An Interview with Occupational Therapist, Donna Walls
In a recent interview with Donna Walls, OTD, OTR, CHT, we discussed her work as an occupational therapist, her role in preparing future therapists, and what it is like to have a parent with Parkinson’s disease (PD).
What is your background as an occupational therapist?
I have been an occupational therapist for 34 years, certified for 28 of those as a hand therapist. I have been an assistant professor in a Master of Science in Occupational Therapy program for the last five years. I have enjoyed a variety of occupational therapy experiences during my career, including working with persons with Parkinson’s (PwP).
How does occupational therapy work?
The word "occupation" simply refers to a meaningful activity or task. This includes activities at home such as dressing, showering, and meal preparation, as well as tasks at work. The occupational therapist will analyze a person’s limitations and deficits in order to plan ways to restore function or help them compensate.
For example, if a person has lost the arm strength to complete a task, we lead them in specific exercises to get strong enough to resume that task. If the person is still unable to perform the task in the manner in which they were accustomed, the occupational therapist will develop strategies or educate the person in the use of adaptive equipment to compensate for the functional loss.
What inspires you? What keeps you going every day?
I am inspired by my students. They are intelligent, eager to learn and have a strong desire to make a difference in someone’s life. More often than not during our coverage of Parkinson’s, someone will say they have a family member with PD. This inspires me even more to learn what is new in PD therapy so I can share it with my students and my father.
Tell us about your father’s Parkinson’s.
Let me first say that my parents are my heroes, and my 88-year-old father has always been bigger than life! Since my dad’s Parkinson's diagnosis four years ago, I have had an insider’s view of his daily life and struggles with Parkinson’s. He was a very strong man but developed severe back problems and the back pain became debilitating as he aged.
Unfortunately, Dad experienced complications after surgery that confined him to a wheelchair. Many hours of therapy and exercise enabled him to walk short distances, care for his own basic needs, and return home. As an occupational therapist, I recognize that each person responds differently to obstacles and therapy. As a daughter, I am just so proud of his hard work and determination.
His Parkinson’s, particularly tremors, has slowed his progress but medications are helpful. We remain flexible because what works for Dad today might need to be changed next month. I have been known to hear of a new product at a conference, find it online, and get it shipped to Dad before I leave the meeting. He is a good sport and will try each new item and give his review.
What are activities of daily living? How can the 4 most common Parkinson's symptoms benefit from occupational therapy?
Activities of daily living include all the tasks an individual performs for self-care. These activities require strength, flexibility, eye-hand coordination, cognitive processing, visual-perceptual skills, sense of touch, fine motor control, and more. When tremors, rigidity, bradykinesia, and postural instability occur there is a loss of function for people with Parkinson’s.
- Tremors can complicate tasks like buttoning, writing, using a computer/phone, and eating. We may suggest the use of adaptive equipment to help with those activities. Such equipment may include a button hook, a specially designed pen, a phone with larger buttons, and anti-tremor utensils for eating.
- Rigidity and bradykinesia (slowness of movement) will lead to secondary problems such as contractures of the joint and tightness of the soft tissue if not addressed. We teach range of motion exercises because they are important to maintain or improve joint mobility.
- Postural instability, along with the other motor symptoms, can lead to increased fall risk. Home visits are made to assess safety issues. We may recommend exercise as well as home modifications to help prevent injury.
The goal is for the individual to learn personal symptom management while maintaining independent self-care.
What's one memorable experience working with PwP?
I recently helped conduct a study that analyzed the benefits of specific types of intense exercise for PwP. My primary responsibility was to assess balance before and after eight weeks of exercise to evaluate each participant’s fall risk.
Secondarily, I assisted with exercise sessions. These one-on-one sessions were memorable reminders of the importance of grit, and the resiliency of the human spirit.
What advice do you have for future occupational therapists about working with PwP?
My hope is that each future therapist sees the individual and not the disease. Each person with PD is someone’s father, mother, brother, sister, friend and they deserve to be treated with respect and compassion.
I hope these future therapists continuously learn, conduct an evidence-based practice, and offer a client-centered approach to occupational therapy.
Do you live with any sleep disorders (eg. insomnia, RLS, sleep apnea) in addition to PD?