What is Sequencing and How Does Occupational Therapy Help?

Sequencing, at its most basic, is the ability to plan the order of tasks correctly to achieve a stated goal. Sequencing can involve reading, listening, expressing thoughts, describing events or contracting muscles in an orderly and meaningful manner.

In the context of NeuLife Rehab’s innovative post-acute rehabilitation, sequencing also refers to the ability to plan a series of complex movements that are needed to complete multi-stepped tasks. It doesn’t strictly pertain to mental planning (thinking ahead), but also physical coordination. That is, a catastrophically injured Client may have to learn how to maintain physical balance, re-learn how to shower or bathe, or, for our male Clients, how to shave.

From the outside looking in, these may not seem like “complex movements.” But consider the steps involved in a seemingly simple act of shaving. It involves many steps that have been done in order, shown below. They don’t even consider, for example, the additional movements and forethought that individuals with spinal cord injuries (SCI) have to engage in if they are confined to wheelchairs and can’t stand in front of a mirror. Or, for that matter, the specialized post-acute rehabilitation that is required to shave if an individual has lost the use, by amputation or otherwise, of (his) dominant hand. In that case, he has to relearn the entire process using a hand that was never used before for shaving.

• Ensure that he has the necessary implements to shave, including soap, shaving cream, and a clean razor.
• Ensure that he is able to either balance on his feet for a long enough time to shave, or have someone nearby to help with balance and endurance. If he is unable to stand, he must ensure that a chair is available and a mirror placed at the appropriate height.
• Wash his face so as to prevent infections in case of a cut.
• Soften the beard by holding a wet, warm cloth against his face.
• Grasp a can of shaving cream, push the dispenser, and put some shaving cream in his hand.
• Spread the shaving cream evenly on the face, neck, and all places he wishes to shave.
• Shave the top section of his face starting from the top to the edge of the jaw-line in long, even strokes.
• Rinse the razor.
• Shave his neck and chin from the bottom of the neck up.
• Rinse the razor.
• Shave his upper lip.
• Rinse the razor.
• Look for missed areas and shave them.
• Rinse the razor.
• Put away the razor.

Fifteen steps to the seemingly “simple” act of shaving!

Growing a beard may seem like an easier option. But not all of NeuLife Rehab’s Clients like or want beards. Because independence is the goal of NeuLife Rehab’s innovative post-acute rehabilitation, shaving, beards, and everything else that achieves independence and fosters choice is part of the equation of what NeuLife Rehab in Mount Dora, Florida does.

Occupational therapy plays an integral role in the post-acute rehabilitation at NeuLife Rehab and bears a direct relationship to sequencing. Occupational therapy does not directly refer to the immediate return to work by an individual who has sustained a catastrophic injury such as a traumatic brain injury (TBI) or a spinal cord injury (SCI). Instead, occupational therapy involves the rehabilitation of injured, ill, or disabled Clients through the therapeutic use of everyday activities.

The post-acute rehabilitation at NeuLife Rehab teaches Clients how to perform everyday tasks, including activities of daily living (ADLs) to enhance their independence. Our discussion of shaving is a perfect example—it is not so simple after all. Occupational therapy may therefore be thought of like what an individual does on a daily basis to “occupy” time. These may be mundane, but they are critical activities of daily living (ADLs), like shaving.

When an individual becomes a Client of NeuLife Rehab in Mount Dora, Florida, he or she undergoes an independent functional evaluation administered by a multidisciplinary team of professionals that may consist of:

• Board Certified Neurologist
• Board Certified Behavior Analyst
• Board Certified Physiatrist
• Neuropsychologist
• Psychologist
• Board Certified Psychiatrist
• Speech Language Pathologist/Cognitive Therapist
• Physical Therapist
• Occupational Therapist
• Nurses
• Certified Rehab Counselor

From the results of the independent functional evaluation, the professionals of NeuLife Rehab formulate a Client Goal Plan. The Client Goal Plan guides the clinically relevant services delivered by NeuLife Rehab. The Client Goal Plan guides the cognitive, psychiatric, neurologic, psychological and neuropsychological therapy of the Client. The goal of NeuLife Rehab’s innovative post-acute rehabilitation is the attainment for our Clients of independence to the fullest extent that his or her physical and mental abilities permit.

NeuLife Rehab in Mount Dora, Florida consistently provides the highest standard of care in the delivery of clinically relevant services to achieve successful, sustained outcomes and exceed the expectations of all persons served.

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” — the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.
NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with Traumatic Brain Injury
(TBI), Spinal Cord Injury (SCI), Amputations, Burns and other Catastrophic Injuries and Challenging Diagnoses.

2725 Robie Avenue
Mount Dora, Florida 32757