity piece to help get different items covered, or if they do have like long-term health insurance and different programs that will help them to pay for these things, we can help to get them the right paperwork that they need to get those things covered and get a better understanding of kind of where they're at with things.
• 31:25
  SPEAKER_00: Yeah, I mean, because that falls under the DME umbrella, and some things are covered and some things just aren't.
• 31:32
  SPEAKER_01: And insurance every day is deciding different different things that they don't want to cover anymore.
• 31:38
  SPEAKER_01: So yes, there's always a constant change there.
• 31:41
  SPEAKER_00: Yeah.
• 31:42
  SPEAKER_00: It's been a long time, but the last time I was helping a patient figure out their equipment situation, the insurance wouldn't cover things like a bedside toilet anymore.
• 31:52
  SPEAKER_00: Is that still pretty standard?
• 31:54
  SPEAKER_01: Yes, they will cover like the bedside commode.
• 31:57
  SPEAKER_01: If say you have two floors and you can't access the second floor and there's not a bathroom on the first floor.
• 32:03
  SPEAKER_00: So there has to be extenuating circumstances, not just it's a safety concern.
• 32:07
  SPEAKER_00: Exactly.
• 32:08
  SPEAKER_00: And that's unfortunate, but this is this is where we're at with insurance, and we could have a whole nother podcast and invite ten other people on to talk about insurance.
• 32:19
  SPEAKER_00: But I mean it's important that whether you're working with Amy or whoever you're working with, like if you're requesting for your insurance company to even potentially reimburse you, you do have to have some sort of medical necessity, right?
• 32:32
  SPEAKER_01: Yeah, you do.
• 32:34
  SPEAKER_00: Yep.
• 32:34
  SPEAKER_00: There's got to be documentation saying that you need these things.
• 32:38
  SPEAKER_00: And is there anything else that you want to share with our listeners that we haven't talked about?
• 32:43
  SPEAKER_01: We're happy to talk with you.
• 32:45
  SPEAKER_01: If you have any concerns, if you feel like maybe my child is doing these things, I'm a little bit concerned about it.
• 32:52
  SPEAKER_01: If you want to run it by us, we're happy to talk with you or set up a consult.
• 32:56
  SPEAKER_01: We also do like screenings.
• 32:58
  SPEAKER_01: I mean, I just tell parents, being a parent myself, like trust your gut.
• 33:02
  SPEAKER_01: You know when something isn't right, you know, and you're their advocate.
• 33:07
  SPEAKER_01: So sometimes the doctor might say, Oh, well, let's just wait at Alice, wait and see.
• 33:12
  SPEAKER_01: But often the sooner the better that they get treatment and they start working on these things, you get the best result.
• 33:20
  SPEAKER_01: So I just feel like you know your child best.
• 33:23
  SPEAKER_01: If there's something that you're concerned about and you feel like somebody's not listening to you, give us a call.
• 33:27
  SPEAKER_01: Like we are happy to just kind of talk through it with you and tell you if we feel like that warrants a screening or an evaluation, and we're happy to help in any way we can.
• 33:38
  SPEAKER_00: We both have a heart for our community, and we both believe that the Lord has called us to serve people and to help people, and that's the heart behind this podcast is to share your knowledge and expertise with people who may not know.
• 33:51
  SPEAKER_00: And you don't know what you don't know.
• 33:53
  SPEAKER_00: And so if you're listening, and even if this is like you're like, oh, that's great, but I don't really need that information.
• 34:00
  SPEAKER_00: I bet you know two or three people that do need that information.
• 34:03
  SPEAKER_00: So please share this podcast with anybody else that you think might benefit.
• 34:08
  SPEAKER_00: And in the show notes down below, I'm gonna link Amy's contact information.
• 34:13
  SPEAKER_00: I'll have her website, her social media contacts, as well as she has a download for you guys, a checklist.
• 34:20
  SPEAKER_00: And so we're gonna put all of that down below in the show notes so you can get everything you need from her and also follow her on social media.
• 34:27
  SPEAKER_00: But I encourage you to reach out to her if your kiddo has a sensory issue, motor planning issue, fine motor coordination, or if you know somebody that may need some home modifications, she's a great resource, and I just love Amy and she's been a great friend of me over the years, and so I'm gonna tutor horn just a little bit and say she and Mindy both are are the best and they're great to work with.
• 34:50
  SPEAKER_00: So if you need anything, guys, please reach out to them.
• 34:53
  SPEAKER_00: And Amy, I just want to thank you so much for being on the podcast and joining us today.
• 34:58
  SPEAKER_01: No, thank you so much for having me, and we love you too.
• 35:01
  SPEAKER_00: We will see you guys next next time, and thank you so much for listening to Root Cause Conversations.
• 35:11
  SPEAKER_00: Thanks for pulling up a seat with us today.
• 35:13
  SPEAKER_00: If this conversation gave you something to think about, make sure you're following the podcast so you don't miss what's coming next.
• 35:21
  SPEAKER_00: And while you're there, take just a second to hit those five stars.
• 35:26
  SPEAKER_00: It really does help more of the right people find these conversations.
• 35:32
  SPEAKER_00: If you're ready to start connecting some of those dots for yourself or your family, I've created a free parent guide called Could These Signs Be Connected?
• 35:42
  SPEAKER_00: It walks you through what to look for when it comes to mouth breathing, sleep, speech, and oral habits.
• 35:49
  SPEAKER_00: It gives you a starting place for knowing what questions to ask.
• 35:53
  SPEAKER_00: You'll find it linked right below in the show notes.
• 35:56
  SPEAKER_00: Until next time, keep asking questions and keep connecting those dots.
• 36:01
  SPEAKER_00: And I'll see you guys soon.