Tom Kaminski (00:32)
When it comes to aging and caregiving, clarity ahead of time can make all the difference. In this series, building your team will introduce professionals who play key roles with aging in place from legal to medical to just practical support. Today we start with occupational therapy. Please enjoy this episode with Dr. Brandy Archie.

Tom Kaminski (00:50)
Welcome everybody to another episode of the Sandwich Bread Podcast. Very special episode today. I'm joined by Dr. Brandy Archie. How are you, Brandy?

Brandy Archie, OTD, OTR/L (00:58)
I'm doing great, thanks for having me on.

Tom Kaminski (01:01)
Yeah,

we're old pals. I did her podcast. Now she's suffering through 20 minutes with me. So we're sharing.

Brandy Archie, OTD, OTR/L (01:07)
We are sharing. We are sharing.

Tom Kaminski (01:10)
We're sharing, we're growing, I love it. All right, so I'm gonna give a little bit of background on Dr. Brandy. Dr. Brandy Archie is an occupational therapist who is certified in living in place, which is particularly relevant to a couple of conversations we'll have with her. She's also the founder of Ask Sami, which I'm excited to spend a

bit of time on this podcast diving into that, but it's a really cool digital platform making daily living safer, easier, and more affordable for older adults and people with disabilities. Really interesting and I want to dive into that a little bit, but a high level 17 years of experience in home health and elder focused care. And she built AskSamie to kind of bridge one of the needs she identified in that space. So, and then last but not least.

She is a graduate of the finest university in the Midwest. Maybe the world. Maybe the world.

Brandy Archie, OTD, OTR/L (01:59)
going say why are you limiting us to the Midwest? I mean it is definitely a

fine University. Go Jays! We're both alums of Creighton University.

Tom Kaminski (02:05)
Go Jays.

That's right. That's right. And even more special, Dr. Brandy played basketball at Creighton, which is my favorite sport. I was not good enough to play basketball for Creighton University. Barely good enough to play in high school a little bit. But the Lady Jays, who I also follow religiously, along with the men's team, very exciting.

Brandy Archie, OTD, OTR/L (02:18)
You

Go Lady J's, yes.

Tom Kaminski (02:29)
when I learned that nugget about you.

Brandy Archie, OTD, OTR/L (02:31)
So I'm loving this era.

Tom Kaminski (02:33)
Yes. And father to two little girls, I was a big fan before their arrivals, but it's extra hits home extra hard, and I watched women's sports extra closely, and tonight I will be coaching a bunch of six year old girls in basketball. It's more like chaos.

Brandy Archie, OTD, OTR/L (02:49)
hear that.

exercising

and herding cats, you know, but try to get a few fundamentals in there. that's as much as you can do with a six-year-old.

Tom Kaminski (02:56)
We're starting a little bit of a series here with you.

you're the first to go for this. we're going to call this Building Your Team. And it's going to be a little mini series within the Sandwich Red Pod universe where we're going to take a few minutes to define and dig into specific experts that are really critical to the elder care.

Brandy Archie, OTD, OTR/L (03:00)
Yes!

Tom Kaminski (03:17)
universe and that includes financial planning, estate planning, elder law. There's a whole range, tax. And this little niche we're going into now is more related to occupational therapy. this is going to be called the Building Your Team Occupational Therapist Edition. And we're going to spend 15 minutes now getting into occupational therapy. What is it? Why is it important? Things to look for. A little tips and takeaways for a listener to do a great job going through the process of finding

the right care for their aging parent or elder. So high level Dr. Brandy, what is occupational therapy and why is it important for aging in place?

Brandy Archie, OTD, OTR/L (03:55)
Occupational therapy, our goal is to help you live life.

So whether that's a little kid who needs to learn how to sit still and have what they need at school to learn or an older adult whose body functions differently than it used to, but still needs to be able to get dressed and feed themselves and go play bridge with their friends. We work across the lifespan in whatever goals make sense for that person. And so because that definition is so broad, it's often really hard to understand like what is OT. But really our goal is to help you be as safe and as

independent as possible doing whatever it is that you want to do in your life. So as a person who might be a caregiver, you might have OT just as a support to be like, how do I manage all of these different components in my life? And then on the flip side, you an OT might work with your parent in order to figure out how are we going to make sure you're taking your meds on time cooking yourself something to eat, even though your standing ability is not as good as you.

be like finding ways to accommodate your life to make it work for your current status in in what things are going on with your mind and body. So as a member of the team in an Aging in Place context because your question was why are we important for Aging in Place?

This is like the gist of it. Actually, I think that if you have a parent that you're trying to help stay living at home, you should get an OTE evaluation. Because our goal is to really help observe the medical and the cognitive and the physical environment and manipulate all of that so that it works better. So if getting up and down the stairs is hard and getting out of the bed is a challenge and they're not hanging out with friends as much as they used to, we're going to get to the bottom.

with the causes for that and either try to rehabilitate the body or accommodate with something, some kind of change or doing something in a different way.

Tom Kaminski (05:46)
Awesome. Okay. So my first kind of takeaway from that is, and I feel like this is going back to my CFP training, the definition of a occupational therapy always kind of branded in my brain as working like rehabilitation toward an occupation, a specific occupation, like a job and myth number one is no, it's really any occupation and that occupation could be just living, being retired.

Brandy Archie, OTD, OTR/L (06:08)
Yes, yes, the definition of occupation, while we have wedged it into is actually what you spend your time doing. That's what that word occupation means. And so whatever you're trying to spend your time doing, occupational therapists help you get to doing that

Tom Kaminski (06:22)
Got it. Got it. And you said a second thing kind of toward the end there about getting an OT evaluation. So for aging individuals, and it could be for their own home, they could be moving into a new home, talk us through.

the evaluation experience, what that means specifically, and looks like in practice for an aging individual. Most people are looking at their home and going, I think it's probably fine. What are those little triggers to say, it's not fine, or let's make sure it's fine? And then where do you go from there?

Brandy Archie, OTD, OTR/L (06:46)
Yes.

Okay, I'm going to take an expansive view of this and talk about it from how you might have experienced OT in the past and then how you could be experiencing OT in other ways. So it's very often that you run into occupational therapists when there's acute change in function. So let's say your parent got total hip replacement, right? We're preparing for this surgery. We know we're going to have precautions after we get done with surgery and not be able to do things in the way that we used to at least for some time, three or six months, right? You'd see it.

Tom Kaminski (06:55)
Okay.

Brandy Archie, OTD, OTR/L (07:21)
occupational

therapist in the hospital. They're help them immediately figure out how to get dressed and how to get up and how to take a shower and they're gonna be training you on that and then you're gonna come home and then you have therapists come to the house to help do those things in that context like how now how can I translate that to home and then might even have an outpatient because we're able to get out of the house now and I might go to an OT to help me figure out how I'm gonna get back to golfing or back to

getting it out of the church or whatever it is that you need to do. So you could definitely use OT in an acute situation which the trigger is, because you asked me about triggers, a change in physical or cognitive status.

Tom Kaminski (07:54)
Got it.

Brandy Archie, OTD, OTR/L (08:03)
And so if you go through the medical system, they're going to kind of push you that way. But the thing is, I think people don't recognize, you could notice a trigger and it might not have a medical event. So let's say mom had a fall. Maybe you did go to the ER, but nothing's broken. We got some ibuprofen and we're going home. Okay, she still had a fall.

and we still had some trouble, now what? Well, that's a great time to have an OT about because we can get to the root of like what's causing the falls and therefore what should we change and make it better to do even though we didn't end up in the hospital and in rehab and on that whole pathway that I explained at first. And so what an OT would do in that situation is come into the home and

Tom Kaminski (08:25)
Yeah.

Brandy Archie, OTD, OTR/L (08:45)
assess like what are the things that mom likes to needs to and wants to do What are the barriers to doing that? So what's our physical condition? What's our cognitive condition? What's the physical area looking like and then taking all that information come up with some solutions? So maybe we're weaker than we should be and we can do some exercises to strengthen Always a good idea, right? And so we're gonna improve the body as much as we can but

Tom Kaminski (08:51)
Mm-hmm.

Okay.

Brandy Archie, OTD, OTR/L (09:13)
But

sometimes we can improve the body. The body is going to continue to get worse maybe because we have a progressive disease. And so what can we change in the home in order to create a more safe environment? Maybe the fall happened because we're getting up at night to go to the bathroom frequently and we don't have enough lighting and she happened to trip over the dog's toy. It's not always there, but it was that time. And so what can we do to prevent that in the future? So then we might recommend some automatic night lights or something like that. And so this is all very

Tom Kaminski (09:38)
Got it.

Brandy Archie, OTD, OTR/L (09:42)
dependent on the person and where they live and who they are and so I can always give examples but it's always going to be a little bit different depending on who it is and what the goals are but does that give like a good overview of like how you might expect to see us work?

Tom Kaminski (09:49)
Yeah. Got it.

Yeah, yeah. those situations or examples seem to be more reactive or sort of responding to a change. doesn't make sense to do proactive OT evaluations if you reach certain age milestones. Is there a recommendation there?

Brandy Archie, OTD, OTR/L (10:09)
Yeah, I think as soon as somebody has decided, you know what? I really want to do everything I can to stay living in this house.

That's a great trigger point for OT because maybe we want to prevent that fall from happening in the first place. And we want to take our time to make some modifications to the home in order to make it look beautiful and also be functional for you. And so as soon as somebody's decided that like, maybe we should just see if there's anything we can be doing better, even if something bad hasn't happened. And OT eval is a great way to go about that.

Tom Kaminski (10:21)
Yes.

Yeah, that's an interesting point you bring up. feel like if your kids are the ones outfitting your home, they're gonna focus on your health and wellbeing. And if you're proactive, you can actually make it aesthetically nice too. You can have it designed to your liking. Cause your kids are gonna come in and be like, I don't want my parents to fall down. They don't wanna get the color scheme just right or those other variables. So you can control it. Yeah.

Brandy Archie, OTD, OTR/L (10:51)
Yeah!

Yeah, but when you have time to plan, yes, you can

take the time to look for the right thing and order the thing instead of getting what's right off the shelf and at your local hardware store and you can get it to match your needs. And I would argue to say as a person who might be caring for a parent, you really should consider the aesthetics. I have worked with not just one, but many, many people who have chosen to put themselves more at risk because they didn't like the aesthetics or how that looked or felt to

them in their home, which is their home, right? And even though they knew the risk and benefits, they decided, for example, putting something on top of a toilet to make it higher so it's easier to get up and down. This person only had one bathroom and it was like, I don't want my grandkids have to get on enough of that. don't want my guests to see that. So I'm not going to do that. And I'm like, you're the one that lives here and you have to do the toilet every day, multiple times a day. And they might come over once a month or a week. And so I

Tom Kaminski (11:31)
Interesting. Yeah.

Yeah.

Brandy Archie, OTD, OTR/L (11:55)
do think it's really important as people who might be suggesting things to other people to do in their own homes to try to meet their needs, know, like not just their physical needs, but also their emotional needs.

Tom Kaminski (12:06)
That's great. Okay, cool. And I have a question about where we find occupational therapists for these types of evaluations. We'll get to that at the end, connected to the Ask Samie platform, but in general, I want your advice on that. And then who isn't a fit for occupational therapy? This might be kind of an easy one, but I want to kind of flip that question on. ⁓

Brandy Archie, OTD, OTR/L (12:23)
⁓

it's maybe an easy one because I'm going to say there's nobody who's not a fit. Because everybody can benefit, I think, at any stage. But as long as you're open to some new suggestions about ways to make life easier, then it's a good fit.

Tom Kaminski (12:27)
Hahaha

Yeah.

Great. All right, we'll jump into finding the right occupational therapist for you. You mentioned OT evaluations. I'm curious, you know, if there are solutions out there to find somebody to do a proactive or reactive OT evaluation in your home, but just at a higher level, if you need an occupational therapist,

What are some certifications or things to look for as a novice individual heading out into the world to try to find an occupational therapist? You know, a lot of people probably start with Google or go to your primary care physician and try to get a referral But

what can help somebody kind of cut through all the noise and find the right OT for your needs.

Brandy Archie, OTD, OTR/L (13:13)
I think that it really depends on the situation. So I'm gonna try to make this as clear and easy as possible. Occupational therapy is a covered service under your medical insurance. And so with a physician's order and in some places you don't even need that to get started, you can see an occupational therapist and have it covered by your medical insurance. And so that first place that I would probably start is with your primary care person, especially if there's already a active

Tom Kaminski (13:18)
Yep.

Brandy Archie, OTD, OTR/L (13:41)
happening.

We're having a decline in our function in our memory or a change in our balance or something medically is happening to our bodies or minds Get an order from your physician and see a therapist But to focus on like the older adult population if you want to be proactive and maybe we haven't gone to the hospital to initiate this you are looking for somebody who can come to the home and so you either want to

access

your home health benefit or find an occupational therapist that comes to the home under the outpatient Medicare Part B benefit.

I'm trying to be really direct, so the first access point is through insurance and the easiest place to start is with your doctor and let them help you figure out the ways to go about it. However, if there's not a medical change or you're looking for an OT to do something specifically, like I want to consider remodeling this house, I'm not really having any real problems right now that are medical in nature, but I do want an expert on the case.

Tom Kaminski (14:25)
Awesome.

Yeah.

Brandy Archie, OTD, OTR/L (14:40)
then you're looking for an OT that specializes in aging in place or living in place. So we asked about certifications. Those are called CAPS, C-A-P-S, and CLIPP, C-L-I-P-P. And those OTs often work in private pay models.

So you don't need to go get a doctor's order. You're gonna pay them for their service to come help you figure out what you need at home and consult with you about what you need. So either can work for you and the goal is to get to one. And I would also argue that every occupational therapist has the baseline skills to be able to be helpful in an agent in place situation, even if they don't have a certification. But the ones who are certified are focused on that specifically.

Tom Kaminski (15:09)
Yeah.

Brandy Archie, OTD, OTR/L (15:21)
And so they're going to be very highly qualified to give you the resources that you need.

Tom Kaminski (15:26)
Great. Yeah, my feeling is that a lot of the work.

occupational therapists do is probably related to aging, at least a decent chunk of your typical occupational therapists. I'm sure there are folks that specialize and say, really, I want to allocate my time to this other type of occupational therapy. But I would assume it's, especially with an aging boomer population, there's a huge demand for that specific kind of aging component to it. And that's the same way with financial planning. There's the CFP certification, which is like the big one.

Brandy Archie, OTD, OTR/L (15:42)
Mm-hmm.

Tom Kaminski (15:57)
And then there are sub certifications that live below that. I don't tell people to just rely on that. It's bonus points, but It helps on the journey to finding the right person.

Brandy Archie, OTD, OTR/L (16:06)
Yeah.

Exactly. Totally agree with that.

Tom Kaminski (16:09)
Great. Yeah, we'll link in the show notes to those specific certifications. So folks can kind of add that to their checklist as like bonus points as they're evaluating. But I think you did a really nice job covering the spectrum of, clinical need to just like an in-home consultation. So let's let's say we're to ask Samie for the closing minutes of this show, because it ties in really nicely to the question of like, how do we source and find occupational therapists for this type of

Tell us a little bit about the platform and the problem it's looking to solve for.

Brandy Archie, OTD, OTR/L (16:39)
Yeah, so Ask Samie is a online marketplace that gives you access to occupational therapy insights to help you with aging in place or anything related to being at home and being functional. So you can literally go to asksamie.com and type in the chat and ask Samie a helpful question. like.

I'm struggling to help my mom get her meds regularly and she has dementia. What can I do? And what it'll provide you is what we would have come up with as an OT as far as the equipment that they might need, or a service they might need, and a resource that you could use.

And so in order to do that we're pulling everything in one spot so the equipment is there, the resources are there, and also occupational therapists are there. So if your question feels more specific and you would like some help from an occupational therapist, we have a whole nationwide network of them there and you can message us and ask us for help with that. So what you'll see today is there's a handful listed and but we have like 450 OTs in the background that are not formal.

in front yet as we continue to build out our network. So if you're looking for somebody in your area, you just message and let us know. And then there's also the ability to get a virtual assessment as well if you would prefer to have it that way. we are your major resource nationwide for the tools and the service providers that you need in order to help make living at home easier.

Tom Kaminski (17:46)
Cool.

I love it. you're at like the forefront of a huge, huge need in the coming decades. So a lot of opportunity to help folks out there. So it's exciting. Well, this is great, Brandy.

Brandy Archie, OTD, OTR/L (18:11)
Yeah, super glad to do it.

Tom Kaminski (18:13)
Thanks so much. This has been perfect. This has been our first ever edition of the building your team segment within the sandwich bread podcast. And I really appreciate you taking the time to lend your expertise and help us understand the occupational therapy field and how we should think about applying it to our unique situations and adding the right occupational therapists to our team. So thank you so much. Go Jays.

Brandy Archie, OTD, OTR/L (18:37)
Thanks

for having me. Go J's.

Tom Kaminski (18:39)
All right. Have a good day.

Tom Kaminski (18:41)
Sandwich Bread Pod is hosted by me, Tom Kaminski. Huge thank you to Lauren Nos, our executive producer for making this show happen, and to Andrew Maxson of Celebrator Creative Studio for branding and design. And lastly, to Audio Nautix for our theme music. Are you someone in the sandwich generation? We'd love to hear from you.

share with us your story, and maybe we'll find a way to work you into our podcast

reference the materials and the experiences you've had. We value that very much. Reach out to us at sandwichbreadpod at twinrobins.com or hello at twinrobbins.com. T-W-I-N-R-O-B-I-N-S.com. Thanks so much again for listening.