Close

Tag Archive for: solutions for living

by

Coping with COVID — Finding the New Normal

In the following video, the team at FunctionAbility discusses the emotions of COVID and provides helpful strategies to help people cope through uncertain times.

For more helpful information check out our Coping with COVID video series on our YouTube channel.

About the Experts:

Brenda Power Ahmad, BSc(OT), BSc(Hons Psych), OT Reg.(Ont.), – Brenda obtained a Bachelor of Science degree in 1999 in Occupational Therapy from Dalhousie University and a Bachelor of Science (Honors) degree in Psychology in 1996 from Memorial University of Newfoundland. Brenda also completed post-secondary education in the fields of Criminology and Linguistics. Brenda has been practicing occupational therapy since 1999 in the provinces of Newfoundland and Labrador, and Ontario. She has extensive experience working with people of all ages with a variety of developmental and physical disabilities and works mainly with clients who have complex orthopedic, psychological and brain injuries. Brenda is trained in administration of the AMPS and the PGAP program and is a Canadian Certified Canadian Life Care Planner. She has completed additional training in catastrophic assessment through the Canadian Society of Medical Evaluators and has successfully completed the C-CAT Certification exam. Brenda sits on the Board of Directors for the Hamilton Brain Injury Association. As Vice President of Clinical and Community Partnerships in one the largest rehabilitation firms in Ontario, Brenda is responsible for training and mentoring other therapists and also leads the Catastrophic Assessment (CAT) program at FunctionAbility. Brenda maintains an active social media presence and co-hosts an educational video series called OT-V which aims at educating the public about the various roles of her profession.

Lynne Harford, BA, MSW, RSW, D.VATI is a Registered Social Worker, Director of Pediatrics and a Clinical Supervisor with The Social Work Consulting Group. She obtained a Master of Social Work degree from the University of Toronto and a Bachelor of Arts degree in Sociology from Glendon College-York University. Prior to her university studies, Lynne pursued a career in business and received a Marketing Administration Diploma from Seneca College of Applied Arts and Technology. In 2013, Lynne achieved her designation of Art Therapist graduating with an advanced diploma in Art Therapy from the Vancouver Art Therapy Institute.

Emma Fogel, MSW, RSW is a Registered Social Worker with a Master of Social Work degree from the University of Toronto. Emma’s true passion is working with youth and families whereby she draws upon an eclectic framework to provide client-centered counseling support, which includes Cognitive Behavioural Therapy, Dialectical Behavioural Therapy, Mindfulness-Based Therapy, Solution Focused Therapy and Play. Wendy Gage MSW, RSW is a registered social worker with a Master of Social Work Degree from the University of Toronto. She received her Honours Bachelor of Arts in Psychology at the University of Western Ontario with a focus on child development. Wendy is a certified Emotionally Focused Couples Therapist (EFT) with advanced training in EFT for families, individuals and trauma. Wendy has training in child-led play therapy (Watch, Wait and Wonder) for children ages 6 months to 6 years. Wendy joined The Social Work Consulting Group with 18 years’ experience practicing clinical social work on the Neurology Program at The Hospital for Sick Children. At Sick Kids, she developed expertise in child and family adjustment to illness, loss and trauma. Wendy has participated in research, teaching and speaking events related to pain management for headaches, managing behavior in children with neurological conditions, and long-term family functioning and adjustment to children’s neurological conditions. She was invited to provide input to the provincial government on gaps in service to children with mental health conditions arising from neurological illness and injury.

by

My Animals Support Me, But Are Not Support Animals

Julie Entwistle, C.Dir. (c), MBA, BHSc (OT), BSc (Health / Gerontology)

Every day I benefit from the love of my animals.  In fact, being an animal owner is not only part of my lifestyle, but has absolutely become part of who I am.  My animals provide me with love, comfort, they calm me and make me smile and laugh.  I have one at my feet right now and he is the one that tends to keep an eye on me – never too far away, watching, waiting, and looking for moments to connect with me, steal some cuddles or give me a quick wag to show his support.  My animals also provide comfort and security to my children and it is not uncommon to see a kid doing homework or relaxing in her room while surrounded by her four-legged beasts much like Snow White.  However, like children, animals are not always easy and at times can be all-consuming, frustrating, and difficult to manage.  Pets are not for everyone, especially during times of trauma, transition, or change.  In the end, my dogs provide me and my family with a “service”, but these are far from “service animals”.  I will explain.

Pets are animals that we keep inside to provide us all the comforts and joys that animals can provide.  Sure, we take them outside, but that is equally for their benefit as it is for ours (dog parks, nature walks, doggie play dates).  Maybe to the vet, groomers or to visit with dog-friendly friends.  But pets are typically a hot mess in public spaces.  My dogs are wonderful at home and are trained to be good here, but If I took one of them to a restaurant he would pretend to be looking for some affection while simultaneously snatching the steak off my plate, or diving to grab that roll that landed on the floor.  He would be underfoot and anxious, nervous of the chaos and commotion.  And in getting him into the restaurant he would not hesitate to chase a squirrel across the road while dragging me as the leash holder into traffic with him.  After all he is a pet; he is not trained in how to properly manage public spaces.

True service animals are pets, sure, because they provide all the supports of an animal at home.  But they are also exceptionally well trained to behave in public.  They can navigate public spaces with focus, comfort and ease because they have experience here, and know what is expected.  They are not distracted by squirrels or steak and get used to being so attentive to their owners such that affection from strangers when out of the home is not something they crave.  They are trained to react to situations with consistency and based on what the owner needs – they will not jump on someone in an elevator, bark, urinate in the lobby, or wrap their leash around someone’s leg.  They won’t bite anyone because they are screened as non-aggressive and are trained to have restraint (unless they are a trained guard dog in which case they provide owner protection on appropriate command).  Service animals provide just that – a “service” to someone in need.  They are not just “pets in a vest out in public.”

In Ontario, owners of service animals, in addition to donning the animal in a vest, are required to carry a “prescription” to explain that they need the dog in public spaces.  This “prescription” can be written by a health professional, and to protect the privacy of the animal owner, is often discrete and vague (“requires the service animal for medical reasons or reasons of mental health”).  Many people with these scripts won’t look or act disabled on the surface, hence the need for supporting documentation.  Unfortunately, with service and support dog vests available online, the note becomes necessary to prove a need and to allow the owner of an establishment to be comfortable having the animal inside.

As occupational therapists, we can provide these scripts and notes to owners of service and support animals.  In many settings, we also assist people to obtain funding for the animal and its training.  What we need to understand, however, is the responsibility that comes with this.  Should the animal misbehave at home or in public and harms someone or the owner, the prescriber of the animal could prove liable as the one indicating the animal was needed and was suitable for the purposes of service and support.  To protect ourselves from this, there are things we should consider:

1.      Ensure the animal is not a pet in the first place.  Confirm that the animal is trained, has been vetted to be suitable, and can handle the important responsibilities that come with wearing a service animal vest.  The best way to do this is to ensure the animal was provided by a reputable facility that works with animals for this purpose.  A list of such facilities in Ontario is included below.

2.      Ensure your note has an expiry date.  An open-ended script that could be carried for years or decades does not ensure that you are referring to “this animal” at “this time”.  Consider dating your script to ensure it is reviewed perhaps annually like other processes that involve our signature (parking permits, tax forms, etc.).

3.      Recognize that supporting the funding for someone to obtain or purchase an animal could also be considered a “script” whereby you are taking ownership for this animal as a service dog.  If you complete a letter of recommendation, complete with funding support, that could be enough for someone to carry with them, written by an “occupational therapist” as proof of the need.

4.      In the cases of mental health, consider the value of having this prescribed by a psychologist, psychiatrist or psychotherapist if warranted.  Consider your own knowledge, skills, and experience with the client and their disability in recommending this type of need.  Ensure there is an appropriate diagnosis of mental health which is best obtained from a registered mental health professional.

In researching for this blog, I was provided a very informative and helpful document written by a Psychologist, Registered Dog Breeder, and Executive Director of Hope Heels Service Dogs: Dr. Aanderson.  This resource is also included below.  This document explains service animal laws across Canada, and clearly outlines the differences between a guide dog, service or support dog and pet.  It provides a decision tree to help professionals like myself navigate the important conversation with clients regarding the use of a service dog, and how this differs from a pet, in deciding whether to “prescribe” this or not.

I am sure many of us have witnessed an animal in a public space that was wearing a vest and misbehaving.  In one instance, someone in an elevator with me said to the owner of a vested “support animal” that was climbing on people “there is no way that is a service dog.”  The owner just exited the elevator without responding.  Service animal or not, it is an abuse of process and blatant disregard to the training and time that goes into true service animals to try and present a pet in this way.  Service animals provide an immense amount of support to those they are trained to help.  As professionals, we have a responsibility to continue to safeguard the true use of these animals, the programs that train them and the people that need them.  Consider using Dr. Aanderson’s guide before providing written support for these valuable four-legged aids to daily living.

Resources:

Aanderson Service Dog Prescriber Guidelines

Service Dog Providers in Ontario – Current as of October 2019

 

by

Tips to Survive the Winter Blues and Put a Stop to SAD

Julie Entwistle, C.Dir. (c), MBA, BHSc (OT), BSc (Health / Gerontology)

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.  If you feel this is you, talk to your doctor and have your symptoms investigated.

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 tips in our infographic below to make the winter bearable, or dare I say, even enjoyable?

 

by

Music: An Experience for All Thanks to this New Technology

Music is powerful.  Music awakens emotions and feelings within our bodies.  But, if you cannot hear, how can you feel this powerful experience?  A new and innovative technology, The Sound Shirt, has transformed what most experience with the sense of sound into one that uses the sense of touch for those who are deaf.  Learn more about this amazing new technology in the following video:

by

Disability and Weight Management: Helping You Tip the Scales in the Right Direction

Julie Entwistle, C.Dir. (c), MBA, BHSc (OT), BSc (Health / Gerontology)

I find that while many of my clients initially lose weight following trauma (hospital food diet); eventually the net impact of a disability is often weight gain.  This is often the result of many factors – most interacting to make the solution difficult to isolate.  Medication side-effects, altered routines, reactive eating, friends and family that provide unhealthy sympathy foods, increased use of fast food because preparing meals is difficult, inactivity, depression, and even hormonal and physiological changes to the body as a result of the trauma.

But we do know that 70% of weight management is diet and assuming this is true, then the solution to weight management should be simple – you can’t eat it if you don’t buy it.  Purchasing unhealthy food is the first step to a weight problem.  And weight problems in disabled people are exponential.  Everything becomes harder – transfers, walking, completion of daily tasks, caregiving, and many pieces of equipment have weight limits that when exceeded result in equipment failure.

What is even more problematic is the role of the caregiver in the maintenance of weight in the person they are caring for.  When people cannot shop for food and cannot cook, then helping them to maintain weight becomes the job of the caregiver.  Just buy and prepare healthy foods – perhaps food prescribed by a nutritionist or dietician.  However, often caregivers rely on the disabled person to dictate the food choices but if people are emotionally eating, or eating out of boredom, then the caregiver cannot always rely on the individual to make the best decisions.  Often raising awareness about healthy eating starts with asking people to track what and when they are eating and drinking.  Then, problems can be identified, and a list of doable solutions can be developed. 

In one instance, in helping a client with weight loss as a functional goal, we discovered through tracking that she was barely eating breakfast and lunch but was consuming all of her calories from 5-10 pm.  We made the goal that, over time, she would consume breakfast, lunch, two snacks and dinner, and would stop eating after 7 pm.  Within a few short months, she lost 30 pounds, and this greatly improved her mobility and tolerances for activity.  Another client discovered through tracking that he was consuming far too many large bottles of pop a day.  By changing his large bottle to a smaller one, and eventually to only one pop per day and the rest water, he was able to drop 20 pounds.  In both cases, the problems, solutions, and commitment to change were made by my clients (with my guidance and support), making the results far more meaningful and lasting.  Further, the client was shown a framework for how to check and modify eating habits should they deteriorate again in the future.

by

O-Tip of the Week: Getting to Know Your Devices

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 help you to get acquainted with your devices and the awesome accessibility features you may not be aware of.

Did you know that on both Apple and Android devices there are many accessibility options you can change to assist you with your unique needs?  Below is a quick primer on where to access these features on your smartphone or tablet.  In the coming weeks, we will delve deeper into some of the great features!

For Apple Users: 

 

 

 

 

 

 

 

 

 

 

 

 

 

For Android Users:

by

Change is Constant – Why Resist It?

Julie Entwistle, C.Dir. (c), MBA, BHSc (OT), BSc (Health / Gerontology)

A few years ago I volunteered at a chronic pain program by assisting with an after-program book study.  This involved a group of program graduates getting together weekly to read and discuss the book A New Earth, by Eckhart Tolle.  I was amazed at the transformations in attitude, beliefs, and thoughts that came from people reading and discussing this very impactful novel.  In fact, some of the benefits we witnessed, and the things people discussed were revolutionary, and I would even argue evolutionary.

Recently I picked up this book again.  Despite some heavy content, some of the examples are life-changing and the messaging vital.  In one section of the book, Eckhart talks about the need to “evolve or die”.  How true.  In fact, this is always our choice when faced with any change, uncertainty, or interruption in how we manage.  People seem to so strongly fight change, but change is both constant and inevitable.  Why resist? 

I have witnessed hundreds of people in my career that were faced with this same challenge – evolve or die.  The ones that were able to overcome adversity, who could find, cherish and expand on ability, who were open to suggestions, coaching, and change, faired far better than those that resisted, clung to the past, and refused to adapt.  I remember one client, many years after her accident, talking to me about her chronic pain, depression, and physical appearance.  She said, “I used to be a gymnast”.  My response was, “So was I – 30 years ago”.  She laughed.  Identifying that she continued to live in the very distant past helped me (and her) to understand where she was getting stuck, and explained why she was not progressing in the rehabilitation process.  Once she could accept her new “normal”, she started to make significant progress in resuming things she used to enjoy, while also finding new meaningful and productive activities she never imagined trying. 

Here is an example that relates strongly to my role as an OT who works with people who are suddenly and significantly injured in an auto accident (page 57):

“whenever tragic loss occurs, you either resist or you yield.  Some people become bitter or deeply resentful; others become compassionate, wise and loving.  Yielding means inner acceptance of what is.  You are open to life.  Resistance is an inner contraction, a hardening of the shell of the ego.  You are closed.  Whatever action you take in a state of inner resistance (which we could also call negativity) will create more outer resistance, and the universe will not be on your side; life will not be helpful.  If the shutters are closed, the sunlight cannot come in”. 

So, given the choice between evolve or die, let’s not only choose “evolve” but let’s also make an effort to live that way.  Evolution is difficult – it requires an open mind, hard work, and a positive and accepting attitude.  It often needs people to accept new opinions, ideas and even help.  This is not our nature, but if we can wrap our head around the fact that we are “evolving”, it makes challenges seem surmountable.  It can let the light in.

 

Previously posted September 2013

by

Foster Independence with Memory Mantras

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

Being an Occupational Therapist can also be a curse when it comes to parenting.  As an OT, the goals are always functional independence.  As a parent, I am no different.  I remember a video I watched in OT school.  This was of a boy (young adult) with cerebral palsy and he was putting his coat on.  The video was probably 20 minutes (or it felt that long).  As I watched this boy struggle with his coat for what seemed liked eternity, I wanted to jump through the TV to help him.  Clearly, with some help, this could be done faster and easier.  But in the end, it was not about that.  It was about independence.

As parents, it is often faster and easier to do things for our kids.  Or, we feel the need to continuously protect our kids from failure by ensuring that we are their second brain.  But is this the right choice when the goal is to create people that can manage on their own?

I have created two memory mantras that are used in our house to ensure my kids are seeing the big picture and are developing some executive functioning (note I also use these mantras with my clients who suffer from memory impairment):

  1. When leaving the house our mantra is:  WHERE AM I GOING AND WHAT DO I NEED?  When my children ask themselves this question, they need to stop and think “I am going to X and thus need Y (water, shoes, birthday present, tennis racquet, money)”.  This prevents them from showing up at X unprepared.
  2. When leaving a place in the community our mantra is:  WHAT DID I COME WITH AND WHAT DO I HAVE?  By asking themselves this question, they quickly realize that they came with X and thus need to bring X home (coat, shoes, water, bag, lunch).  This prevents them from leaving things behind.

The success is in hearing my children repeat this to themselves when on their way out the door.  Recently, at a sporting event, we heard a teenage boy blame his mother for forgetting his water.  She was profusely apologetic and rushed out to find him a drink.  My children (who were younger at the time) turned to me and said: “shouldn’t he remember his own water”?  My thoughts exactly.

Originally posted June 2013

by

Is Hitting Snooze Bad for your Health?

We have all been there.  The alarm goes off and you would give anything for just 10 more minutes… thank goodness for the snooze button.  Some people go as far as to set their alarms up to 30 minutes early just to have the satisfaction of pressing snooze multiple times.  However, as great as hitting snooze may feel in the moment, it may not actually be the best decision for your health.  Learn why in the following article care of the Cleveland Clinic. 

The Cleveland Clinic: Is Hitting Snooze (Once, Er, Maybe Three Times) Bad for Your Health?

by

Summer Vacation has Come to an End: Time to “Just Get ER Done”

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

Often I am asked by others how I balance the many aspects of my busy life.  My answer is that I just “get er done”.  In fact “get er done” is a mantra I use regularly to motivate me to knock things off my list.

For example, if I am driving and realize I will arrive at my destination 20 minutes early, often something (or several things) will pop into my head about how I should spend that extra time (stop into the bank, drop by the post office, grab that birthday present, stop at the store for some fresh veggies, etc.).  Then, my head starts negotiating with itself (“no, just keep driving and you can check email for 20 minutes in the parking lot”, or “I don’t feel like doing that right now”, or “I don’t need that present until next week anyway”).  Really, we can talk ourselves out of anything (mostly healthy eating, getting out of bed earlier, and exercise), but success comes from being able to hear through the noise to make the best decision.  Learn more about how to take advantage of that extra 20 minutes in our post Don’t Multi-Task, Multi-Purpose – It’s Better for You. 

In my case, when my head is conflicted by the devil and angel arguing on my shoulders, I apply the mantra:  “Julie, just get er done”.   Every time I say this, it springs me into action.

I remember watching a YouTube video by Mel Robbins that clearly explained that thoughts are just thoughts and to turn them into action, we need to attach a physical component.  We have five seconds to turn a thought into an action or it won’t happen.  So, when hearing the alarm, we have five seconds to throw off the covers and put our feet on the ground, or the “thought” of getting up will turn into the action of not.  Same with the thought of exercising:  if, within five seconds of thinking “I should go for a good walk” you have not gotten up and moved towards putting your runners on, chances are another thought will tell you to stay put.

So, turn those thoughts into action.  Use mantras and physical responses to your thoughts to just “get er done”.