Meet … Jillian Kenderish, MOTR/L, ATP/SMS

1. What are 3 words that best describe you as an occupational therapy practitioner?
   • Detailed, creative, dedicated
2. Can you provide an overview of your OT practice experiences so far?
   • Jillian has been an OT for the past 20 years. In 2015, she started working in the wheelchair clinic at a major healthcare system rehabilitation hospital. Working there she gets a lot of exposure to spinal cord injuries (SCI). With this client population she works on goals for powered mobility, specifically for proper seating in the inpatient and outpatient setting. Working with the SCI population allows Jillian to see individuals from the moment they first enter acute care, where they become stabilized, then transition to go to the area she works in the rehab hospital for wheelchair seating.
3. How did you specifically become involved in the wheelchair clinic?
   • There are many resources for clients in her place of work. It is a major healthcare system rehabilitation hospital, also considered a model science clinic for spinal cord injuries, where practitioners work a rotation schedule. This informed her about different conditions cared for throughout the rehabilitation hospital. During this time, she particularly enjoyed the challenge of assisting newly diagnosed SCI clients find the right seating arrangement, likening it to a puzzle. She later transitioned to her current role, focusing solely on the seating clinic when an opening occurred.
4. What are common reasons clients may seek OT services at the seating clinic?
   • After clients are stabilized in the acute care setting, they then meet with Jillian as part of the rehabilitation program, the next step in the recovery process of the Jefferson health system, based in Pennsylvania. She sees clients with SCI, CVA, brain injuries, Parkinson’s, covid-19 and more in getting proper postural support so they can continue to have independence in other areas of their life. The services she helps with encompasses a variety of things like: positioning supports for transfers, teaching individuals how to use their wheelchair on different terrain, problem solving different situations when completing ADLs with their mobility device.
5. What are the top 2-3 assessments you use most frequently in the seating clinic?
   1. Posture assessments
   2. Manual musical testing and range of motion to determine how they will drive their powered wheelchair
   3. Box and Blocks test for hand dexterity
6. What are the 2-3 interventions or categories of interventions you use most frequently in the seating clinic?
   • Jillian works alongside the client’s primary OT and PT, so she is more of a consultant on wheel chair driving and postural assessments. She works with the clients and their care team on strengthening anterior deltoids so they can reach for items and manipulate their joystick when drinking their powered wheel chair. She also works on vision field cuts and cognitive issues to help with problem solving. Interventions include being inside then outside when driving a wheelchair to learn how to safely cross the street and navigate curb cuts.
7. What does a typical day look like as an OT practitioner at the seating clinic?
   • On a typical day Jillian works from 7am to 5:30pm. She starts off the shift checking emails and going over her meetings she has planned for the day. In her meetings, she goes over what her clients need, complete evaluations, discuss department wheelchair equipment needs that need to be ordered, communicate with outside suppliers who come into the space, and completes extensive medical forms that express the necessity of the client’s wheelchair device and equipment.
     • Securing an insured powered wheelchair typically takes 3-4 months due to processing and paperwork. This specialty area does a lot to help clients get what they need for a smooth transition at discharge.
8. How would you describe occupational therapy’s distinct value in the seating clinic?
   • This seating clinic along with any role in OT is to support FUNCTION. Clients work with OTs to enhance how do they can independently complete their ADLs, how they will use the manual or powered chair to self catheter without transferring out their chair, integrate themselves out into the community to get to and from school or work, and manage parenting roles among other occupational necessities.
9. What do you think is the biggest challenge (current or future) for occupational therapy practitioners specializing in seating?
   • Insurance has a lot of rules as to what people can get medically. Medicare is a barrier because on paper a client may not look like they are a fit for a specific mobility device item. Letters of medical necessity are vital documents to help with this. They serve to confirm with the client’s doctor and therapy team that the requested items are medically necessary, thus justifying a request for insurance coverage approval.
   • Another challenge involves accessibility in clients’ homes and communities. To address this, I collaborate with case managers on problem-solving client specific barriers.
10. What advice would you have for an OT practitioner or student who is interested in getting involved in a seating clinic?
    • A good way for OTPs and students who are interested in seating and powered mobility is to join RESNA- Rehabilitation Engineering and Assistive Technology Society. This is the place to go where practitioners can get their seating and mobility specialty certifications, resources and take courses.
    • She also encourages students to “get your hands in there early on” in order to make things easier later on in their careers, and never be afraid to ask questions.
11. Anything else you would like to share with our community?
    • Jillian shared that maintaining our expertise in OT includes staying current with the field and staying up to date with our state organizations, such as POTA for OTs practicing in Pennsylvania. She encourages getting involved in conducting home assessments when possible and continuously addressing clients’ accessibility needs.
    • Furthermore, she encourages OT students to explore and learn more about specialty areas that interest them. Since OT programs offer a broad overview of topics, seeking ways to build upon foundational knowledge is crucial for students to achieve their career objectives.