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Archive for category: Original Posts

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National Non-Smoking Week– Be a Quitter!

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

National Non-Smoking week aside, are you ready to butt out?  According to Smoke Free Ontario, smoking takes approximately 13000 lives in Ontario each and every year.  However, the good news is that the number of smokers continues to decrease yearly, and is currently at 18.1%.  Are you in for reducing this number further?

Apparently, quitting smoking is extremely difficult and many need to try different approaches before finally kicking the habit.  For many smokers it becomes more about the habit and the behavior, than the nicotine itself.  So how can you butt out?  Our team of experienced Occupational Therapists have some great solutions for you to try:

1.    Make Your Intentions Public:  The decision to quit takes a great deal of courage and should be celebrated.  Make your intentions public within your family or friends, or by using social media for a larger reach.  By making your goal to quit public it will help hold you accountable and to draw on those close to you to lean on for support.

2.    Devise a Plan:  Quitting cold turkey can be extremely difficult.  We recommend that you create a monthly or weekly plan to reduce your intake and set you well on your way.  This might be as simple as reducing one cigarette per day for a week or a month, then reducing again etc.

3.    Identify Triggers:  While working through your monthly or weekly plan to reduce the amount of cigarettes you consume, ensure you are keeping track of the amount you smoke each day, the times of day you smoke and what in your environment has triggered you to have a cigarette.  Tracking any behavior is the best way to isolate it and is the first step to making improvements.

4.    Modify your environment to help reduce these triggers:  After conducting your research look closely at the time of day, environment, people, stressors or other triggers that promoted your need or wanting to smoke. Is it possible to change your situation or environment to avoid these triggers moving forward?

5.    Work to reduce stress:  Many smoke as a reaction to stress.  Finding ways to reduce stress, such as meditation and mindfulness practice, taking a hot bath, or breathing exercises can help you to reduce this trigger.

6.    Find a healthier habit:  If it’s the “break” you find is your trigger try finding a different way to take 5 minutes to yourself.  Take a quick walk, try yoga poses, grab a warm beverage, phone a friend or practice breathing exercises instead.

7.    Seek Support:  By making your intentions to quit public you have opened yourself up to a group of family and friends to rely on and assist you in your goal to quit.  If these sources are not available, try phoning the Smokers Hotline or join a support group to speak with someone who can help you through your craving and keep you smoke free.

8.    Seek an Alternative Solution:  There are so many different products in the marketplace to assist you with quitting such as:  gums, e-cigarettes, inhalers, and patches.  Find which one works for you and rely on this to assist you along the way.

9.    Speak to Your Doctor:  Your family doctor is a great resource and will gladly support you in your quest to break the habit.  Speak with your doctor about the alternative solutions and medications that exist that can help you quit.  Your doctor may also connect you to OHIP-funded resources that you can access to support you in your quest.

10.  Celebrate Your Success:  Ensure that along the way you celebrate any milestones you have reached.  If you’ve worked for a week or a month to cut your daily intake by 5 cigarettes, reward yourself and share your news with those you love.  This will help to keep you focussed and lead to further success!

11.   Reword the goal if needed:  Yes “quitting smoking” might be the BIG goal, but under this there are layers of other goals that you can focus on that might seem less intimidating and are more fun to measure.  Maybe your smaller goals include walking upstairs without becoming breathless, having whiter teeth, or not wanting your clothing or home to smell like cigarette smoke.  Perhaps if you relate to a more practical goal that is tangible, measurable, and visible to others, your motivation might be enhanced.

12.   Watch for other bad habits to surface:  Sometimes when trying to move from one bad habit we pick up another.  With any reduction in a negative behavior there will be withdrawal.  Accept this and cope through it for the days it lasts, knowing that those symptoms too shall pass.  But when struggling through withdrawal, try not to adopt another bad habit as a coping mechanism.  Switching from smoking to eating unhealthy food or consuming more alcohol will not help you to achieve the ultimate result you want which is to improve your health.

13.   Don’t just change your behavior, change your LIFESTYLE:  Adopting a new way of living, and talking to others about this, is far more impactful and motivating then talking about a behavior change.  When people say “I am trying to lose weight” it is not nearly as impactful as “I have a sugar-free lifestyle” or “I have changed my lifestyle to achieve my health goals”.  Make a LIFESTYLE change to be healthy and let the behaviors follow.

14.  If at first you don’t succeed… try try again!

For more resources and tips to help you along the way visit www.smokershelpline.ca or www.quitnow.ca.

We wish you the best of luck and encourage you to BE A QUITTER this 2016!

 

Originally posted, January 2015.

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Tackling Tough Transitions: Strategies to Find the Silver Linings

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Co-written with Lindsay Sinclair, Occupational Therapist

Throughout our lives we all experience transitions. Whether it is a new job, retirement, the loss of a relationship, change in function due to injury or illness, or a change in environment, transitions are inevitable.  Although transitions can be exciting, positive experiences, there is also a sense of anxiety and fear that is associated with the loss of the past and fear of the future. While feelings of nervousness and pessimism are common during life-change, there are strategies that can make transitions easier, helpings us recognize the silver linings in difficult situations, and transition into a brighter future.

The first important thing to realize about a transition, is that it is different than change. Change is something that happens to people in their lives, whereas a transition is the mental process that occurs as they go through that change. Put this way, change is somewhat out of our control, whereas we have the ability to control transitions through our thoughts and actions.

When it comes to controlling our thoughts about change, there are many strategies that can help turn negative rumination into positive hopes and dreams. First, it is important to accept change. When we play the “what if” game it is similar to trying to row a boat upstream (we won’t be going anywhere and it takes a lot of energy). If we can accept the change, and let the river take us where it is intending, we can enjoy the ride and get to our destination more smoothly. To accept change we can take comfort in the fact that there are elements of our lives that will stay the same, and at the end of the day, no matter what situation we are in, we are fundamentally the same person, regardless of the changes we will encounter.

One strategy to use to think more positively is to recognize when we are having negative thoughts and replace them with positive ones. For example, “What could be good about this change?”, “What new opportunities has this change brought me?”, “What am I thankful for in my life?”, “How has this change been a learning and growing experience?” Although on the surface some changes may seem to be only negative, the truth is that every change does bring something positive to someone’s life.

Reflecting can be an activity that helps foster positive thoughts during a transition. Whether it is journaling, blogging, or just thinking during a long walk, it is important to process emotions and deal with change. During reflection, we can think about all the times in our life we have been through a change, note the strategies that helped us through change in the past, and remind ourselves that we have successfully been through change before.

trans2Another strategy that helps during a change is to engage in behaviours that will facilitate a positive transition. During change, take things one step at a time; set small attainable goals, and connect these to long term goals for the future. Goal setting allows us to take back control over a situation and work towards something meaningful, which can help alleviate the anxiety of change caused by lack of control.

To make transitions easier, engage in meaningful activity. When we isolate ourselves and become inactive, our physical and emotional health are affected, as we are left with too much time to ruminate. Participating in activities we enjoy can help make us feel more connected to who we truly are. For example, engaging in active exercise can boost positive feelings. Furthermore, by engaging in meaningful activities, we can connect with a new community, school, or group, which can help us integrate into a new environment.

Connecting with a social support system, or building a new social support system, is an important step in navigating transition. Finding a mentor who has been through a similar change, and seeking their advice on how they navigated change may be a helpful step to work through difficult times.

A useful quote for thinking about change is: “A ship is safe in a harbor, but that’s not what ships are for.” This quote serves as a reminder that safety is not productive but is merely a resting point, and we had to get to the harbor in the first place.  So, if you are “in the harbor” get the rest you need before leaving port and venturing to another destination.

In the end, change is part of life and it helps people to grow and strengthen. Change is inevitable, and often times, uncontrollable, but transitions are not. We are in control of our own transition process, and we have the power to turn negative and suffocating experiences into a positive learning experience that enables our boat to sail onward.

If you are struggling with a change, or transition, and seem to be stuck in port, considering the services of an occupational therapist for helping you to become “unstuck” in a place that is likely not functional or productive for you.

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Tough Conversations

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

My grandmother always used to say “once an adult, twice a child”.  She was referring to the fact that we start life dependent, and through the aging process, tend to end our life that way as well.  So, what happens when the grown-up “child” needs to become the caregiving adult in a relationship with an aging parent?  It leads to many tough conversations about some pretty big topics.  Recognizing that some conversations are not only difficult, but could cause relationship-changing outcomes, I wanted to give you some pointers for handling the big ticket items adult children might encounter with their aging parents:

Driving

We all have a societal obligation to ensure that the roads are safe.  Just like a parent not giving the keys to a teen that has not demonstrated adequate driving skills, adults need to look for this in their older parents too.  While some seniors self-retire their license when they feel they are unsafe, some are not as willing, or able, to make this decision.  I remember my grandmother stopped driving when one day behind the wheel she “woke up and the light was green”.  While we joked about this as a family, we applauded her for making a responsible decision.

Making sure your parents are able to drive safely is important for them, and the general public.  So how do you manage this?  Next time you are out with your parent drive separately and follow them, or get them to drive with you in the car.  Watch for the following:

  • Are they driving to slow or too fast?  Note that driving too slow can be just as dangerous as driving too fast.
  • Are they obeying the traffic signs?
  • Do they have the range of motion to look both ways and check blind spots?  Are they looking around at stop signs, when merging lanes?
  • How are they negotiating directions, are they getting lost frequently?
  • Do they seem to be driving aggressively, or do they seem oblivious to other drivers, cyclists or pedestrians?
  • Do they obey right of ways, manage one-way streets, can they park the car safely and easily in a lot or on a side-street?

If you have concerns about any of the above, you have a moral obligation to bring your concerns to their attention, or to the attention of their treating physician.  If you choose to have this discussion with them directly, be caring and compassionate, but direct.  Tell them about your concerns but instead of just telling them they shouldn’t drive, suggest the involvement of a professional like their doctor, an occupational therapist, or driving assessment.  If you are not comfortable having this conversation with them, bring your concerns to the attention of their treating physician so they can do their own assessment.

Home Modifications

Most seniors want to remain in their own home as long as possible.  Many recognize that some small changes to the home could have a big impact on their safety and function, and some are very hesitant to consider modifications.  I remember I once had a call from a physician who was calling about his own parents, expressing concerns about his mother and how she was managing at home.  We talked about the value of OT and he agreed that a home assessment would help her.  He then asked “so, what should I say to her to get her to agree to this”?  I found that surprising as even as a physician who is required to have difficult conversations with people all the time, he struggled to know how to approach his mom.  I suggested he tell her that he recognizes it was very important to her to stay at home as long as possible, and that he is concerned that if she falls, staying home might not be an option.  I told him to tell her that he wants to have an occupational therapist come and talk to her about her safety to make sure they are doing everything possible to keep her living at home for as long as she can.  He called his mom, and like a kid planning a sleepover, called back and said “it worked, she said yes”!

I think it is important for adults of aging parents to demystify the home modification process and stress to their parents that most changes are minor, removable, or will actually increase the value of their home, while keeping them there for as long as possible.

But honestly, the best approach is usually letting a professional explain to the aging parent what can be done, and what they should consider either now, or in the future, to ensure their home continues to work for them.  In that case, the difficult conversation is more getting the professional in the door, instead of trying to convince the parent of the changes that you feel (without full knowledge of the options) might be needed.  Occupational therapists are great at getting a sense of what people need, explaining the options, and coming up with a plan.  I always chuckle when I meet with seniors and the first thing they say is “I know my son says we need X, Y and Z, but just so you know we are not doing that”.

Relocation

There may come a time when being the primary caregiver of an aging parent who is trying to live at home, may become too much. Caregiving is a difficult task that often requires time, knowledge or a level of commitment that a working adult-child who might have children of their own, just does not have. Having a discussion with your parent about the need to relocate to get access to skilled or more available care, is difficult.  Like the other conversations, tell your parent that their safety is your primary concern and that you are willing to do all you can to help them get the care they need.  Remind them of your own capabilities and the other responsibilities that you are also trying to balance.  Framing your conversation this way will go a long way to show them you are being supportive, and not just trying to tell them what to do or how to do it.

In the end, yes these conversations will be difficult, but your parents need your love, support and guidance as they navigate the aging process.  I remember having a difficult conversation with my grandmother about her decision to use a walker instead of her wheelchair, when the wheelchair was much safer for her.  She was giving me a hard time and I reminded her that she taught us to care about each other so the fact that I care about her safety was actually her own fault.  She laughed and we had a great conversation about her fears about declining mobility and reducing independence.

I wish you the best as you navigate these difficult conversations with your parents.  But remember, sometimes involving a professional (like an OT) who can assess the situation, come up with solutions, and develop a plan may go a long way to maintaining the parent / adult-child relationship, while keeping the parent safe at the same time.

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Make 2016 Your Best Year!

Happy New Year!  For many of us, this is when we take time to reflect on the previous year, and set Resolutions or Goals for the year ahead. However, significant research highlights that many people who set resolutions or goals for the year end up abandoning these before the end of January. Why does this happen and how can you ensure the positive changes you wish to make come to fruition?

Check out the following infographic created by Weight Watchers: “The Life and Death of a New Year’s Resolution”

new years

Here is a summary of this helpful graphic:

1.       Set A Realistic Goal:   Many people start December 31st or January 1st with the mindset that this is the year for change.  They make a resolution to lose 20 lbs, or eat healthier each and every day, add $10 000 to their savings, or quit smoking immediately.  These resolutions are fantastic!  But are they realistic?  You know yourself and your limitations best.  Ensure the resolution you are making is achievable.  Start small and build upon it.

2.       Create a Plan with Milestones:  If you are hoping to lose 20 lbs in 2015 it would be extremely unhealthy and unlikely to do this in one month.  Create a plan of what is an attainable amount to lose each month to reach this goal and HOW you can accomplish this.  If you’re struggling with creating this plan, enlist the help of a professional who can help you along the way!

3.       Make Your Goals and Milestones Public:  Use social media to your advantage!  Making your goal public on facebook or simply via an announcement to your friends will help hold you accountable, thus helping you stick to your plans.

4.       Celebrate Success:  When you reach a milestone on your plan, it’s time to celebrate!  Take time out to be proud of what you have accomplished and give yourself a well-deserved pat on the back.  Knowing that you accomplished a small part of your plan will keep you motivated toward the next goal.

5.       Use Technology:  In the world today it’s easy to find apps, and devices to help you reach your goal.  Whether looking to save money, reduce debt, lose weight or kick a bad habit, as Apple says:  “there’s an app for that!”  Invest in a FitBit (or other wearable device) or app to help you with your goals.

Whatever your resolution we hope these tips help you to make 2016 your healthiest and happiest year yet! 

 

Originally posted January 5 2015.

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A Goal Without A Plan Is Just A Wish

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

What if I told you that there was one easy way to achieve the goals you have set for yourself?  Could it be that simple?  People are complicated creatures, true.  But if you have taken the time to set goals, are you measuring these and achieving them?  Are you working on your goals every day?

Here is the secret sauce…with every fork in the road, and there are tons of them, ask yourself: which decision aligns with my goals?

Let’s take health as an example.  Your goal is to lose weight, be more active, or be less breathless at the top of the stairs.  So you get to work and the first decision is: should I take the elevator or the stairs?  Then it is lunch and you have the option to work at your desk, or go out for a short walk.  Or you don’t bring a lunch and need to decide if you should buy pop or water.  The salad or burger.  With each of these examples one decision aligns with your goals and one does not. Yet if you continuously choose the option that aligns with your goals, results will follow.  This is true even if you make a small decision in the right direction – like taking the stairs for one flight then catching the elevator for the rest of the ride.  Or instead of ordering the salad, you just choose to not order the fries.

Using my life as an example, I have five key goal areas:  health, family, career, finances and personal growth.  Every evening I have the option of bringing my computer home to continue working into the night.  To do so may align with a financial goal of earning a suitable income, and a career goal to run a successful business, but it negates two other important goals of health (working means I will not exercise), and family (working means I won’t be spending time with my children).  So, I have a conundrum.  But in these cases the reality is that my day at work has already been spent on my career and financial goals, while my other goals have taken a backburner to work time.  So, considering this, aligning my evening time with two different goals helps me to make the important decision to leave the computer at the office, minus the guilt that comes from leaving some work unfinished.

Yes, achieving goals takes discipline, but it is far easier to make small consistent choices, then to make a drastic change that might not be sustainable.  So, on the path to awesomeness that involves you setting goals and blowing these out of the water, just ask yourself daily, as you need to make decisions around your behavior and time, “which option here will help me to achieve my goal(s)?”  Then, as you align your decisions with your top priorities, results will follow.

I wish you the best of luck achieving the goals you set for yourself in the new year ahead!  

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5 Life Lessons Learned From The Elf On The Shelf

The holidays bring a host of traditions. From the process of getting real trees to decorating fake ones, from putting up lights, buying the right gift, and who to visit when, there is no shortage of ways to be busy in December. However, the most recent tradition is the ever popular Elf On the Shelf. Starting only a few years ago, this toy and book is now ranked one of the leading children’s toys of the season.

If you have one you know the drill. If you don’t it goes like this: The Elf has been sent from the North Pole to supervise children. Every night he wanders back to Santa to report on naughty and nice behavior. When he returns in the morning he is in a different place in the house, or is engaging in suspicious, silly or reckless behavior. With this new holiday tradition comes a Social Media flurry of photos showing the Elf assuming a multitude of positions and behaviors.

So while I am personally “traditioned-out” this time of year and have yet to buy an Elf for our home, I think there are some valuable life lessons we can take from this crafty creature:

Don’t stop having fun. If buying an Elf forces you to be silly, fun, spontaneous, and goofy, go for it. We should never take ourselves too seriously.

Childhood is short, keep it exciting. If having an Elf helps kids to start each day with a smile, an adventurous love for getting out of bed to see where the Elf has landed, or to react for several mornings like they do on those special days of Christmas, Easter, or after losing a tooth, it is all good. After all, in the early years that is their one purpose in life – to be curious, interested in the world, and excited to explore new things.

It’s okay to observe. Sometimes we need to sit back, watch, listen, and take it all in. Whether we are reporting back to Santa, or just soothing the interior of our own soul, reflect, pause and just “be” sometimes.

Each day is new. Celebrate it. If we could all awake with vigor and excitement, and like the Elf use our day to engage in new and challenging situations, to think outside the box, and to gain a new perspective, life could be much more exciting. Assume a different position sometimes, look at your world upside down, take a new stance and see what happens. Maybe moving around a little and trying new things is just the perspective you need to head in a new direction or to better the path you are on.

Don’t stop being creative. Whether your Elf is fishing for Goldfish, doing icing sugar snow angels, or almost falling into the toilet bowl, creativity is a spark of life. In the book “Brainstorm” it talks about how important creativity is for developing minds and how this declines in adulthood. This decline in creativity has become a theory to explain middle-age unhappiness. So, use the Elf as a model for how to stop each day from being repetitive and mundane and find ways to creativity explore and express yourself.

If you have an Elf, enjoy. Or, if you are like me, you have enough to do this season. Either way, take these lessons inspired by the Elf on the Shelf and have an awesome December.

 

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Christmas Gifts That Are OT Approved!

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

If you’re a keen and organized shopper, I’m sure you have the majority of your holiday gifts already purchased, and if you’re anything like my Mother had everything done and wrapped in August! However, if you’re anything like my husband, you are waiting until the 24th to think about Christmas.

Although Santa and his Elves are hard at work building the toys your children put on their Christmas wish list, there may be a few items you still need to purchase.

We consulted our talented team of Pediatric Occupational Therapists and are happy to provide you with some fun but functional gift inspiration. These are gifts that are educational and stimulate child development:

1. BOOKS: Although technically not toys, books make an excellent gift. Fostering a love of reading in children from an early age is essential in development of language and literacy skills, while building creativity and imagination. And so many types of books exist! Beyond regular books, pop-up books, and interactive books, there are even books where you can record your voice, or the voice of a loved one into the story so that person is “reading” to your child. This is great for those people in your life who are out of town and are not able to “read” bedtime stories in person.

2. TOYS THAT MAKE THEM THINK: Look for puzzles, games, shaper sorters, science kits and more. Problem solving through play is fantastic for the mind and will help them become independent problem solvers in life. But be prepared to explore and learn with them. Interactive parent-child time through new learning is also essential to development!

3. TOYS THAT GET THEM MOVING: We’re living in the sedentary age of technology where obesity is on the rise. Try some active toys like a skipping rope, scooter, ride on toy, a bike or winter sports gear like skates, skis or snowshoes. But with all riding toys, include the helmet too! Keeping kids active is extremely important for both their physical and mental health!

4. TOYS THAT BRING OUT THEIR CREATIVE SIDE: Fostering creativity in kids at an early age is important for their development. Looks for gifts that will encourage them to be creative like art kits, dress up clothes or crafts and supplies.

5. AN EXPERIENCE THEY WON’T FORGET: Too many toys to choose from? Why not treat the children to an experience instead. Consider tickets to a sporting event, a play, or musical or a child-appropriate concert. Special events like these create fantastic memories and can strengthen family bonds.

We hope you find some gift inspiration from our tips and with you very Happy Holidays!

 

Originally posted December 8, 2014

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Aging in Place

Co-written with Claire Hurd

If you are an “empty nester” you may start to think how this phase in your life relates to your home and ongoing need for a larger space that previously accommodated a growing family.  Or, for some with kids out of the house, married and with their own families, they want to start spending time in a warmer climate, or want to move closer to their grandchildren.  Some will even consider moving in with their children to help raise the next generation, or because financially this is the most suitable option.  Whatever the reason, housing can be a massive contributor to function as we age, and there are several things to consider.

Universal design:
Universal design, or inclusive design, has the goal of maximizing usability for all, without sacrificing aesthetics when possible. You have probably seen universal design in many public spaces, but it can be incorporated into homes as well.  Examples of this may include lever door handles rather than knobs, raised outlets and lowered light switches, and large flat panel switches rather than small toggle versions. Many new homes are being designed to be “visitable,” with a basic level of universal design, including a smooth, ground level entrances without stairs, a wheelchair accessible main floor bathroom, wide doors, and wide hallways with room to maneuver a mobility device. When touring a potential new home, see if principles of universal design have been included. If you are renovating, consider including universal design elements in layout and fixtures.

Layout:
 Bungalows and condos are usually the most accessible options. Stair lifts are expensive, and the more landings or turns there are, the more they cost. It is also difficult to install them on curved staircases. Some side split designs may be conducive to elevator installation, but side or split-level homes are more difficult to accommodate in the event of mobility decline.

Bathrooms:
Bathrooms should have room to maneuver a mobility device. “Comfort height” toilets are a few centimetres taller than standard toilets, more like a standard chair, and make sitting down and standing up easier. A walk-in shower, or, better yet, a roll-in shower with no ledge to step over, will be accessible by family members and guests who may have temporary or more permanent mobility challenges.

Kitchens:
If possible, have variable counter heights in the kitchen, to make food preparation easier for taller adults, shorter children, and individuals who need to sit. Recessed areas underneath countertops and appliances can accommodate mobility devices or chairs. Ensure that lighting is good in all task areas. Rounded corners prevent injuries. Casement windows are more readily opened than the traditional double-hung styles.

Outdoors:
Gardening is a great activity for mind, body, and soul, but bending and kneeling on the ground can be difficult for many people. Raised flower beds and container gardens are a great solution.

Location, location, location:
Even if a house or apartment is otherwise perfect and accessible, if it’s in the middle of nowhere or in a neighbourhood that feels unsafe, it may not promote its occupants’ wellbeing. Proximity to services, such as grocery stores and public transportation, not only prevents social isolation, but may decrease potentially unwanted dependence on others.

Accessibility can benefit health, wellbeing and safety for anyone – regardless of physical or cognitive limitation. If you have more specific questions about how you can help yourself or others age comfortably in place, consider consulting with an occupational therapist.  Occupational therapists are trained to assess the person, their environment and the tasks they need to complete in the places they live and work.  So, before you make potentially costly mistakes in planning how you can better manage the “job of living”, give an OT a call.

 

For more information on Aging in Place and other helpful topics for Senior’s please visit our Senior’s Health page.