Staff Spotlight: Ketra Crosson, Occupational Therapist and Independent Living Specialist
Ketra Crosson, OTR/L, is an Independent Living Specialist with Alpha One, a partnering organization with Maine AgrAbility. She has been associated with AgrAbility since its earliest days (2005) when Maine and Vermont administered a joint program. She has 30 years of experience as a registered OT. In this interview, she talks about a lifetime of experiences that add insight and perspective to our AgrAbility work.
What drew you to Occupational Therapy (OT) as a course of study?
In 8th grade, we were assigned a career report. I knew I was interested in something medical but didn’t see myself in school for many years to be a doctor. I didn’t think I wanted to be a nurse. I looked into physical therapy but it seemed to focus on people recovering function but not how they would use that function day-to-day. Recreational therapy was interesting, but I got the impression that being a jock would be helpful- which I was not. When I read about OT, it just seemed to have the right mix of having knowledge about practical things and medical things. OT’s were employed in many settings. That appealed to me.
Did you have any childhood experiences that influenced your career path?
My best friend from grade school has cerebral palsy. She taught me a lot about living with a disability. We used to joke that I became an OT because of her and she became a psychologist because of me.
Summers in middle school, I volunteered at a summer recreation program that included students with intellectual disabilities. These students needed additional supports so they could participate fully in program activities. Because OT seemed to be where I was headed, during the summers of 9th and 10th grade, I volunteered at a day program run by our local United Cerebral Palsy chapter. The summers of 11th and 12th grade, I worked as a camp counselor at an Easter Seal Camp in the Poconos. In both positions, I learned how to assist individuals with personal care, with transfers, bathing, dressing, etc.
In college, I worked as a personal care attendant for other college students, took notes for students with disabilities, and drove the handicapped van door-to-door to pick up and drop off students. (Snowy winters and a hilly campus were not easy for students with mobility needs). Summers, I continued to work with children and adults who had physical and intellectual disabilities.
At Alpha One, your other job title is Independent Living Specialist. What does an Independent Living Specialist do? How does this differ from being an occupational therapist? How is it similar?
My role as an Independent Living Specialist is to assist consumers with their goals for living independently in the community. This could be helping to find existing community resources. It could also be looking at assistive technology that will help that person manage daily tasks. Are there home access needs? Can they get through the door to bedrooms, the bathroom, and the kitchen? We offer services to meet personal care needs, like bathing and dressing. I help people determine the best model for this. First, the funding source. Then, do they want to hire and manage their own staff? Have a family member hire and manage staff? Or connect with a home care agency that will provide staff?
I also am a licensed adapted driver educator, which allows me to do adapted driver evaluations to determine if someone can drive or return to driving. In a state like Maine where there’s limited public transportation, driving is key to making a whole host of other independent living goals possible.
Alpha One is a Center for Independent Living. All staff have the title of “Independent Living Specialist.” We each bring a different skill set to the job. Our backgrounds include personal experience living with a disability, social work, nursing, rehabilitation specialist, and occupational therapy. This isn’t a conventional setting for an OT, but I use my OT training every day. My work experience in high school and college taught me about many of the day-to-day issues of living with a disability while trying to remain as independent as possible. My first job out of OT school was in a traditional setting, but when I read about the opening at Alpha One, the job description was exactly how I wanted to work as an OT.
How do you apply these skills to your work with AgrAbility?
The understanding of disability or impairment is a skill I bring to AgrAbility. I use OT skills of task analysis, linking functions to tasks, and problem solving to find solutions. Solutions can be low or high tech, off-the-shelf or specific adaptive products. A solution can be adjusting the environment or routine so a task has a lower impact on the body.
An Independent Living Specialist sees the person as a whole—not just how the disability may affect the job tasks, but how it affects other aspects of life, like personal care, home environment, and transportation. My job expects me to stay current on community resources of all types. I bring that skill set to AgrAbility as well.
What is your favorite part of this work?
Meeting the individual. Learning about their needs and goals. Brainstorming and problem-solving.
Normally, you travel all over the state to meet with consumers. Because of the pandemic, home visits have been replaced with Telehealth. How does Telehealth work? Is this working well for you and your consumers?
Telehealth is working with consumers either over the phone or through a video platform such as Zoom. Often consumers don’t have access to the technology for Zoom, or they don’t have internet connections. When I have worked with someone for many years–I have been at Alpha One since 1991–I can visualize them and their setting, so it makes talking on the phone about new needs a lot easier. For new consumers, I need to work very hard to ask good questions about their functions and limitations. I need them to be as descriptive as they can be about home access needs or technology needs.
Often, consumers don’t know the right questions to ask. They don’t know how to describe a limitation and they don’t know their options for being more independent. Without the in-person piece, I don’t feel like I can give the best that we have to offer to our new consumers.
With the restrictions in place for COVID-19, we’re all treading outside our normal comfort zones. I’m sure your consumers appreciate making a connection with you, even if it’s not ideal.
As an OT, I rely on my observational skills when I work with consumers, that is, assessing function by watching the person move in their environment. That piece is missing with telehealth. When I am at their home, for example, it might be clear that a person’s bathroom is not very accessible. I would ask them if they want to make changes, or if they have specific ideas of what they would like to do. We would brainstorm about modification options. I might do a Google search and show them some possibilities. We would discuss options to pay for the changes they want and what funding sources are available.
It’s true that “a picture is worth a thousand words.” Being there in person with the consumer is worth ten thousand words.
Thanks, Ketra. I’ve learned so much from you over the years and appreciate everything that you bring to the AgrAbility program.
You can read Ketra’s ongoing “Raised Bed Garden Journal” where she talks about gardening in a raised bed from an OT’s perspective. The type of raised bed and construction details can be found here: https://extension.umaine.edu/gardening/2020/05/01/maine-home-garden-news-may-2020/#building