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Archive for category: Occupational Therapy At Work

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Ecotherapy: Harness Nature’s Healing Power

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

Of all the ways I take care of myself, my daily walk outdoors with my dogs is one of the most therapeutic.  The only things that keep me from being outside daily would be a horrible rainstorm or temperatures that are too cold for my dogs to endure.

Not only does seeing my dogs enjoying the scents of nature lift my spirits, but the fresh air, sunshine, sounds of nature (or my music, depends on the day), sights of the birds (the hawks are my favorite), trees (and sometimes deer, bunnies and even coyotes) distracts me from the stress of the world, even if just for precious mindful moments.

The below article highlights the concept of Nature Therapy and outlines how sometimes we should consider using the sights and sounds of the outdoor world around us for valuable healing opportunities.

The Hamilton Spectator:  Nature might be the prescription for what ails you

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O-Tip of the Week: Identify What is Helping and What is Hindering Your Success

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 working to achieve any goal there will be things that both help you and hinder you.  We refer to these as facilitators and barriers respectively.  When planning goals identify the facilitators and barriers you expect and have available to you.  This step will help you to create an achievable plan.  It is also helpful, when you regularly monitor your progress, to identify unanticipated barriers and facilitators you have found while trying to achieve your goal.

Try using our FREE printable Barrier and Facilitator Goal Planning Worksheets (below) to get you closer to success today!

 

 

 

 

 

 

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Book Review: Better Now: Six Big Ideas to Improve Healthcare for All Canadians

Guest Blogger Lauren Heinken, Student Occupational Therapist

For anyone with an interest in how Canada’s single-payer medicare system works and how it may be improved, this book written by Dr. Danielle Martin and released earlier this year is a must-read. Although it is written from a medical perspective, the author appreciates that an individual’s health is dependent on much more than biology, and the active role individuals need to play in their own medical care is emphasized throughout the book. Dr. Martin takes the time to acknowledge the psychosocial factors that can impact well-being, and as a whole her perspective aligns well with the profession of Occupational Therapists. Better Now: Six Big Ideas to Improve Healthcare for All Canadians is written in such a way that it can be appreciated by anyone who reads it, but those who have direct contact or personal experience with Canada’s medical system may benefit the most from it’s content.

The book’s introduction showcases Dr. Martin’s rational stance on many issues that at times provoke excessive fear amongst Canadians. An example of such an issue is the economic impact that the country’s aging population may have on the healthcare system. This book is able to provide an alternative, and often more optimistic view, on these “hot” issues compared with the fear-provoking opinions that are often shared through other media sources.

Each of the “six big ideas” discussed in this book form a chapter, and each chapter begins with Dr. Martin introducing a real-life patient case that demonstrates and supports the idea. Aside from providing a human component to the systems-level issues discussed in this book, these patient cases are useful in providing an opportunity for readers to apply chapter content to an actual user of the healthcare system. This helps facilitates readers being able to wrap their heads around what truly are “big ideas”.

You may be questioning what the relevance of this book is to OT practice. An issue identified within the book is that our medical system tends to be one that is largely disjointed, with different parts of the system often not communicating clearly with one another. This lack of connectivity comes at a cost to both individuals who use the system and those who fund it. Although implementation of better communication technology will play a large part in addressing this problem, I would argue that it could at least be improved if health practitioners and those administering the system knew a little bit more about what each other did. This book is a good way for OTs to learn more about the medical system, and they may potentially use this knowledge to influence a smoother and more cohesive system experience for their clients. It also better equips OTs to provide appropriate answers to questions they might be asked that relate to navigating the healthcare system.

The only disappointment in this book is the absence of the OT profession when Dr. Martin speaks to “other healthcare professionals”. OTs have the potential to make big contributions to proactive healthcare, but also to improving how the system functions and these are not explicitly considered in this book. However, OTs know their scopes best and have the skills to advocate for their contributions, so their absence in this book creates an opportunity for them to fill the gap.   How?  Stay-tuned for this to be discussed in a later blog post. 

 

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Community Safety for Alzheimer’s Disease and Cognitive Impairment

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

In recognition of Alzheimer’s Awareness Month, I wanted to touch on the important topic of helping people with Alzheimer’s disease (or cognitive impairment) to be safe in the community.

A few months back I received an email from a friend. She wanted to “pick my brain” about a problem they were encountering with her father who has Alzheimer’s disease. She mentioned that he enjoys spending time in the community on his own, but the family was growing increasingly concerned about his safety. She was wondering if I had any suggestions on how they could monitor his community activities, and be able to locate him should he not return home when expected.

My experience working in brain injury has had me looking for such solutions in the past. Some people, with behavioral or cognitive impairment, are at risk in the community because they become disoriented, confused, lose track of time, or are not attentive to traffic. There is such a loss of independence for people to be told they cannot leave the home alone, and some become agitated or angry when people try to supervise their activities. Yet, even a familiar route can become a problem for people if their cognitive status changes or deteriorates, and what is manageable one day may become problematic the next. Part of my role as an occupational therapist when dealing with cognitive impairment is to problem solve with the client and family the ways we can help them to pursue their goal of independence outside the home, while also ensuring their safety and easing the mind of the care provider. There are several ways to do this, and the list below is not exhaustive by any means.

  1. Consider the local Police Departments. These often have programs and ways to track people at risk of wandering. It is also helpful to notify the police about a potential wanderer so this is in their records should their help be needed.
  2. The S-911 bracelet has multiple features that allows health care workers and families to GPS locate anyone that may have wandered off, or who is in the community unsupervised. There is a monthly and yearly fee for this device.
  3. The Loc8tor is another option and notifies a care giver (or parent of a child for that matter) if the person wearing the device has wandered up to a certain distance away. The Loc8tor is also useful for helping people to find those items that tend to get misplaced – such as keys, wallets and cell phones.
  4. Smartphones have GPS detection capabilities such as the “Find my Friends” application for the iPhone. With this, both users can locate the other person, but it does require the person to be carrying the phone, and the phone to be charged and on. This can be a problem for people with cognitive impairment as they may not always remember to take the phone with them when out, may not understand how to turn this on and / or to check and see if it is charged.
  5. There are home monitoring systems that can notify family when people are coming or going, or even bed alarms if people leave the bed at night. Motion sensors in the home can also help to notify family if someone is wandering or moving between locations indoors. While these don’t work to locate or ensure someone’s safety outside the home, they are a way to give family members piece of mind to go about business inside the home without always needing to provide the person with cognitive impairment constant supervision.

Remember that Occupational Therapy is about helping people to solve the problems that arise when physical, emotional or cognitive abilities change rendering daily activities to become a struggle. In all cases, because disability is experienced differently by everyone, the solution for one person may not be the solution for another – even when dealing with the same diagnosis. So, consult an OT if you have a functional problem to solve!

Previously Posted September 2014

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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?

 

Resources:

Seasonal Affective Disorder. (Canadian Mental Health Association, 2013) http://www.cmha.ca/mental_health/seasonal-affective-disorder-sad/
Beat The Winter Blues (Readers Digest, no date) http://www.readersdigest.ca/health/healthy-living/beat-winter-blues
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) http://psychcentral.com/blog/archives/2012/12/30/10-winter-depression-busters-for-seasonal-affective-disorder/

 

Previously Posted January 2017

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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!

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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

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HIV/AIDS and the Role of Occupational Therapy

Guest Blogger:  Samantha Langan, Occupational Therapist

Today people around the world will be wearing red ribbons to support World AIDS Day. This day of recognition started in 1988 to provide people with an opportunity to unite in the fight against Human Immunodeficiency Virus (HIV), show support for those who are living with HIV and to also commemorate those who have died. According to the Joint United Nations Programme on HIV/AIDS, 34 million people were living with HIV worldwide in 2011. In 2012, The Public Health Agency of Canada reported 2062 new cases of HIV, but it is expected that others are also living with the condition, not yet knowing they have been infected. There continues to be many myths and stereotypes around how HIV is transmitted and stigma remains for those living with HIV. Unfortunately, there isn’t yet a cure for this, but the disease is preventable.

Human Immunodeficiency Virus is a virus that attacks our body’s immune system, and over time, weakens our immune system to the point where it can no longer fight off bacteria, viruses, parasites, and even cancers. These diseases, known as opportunistic infections, can progress in the body of a person living with HIV and become what is known as Acquired Immune Deficiency Syndrome, or AIDS. While those living with HIV do experience difficulties, HIV is now considered a long-term chronic illness that can be treated to help prolong and improve quality of life for those living with HIV/AIDS.

HIV is known to health professionals as an “episodic disability”, which means that for people living with the virus, symptoms can fluctuate unpredictably. Some common symptoms include muscle weakness, fatigue, changes in sensation in the hands and feet, decreased concentration and thinking, digestive problems, chronic pain as well as depression or anxiety. As symptoms can vary, people with HIV / AIDS can experience difficulty carrying out everyday activities like taking care of themselves, managing at home and attending work.

Occupational therapists support and empower people with all forms of disabilities and can assist people living with HIV to better manage in their desired activities despite unpredictable and on-going symptoms. In fact, occupational therapists work with those living with HIV by helping them to: manage their energy despite pain and fluctuating symptoms, find ways to adapt to tasks to make them more manageable, obtain devices that can improve safely and independence when completing daily tasks. Occupational therapists can also help people manage the emotional consequences associated with the condition, and can develop strategies to assist with cognitive changes should these exist. Another great way occupational therapists are helping those with HIV is through education and by providing strategies for them to be able to self-manage their disease. This is essential since HIV is a long-term illness. For more information about HIV/AIDS, check out the links below, or talk to an Occupational Therapist about how we help.

Resources
http://www.worldaidsday.org/about-world-aids-day.php
http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2012/dec/index-eng.php
http://healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/hiv-vih-eng.php

 

originally posted December 1, 2014

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O-Tip of the Week: Properly Recover from a Fall

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.

Despite best efforts to reduce the risk of falling at home and in the community, falls DO still occur.  It is important to be aware of the steps to take to get up from a fall to help prevent further injury.

The following from the 2017 Fall Prevention Month Toolkit provides step-by-step instructions to safely get up from a fall:  

Find more helpful resources on Fall Prevention by visiting http://fallpreventionmonth.ca/.

 

 

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What Does the Current Housing Market Mean for Those with Unique Accessibility Needs?

Guest Blogger Lauren Heinken, Student Occupational Therapist

The Current Market

Over the last few years housing prices have been on the rise throughout most of Canada. The GTA in particular has seen soaring real estate prices, but this done little to deter buyers. Houses are selling quickly, and sellers often receive multiple offers that are well above asking price. This makes purchasing a home difficult, and those with accessibility needs may face additional challenges throughout this process.  This, combined with an aging population of people trying to downsize or find more “suitable” homes, makes for a unique opportunity to enlist the expertise of an Occupational Therapist (OT) for buying consultation.

An Unlikely Partnership

It is not often that one would think of an OT partnering with a real estate agent or broker to provide homebuyer services.  However, this synergy, as I will explain, could have beneficial outcomes for all involved.

OTs are all about helping people function, and our homes are at the core of where we spend most of our time.  The home can be a support or a barrier to our physical, mental and emotional health.  It can help us go about our daily activities easily, or can make managing a struggle.  It can impact our mood – positively or negatively and either be a determinant of good health, or a cause of injury, sickness or death.   Therefore, finding the right home is essential for reasons beyond just aesthetics, price tag and neighborhood.   Yet, homes vary greatly, and the current real estate market moves quickly, so finding just the right fit, especially for those with a disability, can prove difficult.

An OT is well suited to assist in the home buying/modification process, and can bridge the knowledge gap that may exist in addressing the unique needs of the person with realtors who have their own knowledge of homes, the housing market, and the buying process.  Realtors and OT’s joining forces has the potential to change the way people with unique accessibility needs shop for, and purchase, their next home.

The infographic below summarizes a potential service delivery model involving OT and real estate:

Payment for Services and Benefits to the Real Estate Agent or Brokerage

Funding for this service could come from multiple sources, including the real estate agent or brokerage, the customer themselves, and there are also grants and charitable funding options that might be available.  If the real estate brokerage is providing payment they will incur OT fees as part of their cost, so as to provide an accessible home buying experience for their clients.  Having this service as an available option may help the agent or broker to attract a new segment of the home buyer population, thereby increasing their own marketability and profitability in this area. This would ideally produce positive economic gains for the brokerage that far exceed the costs they will be paying for OT consultation.  Or, at the least, the OT should be a “vendor” on the list of other vendors the agent typically supplies to clients during the buy / sell phase (i.e. like movers, stagers, painters etc.).  Then, the client can call the OT to discuss pricing as they would any other supplier.

As the OT profession grows over time, opportunities for partnership with other professionals outside of the usual allied health circle are going to become increasingly common. Thinking forward to opportunities that may exist creates the opportunity for OT’s and other professionals to work together for optimal service outcomes.