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Archive for category: Solutions For Living

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Giving Back this Holiday Season

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

Tis the season for me to carefully balance my dislike for the Holiday season with my desire to not bring those around me down with my “baa-hum-bug” attitude.  My hate-on for Christmas started in my late 20’s probably around the time I had four kids under age 5 and through some lack of communication among my family, my kids had like 15 presents to unwrap EACH.  No, I am not complaining that my kids have access to such “abundance” by some very loving and well-meaning people, but with this display of affection comes a parent’s concern that their child will love Christmas because of the stuff.  And the more stuff they get, the more they want.  The more they want, the more they miss the point on the difference between want and need and the more they expect the “bar” to be raised with each passing year.

So, in my search to not pass on my “hate-on for the holidays” gene to my children, I landed on charity and acts of service to balance the fact that they, like most of their friends, live in abundance but still need to be mindful and grateful that they get a lot of what they want, while “needing” nothing.  After all, most of us can give something and there are so many options for this.  This new approach has been helping me to beat the Holiday Blues for the last few years.  It helps me to slow down, reflect, and be mindful and grateful for the things I have and can provide others, and for the pleasures of my own life. 

But in stepping out and getting my girls involved in local charities over the holidays, I have realized that there is an art to “giving” that can have the most impact.

Here are my Top 5 Things to Consider when Giving Back This Holiday Season:

Donate Money – good and responsible charities are appreciative of every dollar.  From the Salvation Army Bell Ringers to putting in a payment online or in the mail.  Money does help.  Search online with your kids to find a charity close to your heart, and have every member of the family donate.

Donate Items – some charities collect food, clothing, toys, or housewares to provide to those in need.  Time to purge those things you don’t need or use.  But before you donate items, ASK the charity what they need and HOW they want the items provided.  If they want new toys, these need to be packaged and un-used.  If they want them unwrapped then don’t take the time to wrap them – it only adds cost and time for you, and cost and time for the charity to unwrap the item before distributing.  Also, ASK what age groups they have a hard time providing for.  I was volunteering at the Good Shepherd recently and they had an abundance of items for small children, but very few for teens.  If you ask them, they will tell you the age categories they struggle to provide for.  Lastly, be sensitive.  If the charity is serving refugees or people immigrating from war-torn countries, toys that involve violence or war (i.e. guns or tanks) might not be appropriate and will need to be screened out by the charity before providing it to the recipient, again adding time and administration during a busy season.

Purchase Charity Goods – some charities sell “goods” that provide an item with a donation.  World Wildlife Federation sells small stuffed animals to represent an “endangered species” and most of the cost of the animal goes to the charity.  So, for $40.00 my child gets an “endangered stuffie” with a certificate about the animal they have adopted, and the charity gets $32.00 as a donation to their cause.  This is also true of other charities that aim to sell farm animals or agriculture supplies that are provided to third world countries.

Support Events – many charities offer dinners, auctions, or other seasonal events to raise money.  This is a great way to donate while engaging in an “experience” with a friend, partner or as a family.

Donate Time – sometimes donating your time reaps the best reward for you and the charity.  Not only does it provide you with an opportunity to see how the organization operates and allow you to be “hands on” in making a difference, it saves the charity from needing to fund staffing to manage the busy holiday season.  I have been at the Good Shepherd three times this month doing anything from sorting clothing donations, food donations, stocking housewares on the shelves in their store, and sorting toys for their Christmas hampers.  There are many organizations that just need some extra hands during the holiday season and sometimes our time is our most impactful gift.

Next week on our blog we begin our annual tradition of giving back to our readers with the 12 Days of Inspiration.  We hope you find these uplifting stories a source of inspiration and hope this Holiday Season.  

Previously Posted December 2016

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Holiday Survival O-Tip of the Week: Make a list and check it twice!

Our O-Tip of the week series delivers valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of December, one of the busiest months of the year, our O-Tip series will provide you with OT-approved ways to not just “survive the holidays,” but actually enjoy them!  In this week’s O-Tip of the week we take a page from Santa Claus himself.

December is a stressful time of year so organization is key.  Make a list.  Make multiple lists!  Plan it, buy it, store it, and then cross it off your list.  Make separate lists for separate tasks:  cards to send, presents to buy, food to coordinate, functions to attend, decorating to do – then set it and forget it.  Pull out one list a week, tackle it, and then discard.  Repeat.

Try using our printable Holiday Gift Planner to help you stay on track and stress less this Holiday Season.

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“The Cost of Caring” — Coping with Compassion Fatigue

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

Co-written with Kayla Colling, Student Occupational Therapist

There are many reasons we become health care providers.  Sometimes it is a passion for helping a certain population, a desire to help people achieve specific goals, or the recognition that people are needed to fill gaps in health care delivery.  Whatever the reason, there are physical and emotional risks that come with “helping” work.

If you are a helping or social professional who uses compassion and empathy with your clients who have experienced trauma and suffering, you may already be familiar with compassion fatigue.  Nurses, physicians, trauma therapists, social workers, workers in child protective services, and military healthcare teams are recognized to be at risk of exposure to second hand trauma through their work and may benefit from understanding and recognizing compassion fatigue.  Other health care providers, such as occupational therapists, advanced practice registered nurses (APRNs), respiratory therapists and physical therapists may also suffer the consequences of compassion fatigue in their work with people and their families that are experiencing a health crisis.

What is compassion fatigue?

Compassion fatigue is often described as the “cost of caring”.  It can also be called “secondary traumatic stress”, which is a more clinical term, but it is generally agreed that these terms are interchangeable.

Compassion fatigue occurs when providers are exposed to another person’s trauma and suffering.  This could be through routine interactions at our workplaces, when we provide compassion and empathy to clients or patients who have experienced trauma.

Symptoms

Compassion fatigue impacts individuals physically, emotionally and spiritually, and tends to have a rapid onset of symptoms.  The symptoms listed below are not exhaustive and not exclusive to compassion fatigue, so they should not be used to diagnose.  If you are concerned, consider making an appointment with your physician or other mental health worker to discuss your concerns.

Physical:  chronic fatigue, frequent headaches, gastrointestinal complaints, sleep disturbances, muscle tension, aches and pains, and anxiety.

Emotional and Spiritual:  heavy heart, emptiness, decreased sense of purpose, low self-esteem, high self-expectations, helplessness and hopelessness, numbness, apathy, depression, anger, irritability.

Behaviour Changes: avoiding or dreading work, calling in sick frequently, inability to maintain empathy, chronic lateness, overworking, and difficulty focusing and concentrating.

So it’s like burnout?

Burnout has a more gradual onset and results from an accumulation of ongoing, daily stressors at work that wear us down if we do not take proper care of ourselves and try to address the contributing workplace issues.  Symptoms of burnout tend to be more subtle and are sometimes misinterpreted.  It is still very important that we try to both address and prevent burnout, but this is clinically different from compassion fatigue.

Building Resiliency/Prevention

Although we cannot entirely prevent compassion fatigue from happening, we can take steps to reduce the risk, recognize warning signs and seek support early in order to reduce the impact on ourselves, our coworkers, our clients and our friends and families. 

By reading this blog, you have already taken a step toward learning more about it.  If we can normalize these emotions after exposure to these types of situations, it might help us to seek and accept support when we need it.

If your workplace permits, it can be helpful to have regular debriefings, even if a specific incident or crisis has not occurred.

Self-care strategies have been shown to help prevent compassion fatigue.  These strategies will likely include enhancing your boundaries to separate your work life from your home life as much as possible.  It also often involves balancing your activities outside of work as well, including engaging in a variety of relaxing, pleasurable and productive activities throughout the week.  Importantly, getting enough sleep at night and eating healthy and regular meals are also parts of self-care.  Avoiding maladaptive coping mechanisms (such as turning to alcohol, increasing smoking, eating or spending) is also important, including recognizing when things are deteriorating to get help quickly.

Practicing self-compassion can also help us to build resilience against compassion fatigue.  You can find meditations to help cultivate self-compassion, or it might be something you explore through reading, watching TedTalks, attending a course or workshop, or talking to your therapist about.  Having a regular mindfulness or meditation practice may also help you build resilience, along with other positive and adaptive outlets like exercise and social time.

Resources

If you are interested in learning more about compassion fatigue, check out the references below.

If you want to “check in” with yourself, you may be interested in looking at the Professional Quality of Life Scale (ProQOL) available here.  This scale will allow you to calculate scores on scales that consider compassion satisfaction, burnout and secondary traumatic stress (compassion fatigue).  I am not suggesting using this scale for self-diagnosis but it can sometimes be helpful to indicate if there is a concern you might want to speak to a professional about.

The symptoms of compassion fatigue can be severe – if you are concerned for your safety, please call your local crisis/distress line for support.  Find a crisis line near you.

References

Sorenson, C., Bolick, B., Wright, K. & Hamilton, R.  (2016).  Understanding compassion fatigue in healthcare providers: A review of current literature.  Journal of Nursing Scholarship, 48(5), 456-465.  doi: 10.1111/jnu.12229

Sorenson, C., Bolick, B., Wright, K. & Hamilton, R.  (2017).  An evolutionary concept analysis of compassion fatigue.  Journal of Nursing Scholarship, 49(5), 557-563.  doi: 10.1111/jnu.12312

Vu, P. &Bodenmann, P.  (2017).  Preventing, managing and treating compassion fatigue.  Swiss Archives of Neurology, Psychiatry and Psychotherapy, 168(8), 224-231.  doi: 10.4414/sanp.2017.00525

 

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“MO”-Tip of the Week: Prevent the ‘Man Cold’ (It’s a Real Thing!)

Our O-Tip of the week series delivers valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living.

For the month of Movember, a month dedicated to Men’s Health, our “MO”-Tip series will provide you with OT-approved ways to take care of the men in your life.  

Studies show that men have harsher cold and flu symptoms than women, therefore, men may not be simply exaggerating symptoms as many women claim.  That’s right… the ‘man cold’ is real!  So men, to avoid getting the dreaded ‘man cold’ or flu this season, follow these great tips care of the Center for Disease Control.

CDC:  Preventing the Flu: Good Health Habits Can Help Stop Germs

Learn more about the scientific evidence of the ‘man cold’ care of CBC News.

CBC News:  Canadian doctor says there’s evidence the ‘man flu’ is actually real

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The Cognitive Job Demands Analysis: Your Brain at Work

Many employers know that a Physical Job Demands Analysis involves a health professional outlining the physical aspects of a specific job position.  These are common in manufacturing or production industries where jobs can be heavy, repetitive, or require high physical demands.  But these reports are seldom helpful if an employee suffers a brain injury, cognitive or emotional impairment and their return to work issues relate to cognitive or psychological changes and not necessarily physical impairment.

A Cognitive Job Demands Analysis is an objective evaluation of the specific cognitive, emotional and psychological skills required to perform the essential job duties of a given position. As mentioned, traditional Job Demands Analysis typically address only the physical components of the essential job duties.  Yet, jobs are multifaceted and performance at work depends on the interplay of human physical, cognitive, emotional, behavioral and environmental factors.  As such, having a cognitive job demands analysis in conjunction with a physical job demands analysis is ideal, or these can be completed as a standalone assessment if required.

Cognitive job demands analyses can be helpful in providing a baseline measurement tool against which an individual’s cognitive and psychological capacities may be compared, such as when hiring new employees, developing and implementing training programs, or to assist in return to work post injury or illness. These comprehensive and detailed assessments can be utilized when any health condition (cognitive, physical, or emotional) impacts an employee’s thinking, cognition and/or their interpersonal processes and abilities.

Much like with a physical job demands analysis, a cognitive job demands analysis involves an on-site observation of a worker(s) completing the job in question and usually includes objective measurements, and sometimes interviews with employers and co-workers. Some of the more specific aspects examined include:

  • Hearing, vision and perception
  • Reading, writing and speech
  • Memory, attention, and higher level cognitive abilities, like problem solving, insight and judgement
  • Safety awareness
  • Work pace
  • Self-supervision
  • Deadlines and work pressure
  • Interpersonal skills required for the job
  • Self-regulation and the need to work independently, with supervision, or in a group

A comprehensive job demands analysis should include comparisons of the information obtained to standardized classification data related to occupations, such as those outlined by the National Occupational Classification 2011 proposed by Human Resources and Skills Development Canada. After a report is generated, recommendations and interventions for consideration can be developed.

Do you feel that your organization has positions that need to be outlined via a cognitive job demands analysis? Do you have more questions on how a cognitive job demands analysis can be used in the return to work process? If so, seek out the services of an Occupational Therapist, or contact us for a free consultation.

For additional informative posts on workplace health and wellness please refer to our Healthy Workplace page.

Resources

Haruko Ha, D., Page, J.J., Wietlisbach, C.M. (2013). Work evaluations and work programs. In H. McHugh Pendleton and W. Schultz-Krohn (Eds.) Pedretti’s Occupational Therapy Practice Skills for Physical Dysfunction (337-380), St. Louis, Missouri: Elsevier Mosby.

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Why You Need to Talk About End of Life Decisions

You survived the birds and bees talk… what can be more awkward than that?   Having a discussion about end of life wishes is something all adults should do with their adult children, partner, and/or loved ones.  Though the topic may be awkward and something you would rather avoid, without these conversations it is difficult for children, or powers of attorney, to make the decisions you would want if and when the need arises.  The following article care of Chatelaine Magazine reinforces the importance of having these discussions and what they should include.

Chatelaine:  How to talk to your family about end-of-life decisions

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Sparking Change in the Wake of Tragedy – ‘Buckle up for The Broncos’

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

As a kid in the 80’s I remember seeing a newspaper article about a girl that was struck by a car after exiting a school bus.  There was a picture of the girl on the ground being attended to by emergency personnel.  It was a disturbing image and I was about her age.  After that, it seemed that school buses started to have stop signs and flashing lights, and huge fines were imposed for passing a school bus when it stopped to let children on or off.  Whether these two events are directly related or not, it is true that laws tend to change when something horrible happens and people are hurt or killed.

In April of this year, tragedy struck Saskatchewan as the Humboldt Bronco’s Junior hockey team bus was in a collision with a transport truck, killing 16 people on board and seriously injuring 13 others.  Those killed and injured were teenagers, coaches, and trainers.  Could any good come of this senseless loss of life and talent?  Maybe, as those involved are asking people to #buckleupforthebroncos by encouraging the use of seat belts on tour buses if these are present. 

Transport Canada is already responding and by 2020, all newly built transport buses will be required to have seatbelts.

So, what are the current laws in Canada for this?  Well, seatbelt use falls under the jurisdiction of the provincial and territorial governments and in most provinces the law states that seatbelts must be worn if they are provided, but of course, most motor coaches are not required to be equipped with belts, so they are not always available to be worn.  That will change in 2020.

Working in the field of auto insurance where my clients are people injured in car accidents, I can state clearly that seatbelts save lives.  Bus accidents are rare but are catastrophic when they happen.  These new laws could save many lives and hopefully will reduce the significance or impact of bus-accident-related injuries.

But all of this got me thinking…my daughter is a varsity athlete for a prominent University.  I asked her if the coach bus that transports them to games and tournaments has belts.  Her answer was “no, they do not”.  I suspect this means that most University, College or Sports teams buses don’t as well, so change is necessary and if these buses can’t be retrofitted to include belts, they need to be replaced.   I too am in the sports arena as the assistant coach of a sports team and our club also travels by coach bus.  I have asked our travel coordinators to make sure our tour operators provide buses with belts, and if they don’t, to find another vendor.  Hopefully, that can help promote change — one team at a time.

We all need to buckle-up and if belts exist, use them.  Even if you don’t feel the need to wear a belt, in the event of an impact if you are unsecured you would be tossed around the inside of the vehicle, threatening the security of others.  Secure yourself, secure your belongings, and secure your passengers.  There is no logical reason not to.

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“MO”-Tip of the Week: Learn the Male-Specific Symptoms of Depression

Our O-Tip of the week series delivers valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living.

For the month of Movember, a month dedicated to Men’s Health, our “MO”-Tip series will provide you with OT-approved ways to take care of the men in your life.  

According to Movember Canada, across the world, one man takes his own life every one minute.  By learning some of the less-recognized symptoms of depression that are more prominently seen in men we may be able to prevent this.  These include:

  • Being irritable, short-tempered, or inappropriately angry
  • Spending a lot of time on work (they may be trying to escape their feelings by keeping busy)
  • Reckless driving, extreme sports, or other risky behaviours
  • Excessive controlling behavior
  • Alcohol or substance abuse (men are far more likely to abuse substances)

These behaviours are untraditional of typical depressive symptoms but mean that men who may benefit from emotional aid are often slipping under the radar for health professionals, and this can lead to disastrous consequences including poor quality of life and higher rates of suicide.  If you, or a man you know, is experiencing these symptoms speak to a healthcare professional.

This Movember, commit to walking or running 60 km in recognition of the 60 men we lose each hour to suicide.  Learn more here.

Learn more in our post, Stressed or Depressed” – Man Therapy

 

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What are Common OT Recommendations After Assessment?

Research completed by student Occupational Therapists Ashley Carnegie and Natalia Puchala, Supervisor Julie Entwistle.
Blog completed by Ashley Carnegie, Occupational Therapist

As an Evidence Based Research Project through McMaster University, Solutions for Living set out to summarize and highlight common OT recommendations after initial assessment.  The goal was to publish these findings to help student OTs, or OTs looking to enter the sector, to understand the scope, depth and breadth of the recommendations we tend to make.  Here are the highlights of our research findings, the completed study will be submitted for publication to OT journals when finalized.

Occupational Therapists play a valued role in Ontario’s auto insurance sector. In this, Occupational Therapists are hired by lawyers for assessment and treatment, or by insurers to conduct Insurance Examinations. Assessments usually start the OT service delivery process and serve to determine and outline the impact the client’s motor vehicle collision, and resulting injuries has had on all aspects of their previous life (e.g. self-care, productivity, leisure).  These assessments end with recommendations for the treatment and care that are needed to help the client recover. Occupational therapy treatment recommendations are designed to support clients in maximizing their potential to return to pre-accident function in all areas of life.

Despite the 1000+ Ontario Occupational Therapists working in this role, available literature about this sector is limited and does not adequately capture the role of occupational therapy in this setting. Therefore, in this study, a retrospective chart review was conducted of 205 occupational therapy assessments conducted with clients who had a motor vehicle collision. The aim, as indicated earlier, was to summarize OT recommendations post-assessment to help others interested in learning more about this area of practice. Recognizably, Solutions for Living by Entwistle Power Occupational Therapy was the only company involved in this chart review, and different companies may, and are likely to, have different findings.  Further, clients seen for OT assessment are already pre-screened to be eligible candidates for service, and thus assessments with “no recommendations” are unlikely.

Through the 205 charts reviewed, the results demonstrated the following:

Common Injuries

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Intervention Recommendations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

These interventions are in-line with best practices and standard treatment for the most common injuries identified in this study.

Surprisingly, only 3% of OT assessments recommended use of the OTA in treatment delivery, highlighting that most OTs tend to initiate treatment directly.  It is felt that therapists may introduce OTA later in treatment once rapport with the client has been established, but the use of OTA early for some education and device delivery may prove more cost-effective and is something OT’s should consider.

Additional Results

Attendant care: 91% of clients needed attendant care. The average dollar amount recommended for attendant care was $3565, the median was $1733, and the range was between $0 and $10,544. A trend was identified between number of injuries and attendant care recommendations; The amount of attendant care recommended increased with the number of injuries.

Assistive Devices: 91% of clients needed assistive devices. The average dollar amount for devices was $757.46, the median was $397.94, and the range was between $0 and $5670.

Occupational therapy treatment: The average number of occupational therapy treatment sessions recommended was 6; with an average duration of 12 weeks. Injury or number of injuries was not predictive of OT sessions or duration recommended.  Notably, however, recommendations are often made to conservatively encourage insurer approval and only represent the first treatment block.  Multiple blocks of treatment are common.

This retrospective chart review outlined typical injuries, common intervention recommendations, and recommendations for attendant care and assistive devices following an occupational therapy assessment. Although there is some uniformity in recommendations, the lack of consistency indicates the customization taken by OT’s in assessing for client’s unique and specific needs.  This individualized approach is necessary and encouraged as being best-practice and client-centered.  Of further note, it was evidenced that OT’s play a very important part in system navigation and help to outline and connect the client to other necessary providers.   Doctors, lawyers, insurers and other professionals should recognize that OT’s are valuable front-line providers and can be the keystone to helping clients to get the help they need.

As demonstrated, Occupational Therapists play a vital role in Ontario’s auto insurance sector and their assessments are pivotal in helping clients to get care, devices, education and treatment, along with connection to other professionals. This study is the first to showcase the OT role in Ontario’s insurance sector, and more research is needed to look more closely at OT service delivery.

Stay tuned for the entire research study with its methods, findings and recommended next steps.  We will be sure to circulate the article on our blog once published

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Invisible Disabilities and the Impact of OT

A new interview series by fellow Occupational Therapist Karen Gilbert called The Art and Science of Everyday Living is shedding light onto the value of Occupational Therapy for those with “invisible” health conditions.  Covering topics like living with chronic pain, chronic fatigue, and anxiety, Karen interviews Occupational Therapists who share their resources and best practices.  Check it out!

The Art and Science of Everyday Living