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Archive for category: Occupation Is

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Occupational Therapy, Social Work, Both or Neither?

Guest Blogger: Carolyn Rocca, Occupational Therapist

When dealing with any form of injury, illness, or life changing event, clients may find themselves being referred to social work (SW) or occupational therapy (OT), or even both. As there can be overlap between the roles of these professionals, it can be helpful to take a closer look at what each profession specializes in, how they differ, and what they can offer you throughout your recovery.

What is similar about both of these health professions is that their role greatly varies depending on which context the professional is working in, making it challenging to define either simply.

Note: While a SW had input into the content of this blog, the objective here is not to fully explain the SW profession, but rather to try and clarify the similarities and differences between SW and OT.  For more information about Social Work, a few Ontario-based resources are listed as follows, and of course more information is available online or by connecting with a SW directly about the services they offer:

Ontario College of Social Workers and Social Service Workers (OCSWSSW) website:  http://www.ocswssw.org/

Ontario Association of Social Workers (OASW) website: https://www.oasw.org/

The Canadian Association of Social Workers (CASW) describes Social work as a profession that aims to help individuals, families, groups, and communities to enhance their individual and collective well-being, by assisting them in developing their skills and abilities to use their personal and community resources to resolve problems (2017). In most provinces across Canada, the minimum educational requirement to become a SW is a 4-year undergraduate bachelor degree in Social Work, while master’s and doctoral degrees are also available (CASW, 2017).

SWs are trained to provide services across many diverse settings including children’s aid agencies, family services agencies, school boards, general and psychiatric hospitals, correctional facilities, welfare administration agencies, federal and provincial departments, as well as private practice. Not surprisingly their roles vary greatly in each of these settings however, some skills and responsibilities are common across practice contexts.

SWs are unique in that they focus on relationships as the basis of their interventions and are experts in providing services not only to the client, but also to their families. In many settings, SWs often play the role of case manager by linking the healthcare team with the client and family, and connecting the client to relevant agencies, services, or programs based on their needs and community resources (i.e. financial assistance, legal aid, social programming, and housing, employment, and education supports, etc.). Certainly, a large difference between OT and SW is that the latter can provide assistance with parent-child relationships, marriage counselling, and mediation services to assist families in resolving disputes. Fundamentally, they are experts in connecting people to one another and to essential resources.

Whereas, the Canadian Association of Occupational Therapists (CAOT) describes OT as the art and science of enabling engagement in everyday living by empowering people to perform the occupations that foster health and well-being in order to participate to their potential in the daily occupations of life (Townsend & Polatajko, 2013, p. 380). Essentially, OTs focus on helping people manage and participate in the day-to-day tasks that are important to them, including their ability to care for themselves, or carry out their role as a spouse, parent, or employee. In most provinces, to become a registered OT, one must complete a 4-year undergraduate degree, and subsequently a 2-year Master’s degree in Occupational Therapy.

Although OTs can provide services in many of the above listed areas of practice, what they offer can be much boarder in scope. While both professions can provide case management services, individual or group-based interventions (i.e. support or psychoeducational groups), and counseling services to assist people in their recovery from an injury, illness, substance use disorder, or major life transition, OTs can also offer a breadth of rehabilitative services. These services can include prescribing and teaching the use of assistive devices and mobility equipment, and providing recommendations, strategies, and education to find solutions to clients’ day-to-day functional challenges and barriers.

Although there are several differences, OTs and SWs have many overlapping roles, meaning they must communicate and collaborate to ensure they are each offering unique services when both working as part of a client’s healthcare team. For example, consider an individual who has sustained physical injuries and secondary mental health challenges as a result of a motor vehicle accident. Throughout their recovery, an OT will be essential in prescribing and training the client in the use of a wheelchair, suggesting environmental modifications so that the client can navigate in their home, and providing recommendations and education about how the client can safely perform daily tasks like showering and meal preparation. Additionally, the OT would provide psychoeducation and coping strategies to support the client in managing with their mental health symptoms, change in daily routine, altered life roles etc. Meanwhile, a SW might focus on providing counselling services to the individual as well as their spouse or children, who would be adjusting to the change in family dynamic considering the accident and resulting challenges of their spouse / parent. Further, a SW would be helpful in terms of assisting the client in accessing disability support services, funding programs, and local peer support groups.

Overall, despite any shared roles, each profession offers unique strengths, skills, and expertise that the other cannot. Their individual areas of specialization make these professionals vital members of multidisciplinary healthcare teams, and together they offer many needed services throughout the rehabilitation process.

 

Resources and References

Canadian Association of Occupational Therapists (CAOT) website: http://www.caot.ca/default_home.asp?pageid=2412

Canadian Association of Social Workers (CASW) website: https://casw-acts.ca/en

Canadian Association of Social Workers (CASW). (2017). What is social work? Retrieved from https://casw-acts.ca/en/what-social-work

Ontario College of Social Workers and Social Services Workers (OCSWSSW) website: https://www.ocswssw.org/

Townsend, E. A., & Polatajko, H. J. (2013). Enabling occupation II: Advancing an occupational therapy vision for health, well-being, & justice through occupation. Ottawa, ON: CAOT Publications ACE.

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Occupational Therapy Works For Personal Injury

October is Occupational Therapy month in Canada.  This month we will be celebrating and sharing on our blog everything OT.  In our OT Month series, “OT Works Here,” we will be highlighting some of the key areas in which OT works to change lives by providing solutions for living.

Today we want to highlight the many ways that Occupational Therapy works in cases of personal injury in the following infographic:

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Occupational Therapy Works In The Workplace

October is Occupational Therapy month in Canada.  This month we will be celebrating and sharing on our blog everything OT.  In our OT Month series, “OT Works Here,” we will be highlighting some of the key areas in which OT works to change lives by providing solutions for living.

Today we want to highlight the many ways that Occupational Therapy works in the workplace in the following infographic:

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Occupational Therapy Works For Kids

October is Occupational Therapy month in Canada.  This month we will be celebrating and sharing on our blog everything OT.  In our OT Month series, “OT Works Here,” we will be highlighting some of the key areas in which OT works to change lives by providing solutions for living.

Today we want to highlight the many ways that Occupational Therapy works for kids in the following infographic:

 

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Occupational Therapy Works For Seniors!

October is Occupational Therapy month in Canada.  This month we will be celebrating and sharing on our blog everything OT.  In our OT Month series, “OT Works Here,” we will be highlighting some of the key areas in which OT works to change lives by providing solutions for living.

Today we want to highlight the many ways that Occupational Therapy works for seniors in the following infographic:

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Occupation Is: Sexuality

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Don’t worry, this post is rated G.

Remember: Occupational Therapists define the word “occupation” as the way people “occupy” their time. So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?).  In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

So far this month we have slept, gotten out of bed, completed our morning routine, had something to eat, been productive, managed our finances and our home. That’s it, right? Well, not exactly. There is one final piece of “living” that I feel compelled to include.

Sexuality is an incredibly important part of being human. Yet, when we are injured, ill, or suffering from physical, cognitive, emotional or behavioral difficulties, this too can suffer. Many of my clients report a reduced libido, erectile dysfunction, have significant physical barriers to intimacy, or issues with body image post-surgery, amputation, or after gaining weight from inactivity. With lack of sleep, medication side-effects, low mood, and hormonal changes post-trauma, being able to achieve or enjoy intimacy is not always easy.

Believe it or not, but part of Occupational Therapy training includes the occupation of sexual activity. I remember it clearly: I was in my last year of OT school and one of the owners of “Come as You Are” in Toronto was invited to run a lecture on adapted sexuality. When the topic and scope were announced that day, to my surprise, half of the students left before the lecture even started. I suppose not every student was willing to be as open about, and versed in, this sensitive topic. However, I personally found the session extremely helpful. The class openly discussed why sexuality is so important as an occupation, how as future therapists we could be open with clients about this topic without breaking professional boundaries, we reviewed adaptive sexual aids, and also talked about how certain diagnoses impact sexual abilities and how creative positioning can facilitate participation.

Recently, I had a client with a spinal cord injury attend a session at Lyndhurst on sexuality and intimacy. She found the session extremely helpful. The session was hosted by two OT’s and some spinal cord injury survivors. During the session, the OT’s demonstrated how they have been able to creatively adapt different sexual tools so they could be used by people with physical limitations to participation. Other topics around the psychology of intimacy and positioning were also covered, and my client found the session extremely helpful. I also am aware of the information on both sexuality and fertility for people with spinal cord injury at SCI-U.   Of course, this topic stretches far beyond just spinal cord injury, and every diagnosis and problem to sexual participation needs to be treated uniquely. Also, while OT’s can address barriers to sexual activity from a functional perspective, often medical and psychological intervention is also needed to help people return to their previous “normal”.

So, if you have issues with sexuality after an injury or illness, know that OT’s can help with this too. After all, we consider sexuality to be an important occupation.

Check out more posts from our “Occupation Is” series.

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Occupation Is: Managing a Household

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Remember: Occupational Therapists define the word “occupation” as the way people “occupy” their time. So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?). In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

Let’s just assume that we have done all the important stuff. We have slept, are out of bed, groomed, dressed, fed, are done being productive, and did some fun stuff in between. Eventually, like it or not, we need to tackle the not-fun stuff.

The interesting thing about “not-fun stuff” is that everyone defines this so differently. Each of us has our own unique interests, abilities, and standards when it comes to groceries, laundry, cleaning and managing our yard and property. Personally, I loathe grocery shopping (and anything that is meal preparation) and would rather cut the lawn then use a vacuum. My kids do their own laundry as of age 10 because it has a wonderful built in consequence. No laundry = no clothes to wear and I don’t need to say a thing. Besides, I don’t think asking them to start doing this at 16 will go as well. With six of us in our house, and two animals, the meal responsibilities, cleaning, and shopping tasks are time consuming. However, all off these things are another layer in my lasagna of “occupations”.

Imagine you are in a car accident and spend a few weeks in hospital. Your spouse, friend, mother, brother, someone, has to swoop in and help with your children, pets or house. Eventually you come home and find that things have not been done to your standards, if done at all, and it will be months before you will have the ability to get back to these tasks independently. The look of your home and property is stressful for you, the meals are different, and you are home all day to notice. Or maybe you weren’t in a car accident, but have a progressive illness or medical condition that renders you to be no longer able to complete heavier tasks, but you try diligently to manage the smaller tasks within your abilities but this too is now declining. Perhaps you have sustained a brain injury and your memory is lacking for when things were last accomplished, or when you try to go to the store you end up missing half of the items on your list, if you even take one. Or worse, the store is an overwhelming place for you considering the visual and auditory stressors from any busy shopping environment. Maybe mood is the problem: depression and anxiety can be significant barriers to getting things done, but yet the more things are not done, the more depressed and anxious you become. The cycle continues.

Managing a household and all the tasks included in this, is very much an occupation. It is a separate set of demands from personal care, earning an income, or managing our productive time. Occupational therapists routinely help clients to return to the occupation that is managing a home. There are multiple strategies that can be used for people with brain injuries, chronic pain, or social phobias to return successfully to grocery shopping. There are also multiple aids available that makes light and heavy cleaning easier. We often need to help people break down tasks into smaller chunks, or educate people on pacing as a means to get things accomplished. Education on proper body mechanics is also very useful at reducing strain on recovering shoulders, necks and backs for things like lifting, carrying, reaching, and bending. Outdoor tasks are more difficult to resume, simply because they are heavier, but many of the same principles apply. If behavior, mood or avoidance are the problem, we have strategies and tools to help with that also. We believe that most functional problems have a solution.

Occupations are therefore all the things included in managing your home. These tasks can be heavy, time consuming, and “not-fun”, but they are a necessary part of living. If you are struggling to get these things done, or know someone else who is, occupational therapy can help.

Check out more posts from our “Occupation Is” series.

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Occupation Is: Managing Your Finances

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Remember: Occupational Therapists define the word “occupation” as the way people “occupy” their time. So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?). In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

It is no secret that there are physical, mental and emotional consequences of stress. Access to money is a basic human need as food, shelter, and emotional security are all impacted by our ability to provide for ourselves and our family. As such, the stress created from a lack of money, or drastic and sudden loss of income, is significant. In the economic crisis of 2008, there was mounting evidence that financial issues were causing a whole host of associated health problems including a rise in reports of headaches, backaches, ulcers, increased blood pressure, depression and anxiety (http://www.frbsf.org/community-development/files/choi.pdf). Therefore, it is no secret that financial security is a determinant of health.

I can say that 100% of my clients suffer from financial problems after their traumatic event. How could you not? If you think your income is “insured” against illness or disability, check again. If you are fortunate you have private disability or health coverage. Or, you might have a good short or long term disability plan at work and in that case, you might get 80% of your income covered at the time of claim. However, this usually only lasts for two years before the “test” changes and most people find their income loss benefits end. In the world of auto insurance, without other coverage, the maximum income replacement is $400 / week, regardless of what you made before (unless you “bought up” which no one does). And just think – three years ago the Financial Services Commission of Ontario wanted to lower this to $300 / week to put more money back in the pockets of insurers. Could you live on $1200 / month? I digress…

So, you are in an accident, suffer an illness or can no longer work. How will you manage? How will you be able to afford the medications you are now required to take (these aren’t covered 100% either folks), the equipment you need (the government might fund 75% for some items, but when a prosthetic limb is $60,000 that is still a lot out of pocket), the treatment you require (even with extended benefits, $350 in PT won’t get you very far), and your regular expenses that won’t dwindle unless you make major lifestyle changes? The answer is stress, worry, concern, sleepless nights, borrowing, illegal activity, and brutal attempts to unsafely return to work because you “have to”.

Believe it or not, managing your finances is what we call another “occupation”. Working with an occupational therapist, a disabled person can create a new budget around the change in income, get support to make decisions about spending, and gain access to other potential sources of financial support. Perhaps you qualify for the Disability Tax Credit, or the Registered Disability Savings Plan? Maybe you need to apply for the Ontario Disability Support Program, or can access funding for devices through the Assistive Devices Program? Perhaps your home modifications qualify for the new Tax Credit, or you can apply to the March of Dimes under their Home and Vehicle Modification Program? Maybe without other coverage the local Community Care Access Center can provide you with home care, treatment or equipment? Can your medications be covered by Trillium? Are you maximizing the coverage available to you under auto insurance policy or work benefits? Is there a local food bank, or disabled transportation program? These are all things we look at.

Then of course, there is the process of returning to work. What if you cannot manage the demands of your previous job or this is no longer available to you based on a long absence? Perhaps the jobs you are trained for no longer match your abilities? Occupational therapists can help with identifying previous job demands, outlining new job interests, and comparing these to the abilities you have. We can set up structured work programs, gradual re-entry plans, and connect you with people and programs in the community that help people get back into the work force.

Occupation is managing your finances and making sure you can get by. If this is impacted by a disability, Occupational Therapists’ treat that.

Check out previous posts from our “Occupation Is” series.

 

 

 

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Occupation Is: Doing Fun Stuff

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Remember: Occupational Therapists define the word “occupation” as the way people “occupy” their time. So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?). In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

So, what are your plans after work? How do you like to spend your evenings? What do you do for fun? Given the choice, how do you spend free time? While being productive is essential for the human psyche, so is being unproductive. Well, sort of, because even a lack of productivity is productive. Deep, I know.

Personally, I love a good funny movie, dinner with friends, time with nature, getting out with my kids, exercising, playing sports, reading, blogging, and going on vacation. Those are my “fun”. For others, this could be creative hobbies or outlets, museums, live theatre or music, antiquing, collecting, photography, being online, or a thousand other things that I don’t even know exist.

So what if I was injured, suffered from a mental health problem, have a medical issue, or brain injury? Perhaps I would lack the ability to sit through a movie, or could no longer understand the nuances of humor. Maybe my personality would change and my friends would have a hard time relating to the “new me”. Or, I could no longer physically handle my nature walks, exercising or playing sports. If my vision was impaired, I could not read anymore. If I struggled with cognitive communication, or attention problems, putting together a blog article might also be off the table. And vacations? Those are incredibly difficult to plan and organize at the best of times.

Occupational therapists are very skilled at helping people resume the occupation of fun. There are multiple ways we do this, as we recognize that our “fun” defines much of who we are, and why we work so hard in the first place. For example, if I had to rehab myself from the problems above, I might start with suggesting sit-coms as these require less physical tolerances for sitting, and a shorter attention span. I could view these with another person, and discuss the humor, sarcasm, and recall the best one liners. Perhaps I would need education and support to understand how my personality changes are impacting my relationships, so I can try to make some changes. If my physical abilities were limited, my OT could help me find new ways to enjoy nature (bird watching, photography as examples), and could help me discover new sports and forms of exercise within my abilities (yoga, Tai Chi, and many modified sports have become very popular for people with disabilities). If I can’t read a standard book, maybe I could use an iPad or e-reader so I can change the font size, or switch to audio-books. For my blogs, I could learn new ways to move from a blog idea to a full article, by breaking down the topic into paragraphs or chunks, or learning how to dictate if written communication is my challenge. Vacations could take the form of day trips, short overnights, and eventually out of the country through the help of a travel agent that specializes in planning accessible vacations. I would probably learn that in Canada my attendant can fly for free (with approved paperwork), and that many places (Disney included) are highly accessible.

So if a disability is stopping you from enjoying the occupation of fun, OT’s treat that.

Check out more posts from our “Occupation Is” series.