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Archive for category: Occupational Therapy At Work

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The Anxiety of Social Media

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written with Jacquelyn Bonneville, Occupational Therapist

I can only imagine how it must feel to be a teenager in today’s era of technology and social media.  When I was young, our social circles were those we could call, or see at school, in the neighborhood, at camp, or when playing sports.  If we did something wrong, embarrassing, or “bad” it could only ripple so far in the small puddle that surrounded us.  Now, that puddle is an ocean and our activities, photos, thoughts and feelings can not only reach people that we would not otherwise engage with, but can extend across continents.

Over the last decade researchers have been attempting to capture the good, the bad, and the ugly of social media, with mixed results. Social media platforms include websites like Instagram, Facebook, Twitter, and LinkedIn. People of all ages are engaging in social media, as it becomes one of the most predominant forms of communication. Social media has its benefits and risks, and as the rate of anxiety in North America rises it is important to consider how and why you may be using social media, and what it may be doing to your health.

In some ways, social media is not a new concept at its core. Humans have always desired information, gratification, and social exchange to a certain extent – they also require opportunities to de-stress, to socially disengage, or to feel surrounded by others and yet not obliged to interact with them. Social media trends have made it increasingly more difficult to switch off, leading many to feel constantly bombarded by notifications of what others are doing, thinking, saying, feeling (good or bad).

The concept of instant gratification is now more prominent than ever, with instant “likes”, comments, “re-tweets”, or number of “shares” available, and many strive to measure their social success in these numbers. As social media instant gratification is almost a new norm in society, this is likely to transcend into offline world. How will this expectation of instant gratification affect our ability to be patient with life events that typically take a long time to achieve, such as relationships or career development? What is all this pressure to be well-liked (literally) on social media doing to teens who are developing their social identities in the midst of a social, public world? What does online popularity mean for people who are easily influenced, or have low self-esteem and self-concept? These are questions many therapists are now addressing regularly in sessions with teens and adults alike.

You may have heard hot-topic terms like Facebook Addiction Disorder and Social Media Anxiety Disorder; though neither of these are valid diagnoses currently, it points to the notion that a serious shift is happening in our society. Social Media helps us to create a highlight-reel of our lives – either the life we are living, or the life we want to live – and we only post the things we want people to see and this is often enhanced, truth-stretched, fabricated, sepia-toned, and cropped. It leads people to believe that this is what college is supposed to be like, or what my summer is supposed to look like, or how I’m supposed to look as a mother out with my children. Some literature suggests that social media may be holding us up to completely unrealistic expectations, resulting in us feeling less pride for our accomplishments, and more anxious about how we may be measuring up. For more information on this, and an interesting video of youth explaining social media related anxiety, check out these two articles:

The Very Real Anxiety That Comes From Texting, ‘Likes’ And FOMO

Yale psychiatrist has one explanation for why students these days are so anxious

A study published by The New York Times in 2015 reports anxiety is now the #1 mental health diagnosis on college campuses. The constant comparisons, fear of missing out (or ‘FOMO’ as it is often phrased), and misinterpretations of texts are certainly impacting the mental wellness of people of all ages. As a result, anxiety rates are rising exponentially.

Self-reflection is an important tool often encouraged by therapists to help you understand your own behaviour. Occupational Therapists may encourage self-reflection through mindfulness techniques. For instance, why do you use social media? Look at your last status update or picture upload; why did you post that? Maybe the last interaction with social media you had was to write a comment on a co-worker’s LinkedIn profile, and you believe the reason why you did so was to support their competency of certain skills in hopes of maybe boosting their reputation. Now, think deeper than that, to subconscious reasons that may have also motivated you for doing this: Does it make you look like a good coworker or friend for doing that? Does it help spread your name to gain more connections based on who views their profile? Would you be even a little upset if they didn’t return the favour? So, it is important to ask yourself the question: Why am I really posting this? How does it make me feel afterwards? How am I hoping to make others feel?  Do I have a motive deeper than a simple “like”?

It is important to check-in with yourself regarding your thoughts about social media and why you use it, and to respect that the youth of today have entirely different challenges socially than you may have had. To completely withdraw from social media, or to stop your children from using it entirely, may actually be more harmful than good. However, if your urge to use social media becomes so strong that it is negatively affecting your relationships, work, enjoyment in your accomplishments, time-spending, or if it’s making you feel anxious, professionals like Occupational Therapists (especially those with additional training in Psychotherapy) can be an excellent resource to help get you back to functioning in a way that is meaningful and enjoyable for you. OTs are experts and understanding competing life demands, and have a wealth of experience and knowledge helping people to rebalance into productive function.

For other strategies on how to attempt to manage social media related anxiety, check out:

How to Calm Your Social Media Anxiety

In the end, the verdict is still out on the benefits and risks of social media – from a mental health perspective.  Personally, I could not find what I could call “authenticity” on Facebook but still found myself checking this too often.  So I decided to go on a hiatus and have not returned.  I miss the funny videos and seeing photos of my friends’ children, but don’t miss the ads, bothersome images, or personal crusades that people use this platform to promote.  The most important thing here is behavioral regulation – check your screen time, understand your thoughts, feelings and behaviors when engaging in Social Media and make changes if you are not happy with what you find.  And good luck – kicking or changing any habit is not easy!

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Accessible Clothing Can Be Fashionable Too!

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-Written with Jacquelyn Bonneville, Occupational Therapist

As occupational therapists, we often see clients experience issues with dressing after an injury or as a result of a disability.  How do you dress when you have one arm?  Or, how can you don pants, socks and shoes when you have not feeling or movement in your lower body?  What about managing zippers and buttons with reduced fine motor control?  Spasms, reduced range of motion, the inability to stand for dressing, or body changes that make clothing options limited?  There are many reasons why dressing can become a problem.

As a society use fashion for several reasons – to manage the weather, for privacy from sensitive parts, and as an expression of ourselves.  Clothing and clothing choices are important.

Business-wear and athletic wear are two areas of fashion that are generally limiting for persons with dressing challenges.  For this blog we wanted to introduce some simple, but still fashionable and functional, adaptations that can help manage the task of dressing if this has become difficult!

Lock Laces or Elastic Shoe Laces

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Elastic and lock shoelaces are permanently tied, and allow for stretch of the shoe when putting it on or taking it off. This makes it a functional, inexpensive solution for anyone who doesn’t want to worry about their laces coming undone (especially athletes!), or for people who struggle with tying their shoelaces tight enough, or with the intricacies of actually tying the laces.  Note that often these are great in combination with a long handled shoehorn.

Nike Flyease LeBron Sneakers

Nike LeBron Flyease Sneakers (http://store.nike.com/us/en_us/pd/zoom-lebron-soldier-9-flyease-basketball-shoe/pid-10327129/pgid-10327127)

Nike recently announced their release of slip-on ‘wrap-around-fasten’ shoes that are fashionable, basketball style high-top sneakers (designed with basketball superstar LeBron James). Though designed for young adults with Cerebral Palsy initially, this shoe is suitable for anyone who wants some stylish sneakers, without the hassle of laces. See the press release for more information and a video explaining the story behind these sneakers.

Under Armour Magzip

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Zippers are often an integral part of our Canadian Fall and Winter attire to help secure our clothing to keep us warm. Zippers can actually be very challenging to co-ordinate for many reasons, and Under Armour tackled “fixing the zipper” in 2014 with their Magzip technology in a variety of unisex athletic-wear styles. The bottom part of the zipper is magnetic, meaning that it is far easier to ‘thread’ and pull up than a standard zipper, without sacrificing athletic hoodie style. See the press release for more information and a video explaining the technology.

One-handed Snap-Belts

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Standard business attire (or even picture day at elementary school) often calls for a nice belt, and there are many options available online for snap-belts that do not require the threading of a traditional belt such as the RD Adaptive Apparel Snap-Belt pictured here.

Rollin Wear Jeans

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Jeans are a staple of many wardrobes, but they certainly shift and move when people are sitting or standing. For people who spend a lot of time sitting, including office workers and people who use wheelchairs, jeans can be extremely uncomfortable; jeans regularly have rivets on the back pocket which can cause discomfort while seated, they have the same rise around the waist so when you sit they are either too low or bunch up, and the front button can dig into your waist when you sit down.

Rollinwear has designed a line of jeans designed for wheelchair users that offer an easier ring to work the zipper, a clasp instead of a front button, and are overall designed with the different body position of a person while sitting instead of standing. Be sure to look online for other companies offering similar adaptive jean designs!

Part of the role of Occupational Therapy is to have insight and knowledge about products that will help an individual function independently, without sacrificing style, priorities, or efficiency. For more information about customized products that may work for your individual needs, speak with an Occupational Therapist!

As a last inspiring thought, check out this link to the story of a beautiful athletic-wear teen model with Down Syndrome who is changing perceptions of disability, while being stylish at the same time.

 

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Tackling Tough Transitions: Strategies to Find the Silver Linings

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written with Lindsay Sinclair, Occupational Therapist

Throughout our lives we all experience transitions. Whether it is a new job, retirement, the loss of a relationship, change in function due to injury or illness, or a change in environment, transitions are inevitable.  Although transitions can be exciting, positive experiences, there is also a sense of anxiety and fear that is associated with the loss of the past and fear of the future. While feelings of nervousness and pessimism are common during life-change, there are strategies that can make transitions easier, helpings us recognize the silver linings in difficult situations, and transition into a brighter future.

The first important thing to realize about a transition, is that it is different than change. Change is something that happens to people in their lives, whereas a transition is the mental process that occurs as they go through that change. Put this way, change is somewhat out of our control, whereas we have the ability to control transitions through our thoughts and actions.

When it comes to controlling our thoughts about change, there are many strategies that can help turn negative rumination into positive hopes and dreams. First, it is important to accept change. When we play the “what if” game it is similar to trying to row a boat upstream (we won’t be going anywhere and it takes a lot of energy). If we can accept the change, and let the river take us where it is intending, we can enjoy the ride and get to our destination more smoothly. To accept change we can take comfort in the fact that there are elements of our lives that will stay the same, and at the end of the day, no matter what situation we are in, we are fundamentally the same person, regardless of the changes we will encounter.

One strategy to use to think more positively is to recognize when we are having negative thoughts and replace them with positive ones. For example, “What could be good about this change?”, “What new opportunities has this change brought me?”, “What am I thankful for in my life?”, “How has this change been a learning and growing experience?” Although on the surface some changes may seem to be only negative, the truth is that every change does bring something positive to someone’s life.

Reflecting can be an activity that helps foster positive thoughts during a transition. Whether it is journaling, blogging, or just thinking during a long walk, it is important to process emotions and deal with change. During reflection, we can think about all the times in our life we have been through a change, note the strategies that helped us through change in the past, and remind ourselves that we have successfully been through change before.

trans2Another strategy that helps during a change is to engage in behaviours that will facilitate a positive transition. During change, take things one step at a time; set small attainable goals, and connect these to long term goals for the future. Goal setting allows us to take back control over a situation and work towards something meaningful, which can help alleviate the anxiety of change caused by lack of control.

To make transitions easier, engage in meaningful activity. When we isolate ourselves and become inactive, our physical and emotional health are affected, as we are left with too much time to ruminate. Participating in activities we enjoy can help make us feel more connected to who we truly are. For example, engaging in active exercise can boost positive feelings. Furthermore, by engaging in meaningful activities, we can connect with a new community, school, or group, which can help us integrate into a new environment.

Connecting with a social support system, or building a new social support system, is an important step in navigating transition. Finding a mentor who has been through a similar change, and seeking their advice on how they navigated change may be a helpful step to work through difficult times.

A useful quote for thinking about change is: “A ship is safe in a harbor, but that’s not what ships are for.” This quote serves as a reminder that safety is not productive but is merely a resting point, and we had to get to the harbor in the first place.  So, if you are “in the harbor” get the rest you need before leaving port and venturing to another destination.

In the end, change is part of life and it helps people to grow and strengthen. Change is inevitable, and often times, uncontrollable, but transitions are not. We are in control of our own transition process, and we have the power to turn negative and suffocating experiences into a positive learning experience that enables our boat to sail onward.

If you are struggling with a change, or transition, and seem to be stuck in port, considering the services of an occupational therapist for helping you to become “unstuck” in a place that is likely not functional or productive for you.

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Tough Conversations

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

My grandmother always used to say “once an adult, twice a child”.  She was referring to the fact that we start life dependent, and through the aging process, tend to end our life that way as well.  So, what happens when the grown-up “child” needs to become the caregiving adult in a relationship with an aging parent?  It leads to many tough conversations about some pretty big topics.  Recognizing that some conversations are not only difficult, but could cause relationship-changing outcomes, I wanted to give you some pointers for handling the big ticket items adult children might encounter with their aging parents:

Driving

We all have a societal obligation to ensure that the roads are safe.  Just like a parent not giving the keys to a teen that has not demonstrated adequate driving skills, adults need to look for this in their older parents too.  While some seniors self-retire their license when they feel they are unsafe, some are not as willing, or able, to make this decision.  I remember my grandmother stopped driving when one day behind the wheel she “woke up and the light was green”.  While we joked about this as a family, we applauded her for making a responsible decision.

Making sure your parents are able to drive safely is important for them, and the general public.  So how do you manage this?  Next time you are out with your parent drive separately and follow them, or get them to drive with you in the car.  Watch for the following:

  • Are they driving to slow or too fast?  Note that driving too slow can be just as dangerous as driving too fast.
  • Are they obeying the traffic signs?
  • Do they have the range of motion to look both ways and check blind spots?  Are they looking around at stop signs, when merging lanes?
  • How are they negotiating directions, are they getting lost frequently?
  • Do they seem to be driving aggressively, or do they seem oblivious to other drivers, cyclists or pedestrians?
  • Do they obey right of ways, manage one-way streets, can they park the car safely and easily in a lot or on a side-street?

If you have concerns about any of the above, you have a moral obligation to bring your concerns to their attention, or to the attention of their treating physician.  If you choose to have this discussion with them directly, be caring and compassionate, but direct.  Tell them about your concerns but instead of just telling them they shouldn’t drive, suggest the involvement of a professional like their doctor, an occupational therapist, or driving assessment.  If you are not comfortable having this conversation with them, bring your concerns to the attention of their treating physician so they can do their own assessment.

Home Modifications

Most seniors want to remain in their own home as long as possible.  Many recognize that some small changes to the home could have a big impact on their safety and function, and some are very hesitant to consider modifications.  I remember I once had a call from a physician who was calling about his own parents, expressing concerns about his mother and how she was managing at home.  We talked about the value of OT and he agreed that a home assessment would help her.  He then asked “so, what should I say to her to get her to agree to this”?  I found that surprising as even as a physician who is required to have difficult conversations with people all the time, he struggled to know how to approach his mom.  I suggested he tell her that he recognizes it was very important to her to stay at home as long as possible, and that he is concerned that if she falls, staying home might not be an option.  I told him to tell her that he wants to have an occupational therapist come and talk to her about her safety to make sure they are doing everything possible to keep her living at home for as long as she can.  He called his mom, and like a kid planning a sleepover, called back and said “it worked, she said yes”!

I think it is important for adults of aging parents to demystify the home modification process and stress to their parents that most changes are minor, removable, or will actually increase the value of their home, while keeping them there for as long as possible.

But honestly, the best approach is usually letting a professional explain to the aging parent what can be done, and what they should consider either now, or in the future, to ensure their home continues to work for them.  In that case, the difficult conversation is more getting the professional in the door, instead of trying to convince the parent of the changes that you feel (without full knowledge of the options) might be needed.  Occupational therapists are great at getting a sense of what people need, explaining the options, and coming up with a plan.  I always chuckle when I meet with seniors and the first thing they say is “I know my son says we need X, Y and Z, but just so you know we are not doing that”.

Relocation

There may come a time when being the primary caregiver of an aging parent who is trying to live at home, may become too much. Caregiving is a difficult task that often requires time, knowledge or a level of commitment that a working adult-child who might have children of their own, just does not have. Having a discussion with your parent about the need to relocate to get access to skilled or more available care, is difficult.  Like the other conversations, tell your parent that their safety is your primary concern and that you are willing to do all you can to help them get the care they need.  Remind them of your own capabilities and the other responsibilities that you are also trying to balance.  Framing your conversation this way will go a long way to show them you are being supportive, and not just trying to tell them what to do or how to do it.

In the end, yes these conversations will be difficult, but your parents need your love, support and guidance as they navigate the aging process.  I remember having a difficult conversation with my grandmother about her decision to use a walker instead of her wheelchair, when the wheelchair was much safer for her.  She was giving me a hard time and I reminded her that she taught us to care about each other so the fact that I care about her safety was actually her own fault.  She laughed and we had a great conversation about her fears about declining mobility and reducing independence.

I wish you the best as you navigate these difficult conversations with your parents.  But remember, sometimes involving a professional (like an OT) who can assess the situation, come up with solutions, and develop a plan may go a long way to maintaining the parent / adult-child relationship, while keeping the parent safe at the same time.

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Christmas Gifts That Are OT Approved!

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

If you’re a keen and organized shopper, I’m sure you have the majority of your holiday gifts already purchased, and if you’re anything like my Mother had everything done and wrapped in August! However, if you’re anything like my husband, you are waiting until the 24th to think about Christmas.

Although Santa and his Elves are hard at work building the toys your children put on their Christmas wish list, there may be a few items you still need to purchase.

We consulted our talented team of Pediatric Occupational Therapists and are happy to provide you with some fun but functional gift inspiration. These are gifts that are educational and stimulate child development:

1. BOOKS: Although technically not toys, books make an excellent gift. Fostering a love of reading in children from an early age is essential in development of language and literacy skills, while building creativity and imagination. And so many types of books exist! Beyond regular books, pop-up books, and interactive books, there are even books where you can record your voice, or the voice of a loved one into the story so that person is “reading” to your child. This is great for those people in your life who are out of town and are not able to “read” bedtime stories in person.

2. TOYS THAT MAKE THEM THINK: Look for puzzles, games, shaper sorters, science kits and more. Problem solving through play is fantastic for the mind and will help them become independent problem solvers in life. But be prepared to explore and learn with them. Interactive parent-child time through new learning is also essential to development!

3. TOYS THAT GET THEM MOVING: We’re living in the sedentary age of technology where obesity is on the rise. Try some active toys like a skipping rope, scooter, ride on toy, a bike or winter sports gear like skates, skis or snowshoes. But with all riding toys, include the helmet too! Keeping kids active is extremely important for both their physical and mental health!

4. TOYS THAT BRING OUT THEIR CREATIVE SIDE: Fostering creativity in kids at an early age is important for their development. Looks for gifts that will encourage them to be creative like art kits, dress up clothes or crafts and supplies.

5. AN EXPERIENCE THEY WON’T FORGET: Too many toys to choose from? Why not treat the children to an experience instead. Consider tickets to a sporting event, a play, or musical or a child-appropriate concert. Special events like these create fantastic memories and can strengthen family bonds.

We hope you find some gift inspiration from our tips and with you very Happy Holidays!

 

Originally posted December 8, 2014

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Aging in Place

Co-written with Claire Hurd

If you are an “empty nester” you may start to think how this phase in your life relates to your home and ongoing need for a larger space that previously accommodated a growing family.  Or, for some with kids out of the house, married and with their own families, they want to start spending time in a warmer climate, or want to move closer to their grandchildren.  Some will even consider moving in with their children to help raise the next generation, or because financially this is the most suitable option.  Whatever the reason, housing can be a massive contributor to function as we age, and there are several things to consider.

Universal design:
Universal design, or inclusive design, has the goal of maximizing usability for all, without sacrificing aesthetics when possible. You have probably seen universal design in many public spaces, but it can be incorporated into homes as well.  Examples of this may include lever door handles rather than knobs, raised outlets and lowered light switches, and large flat panel switches rather than small toggle versions. Many new homes are being designed to be “visitable,” with a basic level of universal design, including a smooth, ground level entrances without stairs, a wheelchair accessible main floor bathroom, wide doors, and wide hallways with room to maneuver a mobility device. When touring a potential new home, see if principles of universal design have been included. If you are renovating, consider including universal design elements in layout and fixtures.

Layout:
 Bungalows and condos are usually the most accessible options. Stair lifts are expensive, and the more landings or turns there are, the more they cost. It is also difficult to install them on curved staircases. Some side split designs may be conducive to elevator installation, but side or split-level homes are more difficult to accommodate in the event of mobility decline.

Bathrooms:
Bathrooms should have room to maneuver a mobility device. “Comfort height” toilets are a few centimetres taller than standard toilets, more like a standard chair, and make sitting down and standing up easier. A walk-in shower, or, better yet, a roll-in shower with no ledge to step over, will be accessible by family members and guests who may have temporary or more permanent mobility challenges.

Kitchens:
If possible, have variable counter heights in the kitchen, to make food preparation easier for taller adults, shorter children, and individuals who need to sit. Recessed areas underneath countertops and appliances can accommodate mobility devices or chairs. Ensure that lighting is good in all task areas. Rounded corners prevent injuries. Casement windows are more readily opened than the traditional double-hung styles.

Outdoors:
Gardening is a great activity for mind, body, and soul, but bending and kneeling on the ground can be difficult for many people. Raised flower beds and container gardens are a great solution.

Location, location, location:
Even if a house or apartment is otherwise perfect and accessible, if it’s in the middle of nowhere or in a neighbourhood that feels unsafe, it may not promote its occupants’ wellbeing. Proximity to services, such as grocery stores and public transportation, not only prevents social isolation, but may decrease potentially unwanted dependence on others.

Accessibility can benefit health, wellbeing and safety for anyone – regardless of physical or cognitive limitation. If you have more specific questions about how you can help yourself or others age comfortably in place, consider consulting with an occupational therapist.  Occupational therapists are trained to assess the person, their environment and the tasks they need to complete in the places they live and work.  So, before you make potentially costly mistakes in planning how you can better manage the “job of living”, give an OT a call.

 

For more information on Aging in Place and other helpful topics for Senior’s please visit our Senior’s Health page.

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Help Make OT Services More Affordable For All

The profession of Occupational Therapy is holistic, comprehensive, and addresses the many challenges children, adults and seniors face throughout the lifespan.  Through direct therapy, education, devices, and consultation, Occupational Therapy helps people to manage better physically, emotionally, cognitively and behaviorally while completing tasks at home, work, school, or in the community.  So, if OT is so helpful, why is it not included on most benefit plans?  It is time to help people to have access to this impactful profession!

You can help by signing and sharing the petition by clicking on the link below. By signing you are asking for insurance companies, major unions and large employers to recognize OT as a valuable service and include OT services in Extended Health Benefits.

Together we can create change!

Change.org:  Include Occupational Therapy on Extended Health Benefit Plans

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Fall Prevention Toolkit

Falls are the leading cause of injury amoung older adults in Canada and the number one cause of brain and spinal cord injury in seniors.  November is fall prevention month and to assist others in working to prevent the dangers the Ontario Injury Prevention Resource Centre has compiled a toolkit.  Check it out to help seniors prevent falls.

Ontario Injury Prevention Resource Centre:  Fall Prevention Month