Prairie Doc Perspective Week of March 8th, 2026
Meaningful Living in Rural Communities: Pathways to Productive Aging
By: Whitney Lucas Molitor, Ph.D., OTD, OTR/L, BCG and Allison Naber, Ph.D., OTD, OTR/L
Living in rural communities offers unique opportunities to promote successful aging. Incorporating a purposeful lifestyle, developing social connections and engaging in daily physical activity is essential to achieving positive health outcomes and quality of life.
Finding purpose includes exploring the activities you already engage in and being open to new possibilities. Engaging in motivating activities provides a framework for a purposeful life. The selected activities can promote health, foster a sense of identity and give a sense of purpose in life while aligning with personal values and interests. While some daily activities are performed without much thought, identifying others may require careful exploration. 
In rural communities, consideration of the physical context is also essential. The American Occupational Therapy Association provides a framework that incorporates reflection on personal values, interests and prior life experiences. This approach, along with establishing priorities and goals, can be a valuable way to explore daily activities and create new opportunities for engagement that enhance purpose in daily life. To align life purpose with a rural context, it is essential to incorporate outdoor activities, find creative ways to connect with family and friends and explore opportunities with local groups. Activities can be modified to support evolving interests, abilities and desires. 
Establishing and maintaining strong social connections is critical to promoting healthy aging in rural communities. Older adults in rural areas may experience social isolation due to limited opportunities for interaction. This can be due to changes in overall health, technology barriers (limited internet access or limited computer or smartphone skills) or physical barriers (limited community mobility or driving restrictions). Social isolation can pose physical, psychological and behavioral health risks. Engaging in meaningful activities with others can help build relationships, find purpose or fulfillment and develop new hobbies or skills. Educational programs or groups are an excellent way to explore new leisure activities or learn strategies to improve health and well-being. Reaching out to family or friends, visiting your local senior center, attending community events, or joining a club can all provide a sense of connection, purpose and well-being.
In addition to staying socially connected, developing a regular physical activity routine is essential for older rural adults. Adults over 65 should set goals to strengthen their muscles and improve their balance by engaging in at least 150 minutes of moderate physical activity per week. Moderate physical activity increases breathing and heart rate, but you should still be able to talk while active. Beneficial activities include brisk walking, dancing, riding a stationary bike or NuStep, using weights or resistive exercise bands, gardening or participating in water aerobics. Consider setting a goal to move your body for 30 minutes each day to reduce sedentary time. Sedentary activities include watching TV, reading, sitting or lying down. Prolonged sedentary behavior increases the risk of poorer health outcomes among older adults. Intentionally participating in meaningful activities throughout the day will reduce time spent sedentary. Reduce sedentary behavior by standing during commercial breaks, walking around your home after a meal or stretching after reading the paper or playing cards. Incorporating the strategies mentioned in this article can promote well-being and enhance quality of life.


Whitney Lucas Molitor, Ph.D., OTD, OTR/L, BCG, is department chair and associate professor in the Department of Occupational Therapy at the University of South Dakota. Lucas Molitor is a licensed occupational therapist in Iowa and South Dakota. Her research interests include health promotion and productive aging. Allison Naber, Ph.D., OTD, OTR/L, is the academic fieldwork coordinator and an associate professor in The Department of Occupational Therapy at the University of South Dakota. Naber is a licensed occupational therapist in Minnesota and South Dakota. Her research interests include occupational performance and life balance, particularly as they relate to healthy aging. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

Prairie Doc Perspective Week of March 1st, 2026
Cultivating Trust: A Trauma-Informed Approach to the Therapeutic Alliance
By Patti Berg-Poppe, MPT, Ph.D. and Shana Cerny, OTD, OTR/L, BCP


Health care professionals enter every patient encounter with the goal of helping individuals heal, yet many don’t realize how often past adversity shapes the way a person experiences care. Trauma, whether from childhood experiences, medical procedures, accidents, interpersonal harm or environmental conditions, doesn’t remain a distant memory. It becomes embedded in the body through biobehavioral adaptations that influence posture, muscle tension, breathing patterns, nervous system sensitivity and low body safety. When we understand that trauma lives not only in stories but also in tissues and reflexes, we begin to see why a trauma-informed approach is essential for building trust.


Trauma and adverse experiences are more common than we may realize. More than two-thirds of the patients that health care providers encounter in practice are likely to have experienced trauma in some form. Trauma‑informed care should be a universal precaution, guiding providers to assume that any patient may have a history of adversity, even if it is never disclosed. This mindset shifts the focus from “What’s wrong with you?” to “What’s happened to you, and how is it affecting your health today?” For clinicians who rely on touch, such as physical and occupational therapists, physicians, nurses and primary care professionals, this awareness is especially important. Touch can be grounding and healing, but it can also activate the sympathetic nervous system, triggering a stress response before a patient has words to explain why.


Trust becomes the foundation of the therapeutic alliance, and trust is built through safety, predictability and respect. Trauma‑informed practice encourages providers to slow down, explain what they are doing and invite patients into shared decision‑making. Simple actions, such as asking permission before touching, checking in about comfort, offering choices and being transparent about what comes next, signal to the nervous system that the environment is safe. These small shifts can reduce physiological stress responses and create space for true healing.


Research on trauma‑informed health care highlights how past adversity can influence patient engagement, adherence and outcomes. When patients feel overwhelmed, misunderstood or rushed, they may appear “non‑compliant,” when in reality their nervous system is doing its best to protect them. A trauma‑informed lens helps clinicians interpret these reactions not as resistance but as communication. It encourages us to look beyond the symptom in front of us and consider the whole person, including their history, their stress load, their strengths and their goals.


Holistic care means recognizing that physical symptoms rarely exist in isolation. Pain, fatigue, dizziness and muscle tension often have emotional and neurological components. When providers acknowledge this mind‑body connection, patients feel seen rather than dismissed. They’re more likely to share concerns, ask questions and participate actively in their care. This collaboration strengthens the therapeutic alliance, which research consistently links to better health outcomes across disciplines.


Trauma‑informed practice is not a specialty; it’s a skillset. It requires curiosity, humility and a willingness to adapt. It asks clinicians to be mindful of their tone, body language and pace. It reminds us that healing happens in relationships, and that every interaction, every moment of touch, every explanation, and every pause can either reinforce safety or erode it.


When we approach patients with the assumption that their bodies carry stories we cannot see, we create conditions where trust can grow. And when trust grows, so does the capacity for healing.


Patti Berg-Poppe, MPT, Ph.D., is a physical therapist, professor, and Chair of the Department of Physical Therapy at the University of South Dakota. She has published on trauma‑informed care, including work examining how adverse childhood experiences influence patient engagement and how trauma‑aware practices can strengthen therapeutic relationships. Her writing and teaching emphasize the importance of trust, safety and respectful communication in all health care interactions. Shana Cerny, OTD, OTR/L, BCP, is an occupational therapist and associate professor in the Department of Occupational Therapy at the University of South Dakota. Her research, service and teaching interests revolve around trauma-informed care, including publication of practice guidelines for trauma-informed occupational therapy, interventions for individuals after exploitation, and the effectiveness of a trauma-informed care curriculum for multi-disciplinary care providers. She is a Trust-Based Relational Intervention® Educator and co-creator of the Child & Adult Advocacy Studies graduate certificate at the University of South Dakota. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm, YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).

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