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Archive for category: Solutions For Living

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Occupation Is: Managing a Household

Remember:  Occupational Therapists define the word “occupation” as the way people “occupy” their time.  So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?).  In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

Let’s just assume that we have done all the important stuff.  We have slept, are out of bed, groomed, dressed, fed, are done being productive, and did some fun stuff in between.  Eventually, like it or not, we need to tackle the not-fun stuff.

The interesting thing about “not-fun stuff” is that everyone defines this so differently.  Each of us has our own unique interests, abilities, and standards when it comes to groceries, laundry, cleaning and managing our yard and property.  Personally, I loathe grocery shopping (and anything that is meal preparation) and would rather cut the lawn then use a vacuum.  My kids do their own laundry as of age 10 because it has a wonderful built in consequence.  No laundry = no clothes to wear and I don’t need to say a thing.  Besides, I don’t think asking them to start doing this at 16 will go as well.  With six of us in our house, and two animals, the meal responsibilities, cleaning, and shopping tasks are time consuming.  However, all off these things are another layer in my lasagna of “occupations”.

Imagine you are in a car accident and spend a few weeks in hospital.  Your spouse, friend, mother, brother, someone, has to swoop in and help with your children, pets or house.  Eventually you come home and find that things have not been done to your standards, if done at all, and it will be months before you will have the ability to get back to these tasks independently.  The look of your home and property is stressful for you, the meals are different, and you are home all day to notice.  Or maybe you weren’t in a car accident, but have a progressive illness or medical condition that renders you to be no longer able to complete heavier tasks, but you try diligently to manage the smaller tasks within your abilities but this too is now declining.   Perhaps you have sustained a brain injury and your memory is lacking for when things were last accomplished, or when you try to go to the store you end up missing half of the items on your list, if you even take one.  Or worse, the store is an overwhelming place for you considering the visual and auditory stressors from any busy shopping environment.  Maybe mood is the problem:  depression and anxiety can be significant barriers to getting things done, but yet the more things are not done, the more depressed and anxious you become. The cycle continues.

Managing a household and all the tasks included in this, is very much an occupation.  It is a separate set of demands from personal care, earning an income, or managing our productive time.  Occupational therapists routinely help clients to return to the occupation that is managing a home.  There are multiple strategies that can be used for people with brain injuries, chronic pain, or social phobias to return successfully to grocery shopping.  There are also multiple aids available that makes light and heavy cleaning easier.  We often need to help people break down tasks into smaller chunks, or educate people on pacing as a means to get things accomplished.  Education on proper body mechanics is also very useful at reducing strain on recovering shoulders, necks and backs for things like lifting, carrying, reaching, and bending.  Outdoor tasks are more difficult to resume, simply because they are heavier, but many of the same principles apply.  If behavior, mood or avoidance are the problem, we have strategies and tools to help with that also.  We believe that most functional problems have a solution.

Occupations are therefore all the things included in managing your home.  These tasks can be heavy, time consuming, and “not-fun”, but they are a necessary part of living.  If you are struggling to get these things done, or know someone else who is, occupational therapy can help.

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How Healthy Is Your Place of Work?

October is Healthy Workplace Month in Canada.  Many people tend to think of health more outside the workplace, however, in reality we all spend a considerable amount of time at work.   Have you ever reflected on how healthy your work environment and work habits are?  The focus of this year’s Healthy Workplace Month is on Mental Health.  Stress is everywhere, regardless of the job, and managing this is vital to our overall health.  The following article gives tips on how to manage and reduce workplace stress.

Stress at Work

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Occupation Is: Managing Your Finances

Remember:  Occupational Therapists define the word “occupation” as the way people “occupy” their time.  So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?).  In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

It is no secret that there are physical, mental and emotional consequences of stress.  Access to money is a basic human need as food, shelter, and emotional security are all impacted by our ability to provide for ourselves and our family.  As such, the stress created from a lack of money, or drastic and sudden loss of income, is significant.  In the economic crisis of 2008, there was mounting evidence that financial issues were causing a whole host of associated health problems including a rise in reports of headaches, backaches, ulcers, increased blood pressure, depression and anxiety (http://www.frbsf.org/community-development/files/choi.pdf).   Therefore, it is no secret that financial security is a determinant of health.

I can say that 100% of my clients suffer from financial problems after their traumatic event.  How could you not?  If you think your income is “insured” against illness or disability, check again.  If you are fortunate you have private disability or health coverage.  Or, you might have a good short or long term disability plan at work and in that case, you might get 80% of your income covered at the time of claim.  However, this usually only lasts for two years before the “test” changes and most people find their income loss benefits end.  In the world of auto insurance, without other coverage, the maximum income replacement is $400 / week, regardless of what you made before (unless you “bought up” which no one does).  And just think – three years ago the Financial Services Commission of Ontario wanted to lower this to $300 / week to put more money back in the pockets of insurers.  Could you live on $1200 / month?  I digress…

So, you are in an accident, suffer an illness or can no longer work.  How will you manage?  How will you be able to afford the medications you are now required to take (these aren’t covered 100% either folks), the equipment you need (the government might fund 75% for some items, but when a prosthetic limb is $60,000 that is still a lot out of pocket), the treatment you require (even with extended benefits, $350 in PT won’t get you very far), and your regular expenses that won’t dwindle unless you make major lifestyle changes?  The answer is stress, worry, concern, sleepless nights, borrowing, illegal activity, and brutal attempts to unsafely return to work because you “have to”.

Believe it or not, managing your finances is what we call another “occupation”.  Working with an occupational therapist, a disabled person can create a new budget around the change in income, get support to make decisions about spending, and gain access to other potential sources of financial support.  Perhaps you qualify for the Disability Tax Credit, or the Registered Disability Savings Plan?  Maybe you need to apply for the Ontario Disability Support Program, or can access funding for devices through the Assistive Devices Program?  Perhaps your home modifications qualify for the new Tax Credit, or you can apply to the March of Dimes under their Home and Vehicle Modification Program?  Maybe without other coverage the local Community Care Access Center can provide you with home care, treatment or equipment?  Can your medications be covered by Trillium?  Are you maximizing the coverage available to you under auto insurance policy or work benefits?  Is there a local food bank, or disabled transportation program? These are all things we look at.

Then of course, there is the process of returning to work.  What if you cannot manage the demands of your previous job or this is no longer available to you based on a long absence?  Perhaps the jobs you are trained for no longer match your abilities?  Occupational therapists can help with identifying previous job demands, outlining new job interests, and comparing these to the abilities you have.  We can set up structured work programs, gradual re-entry plans, and connect you with people and programs in the community that help people get back into the work force.

Occupation is managing your finances and making sure you can get by.  If this is impacted by a disability, Occupational Therapists’ treat that.

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How Do You Learn?

October is National Learning Disabilities Month.  Learning disabilities affect millions of people across the globe, and these are often overlooked or misdiagnosed.  They can affect both children and adults and can be detrimental to education, work and overall quality of life if left untreated.  The following from the Learning Disabilities Association of Canada discusses learning disabilities and provides an understanding of how certain disabilities can be treated and helped. 

Learning Disabilities Association of Canada: Understanding Learning Disabilities

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Occupation Is: Doing Fun Stuff

Remember:  Occupational Therapists define the word “occupation” as the way people “occupy” their time.  So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?).  In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

So, what are your plans after work?  How do you like to spend your evenings?  What do you do for fun?  Given the choice, how do you spend free time?  While being productive is essential for the human psyche, so is being unproductive.  Well, sort of, because even a lack of productivity is productive.  Deep, I know.

Personally, I love a good funny movie, dinner with friends, time with nature, getting out with my kids, exercising, playing sports, reading, blogging, and going on vacation.  Those are my “fun”.  For others, this could be creative hobbies or outlets, museums, live theatre or music, antiquing, collecting, photography, being online, or a thousand other things that I don’t even know exist.

So what if I was injured, suffered from a mental health problem, have a medical issue, or brain injury?  Perhaps I would lack the ability to sit through a movie, or could no longer understand the nuances of humor.  Maybe my personality would change and my friends would have a hard time relating to the “new me”.  Or, I could no longer physically handle my nature walks, exercising or playing sports.  If my vision was impaired, I could not read anymore.  If I struggled with cognitive communication, or attention problems, putting together a blog article might also be off the table.  And vacations?  Those are incredibly difficult to plan and organize at the best of times.

Occupational therapists are very skilled at helping people resume the occupation of fun.  There are multiple ways we do this, as we recognize that our “fun” defines much of who we are, and why we work so hard in the first place.  For example, if I had to rehab myself from the problems above, I might start with suggesting sit-coms as these require less physical tolerances for sitting, and a shorter attention span.  I could view these with another person, and discuss the humor, sarcasm, and recall the best one liners.  Perhaps I would need education and support to understand how my personality changes are impacting my relationships, so I can try to make some changes.  If my physical abilities were limited, my OT could help me find new ways to enjoy nature (bird watching, photography as examples), and could help me discover new sports and forms of exercise within my abilities (yoga, Tai Chi, and many modified sports have become very popular for people with disabilities).  If I can’t read a standard book, maybe I could use an iPad or e-reader so I can change the font size, or switch to audio-books.  For my blogs, I could learn new ways to move from a blog idea to a full article, by breaking down the topic into paragraphs or chunks, or learning how to dictate if written communication is my challenge.  Vacations could take the form of day trips, short overnights, and eventually out of the country through the help of a travel agent that specializes in planning accessible vacations.  I would probably learn that in Canada my attendant can fly for free (with approved paperwork), and that many places (Disney included) are highly accessible.

So if a disability is stopping you from enjoying the occupation of fun, OT’s treat that.

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Occupation Is: Productivity

Remember:  Occupational Therapists define the word “occupation” as the way people “occupy” their time.  So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?).  In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

So far we have slept, gotten up, groomed, dressed and in the last post consumed some food.  Now what?  Well, this is where the rubber meets the road and we get to be productive.  But let’s not put productivity in the “job” box.  There are a multitude of ways that people spend their time during the day, all equally important.

For those of us that “work” (in a paid capacity), this often dictates when we leave the house, and requires some kind of commute.  When we arrive we need to negotiate our way to where we need to be and the next eight hours (or more) are determined largely by the demands and requirements of others.  If we don’t work for money, perhaps our form of meaningful activity is child care, or care giving in general.  Parents with disabled kids, or adults with disabled parents, spend a considerable amount of time in this capacity.  Maybe we volunteer and that fills our day.  For children, meaningful and productive activity are in the form of play or school.  For young adults, this too is often education, socializing, or a job that is part time with varying hours.  Some people spend their day on hobbies, sports, or exploring creative outlets that are “free time”.  Some enjoy reading, and others watching television, going online, or managing the affairs of a household (errands, housekeeping, meals etc).

So you can imagine the issues that are created by a disability.  What if you can’t drive, or tolerate public transit and now you are unable to get to work.  Some disabilities extend the time required to complete a morning routine, and people with these problems are not able to get anywhere before 10am.  Maybe you can get to work (and on time) but your office is not accessible, or your job requires abilities you no longer possess.  Or if you suffer from significant fatigue, maybe being able to manage a full day, or the stresses of working, are an ongoing struggle.  In your role as caregiver you are required to engage in physical activities of lifting or transferring, or this requires emotional stamina that you no longer have.  As a volunteer you defined yourself by the way you were “giving back” and now this has changed.  You are left feeling disappointed, discouraged and need to find a new purpose.  For children that cannot play and explore their world, they need to learn alternative ways to negotiate and learn from their environment.  Or, if productivity is in the form of other outlets, visual, hearing, dexterity or mobility problems can limit one’s ability to engage in those passions.  Sometimes, productivity is hindered by many things, including physical, cognitive, and emotional and the barriers in each domain need to be analyzed before problems can be solved.

Again, this is all occupational therapy.  For example, when my visually and hearing impaired grandmother was having back problems, I was able to align this with her “productivity” which consists of sporadic computer use and occasional television (both modified to meet her needs).  What we discovered was that her significant leaning into the screens to “see” was the root of her problem.  We were able to bring her computer monitor closer to her face, make changes to her computer chair, and later designed a cabinet that allowed her to get under the units to prevent leaning. Or, for another client that suffered from significant mental illness, we were able to making significant rehabilitation headway by first re-engaging her in her previous passion for making stained glass.  For another client, a business owner, his treatment took the form of setting up guidelines, systems and processes at work that reduced distractions and interruptions so he could effectively work through and resolve priority items.  But my favorite story is helping a friend with his neck pain by watching him use his computer.  I just told him to stop being a chicken pecker and to learn how to type.  Voila, neck pain gone!

The bottom line is that feeling productive and being productive are two of the most important aspects of the human psyche.  Just knock something off your “to do list” and see how that feels.  To become unable to be productive by virtue of physical, cognitive, emotional or behavioral problems creates a long list of secondary disability that is equally, or even more, damaging than the primary disability in the first place.  Productivity following an accident or illness often takes new forms – and modifying ways to play, go to school, work, volunteer, or engage in other meaningful tasks is at the forefront of occupational therapy.  Problems with productivity?  OT’s treat that.

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Be Thankful Today, And Everyday

Thanksgiving is a time for friends and family, a time for self reflection and a time to show gratitude.  Many will pause on this special day and think of what they are thankful for.  It can be quite cleansing for the body, mind and soul to do so.  Did you know that by simply being thankful and showing our gratitude on a regular basis you can improve your overall health?  The following article from Healthline.com discusses how being thankful often can benefit your mental and physical health and lead to a happier life.  So as you celebrate Thanksgiving today, remember to carry the gratefulness you feel today forward, each day of the year.  

Healthline.com: A Dose of Gratitude: How Being Thankful Can Keep You Healthy

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Make Sure to Make Time For Play Time

Looking to connect with your kids?  Then break out the dress up box and indulge them (and yourself) in a game of pretend.  Whether playing school, store, dressing up for a ball or to fight a dragon, pretend play can get imaginations flowing, help with emotional issues and strengthen the family bond.  Research has shown that especially for kids with special needs, pretend play is a must.  Whether you join in or simply encourage your child to play pretend on his or her own, stepping into an imaginary role can do wonders for your entire family!  And this does not include turning on the TV!

Everyday Family: How Pretend Play Helps Kids with Special Needs

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Occupation Is: Eating

Remember:  Occupational Therapists define the word “occupation” as the way people “occupy” their time.  So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?).  In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

So, we have slept, are out of bed, groomed and dressed.  Now what?  Typically we head to the kitchen to grab something to eat.  Admittedly, I am a terrible cook.  And on top of this I am leery of ready-made foods, and think the microwave is the root of all cancer.  So, let’s just say I struggle with everything that is meal preparation.  Many of my clients struggle with this also, but for much more legitimate reasons…

For most of us, breakfast is typically simple.  Cereal, toast, maybe eggs, pancakes, granola or fruit.  Lunch slightly more complicated, and dinner is an effort.  So what if you have a brain injury and have difficulty planning meals?  Or, you cannot drive, or can no longer access public transit so you have problems getting items at the store?  Maybe you are on a strict budget and can only get food from a food bank.  Perhaps you have food in the house, but your appetite is supressed from medication, depression, or some other physiological or mental illness.  The dishes might be too heavy to lift if you have upper extremity problems, or you have one hand you can’t use at all which makes cutting, peeling, and carrying heavy pots very difficult.  If you have a special diet, or cannot consume foods by mouth, meals take on another form – pureed, soft, smoothies, Ensure, or even through a feeding tube.  If the meal is made, perhaps you just can’t carry it to the table as you use a wheelchair, or cane, and the last time you tried the meal ended up on the floor.  If you have tremors, shakes or dizziness, walking carrying anything is a challenge.  Once you are at the table with your food, an upper extremity or visual problem might make it hard to get the food onto the fork, spoon, or into your mouth.  Chewing could be another problem if you have oral-motor difficulties.  Then you have to swallow and choking or aspiration are possible.

Occupational therapy treats all that.  We provide strategies and supports to enable shopping, and aids that might help get the groceries into the car, into the house, and into the cupboard, fridge or freezer.  Or to improve memory we can help to set up systems that enable people to shop efficiently and effectively, including meal planning, creation of lists, mapping out products in isles, and providing strategies on ways to prevent visual and auditory overload common to most stores.  When cooking, occupational therapists look at safety around appliances, provide strategies to reduce bending, standing, or reaching, or even aids to reduce bilateral (two-handed) tasks if necessary.  If there are dietary concerns, occupational therapy can provide aids and education, and can work with a speech therapist or dietitian to make people are able to manage nutritional needs.  If there are negative eating behaviors, we can treat that through cognitive and behavioral therapy, tracking, and helping people access other resources and programs.  For consuming food, there are several devices that we can use to address a visual-perceptual neglect, a dominant hand impairment, and train people how to eat with a prosthetic.  We can make customized utensils and splints to bridge the gap between a hand and mouth if the two can’t connect.

Spoken quite simply – occupation is everything that is eating: from planning what to eat, getting the food from the store to the house, preparing this safely, and making sure the food meets the mouth, or the stomach.  If these things are a challenge for you, occupational therapists treat that.