In this episode of Leaders in the Field, host Mackenzie Bevins interviews Teresa Boswell, wife of Missouri farmer Doug Boswell, who sustained a spinal cord injury. Teresa shares how she has navigated her role as a caregiver within the agricultural community. From adapting farm operations to managing caregiver stress and burnout, Teresa provides valuable insights into the support systems and strategies that helped her through. This episode offers practical advice for healthcare professionals to better understand and support farming families navigating life-altering injuries.

Resources

To find resources for caregivers of agricultural workers, visit http://www.agrability.org/resources/caregivers/ to learn more.

References

Caregiver Burnout. (n.d.). Cleveland Clinic. Retrieved January 10, 2025, from https://my.clevelandclinic.org/health/diseases/9225-caregiver-burnout

Lindt, N., van Berkel, J., & Mulder, B. C. (2020). Determinants of overburdening among informal carers: a systematic review. BMC Geriatrics, 20(1), 304. https://doi.org/10.1186/s12877-020-01708-3

In this episode of Leaders in the Field, host Mackenzie Bevins interviews Doug Boswell, a farmer from Springfield, Missouri, who shares his journey of resilience after a spinal cord injury from an ATV accident in 2017. Doug discusses the physical and mental challenges he’s faced, his rehabilitation journey, and how the Missouri AgrAbility Project and adaptive equipment have enabled him to continue farming. He highlights the importance of healthcare professionals understanding the unique needs of farmers with disabilities and offers valuable advice for practitioners working with the agricultural population. He also shares the exciting progress he’s made toward walking again using an exoskeleton. See below for an inside look at Doug's exoskeleton and adaptive farming equipment.

About Doug's ReWalk Exoskeleton:

The ReWalk Exoskeleton is a wearable robotic exoskeleton that helps people with spinal cord injuries and other lower limb disabilities walk, stand, and turn. Click here to watch Doug using his ReWalk: https://youtu.be/wdAUSMBBdeQ

In Episode 4 of the Leaders in the Field Podcast, we welcome Carla Wilhite, an occupational therapist with extensive experience working with the agricultural population. Carla takes us through the vital role of using a client-centered approach, especially when working with farmers, ranchers, and others in agriculture. Additionally, Carla highlights the importance of understanding the cultural and contextual aspects of life as an agricultural worker to better meet the needs of clients.

In this episode, we are joined by Kathleen Quinn, Associate Dean for Rural Health at the University of Missouri School of Medicine. We discuss the unique health disparities and challenges faced by rural communities, how healthcare practitioners can provide client-centered care, and the resources available for rural practitioners.

Resources

If you are interested in learning more about Show-Me ECHO in Missouri, visit their webpage at https://showmeecho.org/clinics/. To contact Show-Me ECHO, call 573-884-7958 or send an email to showmeecho@health.missouri.edu

To get involved with an existing ECHO program, start your own ECHO program, or explore ECHO resources and training, please visit https://projectecho.unm.edu/model/

The National Rural Health Association aims to provide leadership on rural health issues through advocacy, communications, education and research. Visit https://www.ruralhealth.us/ to learn more.

For more information, opportunities, and resources on rural health, please visit https://www.ruralhealthinfo.org/

References

Missouri Hospital Association. (2023). Hospital Closures in Missouri Since 2014 https://www.mhanet.com/mhaimages/advocacy/Missouri_Hospital_Closures.pdf

United States Department of Agriculture Economic Research Service. (2009). Health Status and Health Care Access of Farm and Rural Populations. https://www.ers.usda.gov/webdocs/publications/44424/9370_eib57_reportsummary_1_.pdf

Rural Hospital Closures. (2020, June 22). Cecil G. Sheps Center for Health Services Research. https://www.shepscenter.unc.edu/programs-projects/rural-health/rural-hospital-closures/

In this episode, we are joined by Karen Funkenbusch, Program Director of the Missouri AgrAbility Project. She explains how AgrAbility offers resources, education, and assistance to help agricultural workers remain productive and successful in their daily work. Our discussion also highlights the importance of healthcare practitioners understanding the unique culture of agriculture, as the values, traditions, and challenges of farm life greatly impact healthcare decisions and interventions. Tune in to learn how practitioners can provide effective, client-centered care to agricultural workers and how AgrAbility is making a difference in the lives of those who feed the world.

References

American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process—fourth edition. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1-7412410010p87. https://doi.org/10.5014/ajot.2020.74s2001

AgrAbility Contact Information and Resources

If you are interested in AgrAbility services in Missouri, please contact 1-800-995-8503 or send an email to AgrAbility@missouri.edu.

To learn more about AgrAbility services in other states or to access the AgrAbility publication database, the Toolbox, or other online resources, visit http://www.agrability.org

American Occupational Therapy Association. (2020). Occupational Therapy Practice Framework: Domain and Process—fourth edition. The American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association, 74(Supplement_2), 7412410010p1-7412410010p87. https://doi.org/10.5014/ajot.2020.74s2001

Castillo, M., & Simnitt, S. (2023). Farm Labor. Usda.gov. https://www.ers.usda.gov/topics/farm-economy/farm-labor/

Hildebrand, M. W., Brinkley, J., Timmons, S., & Mendez, F. (2019). What occupational and physical therapists know about farmers’ health. Journal of Agromedicine, 24(1), 64–73. https://doi.org/10.1080/1059924X.2018.1538917

Leigh, J. P., Du, J., & McCurdy, S. A. (2014). An estimate of the U.S. government’s undercount of nonfatal occupational injuries and illnesses in agriculture. Annals of Epidemiology, 24(4), 254–259. https://doi.org/10.1016/j.annepidem.2014.01.006

Miller, C. D., & Aherin, R. A. (2018). The prevalence of disabilities in the U.S. farm population. Journal of Agricultural Safety and Health, 24(4), 243–260. https://doi.org/10.13031/jash.12934

NEJM Catalyst. (2017). What is Patient-Centered Care? The New England Journal of Medicine, 3(1). https://doi.org/10.1056/CAT.17.0559

Reed, D. (2004). Understanding and meeting the needs of farmers with amputations. Orthopedic Nursing, 23(6), 397???405. https://doi.org/10.1097/00006416-200411000-00010

Thierry, A. D., & Snipes, S. A. (2015). Why do farmworkers delay treatment after debilitating injuries? Thematic analysis explains if, when, and why farmworkers were treated for injuries. American Journal of Industrial Medicine, 58(2), 178–192. https://doi.org/10.1002/ajim.22380

Zejda, J. E., McDuffie, H. H., & Dosman, J. A. (1993). Epidemiology of health and safety risks in agriculture and related industries. Practical applications for rural physicians. The Western Journal of Medicine, 158(1), 56–63.