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Archive for category: Solutions For Living

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Money Matters – Occupational Therapy and Disability Finance

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

One very important subject that affects 100% of the clients I see is financial stress.

We all have been advised to save money for a “rainy day”, but the harsh reality is that people generally can’t or don’t.  And there is a huge difference between saving money to replace an appliance, or car, and saving for the costs that might be associated with ill health.  Yet, I can tell you first hand that the cost of disability is significant and comes from lost work time, medications, equipment, costs of personal care, and therapy to name a few.  When struggling to make ends meet, people encounter stress, anxiety, panic, excessive worry, loss of sleep, relationship issues, poor decision making, and can result in addictions as a form of poor coping.  You can imagine how hard it would be to heal from injury or trauma when significant money stressors are created as a result!

Occupational Therapy fits into the problem of disability and money in two ways.  First, we are often involved in quantifying injury and loss into a Future Cost of Care Report, and second, we provide direct treatment to help people manage their finances more effectively.

A Future Cost of Care Report, or Life Care Plan is the process of and calculating the current and future costs associated with your disability.  This report is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research.  The report provides an organized, concise plan for current and future needs, with associated costs, for individuals who have experienced catastrophic injury or have chronic health needs.  This includes children born with a disability or anyone that acquires a disability, ailment or impairment over their lifetime.  Most often used in medical-legal domains, these are also helpful for families that are working to quantify costs to help someone with a disability to have funding for their future.

From a treatment perspective, occupational therapists are also involved in helping people to re-balance their financial situation, or to reduce the risks and consequences of poorly coping in the face of money problems.  We work with people to establish budgets, to understand and track spending habits, to link the person to their money behavior, to help people develop a plan for better money management, to achieve financial goals, and to prioritize spending to ensure key expenses are not overlooked.  When people become stressed, anxious and depressed we treat those symptoms too and provide strategies and solutions to help people reduce their concerns and reengage in productive activities.

Occupational therapists are also well networked and help connect clients to a banker, creditor, financial advisor or financial social worker.  We might introduce them to tax or savings programs that will help them to recoup expenses or budget for future costs, and often help them to complete and submit the required paperwork to expedite access to public resources.  We are aware of funding programs in the community that can help bridge expenses and income, can fund home modifications, equipment or therapy, or can direct people to community programs that can support them for food, shelter, or other living essentials.

Occupational therapists recognize the significant impact that money problems can have on someone’s recovery and understand that if someone does not have food, shelter or safety, few other goals can or will be achieved.

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Accessibility — There’s an App For That!

Check out the great new app, Access Now, created by Maayan Ziv, a young photographer and entrepreneur from Toronto who lives with muscular dystrophy.  Maayan created Access Now to help others learn about access to places across the world.  Anyone can use the app to search and learn about the accessibility offered at public spaces and to post and share information about the accessibility of places you have visited.  Check it out now!

Access Now

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Students Learn a Valuable Lesson

Recently, in an exercise to gain empathy for a young student, the principal at Holy Family elementary school in Whitehorse tried an interesting experiment.  To allow students to realize what they often take for granted, the principal had students take turns in a wheelchair for a day.  While students were only offered a glimpse into what life is like for their fellow student, many felt the experiment helped them gain some perspective and were able to better empathize with their classmate.  Check out more on this story from CBC News.

CBC News:  Whitehorse students see what life is like in a wheelchair

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Ouch! The Occupational Therapy Role with Chronic Pain

Guest Blogger Jessica VandenBussche, 2015

Pain is a common occurrence following an injury, illness, or traumatic event like a motor vehicle accident. While pain does play an important role in alerting us to potential dangers, injury, or an impending problem, it can also become a significant barrier to function as it can often continue long after the dangerous situation resolves.  Our brain can also change such that the pain message gets so used to being sent, these can start being sent faster and easier, even in non-threatening situations.

Chronic pain is difficult to treat and manage because of all the different factors that contribute to its intensity, frequency, and the many variables that can make it better or worse. Stress, depression, feelings of loss of control, pressures at work or home, and other mental or emotional factors affect pain perception.  Further, currently, there is no objective way for medicine to quantify pain which can make it even more difficult to measure, treat, and to understand the pain experience that varies between people.

The experience of pain then remains subjective.  And as this changes frequently under the presence of other factors such as secondary injury, low mood, stress, and other environmental pressures, pain can still increase even in the face of conservative therapeutic or medical management.  Whether or not tissue damage is found, it is difficult for someone who is experiencing pain to complete activities of daily life and to fulfill the roles that make them who they are (e.g. mother, father, worker, student, athlete).  For any of us that lose the ability to manage in an important life role, this can cause significant mental and emotional losses and anguish.  If the change in roles is sustained for too long without resolution, people can develop an altered sense of self, causing more psychological hardship which can lead to higher perceptions of pain.  Then the cycle continues.  The current best practice for addressing chronic pain is a multi-method approach that addresses mental, physical and emotional issues plus the effect of pain on daily function, roles, and identity.

Occupational Therapists play a pivotal role in the assessment and treatment of physical and psycho-emotional issues including chronic pain. Through our involvement, we analyze function, work to provide solutions and help break the pain-disability cycle.  We connect people to other providers that are necessary and impactful members of the treatment team.  Occupational therapists are also well-versed in strategies to help people sleep better, move differently, and adapt to disability to reduce the limitations that result from any condition, including pain.

In short, any injury, including a car accident, can cause pain. Whether this pain is primarily physical or emotional, visible or invisible, it is important to remember that the pain experience is real and can be debilitating.  Occupational therapists are qualified to identify the psychological, cognitive and physical needs of the individual and to provide treatment to improve function in daily activities. With appropriate treatment, pain and daily function can improve, helping the individual participate in meaningful activities and to regain or maintain their sense of self.

Useful Resources

Michael G. DeGroote Pain Clinic (Formerly Chedoke Chronic Pain Management Unit), treatment option for multidimensional approach to chronic pain

The American Academy of Pain Medicine, videos to understand pain, its reasons and its effects

Entwistle Power Occupational Therapy:  Chronic Pain a Problem?  Try OT

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Travelling With Disabilities

Travelling with a disability is not easy.  It requires planning, a supportive attendant, and an open mind.  March break is around the corner and for months my clients have been asking me about travelling with a disability.  Here are some pointers:

1.    Book the trip with a travel agent who specializes in disability, either by interest or circumstance (some have disabilities themselves), if you can.  These agents understand that “accessibility” is not an inclusive term, and with personal experience, or feedback from other patrons, they can customize the trip to meet the needs of your unique situation.  Check out www.accessholidays.ca as an example.

2.    Planning goes a long way.  Send pictures of your equipment, measurements, and get pictures and measurements in return.  Disclose the nature of your disability if you are comfortable with that, and be clear about what you can and cannot do.

3.    Travel with an attendant.  On a trip to Alaska there was a man from our town also on the boat who had a mobility impairment.  He did not have an attendant with him and was constantly asking other patrons to help him.  They were willing to comply, but at times his needs were not met, and it would have been best for him and the other travellers if he had someone with him who understood these and was trained to assist him with the same.

4.    Look at all your equipment options.  Can you rent something smaller or lighter that might be easier to lift, will fit into narrower places, or can you rent devices when you arrive?  I just provided a client with photos of devices, different from the ones he uses daily, that he could consider renting to facilitate his upcoming overnight to a waterpark with his children.

5.    Become informed.  Check out these government resources. Did you know that in Canada, if you have a disability and are flying domestically, you may be eligible for extra seating, support, or your attendant can fly for free? Learn more from Westjet.  Or that Easter Seals offers a Disability Travel Card for buses and trains?  Also, if you have a disability and require someone to assist you through an airport to the gate, or at the gate through security and customs, there are special passes that can be obtained for this.  In Florida there is a rehabilitation program for people with spinal cord injuries that includes “project airport” and this takes wheelchair uses through an airport, onto a plane, and helps them understand how they can successfully manage this despite a physical impairment.  Many magazines (Abilities for one) often has articles on accessible travel and these highlight many different places that are great to visit, and some of the things to think about before you leave or when you arrive.

6.    Talk to an Occupational Therapist.  Occupational therapists have a wealth of knowledge about how people with different conditions can adapt their environment or equipment to manage.  Consider seeking our expertise if you are embarking on a journey outside of your typical space.  Together we can discuss strategies and solutions that can help ensure your vacation is successful.

Safe travels!

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Changes to Ontario’s Accessible Parking Permits

Someone with an illness, injury or disability often will require an accessible parking permit allowing them to park in the marked, accessible spaces closest to the building they are wanting to access.  Unfortunately, these spaces are often misused by those who do not need them which inhibits access for those who require them.  Some new changes to accessible parking permits in Ontario will help to reduce misuse and make parking more accessible for those who really need it.  Take a look at the following from the Ontario Government explaining the important changes which have come into effect.

Ministry of Government and Consumer Relations:  Ontario Introduces New Accessible Parking Permits

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AODA: Making Ontario Accessible. How Can an OT Help?

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, this is Ontario’s way of making the province accessible 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.  This a catch-all legislation aimed to create a culture of acceptance for people of all abilities.

So where does occupational therapy fit into this and why is this legislation important?

Occupational therapists help people with disabilities to function more safely and independently in any environment in which they need to manage.  That includes at home, work or school, for leisure pursuits, and in the community, and often involves helping people to obtain devices, products or services.  Based on my own experiences, I thought I would share my thoughts on the importance of this legislation by sharing real examples of situations where a company or employee got it wrong when trying to provide service to a consumer with a disability:

Example 1:  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”.

Example 2: The other day I was at the bank waiting for an appointment.  A patron with a cane ventured in and tripped on the scatter rug that was not lying flat on the floor.  Two staff quickly ran to her side and started pulling her up by her shoulders to get her back into standing.  The teller told me that people trip on those mats “all the time”.

Example 3: Also recently, I ventured into the community to help a client purchase an appropriate bed.  The salesperson at the store told my client (who uses a wheelchair) that he “knows about people like him”.  When my client transferred onto one of the beds in the showroom, the salesperson tried to physically assist him, and continued to try and assist even after my client told the salesperson he did not need help.  Then, after the transfer the salesperson (standing behind my client) pulled the transfer board out from under him suddenly causing my client to lose his balance.

Example 4: Or, the story of a client of mine who uses a wheelchair and ventures into a large department store where an employee at the front of the store puts a sticker on him that says “I am special”.

These scenario’s highlight why the AODA legislation is necessary.  Everyday people with disabilities are poorly serviced, spoken down to, underestimated, or encounter barriers when trying to access a product or service.  With an estimated 15% of Canadians having a disability, and the number growing rapidly with the aging population, this equates to millions of consumers that are not able to access products and services, or who are being poorly treated or physically or emotional jeopardized when they do.  Or, expanding this further, these poorly serviced consumers often shop with an attendant, family or friends, doubling the number of people witnessing this problem.

Can you see the problems in these examples?  Would you handle these situations differently?  Has your employer provided you with the education and training to know how to provide proper service to people with physical, mental or emotional impairments, visual or hearing disorders, or how to optimally service someone who may be unable to speak or write, or who shops with a support person or service dog?  Can people with physical disabilities access your building, use the washroom?  If not, your employer is already missing the mark on the AODA legislation.

While many business owners may feel that the AODA legislation is unimportant or does not need sufficient attention, I would argue that this is not something to ignore.  Not properly training staff on the ways to service all people well runs the risk of impacting a business’s reputation, sales, and overall profitability.  Imagine, for example, that I disclosed the names of the businesses above?  What would you think of those establishments?  Or, perhaps worse, if my clients went online following and shared their experiences with others on social media?  Complained to a manager?  Or got hurt and decided to sue?  Or, looking more positively, we can turn this on its head and talk about how companies would be perceived, talked about, and celebrated for getting it right.  People share great stories too and many people with disabilities have a network and community of others that they liaise with for support.

Occupational therapists have the skills, training and experience to show others how to properly service people with disabilities, from barrier-free environments to effective communication and respectful and caring interactions.  Much like you hire a plumber to fix a tap, a mechanic to fix your car, or a lawyer to draft your will, hire an occupational therapist to help you and your business become AODA compliant.

Visit our AODA Training and Education page to learn more on the services we offer.

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Pink It Forward

Today, February 24th, is Pink Shirt Day in Canada.  A day that started as a way to take a stand against the bullying of a Grade 9 student who wore a pink shirt has now spread across Canada and is prominent in schools on this day each year.  Today Canadians are encouraged to don their best pink clothing and show support by “pinking it forward” on social media.  Please visit pinkshirtday.ca/pinkitforward and share your support using the hashtag #PinkItForward on your social networks to raise awareness and funds to help put an end to bullying.

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Hoarding and Decluttering: 10 Suggestions to Free your Home and Mind

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

We all have keepsakes that are difficult to throw away. Personally, I still have a bag of stuffed animals from when I was a kid (downsized from the four garbage bags of stuffies I had when I got married), and also have a box called “sentimental stuff” that is filled with cards, letters, and keepsakes that I just can’t emotionally part with (poems from my great-grandmother, the last card my grandparents sent me before they passed away, etc).

While these items and “stuff” may be taking up some closet space, they do not significantly affect my ability to function.  That is when being a “pack rat” can cross a line and refers to the subset of the population whose life is significantly impacted from ‘stuff’ building up in their homes. In 2013 “hoarding disorder” officially became a clinical diagnosis, and it is estimated to affect 3-5% of the population.

Hoarding is defined as “persistent difficulty discarding or parting with possessions, regardless of the value others may attribute to these possessions. People with this problem accumulate a large number of possessions that often fill up or clutter active living areas of the home or workplace to the extent that their intended use is no longer possible” (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition).

This is a real disorder that has a negative impact on an individual’s emotional, physical, social, financial and even legal aspects of life. Hoarding can get in the way of a person’s ability to participate in daily meaningful occupations, which can result in a deterioration in health and wellness.

It is important for individuals struggling with hoarding to seek treatment. The two current “best treatments” for hoarding disorder are pharmacological and cognitive behavioral therapy (CBT). CBT recognizes that a person’s thoughts and feelings and behaviors are interconnected and influence one another. Occupational Therapists can use CBT to help someone with hoarding disorder address their disruptive thoughts and feelings to decrease the behavior of hoarding.

While the majority of the population does not struggle from hoarding disorder, the build-up of clutter in a home can sneak up on all of us, and lead to negative consequences such as a disorganized home, feeling discouraged and overwhelmed, and the frustration of misplacing or taking time to find items, to name a few. Here are some unique ways to decrease clutter in the home:

1. Start with 5 minutes. It can be overwhelming to start the process of decluttering, therefore, start with 5 minutes a day and be satisfied with your accomplishments at the end of this time.

2. Give one item away every day for a year. Check out www.365lessthings.com, a blog about a woman who gives away one item a day.

3. Start by filling one bag. Whether it is a donation bag or a trash bag see how quickly you can fill one bag of items to give away or throw out.

4. Do the “Closet Hanger Experiment”. Hang all your clothes with hangers in one direction. After you wear an item replace the hanger in the closet facing the other way. After one year throw away all the clothes on hangers facing the original side – you did not wear these items for a whole year!

5. Do the “12-12-12” challenge. Find 12 things to throw out, 12 things to donate and 12 things to be returned to their proper place in your home.

6. Use the “Four-Box Method”. Systematically go through each room in the house and assign every item to one of four boxes: trash, give away, keep, or relocate. Every item must be assigned something! Remember – you do not have to do this all at once, take your time to go through each room!

7. Make a list and set a time. Make a list of areas in your house you want to clean/declutter then set a time for each one (i.e. 10 minutes, 20 minutes, 40 minutes). Start with the first thing on the list and then STOP when time is up. If you did not finish that area within the given time, set a new time and try again later!

8. Try the “Travelers Method”. Think about how small a suitcase is and how you have to prioritize items when packing for a trip. Use the same mindset when decluttering.

9. Rearrange the room. Every few months rearrange furniture in major rooms (i.e. couches, desks, shelves). This will force you to find the junk that has been collecting throughout your home.

10. Play “Musical Chairs” with your closet. Remove all your clothes and hangers from the closet. Take away 5-10 hangers. Start to put your clothes back one at a time, each time assessing whether to keep the clothing item. STOP once you run out of hangers and donate remaining clothes.

A few other useful tips can include calling a friend to come to help – then reciprocate the offer, or call for a free pick-up of household items and once this is on the calendar make sure you fill a box to donate!  Diabetes and Cerebral Palsy are a few local (Ontario) programs that turn your unneeded items into charity.

Decluttering can seem like a daunting process, but using these strategies, and setting small attainable goals, can help you have a peaceful, clutter-free home and mind!