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Archive for category: Original Posts

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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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Back to Routine, Back to Ergonomics

With the change in routine through the summer months, it is time to rethink about how we are sitting and working all day to make sure our body can adjust to the new routines that are devoid of summer vacation and summer activities.

In our previous posts, we have discussed using proper ergonomics to help support your back, neck and shoulders.  Today, we look at how to reduce wrist pain and related injuries.

Wrist injuries and corresponding pain are common work-related musculoskeletal disorders that can have detrimental consequences. Repetitive hand movements completed on the job is often a key culprit, however, improper positioning of the wrists, forearm and shoulder can also be a factor. Keyboarding, use of a mouse and extended periods of sitting at a computer in one position can lead to symptoms like wrist and forearm pain, weakness, numbness or tingling in the fingers and in some cases, development of cysts or nodules around the wrist joint and tendons.

Injuries to the wrist are particularly troublesome as we heavily require use of our hands throughout the work day. Barr, Barbe and Clark (2004) reported that work-related musculoskeletal disorders of the wrist and hand cause the longest absences from work and as such, are associated with greater losses in productivity and wages than injuries in other body areas. This research was also supported by a more recent study, which found that lost productivity costs related to hand and wrist injuries was roughly $411 million dollars per year and this was the highest among any other injury type studied (de Putter, Selles, Polinder et al., 2012). There are some strategies that can be used to prevent and address wrist pain, but it is essential to keep in mind that as with any other potential for injury at work, the worker, work station and job demands must all be considered.  Some great strategies to address wrist pain at work include:

  • Take regular breaks to stretch and allow your wrists to rest. If needed, use a timer on your computer to tell you when it is time to take a break. There are several free timers you can download and use such as Focus Booster (available for download at https://www.focusboosterapp.com/download) or Orzeszek Timer (available for download at http://www.orzeszek.org/dev/timer/)
  • Alter your job demands between typing, using the phone, filing or other duties that reduce strain on the wrist.
  • Ensure you are positioned so that your wrists remain in a neutral position during typing. This may require adjusting your keyboard, mouse or chair.

Many other great solutions to address wrist pain at work can be recommended by an Occupational Therapist, with solutions ranging from low to high cost. For more information, check out Entwistle Power’s FREE Office Ergonomic E-Book or contact an Occupational Therapist to help meet the ergonomic needs of your organization.

 

Resources

Barr, A., Barbe, M. & Clark, B. (2004). Work-related musculoskeletal disorders of the hand and wrist: epidemiology, pathophysiology and sensorimotor changes. J Orthop Sports Phys Ther. Oct 2004, 34 (10), 610-627.

de Putter, C., Selles, R., Polinder, S., Panneman, M., Hovius, S. & van Beeck, E. (2012). Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study. J Bone Joint Surg Am. 2012, 94:e56 (1-7).

http://www.ccohs.ca/oshanswers/ergonomics/office/mouse/mouse_problems.html

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Home Modifications for Under $100

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

There is a misconception that home renovations for safety or disability need to be expensive.  While this can be true for large-scale projects, there are some quick-fix modifications that are small, but pack a punch.  Here is my top 10 pick of modifications you can make for under $100.

Offset Door Hinges – if the doors of your home just seem a bit too narrow1, consider that the width of the door, when open, makes the door opening smaller than it is.  Consider purchasing some recessed hinges that will allow your doors to swing as wide as your door frame, giving you an extra few inches to get through with a walker, wheelchair or commode.
(www.adapativeaccess.com)

Drawer Pulls – if knobs are too difficult to grasp, consider swapping your kitchen and bathroom hardware for U shaped pulls that require less fine motor grasp and control to open.

Easy Grip Shower Head – handheld shower heads are great for allowing people to sit to shower, or to reach difficult areas without bending and twisting, but for people with a reduced grasp, I love these Easy-Grip shower heads from Moen.

Grab Bars – these don’t need to look industrial or institutional and many colors and configurations exist.  One strategically placed grab bar can help you get out of the shower / tub or even on / off the toilet.  Consider the multi-use line from Moen that has grab bars with built in soap or toilet paper holders to help save space.  5

Threshold Ramps – these small ramps are portable and make it easier to transition over small thresholds that are often present at entry doors.   (www.electro-ease.com)

Lever Door Handles – sometimes grasping and turning a door handle can be a problem for people with arthritis or who have issues with fine motor control.  Swapping out some door knobs with lever-style handles is a quick fix to help promote someone’s ability to open and close doors themselves.

Removing Shower Doors – often shower doors can get in the way as we get older.  While some people use them to grab and hold, these have a threshold and limit the ability to use a bench or seat in the shower.  Removing the shower doors and replacing these with a curtain provides more versatility for equipment, makes it easier for a caregiver to help you shower, and is easier to clean and maintain.

Railings – installing a basic railing on any stair is an inexpensive way to greatly reduce the risk of falling when going up and down.

Adhesive Shower / Tub Strips – easy to install, these anti-slip strips give you added protection from falling when you are getting in / out or standing in the shower / 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 / shower.

Shower Seats – with or without a back, these sturdy and often height-adjustable seats allow people with reduced endurance or balance problems to sit when showering.  Sitting means less chance of falling, which can cause injury.  The smaller seats are easy to remove for other people who want to use the shower as well.

Do you feel you need a more custom approach to addressing how you manage your activities at home?  Consider the services of an Occupational Therapist as we are the functional experts!

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Are Kids Too Busy?

How busy is too busy for your kids? It seems that the extracurricular participation of kids in sports and the arts is increasing. Yet, for all this time out of the house, there is time lost for homework, play, proper meals, outdoor time and family. While keeping kids active and engaged in activities they enjoy is extremely healthy, this needs to be balanced appropriately based on the child and the resources of the family. The following from The Huffington Post discusses some key signs to look for if you are concerned that your child is overscheduled.

The Huffington Post:  10 Signs Your Kid is Too Busy

 

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Back to Routine, Back to Ergonomics

With the change in routine through the summer months, it is time to rethink about how we are sitting and working all day to make sure our body can adjust to the new routines that are devoid of summer vacation and summer activities.

In our previous posts, we have discussed using proper ergonomics to help support your back and neck.  Today, we look at how to reduce shoulder pain and related injuries.

Sloppy shoulders – are you guilty? Take a second to freeze at your desk and notice how your body is positioned. If you are like most people, your shoulders are slumped or rounded and you are bending over your desk. Many people’s work stations consist of their computer or laptop, keyboards, phone and mobile devices, requiring them to switch back and forth between devices while still spending extended periods of time in a seated, slumped position.

Being in this position for an extended period causes strain to the upper body, particularly the shoulders and upper back. At first, you may feel achy or tired in these areas, but this goes away at night or during days off work so it doesn’t impact your work performance. However, over time you may start to notice that your aches and pains begin earlier in the day, your muscles feel tight, and this starts to hamper you even when you aren’t at work. This impacts your productivity, quality of life and can lead to more serious and long-lasting injuries.

Here are some great tips to help address these issues before they start to impact your daily function, or if they do exist, to stop them from worsening:

• Lower your keyboard so your shoulders are not elevated when typing.

• Adjust your posture so you are sitting up straight in your chair, with your shoulders pulled away from your ears and your feet are flat on the floor with your knees directly over them.

• Alter your position so that you are not reaching forward to your keyboard or mouse.

• Adjust your chair so that your arms reach your desk at a 90 degree angle.

• Take regular breaks to stretch or stand up to relieve tension in your upper body.

• Stick out your chest to bring your shoulders back and down. Do this several times per day and hold this position.

Want more strategies to address pain at work? Check out our free e-book “Cost Effective Ergonomic Solutions” to learn additional strategies for addressing shoulder and upper back pain, among others, while you are sitting at your desk.

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Chronic Pain a Problem? Try OT

Co-written with Claire Hurd, Occupational Therapist

We have all, at some point, likely experienced pain.  A broken bone, sprained or strained joint, that killer headache, or even a long-term issue – pain prevents people from engaging in activities that are important to them, or at the least inhibits 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. Occupational therapists have many tools they use to assist people in this regard.

Activities that require repetitive movements or a great deal of range of motion may exacerbate pain symptoms. Even if an occupational therapist cannot fix the source of pain, they can instead adapt how a person does an activity, or where they do it and with what equipment. Occupational Therapists know about different tools and devices that can be used to modified activities to improve comfort and prevent future disability, and we stay on top of the latest and greatest devices as these hit the market. Incorporating healthy body mechanics into an activity, whether or not this is assisted with equipment, may help to manage pain. Sometimes the order of steps in the activity can be changed to make it more comfortable. Making rest breaks part of the activity is also very important.

Fatigue often affects people with chronic pain and can be a barrier to planning or doing meaningful things. Occupational therapists are well-versed in energy conservation techniques and pacing strategies, which can not only improve fatigue but can also help to decrease pain symptoms. Energy conservation and pacing can sound simple, but it can be challenging to integrate new habits into one’s life; an occupational therapist can provide an individualized system and the support to stick to it and make it routine. Good sleep hygiene, which typically includes a bedtime routine as well as avoiding substances and activities which can interfere with sleep, is also important to prevent fatigue. What constitutes an effective sleep routine is also unique to each individual, and an occupational therapist can help you find what works best for you.

One of the most difficult consequences of chronic pain is often its’ effect on mental health. Occupational therapists trained in psychotherapy can provide counseling and teach emotional coping skills. They may also provide cognitive behavioural therapy, which helps clients to change their thoughts and behaviours, in this case related to their pain. Training in the skill of mindfulness can also allow individuals with chronic pain to change the way in which they are aware of their pain in the moment, and decrease an overall perception of it.

Chronic pain is best managed with prevention and early intervention. Occupational therapists can help you ensure that how you do your favourite activities does not cause or worsen pain and that you get to participate in those meaningful life roles (old or new) despite the pain. Everyone’s experience of pain is different, and you and your therapist will work collectively as you find solutions that help you manage your pain and work on the “solutions for living”.

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Back to Routine, Back to Ergonomics

With the change in routine through the summer months, it is time to rethink about how we are sitting and working all day to make sure our body can adjust to the new routines that are devoid of summer vacation and summer activities.

In our previous post, we discussed using proper ergonomics to help support your back.  Today, we look at how to reduce neck pain and injuries.

Text Neck—are you guilty? A recent article in the two way by Laura Sullivan discusses the posture adopted by many people when leaning over a cellphone while reading and texting. This bad posture can put up to 60 pounds of pressure on the upper spine — sometimes for several hours a day, depending on how often people look at their devices.

And it isn’t just texting. Believe it or not, holding the upper body still and sitting in an upright position, as is required when spending time sitting at a desk for long times such as working at a computer, requires a lot of effort from our muscular systems. There is an invisible but constant battle against gravity to maintain the head in an upright position, at the optimum distance from the screen, combined with maintaining one’s arms in the proper typing position increases the static load on our body, especially the neck and shoulders.

The Institute of Work and Health reported that neck pain related to work is one of the most common complaints of working aged adults and in 2006 it was reported that injuries to the upper extremity account for 30% of lost-time claims in Ontario.

There are often some commonly occurring culprits in the office that lead to poor postures and over time, fatigued bodies and resulting neck pain. Some of these culprits include:

• Non-adjustable workstations

• Workstations that are not properly designed or not well suited to the individual

• Lack of knowledge and experience on how to set up and adjustable workstation properly according to the worker’s needs (being sure to consider the worker’s body and their job tasks)

• Unsuitable job design that requires workers to sit uninterrupted for longer than an hour at a time

The good news is that many of these issues can be addressed through prevention. Some great tips for adjusting work stations to prevent neck pain include:

• Making sure that your monitor is directly in front of you and does not require you to look to the side

• If your monitor is too low, raise it with a book or another solid object

• Use split screen to read two documents at once while reducing neck rotation

For more great suggestions on how you can address neck pain in the workplace, download our E-Book:  “Cost Effective Ergonomic Solutions” and check out past posts on Wellness in the Workplace.

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Financing Home Modifications

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

The foundation of the profession of Occupational Therapy is creating Person-Environment-Occupation fit.  We call this our PEO model.  What it means is that optimal function arises from the best interaction of the person, their environment, and those “occupations” that are the daily tasks they need to complete.

So, if you are struggling to complete daily activities, or are feeling that you need more support to manage at home, or are worried you might get injured falling in or around your house, perhaps you need to consider, or are considering, home modifications.

But before you get scared at the thought of a large-scale renovation, it is important to recognize that home modifications can be as small as changing some door handles to as large as installing an elevator.   There is a continuum, and your capabilities, needs, and current environment will dictate a custom approach.  So, what is the process for understanding how home modification can help, and how can you possibly fund these?  I am glad you asked…

Perhaps I am biased, but in my opinion, the process should start with an occupational therapy assessment.  If you call a contractor for a quote to say, renovate your bathroom, he will provide you with the estimate you want.  But what the contractor won’t understand is the PERSON or the OCCUPATIONS that person is struggling to complete.  For example, if there are larger issues, or bigger problems lurking, is the contractor the right person to advise you on this?  What if there are ways to improve your safety in the washroom without engaging in a full renovation of the space?  An occupational therapist will be able to problem solve your concerns with you, while recommending multiple options to consider – from inexpensive to more costly.  The few hundred dollars you will pay the OT may just save you thousands in unnecessary renovation costs.

Once you have considered all the available options, and have confirmed the scope of work, you will need to get estimates on the costs of the work involved.  It is important that you hire a vendor that has completed renovations for accessibility before, as not all contractors will have this knowledge and expertise.

Now you have your price – so how can you pay for it?  Here are some financing suggestions based on my years of experience in this field:

Insurance:

Extended Health – if you are still working, or still have access to extended health benefits, check your coverage.  Many plans have up to $10,000 in coverage for home modifications.  You will need to submit an estimate to them first for approval.

Motor Vehicle – if your disability has been the result of a motor vehicle accident, and you still have an open claim, you may be able to access funding through your insurance provider.

Veterans Affairs – if your disability has been the result of military service, Veterans Affairs may be able to provide funding.

Workplace Safety and Insurance Board – if your disability was the result of a workplace accident, and you still have an open claim, funding may be available through your WSIB.

Lenders:

Traditional Loan – if you are a homeowner with good credit, your bank may be able to provide you with a traditional loan for the monies you need.  As with all loans, there will be interested and a set repayment schedule so budgeting beforehand is important.

Line of Credit – often people borrow money using the equity in their home as collateral.  These are more flexible than a traditional loan and work more like a credit card.  However, it requires discipline to make sure you are paying off some of the principal with each payment, as only interest payments are required on a monthly basis.

Reverse Mortgage – According to the Financial Consumer Agency of Canada, a reverse mortgage “is a loan that is designed for homeowners 55 years of age and older.  Unlike an ordinary mortgage, you don’t have to make any regular or lump sum payments on a reverse mortgage. Instead, the interest on your reverse mortgage accumulates, and the equity that you have in your home decreases with time. If you sell your house or your home is no longer your principal residence, you must repay the loan and any interest that has accumulated” (Understanding Reverse Mortgages).  There are pros and cons to this arrangement, and not all lenders offer this.

Second Mortgage – A second mortgage is basically another mortgage against a property that already has a mortgage.  The second mortgage typically has a higher interest rate and is more risky for lenders and thus not all of them will offer this.

Talk to your lender or bank if you are looking to finance a renovation through one of these channels.

Government Programs:

March of Dimes – The March of Dimes Home Modification Program will provide $15,000 as a one-time home modification grant to people who qualify.  For information on this program, click here.

Ontario Renovates – Formerly the Regional Assistance Program (RAP), this is a municipally-based program for low-income homeowners.  The funding is provided to the municipalities to administer, but basically low-income homeowners apply based on modification needs related to a disability.  The proposed changes need to be prescribed by an occupational therapist and the funds are provided in a forgivable loan, and / or via grant.  The funding can even cover devices such as porch lifts, stair glides, etc.  Each municipality has different funding allotments and qualification criteria.  For the City of Hamilton, the program was just extended into 2019.  For more information about the program, click here or contact your municipality.

Healthy Homes Renovation Tax Credit – while not a loan or grant, this program does allow people to claim a taxable benefit for funds they spent on home modifications.   The maximum taxable return is 15% on $10,000 spent ($1500), and not all renovations are covered.  For more information on this grant, click here.

Remember, properly planned renovations or changes to your home can have a significant impact on how you manage, and can protect you from future injury.  You may not need one solution per problem as the best solutions are often ones that impact many areas of living in one foul swoop.  Seek the services of an Occupational Therapist so they can help you to find the best PERSON-ENVIRONMENT-OCCUPATION fit for your renovation project.