Keep it moving

Students with the program Putting Patients First built a sidewalk for Valerie Richardson of Gainesville. Richardson, who uses a motorized wheelchair, uses the sidewalk to access her van, which has been specially fitted to her needs.
Students with the program Putting Patients First built a sidewalk for Valerie Richardson of Gainesville. Richardson, who uses a motorized wheelchair, uses the sidewalk to access her van, which has been specially fitted to her needs.
By Morgan Sherburne

Valeria Richardson Harden has one singular life motto: No matter what, you have got to keep it moving.

“I have better days than others, but whether I have a good day or not, I have to keep it moving,” she says. “I have to keep it moving. It’s important that I do that.”

She, her husband, Garry, and daughter, Alexandria, 15, live tucked away in a small community of homes branching off a crushed limestone road in Southwest Gainesville. Their home, where Valeria has lived her entire life, is surrounded by a neat yard of fruit trees — lime, grapefruit and sour oranges, the small, tart citrus used to make marmalade.

The Hardens planted the trees on the property just after they were married more than 30 years ago. Most days, Valeria — Mrs. V. to many who know her — navigates through a sliding glass door, down a ramp through the fruit trees and to a van equipped to lift her motorized wheelchair. Garry, who also has a disability but can drive, takes her to her job at Target.

“She can’t drive, but if she could, she’d be great at it,” Garry says, laughing. “If there was a license for backseat driving, she’d have it.”

But some days, that van isn’t working. So Valeria calls her manager at Target, lets him know she may be a bit late, and sets on down the dirt road. She navigates to a sidewalk along a side road, crosses and wheels along one major thoroughfare, continues along yet another boulevard, and finally, nearly 2 miles later, crosses the four-lane Archer Road and arrives at her destination.

Valeria does this through the heat, rain and Gainesville’s chilly winters, which Valeria says affects the spinal muscular atrophy, a genetic disorder that affects the nervous system, that has kept her in a wheelchair all her life. The rain also concerns her, given her electric wheelchair. Sometimes, that rain turns her front yard into mud and Valeria gets stuck, requiring a call to a family member to free her. But as soon as she can, she gets moving.

Putting Families First

Back in September 2015, first-year medical student Stephanie Socias, first-year pharmacy student Camila Galindo, first-year health administration student Daniela Sanchez and first-year dentistry student Sara Sardano began meeting with the Harden family as part of a program called Putting Families First, offered to first-year students in all six health science colleges across UF Health.

“There are many goals for this program, and one is to have students better understand the need for community resources, and to understand the circumstances in which patients live,” says Amy Blue, Ph.D., associate dean for educational affairs for the UF College of Public Health and Health Professions and associate vice president for interprofessional education for UF Health.

For an academic year, student groups are paired with patients and their families. Throughout the year, the students meet four times with the patient families, who are of varying health and economic statuses. Then, the students determine a specific health improvement project that would benefit the family, based on the family’s goals and wishes, according to Blue. Students do not provide clinical care, but instead provide support in different ways, such as initiating paperwork for disability, helping find ways a person can exercise more or coming up with recipes for people who have diabetes.

The program, which was started about 20 years ago by the now-retired Richard Davidson, M.D., M.P.H., previously the associate vice president for interprofessional education, is housed in the UF Health Office of Interprofessional Education. The program also aims to educate each health care student about their fellow students’ particular areas of expertise — and their areas of challenge.

In addition to the four family meetings, the students also attend six in-class sessions, facilitated by an interprofessional group of faculty. The students study issues around health literacy, access to health care, cultural differences in perceiving and accessing health and how health is affected by socioeconomic status. The students also learn about each other’s professions and discuss home meetings with their families. Case managers with the Office of Interprofessional Education Cindy Wielgos and Gina Murray step in when families need aid beyond what students can provide them.

“The whole purpose of the program is to promote interprofessional teamwork and for students to gain much greater appreciation for social determinants of health and providing patient-centered care,” Blue says.

Putting Patients FirstOne big job

“Valeria’s a quiet person, and was not going to say ‘I need X, Y or Z,’” Socias says. “She was more teaching us rather than us teaching her.”

Late in the first semester of the program, Socias’s group still didn’t have a plan, and their project deadline was the first week of April. During one meeting, Harden mentioned the issue of getting stuck in her front yard.

“You didn’t mention the sidewalk in the beginning,” Socias says to Harden. “You mentioned offhand, ‘Oh, it’s really hard to get to my car because of the dirt.’ We were all a bit shocked because that was really tough. I don’t know how you’ve done that for so long.”

Harden smiles as if she knows this is true — she has spent all of her 56 years working around exactly these obstacles in her life.

In fact, Harden had been thinking of a sidewalk for a long time. Another Gainesville organization had built the ramps that lead out of her bedroom and living room, but didn’t have the capacity for a project of that scale. Harden was ready to take on the task herself. If someone could just dig the path for the sidewalk, she would wheel herself to and from Lowe’s for the concrete — one bag at a time.

Socias and her group thought the same thing. They would dig a path, mix up a few bags of concrete and Harden would have her sidewalk.

“We kind of underestimated everything, thinking, ‘Oh, this is no big deal. We’ll go to Lowe’s, fill up some wheelbarrows with mix-up concrete and just pour it out,” Socias says. “We had to do a little more than that.”
Harden starts laughing.

“She didn’t let it stop her though — but I guess she said ‘I bit off more than I could chew.’” Harden says. “She was so attentive and so adamant about hearing what I had to say. I didn’t realize what was taking place until she already had it in process.”

To build a sidewalk

Socias began talking with a few members of the UF M.E. Rinker Sr. School of Construction and with the Gainesville organization Christians Concerned with the Community, which had built Harden’s ramps, to understand the scope of the sidewalk project. The group soon realized the project would take more than just a few bags of ready-mix from the store.

Through the help of people in the UF Planning, Design and Construction division, Socias was able to connect with the Gainesville company Parrish-McCall Constructors.

“Over the years, we’ve done various small projects throughout the community,” said senior project manager Bill Pearson, who helped design and oversee the project. “But Stephanie was the one who did all the work: She coordinated getting the form materials for the sidewalk, and a load of concrete donated.”

Then, one day in March, the group got to work.

They spent a day digging a several-inch-deep outline of the sidewalk, leading from the Hardens’ ramp in the back of the house to the area where Garry Harden can park the van. A few days later, the concrete was poured, and the contractors helped finish the concrete. The next day, they ripped out the wood molds for the cement, and Harden had her smooth sidewalk.

Jean Cibula, M.D., division chief for epilepsy in the UF College of Medicine’s department of neurology and the Wilder Family professor for epilepsy, says Socias’ group’s project was the most involved she’s ever seen.

“We were dumbfounded when the group made their presentation,” says Cibula, who has been a small group facilitator with the Putting Families First program since 2010. “We had no idea of the scope of what this group was doing, and they did not get assistance from us whatsoever. Just — wow.”

In all, the group estimated the community donated about $4,000 to complete the project. Christians Concerned with the Community, which built the Hardens’ ramps, advised the UF group about the project. Alpha Phi Omega, a service fraternity, donated labor. Panera Bread donated snacks for the volunteers; Parrish-McCall donated labor and contractors to oversee the project; Marques Contracting donated the concrete and mixing truck; and Home Depot donated and delivered the boards that formed the sidewalk mold.

400 square feet of independence

Now, Harden’s sidewalk allows her to easily get from her home to her van, and if the van is broken down, at least to the driveway, where she can wheel to her much-loved job.

It’s an effort Syed Rizvi, store manager at the Gainesville Target, would appreciate — if he knew she was going to that amount of trouble.

“A lot of times, they don’t know how I got there. It’s not their job to worry about how I got there, as long as I got there,” Harden says.

Even so, Rizvi knows he has a valuable employee.

“She’s able to take the guest and really connect with them, and more than just selling items or finding out what they’re looking for, she’s going to have a conversation outside of what we sell here,” Rizvi says. “She is a unique person, and she creates unique experiences, something we can’t replace.”

Harden attributes her drive and attitude to her parents, who raised four children, three of whom had the same type of muscular dystrophy. Harden’s mother would pack all four children into the family car, fold up three of the children’s wheelchairs, drive them to school — sometimes to three separate buildings — hand them their backpacks, and send them off for the day. Harden’s father, a machine operator, would often be working from daybreak to sundown.

“Doctors told our parents that we wouldn’t live to see our teens,” Harden says.

Harden’s younger brother, Marion, died when he was 28. Her sister, Deborah, died when she was 42.

“I often thank God I’m still here,” Harden says. “My parents raised me to be a strong-minded, independent young woman. They also taught me that if there’s anything in life I want to do, I can do it, if I put my mind to it.”

So she coaches herself to excel at whatever she puts her mind to — like her job at Target. Before her time at the store, Harden spent 11 years with the Alachua County Public Schools system as an assistant volunteer teacher, working with children of all ages. After becoming ill too frequently, Harden finally had to give up that job.

“I strongly believe in myself and get disappointed when I don’t achieve my goals because I set high goals for myself.

I want more. I have high standards,” Harden says. “When I’m at Target, every one of those guests who come through that door, if I can be of help to them in finding something or getting something, I’ve done what I wanted to do.”

Now, with a little help from Socias, her group and UF Health’s Putting Families First, Harden can achieve those goals just a little more easily.

“So when I go into the hospital, I try to get out as quick as I can. I have to keep it moving. There’s no downtime for me. I can’t stay down for too long. I’ve got too much responsibility — to my husband, to my child, to my job,” Harden says. “I’ve got a lot to do, baby. So I’ve got to keep it moving.”