Therapist Helps Patients Adapt to Change

Sunday, November 25, 2012
Adjusting to life after an amputation, brain injury or other traumatic accident is a gradual, deeply emotional journey. Patients usually want to return to a lifestyle that is as close as possible to their previous one, says recreational therapist Michael Denmeade. But helping them adjust to that “new normal” isn’t just a matter of jumping in and giving directions.

Denmeade, 49, is director of therapeutic recreation at Mt. Ascutney Hospital and Health Center in Windsor. He says the first step in a successful rehabilitation is getting to know patients, their hobbies and exercise routines, what they do to relax, how they like to socialize. Developing that “therapeutic relationship” helps them develop faith in their providers, as both professionals and people.

“You have to build up that relationship so they will take that risk,” he said, “go up that first stair.”

He also asks patients about their spiritual needs, such as religious services, prayer groups, meditation or yoga practices, and offers to contact their ministers.

After an amputation, injury or diagnosis of a terminal illness, “You start to ask questions,” Denmeade said. “What will my life be like? How long do I have? ... Why are we here?”

On Tuesday morning, he checked in with Steve Seiler, 60, who was getting ready to go home to Enfield.

Seiler, who lost his right leg after one of his arteries burst, wore a bright orange Harley Davidson T-shirt over his blue hospital pants.

As part of the “community reintegration” process, Denmeade and Seiler discussed the accommodations he would need when he returned home. His car would require a gas pedal extension, but Seiler, whose hobbies include small engine repair, was undaunted.

“It’s simple,” Seiler said from his hospital bed. “That’s nothing.”

But paying for renovations, such as a ramp leading into his home, might not prove so easy.

“I know there are resources out there,” he said. “I just haven’t got a clue where to start.”

But then, he remembered some friends he had helped. They were “champing at the bit” to pay him back, he said, which made him happy, if a little uncomfortable.

He’s always been someone who helps other people, Seiler said. “I’m not used to accepting help.”

Recently, an older friend made a special effort to visit him.

“He wanted to know what he could do to help me,” Seiler said, “and he’s 87 years old.”

Denmeade listened carefully and then reminded him that giving is a two-way street.

“When you let people help you, it makes them feel good,” he said. “It makes them feel useful.”

At one point, Seiler fell silent, wincing in pain.

“Remember what we talked about to do to help it?” Denmeade asked.

“Breathe through it,” Seiler answered.

“Sometimes rubbing where (your leg) should be helps because of the phantom pain,” Denmeade said.

Despite the pain, Seiler is looking toward the future.

A stand next to his bed holds several snapshots that keep him motivated to heal: his “lady friend,” three cats and motorcycle, a red Harley Davidson and sidecar all share one frame. A lifelong motorcycle aficionado, he and some friends have long planned to attend the Sturgis (S.D.) Motorcycle Rally, and Seiler’s not about to change his mind.

“I’ve been riding way too long to stop just because of this,” he said.

In addition to physical rehabilitation in the pool and gym, the hospital also offers stress management tools, including reiki, qigong, massage and relaxation. Such techniques “really help manage symptoms, such as pain, soreness and stiffness,” said Denmeade, who practices meditation and tai chi.

“On a cellular level, if we are in pain, our nerve cells do this,” he said, making tight fists. Then, the tension spreads to adjacent cells.

“If you get some of those cells to relax,” he said, surrounding cells can begin to do the same.

When encouraging patients to exercise, Denmeade shares his own experience with arthritis, which troubles his hip and knee. He reminds them that working out helps prevents stiffness from setting in.

“I know it here,” he said, touching his head, “and I know it here and here,” touching his knee and hip.

And he stays active himself, weight training, hiking. “We’ve got to practice what we preach.”

Denmeade received an unexpected introduction to recreational therapy while he was a student at Kent State University in Ohio. A journalism major, he’d blow off steam by shooting baskets in the gym. There, he met a group of guys playing wheelchair basketball, part of an intramural league. The team was too small to break into two for scrimmages, so they asked Denmeade and some buddies to play them. They did, and he was hooked.

“I started helping out with their league, and someone said, ‘You’d make a great recreation therapist,’” he said.

Soon after, he switched his major to therapeutic recreation, a degree that required him to study adaptive recreation, hypnosis, stress relief, motivational psychology, and the science behind physical rehabilitation.

Denmeade paid his way through school by answering a suicide crisis line and doing counseling and relief work. Realizing he was “good at the pysch stuff,” he took an internship at Brattleboro Retreat. After graduating, he worked for about a decade with patients struggling with substance abuse and psychiatric disorders, including a stint at the Brattleboro site. Then, in 1995, he joined Mt. Ascutney Hospital. A certified therapeutic recreation specialist and certified brain injury specialist, he received the Governor’s Award as Professional of the Year at the Brain Injury Association of Vermont’s 2010 conference.

Tuesday afternoon, Denmeade met with Betty Corkum, who had just lost her second leg due to vascular disease. He wanted to know how Corkum, an avid crafter, was making out with her new sock loom. But with the holidays approaching, Corkum, who is due to leave the hospital next month, had other topics in mind.

“I think I’m ready to go home,” Corkum said, wheeling herself up to a table in a common room. “Christmas is coming, and I have things at home I can only do at home.”

She’s learned to get in and out of the shower and the car, the North Springfield, Vt., resident said. Couldn’t she leave sooner?

Denmeade acknowledged her frustration and said he’d find out what else she needed to do before returning home.

“You’re the boss,” he said. “We’re just the hired consultants.”

For a while, Corkum, 79, talked about her grandchildren, and how she missed spending time at home with them. Denmeade reflected on what he had heard.

“I’m listening to you talk about your grandkids, and you light up!” he said.

Eventually, they came around to the loom.

“Do you feel like it’s OK?” he asked Corkum, who has rheumatoid arthritis. “It’s not too stressful on your hands?”

“No,” she said. “It’s a nice pastime. It doesn’t bother my hands at all.”

A longtime quilter, Corkum had recently made a great discovery. Denmeade found an old sewing machine that she could work using her prosthesis.

“You don’t know how many nights I lost sleep over wondering, ‘Am I going to have to give that up and just make socks?” she said.

When their visit came to an end, Corkum was joking with Denmeade.

They had recently driven to West Lebanon to visit a craft shop. During the trip, Corkum had learned to transfer into and out of a car using a narrow wooden “slide board,” and they both agreed they’d had a good time.

“It was just so nice to get out and go to my favorite store,” she said, before adding jokingly, “You wouldn’t let me drive, though.”

Aimee Caruso can be reached at or 603-727-3210.

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