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Golf FORE All

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

I don’t quite understand why hitting a stationary ball is so difficult but alas, golf is one of my favorite sports.  I started playing as a teenager and spent years figuring out that my old baseball swing aimed lower would hit a golf ball far, but not really straight.  With practice I have removed the sway, slowed down my tempo, and learned that trying to kill the white-dimpled-target does not work out either, and voila, I am hooked.

But beyond my love of the sport as an athlete, I also love how adaptable it is.  Growing up I remember playing with my grandfather who had polio.  He would swing a club with one arm while his other arm held his crutch to keep him standing.  Yet, even with one arm, he could hit the ball consistently far and straight – skills foreign to most amateurs.  As an occupational therapist, I now suggest golf as one way to re-integrate clients into the athletic world following an accident or injury.  How?  By breaking the sport into its component parts, and structuring participation around ability. 

Many people start with putting.  While putting can be boring to practice, it is the most important part of the game as you are likely going to put at least 18 times a round.  Putting requires neck flexion but can be done in sitting or standing.  Mats can be purchased to putt at home that will eject the ball back to your feet if your putt is successful.  At times, I have even used putting with clients at their home to test for visual-spatial deficits which makes it a great exercise to also practice if deficits are noted.

From putting, people can slowly increase the club speed through chipping, pitching and low wedge shots.  In these cases, there is little body movement and reduced torque through lowered club speed that would cause pain if the ground, not the ball, was impacted.  Then, if feeling good around the greens, the player can start with low irons on the range and work backwards to full swings.  Eventually, they can try a few holes with a cart to pace the walking, then consider a pull cart with walking later if that is within their abilities.

What is also great about golf, however, is how this is getting attention in the world of modified sport.  Now, some courses have Solo Riders (www.solorider.com) that can be used by people who have deficits in independent standing.  These Solo Riders position the golfer in swing distance from the ball, then elevate them into a standing position to facilitate the swing.  These carts can go on the tees and greens as they only distribute 70 pounds for force through each tire – less than a person’s foot so they don’t damage the course.  I played in a tournament recently where a local golf pro, who had a spinal cord injury, demonstrated the use of a Solo Rider on a par 3 from the tee and hit the ball within a few feet of the pin.  Apparently, for the group before us, he hit a hole in one.

I also remember reading an article a few years ago about physiotherapy programs that were focusing on golf-related skills in therapy such as balance, trunk control, pelvic rotation, and fluidity of movement to help golfers return to the game.  Other activities, such as yoga and Tai Chi are also now known as ways golfers can improve flexibility, strength, endurance, and muscle control in the off-season.

My parents vacation in Florida all winter, and while there met Judy Alvarez who instructs and assists disabled people to learn, enjoy and excel at the game of golf.  I read her book (Broken Tees, Mended Hearts) on a recent holiday.  What is most compelling in her book is not about the physical benefits of golfing, but rather the emotional and participatory value golf has for her disabled clients.  Through participation in a challenging but modifiable sport, people can regain passion for sport, competition and can work to achieve personal bests.  Golf really is FORE all and I hope you will consider hitting the links.

Originally posted July, 2013.

Summer Programming Note:

Summer vacation is here and we will be taking a break from our regular schedule.  We will be posting some of our popular seasonal blogs just once a week throughout the summer but will resume our regular three weekly posts in September, filled with new and exciting content including our popular O-Tip of Week series.

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Reporting Unsafe Drivers: The New Role of Occupational Therapists in Ontario

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

Co-written with Samantha Hunt, Student Occupational Therapist

My father-in-law was terminally ill and suffered from dementia.  Eventually, his decline became significant and his doctor filed a mandatory report with the Ministry of Transportation (MTO) to suspend his license pending a driver’s exam.  He refused to attend the exam yet continued to drive even without a valid license.  He still paid for car insurance because he knew this was important but was not well enough to connect his own disabilities to his safety and the safety of others.  The family planned to remove his vehicle from his possession but before we could he ventured out one night, got lost, and the police found him 8 hours later driving in a farmer’s field.  The good news was that no one got hurt and his car was beyond repair.  Now, he could no longer drive even if he wanted to.

Driving is an important daily activity for many and provides drivers with an independent means to get around and to manage our own needs outside of the home.  It reduces our reliance on others and provides us with freedom and control.  But it is a privilege, not a right, and sometimes people reach a point where driving is no longer safe, but yet they don’t voluntarily stop.

Up until recently, the ownness to report unsafe drivers has fallen to the legal responsibility of doctors, nurse practitioners and optometrists.  However, on July 1, 2018 the legislation will change to add a new class of “discretionary” reporting, and occupational therapists will be included in the list of professionals that can submit these “discretionary” reports. 

Considering this major change to the Highway Traffic Act (HTA), and the significance of this on OT practice in Ontario, we wanted to provide a brief overview of the key facts and guidelines for the OT’s that this may impact.

Background on Medical Reporting Legislation

Mandatory medical reporting for physicians and optometrists in Ontario has been in place since 1968 and was enacted to help protect the public from drivers diagnosed with certain medical conditions or impairments that made it dangerous for them to drive. Mandatory reporting is a legal requirement to report that pertains to physicians, nurse practitioners, and optometrists, outlined in the HTA. The legislation states that every prescribed person shall report to the MTO “any person who is at least 16 years old who, in the opinion of the prescribed person, has or appears to have a prescribed medical condition, functional impairment or visual impairment that may impair driving ability.”

What’s New

In 2015, amendments were passed that allowed for a new reporting model to be introduced in Ontario and were approved in February 2018. These include:

·       A combination of mandatory and discretionary reporting

·       Authority to add additional healthcare professionals

·       Specific requirements regarding what must be reported

Resulting from these amendments, the MTO regulations state that as of July 1, 2018, occupational therapists are identified as discretionary reporters. Discretionary reporting is not a legal requirement but gives authority for reporting to occupational therapists, physicians, nurse practitioners and optometrists for: “any person who is at least 16 years old who, in the opinion of the prescribed person, has, or appears to have, a medical condition, functional impairment or visual impairment that may make it dangerous for the person to operate a motor vehicle”. Discretionary reporting therefore allows OTs to report concerns about a client’s fitness to drive if they choose.

With respect to consent and confidentiality, OTs are protected from legal action for breaking confidentiality when making a discretionary report; the HTA states that the authority of a prescribed medical professional making a report to the MTO overrides the duty of that professional to maintain a client’s confidentiality. Nevertheless, an OT making a report would be expected to advise the client of this decision.

Summary of Discretionary Reporting Rules for OTs

·       OTs can report concerns about a client’s fitness to drive directly to the MTO.  There will be a standard MTO form to be used for this purpose.

·       OTS may report a driver but are not legally required to do so.

·       OTs can make a report without client consent to prevent or reduce risk of harm.

·       OTs can only make a report if they have met the client for assessment or service delivery.

·       OTs can report on both prescribed conditions and any other medical conditions, functional impairments or visual impairment that may make it dangerous for a client to drive.

Prescribed medical conditions include the following:

1.     Cognitive Impairment: a disorder resulting in cognitive impairment that,

                 i.      Affects attention, judgment and problem solving, planning and sequencing, memory, insight, reaction time or visuospatial perception, and,

                 ii.     Results in substantial limitation of the person’s ability to perform activities of daily living.

2.     Sudden incapacitation: a disorder that has a moderate or high risk of sudden incapacitation, or that has resulted in sudden incapacitation and that has a moderate or high risk of recurrence.

3.     Motor or sensory impairment: a condition or disorder resulting in severe motor impairment that affects co-ordination, muscle strength and control, flexibility, motor planning, touch or positional sense.

4.     Visual impairment:

                 i.      A best corrected visual acuity that is below 20/50 with both eyes open and examined together.

                  ii.     A visual field that is less than 120 continuous degrees along the horizontal meridian, or less than 15 continuous degrees above and below fixation, or less than 60 degrees to either side of the vertical midline, including hemianopia.

                 iii.    Diplopia that is within 40 degrees of fixation point (in all directions) of primary position, that cannot be corrected using prism lenses or patching.

5.     Substance use disorder: a diagnosis of an uncontrolled substance use disorder, excluding caffeine and nicotine, and the person is non-compliant with treatment recommendations.

6.     Psychiatric illness: a condition or disorder that currently involves acute psychosis or severe abnormalities of perception such as those present in schizophrenia or in other psychotic disorders, bipolar disorders, trauma or stressor-related disorders, dissociative disorders or neurocognitive disorders, or the person has a suicidal plan involving a vehicle or an intent to use a vehicle to harm others.

·       OTs who make a report in good faith are protected from legal action but failing to report when they should have could be a breach of professional obligations.

OTs are NOT expected to report on conditions that, in their opinion, are of:

·       A transient or non-recurrent nature

·       Modest or incremental changes in ability

Lastly, although OTs are not legally required to make discretionary reports, a professional obligation to identify a potential safety issue with a client (such as a concern about fitness to drive) and, taking action to address this concern, is expected of the OT. Taking action may or may not include making a discretionary report to the MTO.

Next Steps

Reporting, Intake, and Review Process

The three types of approaches for assessing fitness to drive include a General Functional Assessment, Driving Specific Functional Assessment, and/or a Comprehensive Driving Evaluation (more information can be found in the resources below). Once an assessment has been completed or a concern has been identified, an OT may fill out a report. A new standardized form that OTs (along with physicians and nurse practitioners) must use when making a report has been approved and will be available online as of July 1, 2018. Once reports are received by the ministry, they will be reviewed and the MTO is to take appropriate action following within 30 business days.  When an OT is reporting to the ministry, this does not mean the OT is taking the person’s license away. The licensing body has the responsibility to make this decision or to decide if more information is required.

For more information and resources, the College of Occupational Therapists of Ontario has created an Interim Guide to Discretionary Reporting of Fitness to Drive, which can be found at:  https://www.coto.org/resources/interim-guide-to-discretionary-reporting-of-fitness-to-drive-2018

Resources

www.coto.org/news/changes-to-medical-reporting-of-drivers-gives-ots-new-reporting-authority

www.coto.org/resources/interim-guide-to-discretionary-reporting-of-fitness-to-drive-2018

www.mto.gov.on.ca/english/safety.medical-review.shtml

www.youtube.com/watch?v=dOIJ7CrDTT0

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Occupational Therapy and Physical Therapy: Key Differences and Similarities

The differences and similarities between Occupational Therapy and Physiotherapy have long been confused.  Although both Occupational Therapy (OT) and Physiotherapy (PT) are registered healthcare professions specifically in the domain of rehabilitation, each profession has it’s unique role and purpose in one’s recovery following injury or illness, as well as in the prevention of disease, further injury, and disability. 

Learn more about the key differences and similarities of these two extremely valuable therapies in the following infographic:

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Living with Cancer: OT Can Help

Cancer and cancer treatment can lead to changes in how we do our daily activities due to physical, cognitive or emotional changes resulting from the diagnosis, resulting surgery, medications, chemo and radiation. For a cancer patient sometimes just doing daily activities leaves little energy for leisure, social, or work-related tasks.  Common side effects of cancer or its treatment include fatigue, pain, weakness, cognitive difficulties, anxiety or depression, and changes in self-esteem or self-image. Each person diagnosed with cancer will experience different challenges in his or her participation in various daily activities and life roles over the course of the disease.

Occupational therapists have knowledge and expertise to allow individuals with cancer to do the things they want and need to do to maintain their level of independence and quality of life. Occupational therapy services are helpful for individuals throughout the continuum of cancer care, including those who are newly diagnosed, undergoing treatment, receiving hospice or palliative care, or who are survivors reintegrating into previous roles. Caregivers also benefit from the training and education provided by OT’s as this arms them with the essential tools to offer support and assistance to their loved ones when performing daily, important, and meaningful activities.

Take a look at the following infographic to learn more about how Occupational Therapists can help:

Previously posted April 2017.

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Sexual Harassment and Sexual Abuse: OT Can Help

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

The pendulum has surely shifted on what society will and will not tolerate when it comes to sexual harassment and sexual abuse.  For those that remain confused on these two overlapping but very different concepts, here are simple definitions from Wikipedia:

Sexual Harassment:  bullying or coercion of a sexual nature, or the unwelcome or inappropriate promise of rewards in exchange for sexual favors.

Sexual Abuse:  undesired sexual behavior by one person upon another.

Sexual harassment has often been related to the workplace and women tend to be the most common recipients.  It also tends to involve a power imbalance whereby one person is in a position of authority over the other, but by definition, this does not have to be the case.  With the current societal shifts, it is now recognized that harassment can extend beyond the workplace, and is not gender specific.  Sexual abuse, on the other hand, has always been more of a global term, applying to anyone, anywhere, anytime, who is forced into sexual activity without their consent.  It has always been socially unacceptable, even when sexual harassment was more of a commonality.

Truth be told, I have been a victim of both.  I can say that harassment is easier to talk about but at the time I was being harassed it was not as socially unacceptable as it has become.  In fact, it almost seemed common that a young woman working (and in my case playing sports) who was exposed to men in more senior positions would be solicited, propositioned, flirted with or asked on dates or to social events.  I was fortunate in that none of these experiences turned into sexual abuse and I trust (hope) that men today behave much more professionally around women in general.  Sexual abuse, on the other hand, is much harder to talk about, and my experience with this is not one I am comfortable sharing publicly.  I do know though that victims of sexual abuse often need therapy to help them recover from their trauma, and I am hopeful that the recent media attention to this will encourage victims to come forward and seek help should they need it.

Occupational therapy can be one form of treatment for people who have suffered from sexual harassment or abuse.  When people are off work or struggling with work, our therapy helps people to discover functional barriers, develop solutions, proactively engage in problem solving, and then assists people to forward in their new chosen direction (albeit return to work, seeking new work, or addressing retraining).  With sexual abuse some occupational therapists are trained in psychotherapy and work with people directly to address the results of their trauma.  Occupational therapy also helps people to rebuild the elements of their life that have been lost because of their trauma.  Sometimes victims of sexual abuse develop maladaptive ways to cope (addictive behaviors, inactivity, social isolation to name a few) and these can be addressed in treatment.  It is also common that depression and anxiety surface following sexual abuse, and these too can be tackled through activation at home and in the community.  Occupational therapists work very well with other providers who may also be involved – social workers, psychologists, and the medical team, helping to create a cohesive and impactful approach to recovery.

If the media attention to these problems results in positive societal and behavioral change, then we all need to be thankful and grateful to the people that have come forward and for the stories that have been shared.  And if sexual harassment or abuse have caused problems for you and impact how you manage your day-to-day activities including work, taking care of yourself, enjoying leisure, or managing important elements of how you want to spend your time, consider occupational therapy as one element of your recovery team.

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Thinking Big: The Impact OT Services Can Have on the Healthcare System  

Guest Blogger Lauren Heinken, Student Occupational Therapist

Recently we reviewed the book Better Now: Six Big Ideas to Improve Healthcare for All Canadians, written by Dr. Danielle Martin.  While the book is excellent, it did omit to include how Occupational Therapy (OT) services may impact Canada’s Healthcare system, and this blog will fill this gap. I believe that an increase in OHIP funded OT services has the potential to have a positive economic impact on the healthcare system as a whole. This is mainly due to OT being a proactive form of therapy that may help in preventing individuals from requiring more reactive forms of care following an acute bout of illness/injury.

An aging population has the potential to place strain on our healthcare system; however, this can be minimized through strategies that: decrease the number of episodes of acute illness/injury experienced by this population, and improve the management of the chronic conditions they face. These strategies require that a proactive approach to healthcare be undertaken. OTs are well positioned to provide preventative care due to their focus on helping individuals find ways to safely engage in their daily occupations despite limitations that they may have. The OT focus on helping clients to maintain independence and through empowering clients to be accountable for the management of their own health aligns well with a preventative approach. So why does OHIP coverage (and even private coverage) for OT services remain so limited? By limiting the number of individuals who can access these services, aren’t we missing out on an opportunity to reduce costs to the healthcare system in the future?

The answers to these questions lie in the fact that our healthcare system remains highly focused on reactive care. It is no secret that Canada’s healthcare system is much more effective in providing urgent and acute medical services than it is in providing services to those with health conditions that cause functional decline, but not to the point of being imminently life-threatening.  Although having these acute services is essential, making cutbacks to services that have the potential to reduce these acute events, is shortsighted. Because acute medical services are necessary, increasing funding for preventative services will initially result in an increased cost to the system. However, as these preventative services become utilized it can be expected that acute costs will decrease to a greater extent than the cost of preventative services in the first place. This is especially true if these services can be administered in a group setting, and OTs are trained to provide educational self-management interventions in this manner.

OTs are also well positioned to provide transitional services that can help to bridge the gaps between care settings, for example when transitioning from acute hospital care to the care received afterwards in the community. Problems can arise during this transition especially if information is not communicated effectively between care sources. This can lead to hospital readmissions and complications in the recovery process, which lead to further healthcare costs. OTs can be effective coordinators and can help to arrange the necessary community care following the acute phase of recovery in the hospital. OT’s understand the demands required for someone to perform their daily living activities at home and are uniquely positioned to assess if returning to these activities is possible, or what assistance might be needed.  If patients are given the appropriate assistance during their recovery process, their health outcomes will naturally be more positive. Additionally, since occupational therapists are trained to address all factors that can influence a person’s well being, they are more likely to pick up on additional challenges an individual may face when returning home post hospitalization. Maybe their home environment is poorly suited to their current needs, or maybe they have little social support available to them; whatever the situation, OTs know how best to solve these problems.

Considering the role OT’s can play in improving the lives of Canadians, and in reducing long term costs, as a profession they need to continue to advocate for their services, particularly those that may be considered preventative in nature.  Outcome studies do exist that showcase how OT reduces costs and prevents re-institutionalization.  This is the data we need, combined with qualitative case studies and stories of client experiences, to promote change.  But in the end, it is a paradigm shift that is required in the minds of all Canadians – the “it won’t happen to me” needs to become “it is happening to me and I need help” before people will be able to reshape their activities and get the support and answers required to result in more positive health outcomes.  

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Overcoming Eating Disorders: OT Can Help

Guest Blogger:  Carolyn Rocca, Occupational Therapist

According to Statistics Canada, in 2012 over 130,000 Canadians over the age of 15 years old reported that they have been diagnosed by a health professional as having an eating disorder. Considering these high rates, and the likely underestimation of reported diagnoses, eating disorders remain a form of mental illness that are not openly talked about.

Eating disorder is an umbrella term for several categories of diagnoses, with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified being the most common. Although symptoms vary based on the diagnosis, some overall symptoms experienced with eating disorders include a pre-occupation with body weight, body dissatisfaction, behaviours to prevent weight gain, perfectionism, emotional dysregulation, depressed mood (including suicidality), anxiety, and low self-esteem. Naturally, these symptoms can lead to secondary impacts such as physical adverse effects, social isolation, and a compromise of occupation in the areas of self-care, daily living, leisure, and productivity (NCCMH, 2004).

The treatment and recovery of adolescents with eating disorders involves the collective work of many healthcare professionals including physicians, dietitians, nurses, psychiatrists, psychologists, social workers, teachers, child and youth counselors, and, yes, occupational therapists(Norris et al., 2013). Each of these team members works collaboratively to deliver the best practice approaches of pharmacotherapy, nutritional rehabilitation, and psychosocial interventions, including cognitive behavioural, dialectical behavioural, interpersonal, and family based therapies, among others (APA, 2006; NCCMH, 2004). Several of the healthcare professionals working with adolescents with eating disorders can deliver these therapies, including occupational therapists.

This means that occupational therapists work effectively with several disciplines to deliver best practice approaches, while also integrating their unique focus on occupational functioning to the team. Occupational therapists’ unique contribution is their ability to holistically address the physical, cognitive, behavioural, and psychosocial aspects of adolescent eating disorders through occupation-based approaches to improve adolescents’ self-worth and self-esteem (Kloczko & Ikiugu, 2006). As mentioned previously, eating disorders commonly have a substantial impact on adolescents’ function in the areas of leisure, self-care, daily living, and productivity (NCCMH, 2004), meaning many youth have difficulty balancing their family and social lives, education, employment, extra-curricular participation, ability to regulate their own activities, and thus overall health.

Occupational therapists have the expertise to work closely with adolescents and their family to help them with their goals around succeeding in school, work, leisure, and overall re-engagement in meaningful activities. In fact, Occupational Therapists are skilled at using meaningful activities as a vessel to get to the underlying problem of the eating disorder.  Sessions don’t focus on eating, food or binging behavior, but on being productive, enjoying life, and accomplishing things that matter.  The indirect influence is better choices in other areas (including diet) and recognizing the link between mental and physical health, quality of life and wellness.

If you know a teen (or adult for that matter) that may be dealing with an eating disorder, encourage them get help.  There is a team of professionals, including occupational therapy, that are skilled at assisting teens to recover from these, and other mental health issues.

 

References & Resources:

American Psychiatric Association (APA). (2006). Practice guideline for the treatment of patients with eating disorders (3rd ed). Retrieved from https://www.guideline.gov/summaries/summary/9318/practice-guideline-for-the-treatment-of-patients-with-eating-disorders

Kloczko, E., & Ikiugu, M. N. (2006). The role of occupational therapy in the treatment of adolescents with eating disorders as perceived by mental health therapists. Occupational Therapy in Mental Health, 22(1), 63-83. doi:10.1300/J004v22n01_05

National Collaborating Centre for Mental Health (NCCMH). (2004). Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. Retrieved from https://www.nice.org.uk/guidance/cg9/evidence

Norris, M., Strike, M., Pinhas, L., Gomez, R., Elliott, A., Ferguson, P., & Gusella, J. (2013). The Canadian eating disorder program survey–exploring intensive treatment programs for youth with eating disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(4), 310.

Statistics Canada: http://www.statcan.gc.ca/pub/82-619-m/2012004/sections/sectiond-eng.htm

 

previously posted March 2017

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Book Review: Better Now: Six Big Ideas to Improve Healthcare for All Canadians

Guest Blogger Lauren Heinken, Student Occupational Therapist

For anyone with an interest in how Canada’s single-payer medicare system works and how it may be improved, this book written by Dr. Danielle Martin and released earlier this year is a must-read. Although it is written from a medical perspective, the author appreciates that an individual’s health is dependent on much more than biology, and the active role individuals need to play in their own medical care is emphasized throughout the book. Dr. Martin takes the time to acknowledge the psychosocial factors that can impact well-being, and as a whole her perspective aligns well with the profession of Occupational Therapists. Better Now: Six Big Ideas to Improve Healthcare for All Canadians is written in such a way that it can be appreciated by anyone who reads it, but those who have direct contact or personal experience with Canada’s medical system may benefit the most from it’s content.

The book’s introduction showcases Dr. Martin’s rational stance on many issues that at times provoke excessive fear amongst Canadians. An example of such an issue is the economic impact that the country’s aging population may have on the healthcare system. This book is able to provide an alternative, and often more optimistic view, on these “hot” issues compared with the fear-provoking opinions that are often shared through other media sources.

Each of the “six big ideas” discussed in this book form a chapter, and each chapter begins with Dr. Martin introducing a real-life patient case that demonstrates and supports the idea. Aside from providing a human component to the systems-level issues discussed in this book, these patient cases are useful in providing an opportunity for readers to apply chapter content to an actual user of the healthcare system. This helps facilitates readers being able to wrap their heads around what truly are “big ideas”.

You may be questioning what the relevance of this book is to OT practice. An issue identified within the book is that our medical system tends to be one that is largely disjointed, with different parts of the system often not communicating clearly with one another. This lack of connectivity comes at a cost to both individuals who use the system and those who fund it. Although implementation of better communication technology will play a large part in addressing this problem, I would argue that it could at least be improved if health practitioners and those administering the system knew a little bit more about what each other did. This book is a good way for OTs to learn more about the medical system, and they may potentially use this knowledge to influence a smoother and more cohesive system experience for their clients. It also better equips OTs to provide appropriate answers to questions they might be asked that relate to navigating the healthcare system.

The only disappointment in this book is the absence of the OT profession when Dr. Martin speaks to “other healthcare professionals”. OTs have the potential to make big contributions to proactive healthcare, but also to improving how the system functions and these are not explicitly considered in this book. However, OTs know their scopes best and have the skills to advocate for their contributions, so their absence in this book creates an opportunity for them to fill the gap.   How?  Stay-tuned for this to be discussed in a later blog post. 

 

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O-Tip of the Week: When Creating Goals Use Proactive and Positive Language

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

For the month of January our O-Tip series will concentrate on creating achievable resolutions and goals for the new year.

When creating your goals try changing the phrases “I hope to” or “I want to” to “I WILL.”   Let the power of a proactive and positive mind guide you to success this year!

Learn more about how the phrases you use can help you achieve success this year in the following article from our blog.

Solutions for Living:  Say “I Will…” this New Year

 

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Blue Monday and Beyond — How to Beat the Winter Blues

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

I made a comment after the Holidays that I was slowly recovering from Christmas Affective Disorder.  For me, Christmas is stressful, hectic and challenging.  I struggle with it every year.  After the seasonal rush, it takes me days, or even weeks, to get back to my normal equilibrium.  However, really, winter despair is not a joke and for some, can be debilitating.

In fact, some research suggests that up to 15% of people in Ontario experience the “winter blues”. These leave you feeling tired, groggy, and maybe even sad or irritable.  While this causes discomfort, it is not incapacitating.  However, a more serious form of the winter blues, known as Seasonal Affective Disorder (SAD), can be.  While occurring less frequently at 2-3% of the population, the symptoms can prevent individuals from leading a normal life.  Symptoms of SAD include decreased energy, changes in appetite, especially leading to cravings for starchy or sweet foods, oversleeping and weight gain, among other things.  If you feel this is you, talk to your doctor and have your symptoms investigated.

The problem is not always the blues, but how these create a negative behavior cycle.  When you feel down, you revert, avoid, or change habits.  This leads to feeling worse and the cycle continues.  Occupational therapists (OTs) recognize the importance of being engaged in activities that are meaningful, active and productive, and understand how these contribute to health and well-being. In fact, one of the best treatments for beating the winter blues involves just “keep on keeping on” by doing what you normally do every day.  Some tips include:

  1. Use behavioral activation to keep your normal routine.  Make the bed, have a shower, prepare a decent breakfast, walk to the mail box.  Don’t change habits that are ingrained just because it is winter.  Never underestimate how damaging it can be if you avoid even small things that ultimately add up to a productive day.  Gradually try to get back to those important tasks if you have found that your daily behaviors have become unproductive.
  2. Stay active. Those that love the winter do so because they get outdoors.  Walk, ski, skate, toboggan – something to help you appreciate how wonderful a change of seasons can be.  This is best facilitated by proper clothing that will keep you warm.  If exercise is tough for you, build it into your day by default – park farther from the door, use the stairs, make a few trips from the car with the groceries to get the blood flowing.
  3. Consider light therapy. Sit by the window at lunch, get some fresh air when the sun is out, or consider purchasing an artificial light for your use at home.
  4. Up the nutrients. When some bad eating habits creep into your winter these can be hard to break come spring, and only contribute to further mood declines.  Shop in the fruit and veggie isles, and avoid the isles that house the bad foods you seem to be eating too much of.

Finding ways to help you do the things you want to, need to, or enjoy, is at the heart of occupational therapy. While the winter months can be long, dark, and cold, ultimately how we adapt to the seasonal change is up to us.  If moving or going south is not an option, consider some of the above tips to make the winter bearable, or dare I say, even enjoyable?

 

Resources:

Seasonal Affective Disorder. (Canadian Mental Health Association, 2013) http://www.cmha.ca/mental_health/seasonal-affective-disorder-sad/
Beat The Winter Blues (Readers Digest, no date) http://www.readersdigest.ca/health/healthy-living/beat-winter-blues
Kurlansik, SL & Ibay, AD. (2012).
Seasonal Affective Disorder. Am Fam Physician. 2012 Dec 1;86(11):1037-1041.
10 Winter Depression Busters for Seasonal Affective Disorder (Borchard, no date) http://psychcentral.com/blog/archives/2012/12/30/10-winter-depression-busters-for-seasonal-affective-disorder/

 

Previously Posted January 2017