As occupational therapists, we meet all kinds of people. Some do great with the skills we teach them. Others, however, may need more to regain their independence and live life to its fullest. This is one such story, told to me by Diana, a friend and fellow home care OT.

The patient was in his early 60s, working full time and driving, until his neighbors and EMS found him, in his very cluttered home, in a diabetic coma. He had no family support. He relied on a neighbor who would get him the items he needed at the store. Due to the conditions in which he was living, it was thought that he might have mental health issues.

While he was in the hospital for a below-knee amputation, a neighborhood program came in to clean out his house, which had been deemed uninhabitable. They removed everything including his stove and furniture. When Diana saw him for his initial evaluation in the early fall, he had received a sofa, which he slept on, from a neighborhood church. He also received a TV and microwave. He was set up on the first floor with a commode and wheelchair.

After his amputation, he was to go for inpatient rehabilitation for prosthetic training. He was unable to get to the second floor or leave his house due to steps; this warranted a prosthesis. Home occupational therapy consisted of transfer training (a hospital bed was ordered for him), stump wrapping, ADL and a home-exercise program for upper-extremity strengthening, standing tolerance and balance.

The patient's personality was a bit difficult. He agitated easily and felt that no one cared about him. He was not following a diabetic diet and refused help in the form of a home health aide. His home was infested with roaches and rodents, there was trash everywhere and he had no heat.

After he was discharged from the agency, Diana followed up with a phone call to see if he had been admitted to rehab. She found out the facility would not accept him because of his disposition, and they could not discharge him to a house without heat. He desperately wanted to get into rehab because of the lack of heat.

This is where occupational therapists show what outstanding problem solvers we are! Diana and I are fortunate to work for a large health system that has home care along with a hospital and a skilled nursing facility. Diana reached out to another OT who happens to be a nun at Holy Redeemer.

The sister contacted the skilled nursing facility and the intake coordinator for the subacute rehab. Her supervisor also got involved. Diana contacted the patient's physician and the managed-care case manager, both of whom agreed with the plan. Everyone was willing to take a chance on this patient, and he was admitted on a grant. He was picked up at home by an ambulance at no cost to him. His prosthesis was delivered to the subacute rehab facility the next day so he could start training.

While the patient was in rehab for three weeks, Diana contacted a friend who owns a heating and air conditioning business.

He agreed to fix the heater at cost. By the time the patient returned to his heated home, he was walking and eventually returned to driving.

Patients may not always be capable of doing things on their own or making good choices. For this man, Diana was able to tap into her resources and get help from a number of people.

As therapists, we do things everyday that we think are "no big deal" and usually go unrecognized. This particular act of generosity and resourcefulness was definitely "above and beyond" and earned Diana our Employee of the Year award. Congratulations Diana!

Phyllis L. Ehrlich, MS, OTR/L, CHES, works for Holy Redeemer HomeCare. She has co-edited and is a contributing author to Occupational Therapy in Home Health Care. Readers may contact her by e-mail at pleotr1@earthlink.net.