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Archive for category: Original Posts

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O-Tip of the Week: Safer Transitions

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of November, Fall Prevention Month, our O-Tip series will concentrate on preventing falls at home and in the community.

Falls are the leading cause of injury among older Canadians with 20-30% of seniors experiencing one or more falls each year (Statistics Canada).  With seniors most falls often happen when someone is just trying to go about their day by having a shower, coming down the stairs, or taking a leisurely walk.

This week’s O-Tip of the Week returns to the bathroom, which can be the most dangerous room in the home, especially for seniors.  Transitions into and out of the tub or shower are often the cause of falls in the bathroom.  The installation of grab bars in the tub or shower can greatly reduce this risk.  An Occupational Therapist can help by assessing the older adult’s functional status and reviewing the hazards in their environment that may put them at risk for falling.

Learn more helpful fall prevention tips for older adults from our infographic:  An OT Knows How to Help Seniors Age in Place.

 

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Being an Advocate – Prompting Change as an OT

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

As Occupational Therapists, we spend a significant amount of time with people in their homes and in the community.  In this role, we witness daily injustices, challenges or problems that our clients unnecessarily or unfortunately experience due to vendors, landlords, or business owners / operators failing to understand, care, or address the needs of people with disabilities. 

Recently, a student I was supervising on placement experienced an accessibility challenge with a client as they attended a local coffee shop.  We blogged about this in our post, Accessibility Issues in Our Daily Lives.  As her mentor, I discussed with her the need to advocate for change and to send the owner a letter about the problems that client experienced.

That situation made me reflect on my history of advocacy as a person and an OT.  I remember as a teen writing a letter to a restaurant who would not book us a reservation on the “main floor” such that my two disabled grandparents could attend my birthday dinner.  As a young adult, I wrote a letter to an Alaskan cruise line about the challenges my grandfather experienced using his scooter around the boat and on the gangways.   Then I became an OT and the advocacy continued.  I have written, and continue to write, letters to equipment vendors, drug and department stores, public and private places, major banks, landlords, the CCAC, and fast food restaurants.  Sometimes my letters are specific and highlight an “incident”, while others speak more to general accessibility or service problems.  My advocacy initiatives even resulted in me building a training program aimed at helping the “average Joe” best service people with disabilities.  I personally feel that advocacy is how I will make my mark on the world, regardless of how small, with the hope of leaving this world in better shape than how I found it.

For this blog, I wanted to take the spirit of advocacy further, and to embrace our human responsibility to try and be catalysts of social, environmental and institutional change, by sharing a guide of sorts that could be used by other therapists, clients, caregivers or really anyone who wants or needs to bring an issue to someone’s attention.  Give this a try and keep us posted on your outcomes:

DATE

Name of Person / Establishment

Address

Dear Representative/Manager/Person:

I am X.  On DATE (I, my family member, client etc) experienced the following problems (when accessing your establishment, using your services, interacting with your staff, etc):

In bullet or paragraph format, list the problems you had.  Be factual, truthful and professional.  Avoid judgement, anger or threats as these will not result in change.

Provide some input on how you feel the problems you had might be impacting their service, business, etc.  Try to hit home with how the issues you experienced will turn people away, or jeopardize their reputation. 

Next, explain what you feel the solutions are or how it can be better for you next time. Help them to know what to do.  You don’t have to be prescriptive or specific, but maybe they need to consider some building modifications, better trained staff, to understand disability codes or acts, an easier to navigate website, consultation with someone who can develop solutions with them etc.  This is where you can really try to be helpful.

End the letter by thanking them for considering your feedback and provide your contact information.  Be prepared to have a discussion with them about it.  Some might ignore your letter, but I hope most will not.  Either way, if your letter stays friendly and is perceived as helpful, they may want to thank you for your time or seek more input.

Of course, add a final sign off like “sincerely” and your name.

I hope this format / suggestion will be helpful as you venture forward and try to educate, share and advocate for the change you hope to see in the world.

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OT Improves the Quality of Life for Those with Chronic Pain

Pain is real.  It can prevent people from engaging in activities that are important to them, or at the least inhibit enjoyment and full participation in those things they want and need to do. It doesn’t matter if the cause of the pain is fully understood — the person’s experience of pain is what is important, and is what affects function.  As the role of an occupational therapist is to enable clients to engage in activities that they want, need, or are expected to do, OT’s have the capability to help individuals with chronic pain to better manage their lives.

The following from article from Medical Xpress sheds light onto the benefits of OT for managing chronic pain and helping sufferers maintain a better quality of life.

Medical Xpress:  Occupational therapy shown to improve lives of people in chronic pain

Learn more about how OT can assist with chronic pain in the following episdoe from our OT-V series, Managing Chronic Pain.

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O-Tip of the Week: Shed Some Light on Fall Prevention

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of November, Fall Prevention Month, our O-Tip series will concentrate on preventing falls at home and in the community.

This week’s O-Tip of the Week focuses on a simple, yet often forgotten aspect of the home that can prevent falls:  proper lighting. 

Seniors need to be attuned to the physical, balance and vision changes they are experiencing as they age, and need to consider the importance of proper lighting to help them navigate and reduce the risk of falls in their living spaces.  Helpful and simple lighting suggestions may include:

–        Night lights around the home

–        A bed side lamp

–        Illuminated light switches

–        Storage of flashlights in the bedrooms, the kitchen and bathrooms

–        Change of light fixtures to provide both ambient and task lighting based on needs

An Occupational Therapist can assist in assessing the living space to suggest lighting modifications and more.  Learn more about how OT’s assist in fall reduction in our OT-V Episode, Fall Prevention.

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Accessibility Issues in Our Daily Lives

Guest Blogger: Carolyn Rocca, Occupational Therapist

As I stroll into my favourite coffee shop to start my morning, I am reminded that this is a part of my day that I take for granted. Particularly, I am reminded of an observed experience that I encountered with a client who had a personal goal around using his walker to go into his favourite local coffee shop, something he had not been able to do since his brain injury.

After weeks of working up to this goal, it was finally time to assess his mobility in the community. As soon as we arrived at the coffee shop’s parking lot I could tell that this was going to be much more challenging than I had anticipated, as it quickly became apparent that there were several accessibility issues we would need to navigate.

Although the accessible parking spots provided us enough room to safely transfer out of the vehicle, and the ramp onto the side walk was graded appropriately, once up on the sidewalk, the client could sense a shallow slant in the pavement causing him to panic as he felt he was going to fall over. What became even more challenging was that there were no automatic doors at either entrance, and that the front entrance had a tightly-spaced vestibule with two sequential, single-passageway doors. On top of all of these challenges, there was about a 2-inch difference in the threshold of the door meaning the client had to lift his walker while already feeling nervous about the slanted pavement. Ultimately, the inaccessible nature of this establishment meant that it took over four people to safely get the client into the coffee shop, which not only increased his nervousness but also completely decreased his level of independence.

Although this experience was largely a success and the client was incredibly proud of what he had accomplished, it also brought to light some issues in our society. It was shocking that a well-established company (who shall remain nameless) had not yet invested in making all of their franchises accessible.

According to the updated accessibility requirements of the Ontario Building Code, buildings are required to have a barrier-free path of travel by having powered door operators at their entrances, meeting minimum requirements for doorway widths and ramp dimensions, and having adequate turning space (Ministry of Municipal Affairs, 2015). The unfortunate part is that these requirements do not affect existing buildings, and are only applied to newly constructed buildings or those undergoing extensive renovations.

What this means is that the current level of accessibility of this coffee shop will not be improved until this franchise decides to undergo major renovations. As a result, this franchise is not only impacting those who use gait aids or wheelchairs, it is also impacting individuals who have mobility challenges, low vision, and parents with strollers, to simply name a few. Additionally, according to the Royal Bank of Canada, people with disabilities have an estimated spending power of about $25 billion annually across Canada (Accessibility Ontario, 2017), meaning this franchise is also losing valuable business from a population who happens to love their coffee.

In being reminded of this experience, it also brings to light the impact that the profession of occupational therapy can have in terms of advocating for their clients needs and promoting equal access for all. Occupational Therapists (OTs) have a unique skill set in terms of assessing the needs of individuals, and identifying barriers in their environments that prevent their access or ability to engage in occupations that are important to them, such as grabbing a coffee. OTs teach people how to be proactive in their own lives, but bigger than this, also have the ability to communicate their clients’ / societies needs to others, and to offer solutions to barriers by involving appropriate stakeholders.

As such, I have written a letter to the coffee shop to bring awareness and attention to the challenges my client experienced while at their establishment. Moreover, in the future, I plan to examine buildings and public spaces beforehand to make sure I am helping my clients to be familiar with, and access, places that have the appropriate supports in place to maximize their level of safety and independence.  In doing so, I will increase my clients’ future independence as they venture out without me, while also supporting businesses that have dedicated their time, effort, and resources to creating welcoming and barrier-free environments.

 

References

Accessibility Ontario (2017). About the Accessibility for Ontarians with Disabilities Act (AODA). Retrieved from https://accessontario.com/aoda/

Ministry of Municipal Affairs (2015). Overview of updated accessibility requirements. Retrieved from http://www.mah.gov.on.ca/Page10547.aspx

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O-Tip of the Week: Hydrate to Prevent Falls

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of November, Fall Prevention Month, our O-Tip series will concentrate on preventing falls at home and in the community.

This week’s O-Tip of the Week focuses on a simple way to prevent dizziness and balance issues which can lead to falls:  hydration. 

Learn more about how to properly hydrate yourself in the following post from our blog Help with Hydration – How Many Glasses Do You Really Need?

Learn more helpful fall prevention tips from our infographic:  An OT Knows How to Prevent Falls: 

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When Self-Service is Not an Option – Refueling with a Disability

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

When I was a kid I loved the movie “Back to the Future” with Michael J Fox.  I remember clearly the scene where it shows his parents in the 50’s at a gas station – back then, “full serve” meant windows were cleaned, the car shined, tires pumped, and of course your gas tank refilled.  It was like the pit-stop at a NASCAR race where you would have multiple people at your vehicle getting you on your way quickly.  Fast forward to today where “full-serve” is uncommon, and finding a station where someone can fill your tank while you wait in the car might require you to venture out of your way. 

So, how does this translate for people with disabilities?  Well, firstly, there are many people that can and do drive a car regardless of a mobility impairment.  Cars can be modified to accommodate the specific needs of many people with physical challenges.  Hand controls, left-footed gas pedals, spinner knobs, automatic wipers, voice controls…to name a few.  That is all fine while the vehicle is being operated, but what about when it is time to refuel?  It is possible, but not always efficient or safe, for people with a physical impairment to get out of the vehicle, grab their mobility device, and wait outside the car in the elements to refuel.  Not to mention the safety risks of these tight spaces, other vehicles, and fall / slipping hazards of wet and uneven ground.

Considering the move away from “full-serve”, I wanted to look in detail at the services offered by gas stations to help people to refuel when mobility is a challenge.  I was surprised at what I found – some stations have well listed policies that are clear and supportive, while others have no policy or tell people to “call ahead” before coming to refuel.

Here is what I found about ways to refuel if getting out and around your car at a gas station is not the best choice for you…

I give the following companies a THUMBS UP:

ESSO

(https://www.esso.ca/en/gas-stations)

Drivers with disabilities can use the Esso Fuel Finder to find stations that offer the fueling option that best meets your needs: 

Split serve stations: Both full- and self-service options are available to customers
Full serve only stations: Full service is available to customers
Self-serve only stations: While some of our stations have designated Disability Fueling Assistant hours where more than one attendant is available, often there is only one attendant on duty at self-serve stations.

We recommend you call ahead to see if appropriate staffing arrangements can be made. Contact information is available on the Esso Fuel Finder.

SHELL

(http://www.shell.ca/en_ca/motorists/inside-our-stations/refueling-for-drivers-with-disabilities.html)

Drivers with a disabled parking permit will receive full service at self-serve prices at stations with both full and self-serve pumps. The gas station attendant will fuel your vehicle at the self-service island so that you pay only the self-serve price for fuel. Customers should identify themselves to one of our gas station attendants. Please note this service is available only during full service hours.

At self-serve only stations, staff will make every effort to help customers displaying disabled parking permits with refueling. Please identify yourself to one of our gas station attendants. We also encourage you to contact your local station to discuss your individual needs as some stations have limited staff and payment access.

PETRO CANADA

(http://retail.petro-canada.ca/en/stationsstores/customers-with-accessibility-needs.aspx)

At participating split-service stations, a site which provides self-service and full-service at the islands, drivers with an accessible parking permit will receive full-service at self-serve prices. The full-service attendant will fuel your vehicle at the self-service island so that you pay only the self-serve price for fuel.

Find a Petro-Canada station with full service

At participating self-serve stations, customers with an accessible parking permit can drive up to a two-way call station located at the fuel island and press the button to speak to the attendant inside the store to request assistance with fueling their vehicle.

The following get a THUMBS DOWN:

PIONEER

(http://www.pioneer.ca/Portals/1/Images/About%20Pioneer/Pioneer%20Accessiibility%20Policy.pdf)

Pioneer’s site only speaks to assistive devices, communication, support persons and service animals, but does not address the challenge of people with physical impairments being able to refuel.

CANADIAN TIRE GAS

For non-full serve stations, people are required to schedule an appointment with the retailer for refueling.  ONRoute locations offer full serve to all customers between the hours of 7am and 10pm, 7 days a week.  For service outside of these hours, an appointment is required.  Those using the full serve through the Disability Assistance Program will be charged self-serve prices.

COSTCO and ULTRAMAR:

No information is provided. 

In summary, I was impressed by what I found and applaud Shell, Esso and Petro-Canada for being so progressive and supportive on this issue. For the rest, I presume that the Accessibility for Ontarians with Disability Act (AODA) will require those that are behind in offering disability-friendly refueling options to develop policies and procedures and to post these to be easily found on their websites.   In the meantime, I trust those drivers with mobility issues will use and benefit from what Shell, Esso and Petro-Canada have to offer people in their situation.

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O-Tip of the Week: Prevent Slips in the Tub or Shower

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living.

For the month of November, Fall Prevention Month, our O-Tip series will concentrate on preventing falls at home and in the community.

This week’s O-Tip of the Week focuses on simple ways to keep you safe in the bathroom, one of the most dangerous rooms in the home.

For a simple and inexpensive solution to improve bathroom safety we recommend using adhesive shower or tub strips which are easy to install, and provide added protection from falling when you are getting in and out or standing in the shower or tub with bare feet on a wet surface. Strips are easier to maintain and clean than a standard bath mat and stick better to the bottom of the tub or shower.

Learn more about how to improve safety in your bathroom in this episode from our OT-V series, Bathroom Safety.

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Book Review: Licit, Illicit, Prescribed – Substance Use and Occupational Therapy

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

As an occupational therapist working in private practice, I have been involved with many clients who have substance abuse issues sometimes before, but more so often after injury or trauma.  Sometimes these substances were prescribed and become misused, and sometimes clients turn to substances to cope with their new life circumstance.  Either way, it is essential that the OT role include understanding, assessing and treating the whole person while recognizing the role addiction can play in influencing a recovery path and overall function.

Released in 2016, the book Licit, Illicit, Prescribed by Dr. Niki Kiepek is an all-in-one resource to help Occupational Therapists to advance their foundational knowledge and practices skills when working with clients who have problems with substance abuse.

This book is so thorough at addressing the very complicated clinical facets of substance use and abuse that it could very readily become a textbook for OT’s in their schooling, job-training, and ongoing clinical work.  It starts by providing the important background into the occupational perspective on substance abuse and links this to the models of human occupation and engagement that are the essential backbone of our profession.   It then moves to really define addiction and the many factors that influence this and how it fits with models of health and behavior.  After a very detailed look at psychoactive substances and their pharmacological properties, and the concept of harm reduction, it dives deep into Occupational Therapy Assessment and Intervention. Complete with clinical scenarios, examples and direct techniques, any OT reading this book will be able to elevate their practice and work with clients who use substances – licit, illicit or prescribed.

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O-Tip of the Week: Ways to Prevent Sitting Disease

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

This week’s O-Tip of the Week focuses on ways to get you moving throughout the day in order to keep a healthy lifestyle and prevent sitting disease.

Bring a pair of running shoes with you to work and take a walk on your lunch and/or breaks.  Walking is great for cardiovascular and bone health and will help to prevent the negative effects of sitting all day.

Learn more ways to combat the negative effects of sitting disease in our post, Solutions to Stop Sitting Disease.