Julie helping Keith with an iPad mount.

Last week you learned about Julie Jacob who was recently honored with the ARRM Cares Award. She is part of the Therapy team at Living Well Disability Services, and we want to take this opportunity to introduce you to the team and give some background about the incredible work they do.

Julie Jacob, with Living Well 31 years, with Jim at the Elton John concert.

As mentioned in the previous article, Julie has been with Living Well for decades. She is one of three members of the team, and we are so lucky to have them on board. While there are several things that make their department unique, first and foremost is that we even have a therapy department. Living Well is one of just a few organizations to commit time and resources to onsite therapy, as the expenses are not covered by government funding. Which means the expenses are above and beyond reimbursement but deemed essential to our mission of transforming the lives of people impacted by disabilities through the delivery of exceptional services. And leave no room for doubt, therapy services are indeed exceptional!

Jesi Kaiser, with Living Well 30 years.

With Living Well celebrating 50 years this year, you might be curious how long there has been a therapy department. Rhonda Arendt, Therapy Services Supervisor, and a Registered Occupational Therapist OTR/L, has been with the organization for 42 years and has helped build the program and create the team. This means for over four decades there have been systems in place to make sure the people we serve have the materials and plans they need to live rich and full lives, to move about as freely as possible, and be a part of community with access to activities that help their bodies and minds feel supported. Therapy Services Coordinator, Julie Jacob COTA/L (Certified Occupational Therapy Assistant) has been with Living Well for 31 years. And wrapping up the team, Jesi Kaiser COTA/L, Therapy Services Coordinator, has been with the team 30 years.

Rhonda Arndt, with Living Well 42 years, at her desk

Together Rhonda, Julie, and Jesi work to create therapy plans for the people served at Living Well. Those plans are then carried out by direct support professionals who do the work with the people served. Areas the therapy team concentrate on are motor skills (mobility), sensory needs, eating, and augmentative communication (nonverbal ways of communication).

Major areas of service offered in the plans include:


Rodney with a walker.

Motor skills. This entails looking into walking and adaptive equipment to help make movement easier.

Gary using a stander.

Standing. Plans also include providing opportunities to stand, which may sound unfamiliar for able bodied people reading this. But if you are in a wheelchair, and cannot stand without assistance, your health is affected in many ways. Standing in a stander and spending time upright helps with weight bearing which helps bone strength and stretches muscles. Standing is good for digestion and circulation as well as respiration. Standing helps us breathe and be less constipated.

Laura with Jill.

Range of motion. This is critical for movement and agility. Plans for people focus on helping them keep their muscles stretched. If you have involuntary muscle tightness which can be seen with Cerebral Palsy, the movement can help it from getting worse. Muscle contracture is when muscles get shorter, and range of motion exercises are designed to keep them stretched. Some people with disabilities cannot voluntarily lift their arms up or straighten their legs. It is good for the body to move and be assisted with movement.

Strength. Muscle strengthening and exercises to get stronger are important. Physical therapy will give you exercises like pulling cords or bands. The challenge here is the same as it is for all of us—no one likes to exercise for exercise! With that in mind, they make it into a game to help them get the exercise in a quiet way. Why is strength so important? So you can move! Mobility and endurance, and being able to walk, means you can participate in activities, and go out into community easier.

Balance. Finding activities to help people served maintain their balance is a big part of therapy. The main reason this is important is so people can move safely. Balance plans mostly come into a play when people are having falls, or their walking and standing is in decline with certain conditions. Age is a major part of it. With an aging population there is more need for this type of therapy.

Julie helping Noah with some coordination exercises.

Coordination: This refers to hand eye, so people can use their hands for functional activities like feeding themselves, playing games, or using a tablet. Therapy in this area help people use their hands and arms as best they can. When you take a moment to realize how often you use your hands in a day, or even an hour, you realize how critical this is!

Julie helping fit a headset for Keith.

Assistive technology: A big part of therapy services is helping with many types of assistive technology which allow people to be as independent as possible. Adapted eating and grooming aids, walkers, wheelchairs, standers, picture or electronic communication aids, household helpers, and bathing aids to mention a few.

As you can see the needs are vast and can be complex. With all the services offered in mind, the three biggest parts of the therapy department workload are creating the therapy plans, assessing the needs for assistive technology and training new staff (and occasionally retraining all staff) as the plans are only successful when implemented properly. Julie and Jesi are regularly in the houses and train on the various equipment and plans. They also refresh plans as needed. They have an assistive tech screening that is done once a year by a staff familiar with the person, which helps them determine what new equipment/plans may be desired. And being in the houses helps a lot, as the department can also see what is needed firsthand and adjust accordingly.

David from Cope getting his new power chair.

Rhonda says they work well together and are good advocates for the people because they have a lot of experience in the field. They fully advocate for people’s needs and are invested in their care. She admits it has been difficult the last few years with staff challenges as it can make it hard to get the plans implemented. While the team creates a plan, the program managers, assistant program managers and direct support professionals carry them out.

Rhonda says, “The mission of providing the best opportunities and to be as independent as possible is foremost. What is different here is having us on staff.  Living Well is not reimbursed for us. They do not bill for our services.” She adds that “Living Well can go above and beyond because we are not billing for the services, so we do not have to work on reimbursement, paperwork, and limits on services. That showcases a dedication to quality care and allows the team to flex whatever time and resources we need.”

While all of this is just a little harder with staff shortages, one thing is clear—Living Well’s Therapy team has made it work! And Living Well is fully invested in the Therapy team. Their work is essential to the quality of life for the people we serve. Big thanks to Rhonda, Julie and Jesi for spending 42, 31 and 30 years caring for the people we serve. It says a lot knowing they stuck around for decades. And it really shows what wonderful humans they are. All three are born caregivers who see value in the work they do, and when they go home, they know they made a positive impact on the lives of people they work with. They are a gift to families, guardians, and staff!