Archive for category: Seniors Health


Forgot Where You Left Your Keys… Should You Be Concerned?

Do you have trouble remembering where you left your keys?  Is it hard for you to remember the name of the person you were just introduced to?  Many who experience these momentary memory lapses often feel it’s cause for concern, but that’s not always the case.  The following from WebMD discusses a study which looked at memory in young and older adults and explains why these forgetful moments sometimes occur.

If you are concerned about your cognition and memory as you age there are great ways to keep your mind sharp!  Read a book, do a Sudoku or crossword puzzle, learn a language, stay social, or try one of our weekly mind benders.  Frequently using your brain will help to keep you on the ball through the years!

WebMD:  Midlife Memory Lapses May Be Normal Part of Aging


Preventing Brain Injury

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

Previously posted June1, 2015

“An ounce of prevention is worth a pound of cure.”  Benjamin Franklin

In recognition of Brain Injury Awareness month, I thought it would be fitting to start at the very beginning. PREVENTION. Really, it is the best medicine. For now, let’s forget about the symptoms of brain injury and its’ impact on work, home, school, and quality of life. Let’s not talk about how it is assessed and treated. Instead, let’s focus on trying to stop it from happening in the first place.

But even before that, we need to know what we are dealing with. It is well known that brain Injury is the leading cause of death and disability worldwide. In Canada, Traumatic Brain Injury (TBI) is more common than breast cancer, spinal cord injury, HIV/AIDS, and multiple sclerosis (MS) combined. There are approximately 18,000 TBI hospitalizations annually. In the province of Ontario, 25% of the two million people diagnosed with a neurological condition have suffered from a TBI. In 2000-2001 brain injuries accounted for $151.7-million in direct costs to Canadians (1).

By way of distribution, TBI is most common in children (0-19) at 30%, followed by seniors (60+) at 29%. In kids, falls are the most common cause followed by motor vehicle accidents and then sports. In adults, motor vehicle accidents cause the most TBI’s, and in seniors the causes include falls (76%) followed by car accidents (2).

Knowing the causes helps to look at how we can engage in preventative strategies. As an occupational therapist with a background in health promotion, a parent of four, and athlete, here are my thoughts:


Kids fall all the time, so how can we prevent that? Well, there is a difference between a child falling when walking, running or jumping, versus falling from, say, a shopping cart, off of a playground structure, or from a tree they tried to climb. Falls from bikes, skateboards and scooters are going to happen – and a helmet can mean the difference between a head injury and not. The bottom line is that falls in kids are best prevented by proper adult supervision. Yes, it is that simple.

In seniors, falls take on a different form. They are not from carefree or reckless behavior, but often happen when someone is just trying to go about their day by having a shower, coming down the stairs, or taking a leisurely walk. Seniors need to be attuned to the physical, balance and vision changes they are experiencing as they age, and need to consider the importance of anti-slip mats in the bathroom, removing scatter mats, installing grab bars or railings, and the benefits of a walking stick or cane when outdoors. Seniors need to engage in regular exercise and activity to maintain bone density, mobility and intact balance. They have to be very careful when living with pets or when trying to negotiate places that are cluttered or dark. Awareness of declining abilities is the first key to addressing these properly such that a prevention plan can be developed that will ultimately improve safety and reduce the risks. Note that the services of an occupational therapist can be pivotal in creating this safety plan.

Check out our OT-V episode “Fall Prevention” for more helpful information.

Motor Vehicle Accidents

Like falls, despite our best intentions, these can and do happen. The issue here is trying to minimize the risk and optimize the outcome. Safe drivers are attentive, undistracted, and alert. They travel at safe speeds, approach intersections with caution, stop behind the line, pass when appropriate, and recognize that rushing to get somewhere on time is useless if it means you never get there at all. Safe drivers don’t text or hold a phone to their ear, don’t eat a hamburger and steer with their knees, and don’t drive when tired. If you are one of these drivers you are going to increase your chances of avoiding a collision, and lower your chances of being the cause. Unfortunately, however, not everyone is a safe driver. So, all the rest of us can do is wear our seat belt, buy a car with a good safety rating, make sure everyone in the car is buckled properly, make sure the headrest is at a proper height, put loose belongings in the trunk (I know of a child who got a head injury from a flying jar of pickles that escaped the grocery bag during a collision), and follow the rules for child seats.


I am an avid athlete and have pretty much played or tried every sport. There are very few sports I dislike and I honestly feel that sports can be the most positive and influential outlet for young people, and one of the most engaging and social outlets for adults. The issue is that sports seem to be becoming more and more competitive, kids and adults are getting bigger and stronger, and the culture of some sports has changed from friendly competition to all-out war. Preventing head injury in sport can include outfitting your kids with proper equipment (many hockey parents spend more on a stick than a helmet), ensuring they are playing at their level, monitoring the coaching influence and team culture to make sure this is appropriate, and my favorite is from the book “The Secrets of Successful Families” and includes that the only job of a parent in organized sport is to “shut up and cheer”. No parent should be on the sidelines encouraging reckless, mean or harmful behavior. The results can be devastating. And if you are concerned about your child’s risk of head injury in sport, know that there are many other sports that reduce the risk but are equally as challenging, competitive, fun and have the same physical, cognitive and developmental benefits.

So, let’s start our recognition of Brain Injury Awareness Month by practicing prevention. It does not have to be easier said than done.




The Business of AODA

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

As an occupational therapist, business owner, and MBA, I can’t help but to reflect on the colossal legislation that is the Accessibility for Ontarians with Disabilities Act, or AODA.  If you are not familiar, the AODA is Ontario’s way of making the province accessible by 2025 by addressing the following key areas so that people with disabilities can more fully participate in their communities:  customer service, employment, information and communication, transportation, and design of public spaces.

Here are some real examples of poor service that demonstrate why such a legislation is needed:

  • A few months back I was taking an ailing relative to an appointment at a lawyer’s office.  We arrived and the building was poorly marked.  We tried a couple of entrances and walked around the building a few times.  We finally found the entrance and were met with three flights of long and windy stairs.  We climbed these slowly and when greeted by the lawyer he said “you should have told me stairs were a problem and I could have met you at home”.  My response was “how could we have known that your office was on the third floor of a commercial building that lacked and elevator, and if a home visit was an option, this was never explained to us”.  NOT AODA compliant.
  • The other day I was at the bank waiting for an appointment.  A patron with a cane ventured in and promptly tripped on the scatter rug that was not lying flat on the floor.  Two staff quickly ran to her side and started reefing on her shoulders to get her back into standing.  The teller told me that people trip on those mats “all the time”.  NOT AODA compliant.
  • Or, the story of a client of mine who uses a wheelchair and ventures into a large department store where a “greeter” puts a sticker on him that says “I am special”.  NOT AODA compliant.

Would you, or the people of your organization, make these mistakes?  Do you even know what the mistakes are?  Does your organization know how to manage these situations better, with tact, and preventatively?

My business hat tells me that business owners will respond to the AODA in one of three ways: “it won’t happen to me”, “tick the box” or “this is important”.

It Won’t Happen to Me

These are the group of owners that will ignore the legislation and not fear the result.  They won’t care about the impression they leave on people that may try to access their services but can’t.  Or the people that may try to get into their building and can’t.  Or the people that will try to use their website and can’t.  They won’t concern themselves with the comments lost consumers may spread about how they felt or how unfortunate it was to encounter such correctable barriers.   These owners feel confident in the fact that not being able to meet the needs of a disabled customer will not impact their reputation or bottom line.  They sleep well and don’t concern themselves morally or ethically with the possible ill experience of one lost consumer who really just wanted to have equal access.

Tick the Box

These owners will review the legislation and will make sure they do the bare minimum.  They will send someone from HR, or one employee, to a one hour seminar on how to provide service to people with disabilities and that person will return and teach the rest of the team.  They will “tick the box” that they did some AODA customer service training and will hope that this is enough.  These owners do care about potential customers with disabilities and recognize that while 15% of people in Ontario have a disability, even more are caregivers, parents of a disabled child, or that the demographic shift with the aging population will make AODA even more important.  While they care, they don’t care enough to actually ensure they get it right.  They feel the bare minimum will be better than nothing, and will hope that their staff at the least don’t upset or hurt someone that may try to access their building, or their services.

This is Important

This is the group of concerned owners that want to hit the nail on the head.  They don’t believe in doing the bare minimum because they are interested in providing amazing service to all customers.  These owners are forward thinkers that recognize the growing number of disabled consumers, and see how the ripple effect from one person’s great experience can transfer to a story told to many.  These owners want to have caring and compassionate staff that are comfortable helping a visually impaired client sign forms, or a client with a hearing impairment to get information over the phone.  They embrace everyone that enters their building and know how to offer great service without saying the wrong thing or without the fear of coming across as condescending or ignorant.

I guess what box you fit into will ultimately depend on your:

1. Risk tolerance – can you tolerate a bad reputation, poor social media reviews or comments, or the threat of being sued over failure to comply?

2.  Values – do you care about people with disabilities and the experience they get from your organization?  Do you value being seen as caring, compassionate, and accommodating?

3.  Resources – do you have the time, interest or resources to invest in thorough and proactive solutions?  Will you take the time to explore the options and to provide your team with the most practical and useful training?

4.  Goals – is one of your goals to provide exceptional service to all?  Do you see a customer as a customer, all having equal value and an equal opportunity to not only benefit from your service, but to also benefit your bottom line?  If your goal is business success then the AODA is nothing to ignore.

Let me demystify how my examples earlier could have been handled better:

  • When we called the lawyer to book our appointment, his receptionist could have simply indicated “please be aware that we have three flights of stairs to our office and the building is not equipped with an elevator.  If that may pose a challenge for you or your relative, please be aware that we can also meet you at home”.
  • When the lady fell at the bank, the staff could have asked “do you need us to call 911 for help, are you okay to try and stand, or how can we help you”?  Then, before lifting her by the arms they should have asked “how can we best help you back into standing, will holding your arms to help you rise be okay for you”?
  • The “greeter” at the department store could have simply greeted my client in the wheelchair to say “I hope our store is easy for you to manage and that you can access all the things you are looking for.  If you need any assistance, or would like to consider using one of our scooters, I am here to help”.

What kind of owner are you?


Pedestrian Safety

In cities across Ontario pedestrian deaths are on the rise, and statistics are showing the elderly are affected most.  A report from the Ontario Coroner in 2012 found that those older than 65 accounted for 36% of pedestrian deaths in Ontario, while the population of those age 65 and older is only 13%.  This is an alarming statistic.  Many blame distracted driving, the prevalence of larger vehicles and city design for this increase.  Whatever the cause, something must be done.  Do you think the new traffic laws under the “Making Ontario Roads Safer Act” can make a difference?

Metro News:  Elderly pedestrian deaths on the rise in Toronto


A Practical Guide to Barrier Free Design

There is a greater awareness in society that our buildings and spaces must be more accessible to all.  In Ontario, the Accessibility for Ontarians with Disabilities Act (AODA) is ensuring that all businesses are accessible by 2025 in many ways, including design of public spaces.

Today we focus on the physical environment.  This is where barrier free design comes into focus.  What is barrier free design? It involves designing spaces, both public and private, to allow access for the greatest majority of people.

Some common barriers include:

  •  Curbs
  •  Uneven sidewalks
  •  Stairs
  •  Heavy doors
  •  Absence of handrails

In the following video from our OT-V series we discuss these obstacles and how occupational therapists promote accessibility, and assist individuals and businesses with creating a barrier free environment.



Life is a Terminal Disease – Palliative Care and Occupational Therapy

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

Originally posted May 4, 2014

It was a life-changing experience. I was 19 and essentially never stopped. I had goals, drive, energy, and big plans for my future. I was a varsity athlete, had three jobs, was a full time university student, owned a student house, and had bought myself a dog. Knowing I wanted to work in healthcare, and after strongly connecting to some school courses in death and dying, I decided to pursue a volunteering opportunity at the local Hospice Society. This required a comprehensive training program followed by placement in the home of someone who had a terminal disease. My first (and only) placement was with a mom, age 37, who was dying of cancer. She had a 7 year old daughter and a husband who was also ill. I would attend their home once a week to spend time with the daughter, help to prepare meals, and would even assist with running errands and groceries. I provided emotional support and mentoring to a scared little girl, and was an extra set of hands for a dad and desperate husband. I was fortunate enough to be involved with the family for many years as the mother passed about a month after my wedding – four years after I met them. My husband and I tried to stay in touch with the daughter following, but dad really struggled and eventually his phone was disconnected.

The impact of this experience on me personally was huge. The things my parents had been telling me were true: “stop to smell the roses”, “don’t sweat the small stuff”, “make sure you have fun too”…I was intense and driven to the point of missing it. My experience in Hospice changed my outlook, my appreciation for my health, family and all those blessings that we take for granted daily.

Recognizing it is National Hospice Palliative Care Week, I wanted to showcase the role of Occupational Therapy in this challenging but rewarding field. To do this, I reached out to a colleague who has spent many years practicing occupational therapy in palliative care settings. Her reflections are as follows:

What I have learned is that Palliative Care is not particularly a specific intervention but rather a perspective of care that can be provided in a multitude of settings where end of life is faced such as our homes, hospitals, hospices or long term care facilities.

The Canadian Hospice Palliative Care Association defines End-of-life care as aiming to relieve suffering and improve the quality of living while dying for persons diagnosed with an advanced or terminal illness or who are bereaved.

Who defines how the client is suffering (physically, emotionally, spiritually) or that what we as healthcare providers do is indeed improving quality of living while dying? In a truly client centered approach, it is the client or their substitute decision maker that determines this. A collaborative interprofessional team has the potential to honour the client’s hopes and decisions in an identified plan of care.

The Canadian Association of Occupational Therapists identifies various interventions in palliative care, based upon clinical setting, that the therapist can provide including addressing activities of daily living (ADLs), psychological and emotional issues (including stress and anxiety), exercise programs, splinting and positioning, energy conservation, relaxation techniques, seating and mobility, comfort, adaptive and assistive equipment, support and education for the family caregivers, connecting the client with community services and supports, and conducting home assessments.

What this can look like is, for example, providing mobility devices such as a walker or wheelchair to address declining physical abilities while maintaining engagement with family in a safe manner. Considerations also include provision of therapeutic surfaces whether on a bed, wheelchair or favourite recliner to help reduce the development of pressure ulcers once time spent sitting or lying in bed increases. It can be planning and preparing with the client and the team to assist the client attend a final function such as a family wedding where comfort, endurance and being relatively symptom free are the goals.

Ultimately, as roles in life are challenged due to losses with life limiting illnesses, the Occupational Therapist attempts to facilitate meaningful engagement that reflects a client’s goals in a dignified manner.

Carla Floriani, OT Reg Ont

I want to thank Carla for providing this insight and for guest-blogging on our site. Personally, I miss my volunteer work in Hospice but know that this is something I will eventually return to as it impacted me in a way I have not forgotten. The harsh reality is that life is a terminal disease – but we should not need to be given a deadline to act that way.


Promoting Safe Driving In Older Adults

In our previous blog, Senior Safety– Occupational Therapy Can Help!, we included information on how there are now almost 6 million seniors over age 65.  With this growing population, how can we ensure older adults are safe, secure, and maintain independence, especially on the road?

Seniors are the fastest growing segment of the driving population. Driving helps older adults remain mobile and independent in their community. This form of transportation provides the most convenient means to access the places and people that are important to them. Unfortunately, as seniors grow older they are more likely to experience age and health-related changes that can impact their medical fitness to drive.  However, not every senior is affected; hence, understanding the impact on functional abilities, rather than age, is key to preventing crashes and injuries.

Occupational Therapy can help seniors who drive by:

·        Educating seniors and family members on proper driving techniques

·        Assisting them to properly “fit” their vehicles. Ensure you have a clear line of sight over the steering wheel

·        Creating solutions to barriers through developing programs to improve safe driving

·        Consult on different forms of transportation

·        Recommend adaptive equipment to enhance your driving habits

Driving is an important part of mobility and independence for Canadian seniors.  Entwistle Power and McMaster University partnered together this past spring to host a CarFit event that was aimed at educating seniors about their personal vehicles.

What is CarFit?

CarFit is an educational program that offers older adults safety information along with the opportunity to verify how well their personal vehicles “fit” them and their needs. The event consists of 12 stations which will assist older adults to learn how well their vehicle fits them and their needs.

The Carfit program was designed to:

·        Promote continued safe driving and mobility among older drivers through education not evaluation

·        Create an open environment that promotes conversations about driving

·        Provide information, education and community based resources to older drivers in a quick and easily accessible manner.

Why do we need CarFit?

CarFit programs help drivers assess and adjust their seat position, mirrors, head restraints, and controls. Many people buy cars, and just jump in and drive off. Most often, they do not and are unaware of how to adjust all the safety features to their maximum effectiveness. With the technological advances of the automotive industry, automakers have been making strides to designing vehicles that are beneficial for older adults. Designing controls with larger buttons, blind spot detection systems, rear – backup cameras, lane departure warning systems have all had a profound impact on the safety and convenience of technology for senior drivers. However, with some design changes, they’ve created smaller windows, thicker windshields and roof pillars, which limit a senior’s visibility. Complicated technology control systems can be distracting or difficult to use and may be distracting. With older adults representing the fastest growing population of drivers, it’s important to understand the proper fit of vehicles to promote safety for older drivers.  CarFit helps to provide education and strategies on how to achieve the safest fit.

CarFit is a community-based program which consists of working through a 12-item checklist to provide participants with information about on how well they and their car work together. These stations include tips on the following:

·        Proper use of seat belt

·        Position of steering wheel tilt/ head restraint

·        Proper distance between chest and steering wheel

·        A clear line of sight above steering wheel

·        Proper positioning to gas pedal

·        Proper positioning to the brake pedal

·        Adjusting mirrors

·        Appropriate Neck mobility to check blind spots

·        Safe use of ignition key

·        Operation of vehicle controls

·        Overall use of the vehicle

Does your vehicle fit you?  What can you do?

Finding out if you have the proper fit for your vehicle is essential for both your safety and the safety of others around you.  Do you have a clear view out your window? Can you reach and manage all of your controls? Is your seatbelt secure and properly fitted? Making these small adjustments can provide a huge impact through improving your comfort, control and confidence behind the wheel!

During our CarFit event, we provided education to help twelve older adults adjust their vehicles to their own unique needs. Participants left with:

·        Recommendations on car adjustment and adaptations

·        Education on the benefits of occupational therapy

·        Information regarding local resources and assistive equipment

This was the first CarFit event hosted in Hamilton, Ontario. While much was involved with hosting the event and getting things organized, our participants expressed satisfaction with being part of this experience – we hope we have started a tradition!

Interested in learning more?

If you or someone you know is interested in attending a CarFit event in the future, you can:

·         Visit CAOT’s CarFit Page, or contact your nearest CAA store for future CarFit event listings

·         Connect with us on Social Media, and keep an eye out for topics related to older adults

·         Explore for driving research and resources for older adults

·         Phone Entwistle Power Occupational Therapy at 1-866-683-0345 or email us to inquire about our occupational therapy services that can support you and/or your loved ones to age well.