Archive for category: Original Posts


Meal Preparation: Tips to Save Time and Energy

Making healthy and satisfying meals takes a lot of time and energy.  For those living with injury, illness, or the effects of aging cooking can become something that easily zaps precious energy.  The following care of Tru-Therapy Kitchen, an OT website focused on promoting optimal function and independence in the kitchen, discusses 5 great “hacks” that can help save time and energy when making meals.

Tru-Therapy Kitchen:  5 Energy Conservation Tips for Meal Prepping


O-Tip of the Week: When Creating Goals Use Proactive and Positive Language

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 January our O-Tip series will concentrate on creating achievable resolutions and goals for the new year.

When creating your goals try changing the phrases “I hope to” or “I want to” to “I WILL.”   Let the power of a proactive and positive mind guide you to success this year!

Learn more about how the phrases you use can help you achieve success this year in the following article from our blog.

Solutions for Living:  Say “I Will…” this New Year



Blue Monday and Beyond — How to Beat the Winter Blues

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

I made a comment after the Holidays that I was slowly recovering from Christmas Affective Disorder.  For me, Christmas is stressful, hectic and challenging.  I struggle with it every year.  After the seasonal rush, it takes me days, or even weeks, to get back to my normal equilibrium.  However, really, winter despair is not a joke and for some, can be debilitating.

In fact, some research suggests that up to 15% of people in Ontario experience the “winter blues”. These leave you feeling tired, groggy, and maybe even sad or irritable.  While this causes discomfort, it is not incapacitating.  However, a more serious form of the winter blues, known as Seasonal Affective Disorder (SAD), can be.  While occurring less frequently at 2-3% of the population, the symptoms can prevent individuals from leading a normal life.  Symptoms of SAD include decreased energy, changes in appetite, especially leading to cravings for starchy or sweet foods, oversleeping and weight gain, among other things.  If you feel this is you, talk to your doctor and have your symptoms investigated.

The problem is not always the blues, but how these create a negative behavior cycle.  When you feel down, you revert, avoid, or change habits.  This leads to feeling worse and the cycle continues.  Occupational therapists (OTs) recognize the importance of being engaged in activities that are meaningful, active and productive, and understand how these contribute to health and well-being. In fact, one of the best treatments for beating the winter blues involves just “keep on keeping on” by doing what you normally do every day.  Some tips include:

  1. Use behavioral activation to keep your normal routine.  Make the bed, have a shower, prepare a decent breakfast, walk to the mail box.  Don’t change habits that are ingrained just because it is winter.  Never underestimate how damaging it can be if you avoid even small things that ultimately add up to a productive day.  Gradually try to get back to those important tasks if you have found that your daily behaviors have become unproductive.
  2. Stay active. Those that love the winter do so because they get outdoors.  Walk, ski, skate, toboggan – something to help you appreciate how wonderful a change of seasons can be.  This is best facilitated by proper clothing that will keep you warm.  If exercise is tough for you, build it into your day by default – park farther from the door, use the stairs, make a few trips from the car with the groceries to get the blood flowing.
  3. Consider light therapy. Sit by the window at lunch, get some fresh air when the sun is out, or consider purchasing an artificial light for your use at home.
  4. Up the nutrients. When some bad eating habits creep into your winter these can be hard to break come spring, and only contribute to further mood declines.  Shop in the fruit and veggie isles, and avoid the isles that house the bad foods you seem to be eating too much of.

Finding ways to help you do the things you want to, need to, or enjoy, is at the heart of occupational therapy. While the winter months can be long, dark, and cold, ultimately how we adapt to the seasonal change is up to us.  If moving or going south is not an option, consider some of the above tips to make the winter bearable, or dare I say, even enjoyable?



Seasonal Affective Disorder. (Canadian Mental Health Association, 2013)
Beat The Winter Blues (Readers Digest, no date)
Kurlansik, SL & Ibay, AD. (2012).
Seasonal Affective Disorder. Am Fam Physician. 2012 Dec 1;86(11):1037-1041.
10 Winter Depression Busters for Seasonal Affective Disorder (Borchard, no date)


Previously Posted January 2017


Better Health: Is There an App For That?

At this time of year people are focused on finding ways to improve their health and well-being.  A great way to facilitate this is through the use of technology, specifically helpful apps.  The App Store and Google Play Store feature thousands of apps for health, weight loss, smoking cessation, disease management and more, but how do you know which ones will actually help you reach your goals?  Take a look at the following from MedScape which provides rankings of the top clinically rated apps for both health and wellness and condition management and try one today!

MedScape:  Healthcare Apps to Recommend to Patients

Have you found an app that has helped you improve your health?  Please comment — we’d love to know what has and hasn’t worked for you!


O-Tip of the Week: When Setting Goals Think “SMART”

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 January our O-Tip series will concentrate on creating achievable resolutions and goals for the new year.

Make sure when setting your goals they are SMART goals.  Learn all about SMART goals in our goal planning guide, complete with a free printable to help you on your way!

Solutions for Living:  Goal Planning Guide


Increasing Form 1 Rates Equals LESS CARE for Injured People in Ontario

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

I can only imagine that the general public is getting overwhelmed and confused by all the recent media, hype and dialogue over the current state of car insurance in Ontario.  The sad reality is that until you need your car insurance because you have been injured, you are likely not going to understand it.

But for those of us that work in this sector, understanding, fighting and trying to bring clarity to the challenging opinions of government, third-party consultants and insurers is a daunting task.

My only ask is why can’t the insurance sector be ruled by logic? 

Here is my latest example:

If you are injured in a car accident you may need care.  This is time other people will spend helping you manage the most basic activities – getting dressed, showering, taking medication, being safe in your home, etc.  The monies you have available for this care is calculated through a document completed by an Occupational Therapist (or a nurse).  It is actually pretty simple – an occupational therapist does an assessment, calculates the amount of care, and that is the care that can be provided.  But here is the lack of logic in how insurer’s and the industry seem to be interpreting this form to the disadvantage of the consumer:

1.      There is a cap to the maximum amount you will get anyway.  So, if you need $8000 in care per month, you will only get $3000 or $6000 depending on if you have a catastrophic injury or not.

2.      If your family wants to provide some care, they can’t get paid any of this money unless they are off work or incur an “economic loss” to provide the care.

3.      If your family is suffering an “economic loss” providing the care, they will only be paid the amount per hour of the form, not their actual loss, and the monthly maximum applies.

4.      As per a recent “raise” for care providers, the amount that is paid per hour for the services ranges from $14.00 to $21.11 per hour.  If your family member was making more than this per hour, it would cause hardship for your family if they decided to provide your care for a lesser rate of pay.  So, your option would be to hire help.

5.      PSW’s can provide this care, but they are typically $25-$30 / hour.  So, the services you need you cannot get because they charge more than the form allows.  The result is you get less help than you need because the time runs out faster when you are paying more.

6.      If your accident happened before January 1, 2018 then you actually don’t even get today’s minimum wage for your care.  You get the minimum wage (or less) for the time that your accident happened.  So, if your accident was before October 1, 2003 you are required to find or hire care for $7.00 per hour (see the below rate chart).

7.      There are two amounts in the document.  The “total” of all the time added up, and the “minute” time calculated for each section.  Some (many) insurers are now taking the position that they will pay for the “minute” time, not the “entire time”.  So, if I assess you to need 30 minutes per day of care that comes to $210 per month, the insurer will only pay for 30 minutes per day.  But PSW companies have minimums so they won’t come to your house for 30 minutes per day – they want 2 hours at the least.  But the insurer won’t pay them for 2 hours up to $210, they will only pay for $7.00 per day.

8.      Even if you can get your care at the amounts allowed, this will still come from your total claim budget that is also used for rehabilitation.  The choice becomes – get care or get better?

All of this to say that the system is not easy to navigate and getting the care you need will prove difficult.

So, what are the options?

Well, if minimum wage is going to continue to increase then it would only seem appropriate that ALL people with an OPEN CLAIM get TODAY’s rates for care – after all, it is today that they need the services – not in the era of their date of loss. 

It would also seem appropriate that the maximums for care coverage INCREASE proportionately to the raise in care pricing.   So, if $3000 a month was an appropriate maximum in 2003 when the care was at its lowest ($7.00 / hour), then why do we have the same maximum when the care costs have doubled?

Trying some simple math…

If I was eligible for 24-hour care in 2003 at a maximum of $3000, under the Level 2 rate then (see chart) of $7.00 / hour, I could get 14 hours of care (if family was willing to work for that).

If I am eligible for 24-hour care today at a maximum of $3000, under the new Level 2 rates of $14.00 / hour, I get 7 hours of care (if family was willing to work for that).

So, increasing the minimum wage for care providers only makes people get to the maximum more quickly, providing them access to LESS CARE. Thus, in the absence of an increase in the maximum’s allowed, these higher care costs are reducing people’s ability to get the total care they need.

My suggestion is that if the industry could be ruled by logic, then the maximums would increase with the care cost changes.  Using an average of care costs, here is where I think the maximums should be:

2003 average ((9+7+15)/3) = $10.33 per hour

2018 average (($14.90+14+$21.11)/3) = $16.67 per hour

% change between 2003 to 2018 = $16.67-$10.33 / $10.33 X 100 = 61%

So, if the hourly rate has increased 61% in 15 years, then wouldn’t logic tell us that the maximums for care should also increase by that same percentage:

$3000 (maximum in 2003) becomes $4830

$6000 (maximum in 2003) becomes $9660

Auto insurers have eroded so much from the customers of Ontario over the last 8 years and while this subtle increase in care costs seem to be provided in “good faith” to align with minimum wage increases, they actually cause people to get less care as they just reach the maximums more quickly.  Then, they create significant payment issues when they nickel and dime the form and pay by the minute.  Rock meet hard place.

However, I realize fully that even if insurers decided to proportionally increase care maximums as I have suggested, I know this care now comes out of a bigger budget that includes rehabilitation (when before care had its own budget).  These budgets are currently $65,000 (was $172,000) and $1,000,000 (was $2,000,000).  But the system is currently set-up for people to have “choice” between care and rehabilitation, so I still think the choice should be fair in that at care prices today, the maximums need to be increased.

If insurers really cared about people getting the personal support they need post-accident, they would:

1.      Pay today’s rates for everyone with an open claim.

2.      Increase the maximums proportionally to the increase in hourly pay.

3.      Make it easy for people to get the care – pay to the amount of the form so people can choose to pay a bit more for private services if that is what they need – it all comes out of the same budget anyway, so I am not sure why payment needs to be made difficult too.

The choice is ultimately care or rehabilitation…too bad when our premiums remain high and the outcomes of these losses can be devastating. 

For those working in the sector, here is the chart of rates spanning the last 15 years.


O-Tip of the Week: When it Comes to Goals Don’t Just “Set It and Forget It”

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 January our O-Tip series will concentrate on creating achievable resolutions and goals for the new year.

We encourage you to set goals and resolutions not just at New Year’s, but throughout the year.

Follow our guide to help you create resolutions you can achieve and start you on your best year yet!


Never Stop Learning

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

Over the holidays we were prepping for a family ski trip.  Our children are not yet skiers, and were asking us questions about our upcoming adventure.  My oldest daughter asked my husband “Daddy, have you ever fallen when you ski”?  His response was “Of course…that is why I am a good skier – if you are not falling you are not learning anything”.  So true.

His comment got me thinking about fear, risk and how people learn.  We need to fall to know how to get back up.  We need to fail to know how to succeed.  We need to make bad decisions to know how to do it right the next time.  We need to lose money to know how to keep it.

Humans seem especially good at falling, failing and learning as children, teens and young adults – provided the people in their environment provide them with these valuable opportunities.  As adults we tend to fall and fail in our early careers, social and personal lives while we learn how to behave as an adult and to manage our growing responsibilities like work, families, homes, etc.  Then we seem to reach an age where we become teachers, leading the younger generations to grow as we have.  We still need to gain knowledge during this time, but ultimately we might be revered as wise for all we already know.  But then do we stop learning?  Or stop having the will to learn?  Do we reach a point of “knowing it all”?

I will use another example to explain why I ask these important questions.  I have a close friend whose elderly grandparents are struggling to manage in their home.  They both have health issues and struggle to mobilize, access their upper level, get into the community, and cannot care for their home as they need to.  Family is providing a significant amount of support while living in a state of constant worry.  Really, the couple are one fall or new health problem away from losing their home and being institutionalized.  My friend mentioned to the daughter of this couple that an Occupational Therapist could provide valuable insight into how they might be able to manage more safely and independently so they can stay at home.  The daughter replied “Oh, they would never go for that”.  How sad.  This couple are unwilling to learn.

With a background in Gerontology (the study of aging), I understand fully the challenges most of us will face as we age.  And as an Occupational Therapist (the study of human function) I also understand the difficulties of living with a physical, cognitive, emotional or behavioral disability – age related or not.  But the big difference I see between my younger and older clients is their willingness to learn.  My younger clients seem to want to learn what I know, they appreciate how I can help, and engage in the process of working with me to make things better.  Yet my older clients are historically much less open to suggestions.  It is more difficult to get them to consider alternative ways to manage, devices that might help, or to accept assistance to do activities that are now unsafe for them to do on their own.  My funniest example of this was a 96 year old client that told me “scooters are for old people”.

I consider myself a life-long learner.  I recently finished my MBA, am constantly reading books about business, health and wellness, I take great interest in the stories and experiences of other people, take courses, attend conferences.  I just hope that when I reach that wonderful age of ultimate maturity I will continue to appreciate the value that other people can bring to my life and situation.  And hopefully I will accept suggestions, input and ideas proactively.  Because while falling is one way to learn – like when skiing – the older we are the harder it is to get back up again.


previously posted February, 2015