Beating the odds

Although he’s completing the final course required for his degree at Ranken Technical College, 30-year-old Linden De Ment is not your typical student. Since sustaining a traumatic brain injury from a fall in his garage in 2010, De Ment has spent much of the last five years re-discovering himself and uncovering what brings him meaning as a client at the Occupational Performance Center, a joint venture between the Program in Occupational Therapy and The Rehabilitation Institute of St. Louis (TRISL).

De Ment’s injuries were severe. Upon admission to Barnes-Jewish Hospital, he was given only a one percent chance of survival. Physicians told his parents that – if he lived – he would likely never walk again and could have significant cognitive delays. Against all odds, De Ment survived the ensuing surgeries and began to show miraculous improvement. One month after being admitted to Barnes-Jewish Hospital, he was transferred to TRISL, where he completed three months of inpatient rehabilitation. “Linden had to learn how to eat again, walk again, talk again; he said his first words again,” shares De Ment’s mother, Leah De Ment. “It was a long process and sometimes he’d take two steps forward, only to turn around and take two steps back.” De Ment’s continued progress led to his discharge from the hospital in July and a referral to Washington University’s Occupational Performance Center (OPC), where he began working with Mary Seaton, MHS, OTR/L.

“We’re often referred to as a return-to-work type of program, but that’s only one component of what we do; we also explore ways to enable our clients to participate meaningfully in other environments, including school or a volunteer role,” Seaton says. The OPC staff uses a variety of assessment tools, education and other interventions to understand a person’s capabilities and limitations when determining next steps and possible opportunities.

“When I first met Linden, he was determined to get back to work and school as quickly as possible,” shares Seaton. “He was used to going full speed ahead, and expected his life to pick up right where he left off before the fall.” Although De Ment is highly motivated and energetic, his expectations and self-awareness of his abilities following the accident weren’t entirely accurate. The two had to prioritize their goals and form a plan together. “My goal as a therapist is to get him where he needs to be, where he wants to be, but also somewhere that’s realistic. Linden, like much of the population we work with at the OPC, experienced some expressive and receptive communication difficulties (aphasia) and lingering cognitive effects, and he requires reasonable accommodations to be successful,” Seaton says. “He has remained consistently positive and motivated to move forward despite these performance challenges, and that has made all the difference.”

Through a process of guided exploration of his interests and then performance of simulated work/school tasks which tap into critical social, cognitive and physical demands, Seaton and De Ment began to identify the things he could and couldn’t do. “With Linden, we determined that he wasn’t ready to return to both work and school at the same time, so we focused on getting him ready to return to work roles first,” says Seaton. “Starting out in a volunteer role may help to ease the transition back into community life and is an activity that we use as appropriate to each client.”

After simulating performance demands, they explored volunteer opportunities that seemed to be a good fit for De Ment’s skills. Before his injury, De Ment was pursuing his associate’s degree in information technology at Ranken Technical College and waiting tables at a local restaurant. Given his interest in computers, they connected him with an organization that cleans and restores donated computers prior to distributing them to under-resourced students. For months, De Ment participated in several volunteer roles with community organizations to explore various possibilities.

When De Ment was ready for full-time work, they partnered with Vocational Rehabilitation, a government program that assists eligible persons with disabilities in obtaining and maintaining quality employment. Vocational Rehab was able to help place De Ment in a paid role with a home improvement store in 2013. Encouraged by his progress in the workforce, De Ment was determined to return to school and finish his education. Again, he turned to the OPC for help in 2014. “I was three classes short of finishing my degree,” De Ment says. “Just three classes. I had to go back.”

After tackling transitions to work and community life, De Ment found that his return to school would require additional analysis and preparation. “Each time a person wants to switch roles or try something new, we have to start the process over again to some extent,” Seaton says. “This involves ensuring that the client is fully aware of his/her abilities, teaching strategies to accomplish identified goals and tasks, and developing routines to participate in the new work or behavior.” In order to identify reasonable accommodations that would enable De Ment to be successful in the school environment, Seaton served as a liaison with De Ment’s counselors and the team at Ranken. Now, De Ment has completed two of the remaining three courses required for his degree, and is finishing his final requirement, English Composition II. “This class will be a challenge for Linden,” shares Seaton. “It requires significant reading, writing and comprehension, and those remain difficult for him. We’re revisiting his documented accommodations list, and working with the school officials every step of the way throughout this class, so that he can accomplish his goal.”

According to Leah De Ment, her son was always extremely motivated in life. “He’s always been busy and social – prior to the accident he was going to school and working two jobs, so his determination comes as no surprise,” she shares. “It’s like he sees himself from the outside, and he doesn’t like where he’s at, so he wants to move forward and onto the next thing.”

She attributes much of her son’s continued success to Seaton and her willingness to work with him throughout each stage of his recovery. “Mary is so positive and encouraging,” she says. “She always takes the extra time to find answers to any questions that you may have and always has his best interest at heart. She seems to identify right away with what his wants are, so she can work from his perspective. Mary is awesome and this is exactly where she should be – she takes her time, she cares, and always follows-up to help her clients succeed.”

Once De Ment receives his degree, he plans to get his driver’s license, settle into a new apartment, meet the right girl and find a job in his field of expertise. Though not necessarily in that order, says Leah. “I don’t know what Linden will decide to do next, but we are so grateful for his recovery, and incredibly thankful to Mary for all the help she’s provided over the years.”

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