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The Physical Demands Analysis – Risk Reduction for Employers, Employees and Physicians

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

As occupational therapists, we are often asked to coordinate return to work programs.  Often, this starts with an injured employee who has a note from his doctor saying he is fine to return to work – sometimes with a comment about modified hours or duties.  While it is great that doctors may recognize the difficult transition of going back to work after an absence or injury, I am always fascinated that they seem to approve return to work without having documented evidence of the demands of the job.  I see this omission as forming considerable risk to the employer, employee and doctor as I will explain.

However, before talking about risk, let’s clarify what I mean by a “Physical Demands Analysis”.  These are assessments of work positions that serve to outline all the different physical demands (and / or cognitive demands) of that specific job.  These are analyses of the JOB, not the PERSON, thus they showcase what any one person would need to do in order to complete the job successfully.  They cover demands (with objective measurements) for walking, lifting, standing, sitting, carrying, bending, climbing, stooping, crawling, finger dexterity, neck positioning, reaching, etc. and categorize these as things that are completed “never, occasionally, frequently, or constantly” to complete the job requirements.  Cognitive Demands Analysis are similar and include things such as attention, memory, visual perception, concentration, etc. – focusing on the mental demands of the position.

Now let’s talk about risk.

Employer Risk

Employers need to understand the physical demand requirements of the positions they fill.  And each workplace is unique regardless of similar positions and titles.  For example, the job of a Long Haul Trucker, Delivery Driver, Shipper / Receiver, or Stock Clerk are going to vary considerably based on the weights of the items, the distances to traveled or walked, and the positions the body needs to assume to get the job done.  Knowing this as an OT who analyses jobs, I wonder how employers not only hire for these positions when the demands are not typically transparent, but even more so, ensure appropriate medical clearance is obtained when an injured worker is returning.   I would worry, as an employer, that I would be liable for injuries caused to the worker had I not reviewed with them the demands of the position (via a detailed report) before they started.  Or, the risk of accepting and accommodating a worker’s return when they “told” their doctor what the job entailed and half of the information was not accurate.  In some cases it is important for employers to pre-screen people for the work they will be doing to determine the right physical fit.  This not only adds protection for the employer from a compensation claim, but also protects the worker from accepting a position that they don’t yet know exceeds their abilities. Further, if someone is injured (on or off the job), the employer should be ready, Physical Demands Analysis in hand, to send this report to any doctor, insurer, or rehabilitation professional that requires it.  Only then will you know for sure that the person is rehabilitated properly and any return to work has been based on the accurate demands of the job they need to return to.

Employee Risk

Not all jobs are suitable for all people.  That explains why some positions are more gender biased, why others require specific training, and why some can be competently done by high school students.  As an individual looking for work, it is important that people understand the nature of the job they will be completing.  This is more than just a job description.  For example, “filing” is fine as a job task, but maybe not if the cabinets are in the basement, there are two sets of stairs to get there, the files weigh 10 pounds each, and the employee has a previous knee injury.  Accepting a job is just as much about the employee feeling it is the right fit for them, as it is the employer feeling they can do the work.  People need to make informed decisions about the positions they are considering, and this needs to include the physical work that will be required, the environment in which it will be completed, and the risks involved from repetitive strain to lifting, carrying and reaching.  A Physical Demands Analysis tells them all this.

Physician Risk

I get that some people want (need) to return to work before they are ready.  And I also get that some never feel ready to return, or have other motivating factors to stay home.  In return to work cases the doctor (family doctor or hired physician usually by an insurer) becomes the gatekeeper between back to work and not.  What baffles me though is the doctors that make return to work decisions when they are uniformed.  I say “uniformed” because often this decision is made without the supporting documentation provided by a Physical Demands Analysis.  If the person says to their doctor “I can work” they often get a note.  If they say “my job is too heavy” then they don’t.  But what if both of these patient-driven comments are untrue?  Someone wanting or needing to work fearing ongoing loss of income or job security may not be able to meet the demands of the job, know this, but tell their doctor to sign them back anyway.  Then they become reinjured.  Or, one client that I saw told her doctor she had to lift 50 pounds so he would not approve a return, when after we analysed the job the maximum lifting requirement was 10 pounds.  Ideally, before anyone returns to work post injury, they should participate in a battery of tests that match their current physical abilities to the demands of their position.  Yet, these tests cannot be done without a confirmed and documented Physical Demands Analysis.  Lastly, the Physical Demands Analysis can also contain information about “modified duties” that would be available to an employee if injured.  Thus, if a doctor was not able to say that someone is cleared to do their previous job, they could reference the list of alternatives and provide clearance to an alternate position.  That gets people back to work faster while reducing liability risks to the employer, employee and physician.

In the end, having a Physical Demands Analysis report on file for every position within a company is an ideal way to reduce liability risk when hiring, to return injured workers to the job, and to prevent injury in the first place.  This report needs to be accurate, complete, and should outline the physical and cognitive demands of the position, in addition to recommendations about how to reduce injury and any return to work options for an injured person.  Employers need to be proactive – they should not wait for a lawsuit to expose this business risk.

And who is better to complete your Physical Demands Analysis than an “Occupational” Therapist?

For more on workplace health and wellness please refer to our Healthy Workplace page.

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Epilepsy and Occupational Therapy

If you happen to be anywhere near the downtown Toronto area or Niagara Falls on March 26th, you may be seeing the colour purple. That’s because March 26th has been designated Purple Day across the globe in honour of epilepsy awareness. Individuals are encouraged to wear purple clothing, local organizations host events, and this year two of our nation’s biggest landmarks will also be bathed in purple light to increase awareness of the need for research about epilepsy.

One in one hundred Canadians are affected by epilepsy and it is currently estimated that 300,000 Canadians are living with the disorder. The term epilepsy is derived from a Greek term for possession, as the Greeks believed the person affected was being overcome, seized or attacked. It is now understood that epilepsy is a neurological disorder that leads to brief disturbances in the typical electrical functions of the brain. These disturbances are characterized by sudden and brief seizures, which may vary in form or intensity for each person. For example, a seizure may appear as a brief stare, an unusual body movement, altered awareness or a convulsion.

Epilepsy is a chronic medical problem, but for many people it can be successfully treated through medication, a special diet regimen, or surgery. However, treatment is unique for each individual and must be tailored to their needs in order to be effective. Because of the unpredictable nature of epilepsy, it can disrupt a person’s routine and their ability to participate in their desired daily activities. For some, they may experience changes in their thinking, energy levels, coping skills, or feelings of self-esteem and in some cases, postural deformities such as contractures may develop.

Occupational therapists can assist those with epilepsy and their families to improve their independence and enhance their participation in daily tasks. Occupational therapists may provide advice or education in regards to safety such as how to adapt potentially unsafe areas of the home like the kitchen and bathroom or support medication adherence and management. They can also recommend equipment and devices that can be used at home and in the community to enhance safety.  OTs can assist with developing social skills and coping strategies that may be affected as a result of epilepsy and can also help by examining and addressing sensory integration challenges like sensitivity to light or noise. Another common area occupational therapists address involves developing strategies to increase organization and enhance routines to support a person’s performance at home, school or in the community. Using their task analysis skills and their holistic and individualized approach, Occupational Therapists are well suited to help individuals with epilepsy and their families find a variety of options and ways to be able to achieve their goals and fully engage in everyday life.

Resources

http://www.epilepsyontario.org/

http://www.epilepsy.ca/en-CA/Home.html

 

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Accessibility in Ontario: Is Your Company Compliant?

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

Ontario is the first in the world to enact the Accessibility for Ontarians with Disability Act (AODA) – a law requiring businesses to provide accessibility standards for people living with a disability. This is a multi-year plan that requires all public, private and not-for-profit businesses to make their organizations accessible for everyone by 2025.

The Government of Ontario Legislative Assembly designated that public sector organizations, and large organizations must establish, implement and document a multi-year accessibility plan that outlines their strategy to prevent and remove barriers to meet these standards. Plans are to be maintained every five years, posted on the business’ website, and modified to be specific to each individual upon request. Timelines and details for the following policy implementation will depend on the type and size of business.

Do you know if your business is accessible? Are you complaint to the legislation?  Here is some helpful information and resources to help you find out.

5 Areas of Accessibility Standards

1.  Customer Service – this refers to the services provided to disabled persons, beyond just the specifics of the building itself.  It also includes training of staff to be able to communicate with people who are using assistive devices, service animals, and support personnel.

2.  Employment – this involves including employee accessibility needs in human resource practices.  It covers the need to notify employees and new applicants of work accommodations, and outlines the requirement of developing a written process specific to each individual requiring accommodation.  Lastly, also includes an individualized emergency response plan if deemed necessary, return to work processes, performance management, career development and redeployment parameters. Private or non-profit organizations must comply by 2016.

3.  Information and Communications – this refers to employers providing accessible feedback options, educational and training resources and materials, along with how the employer is making internal communication accessible (i.e. electronic, Braille, audio formats, large print, text transcripts, note taking, captioning, augmentative or alternative communication devices, sign language and repetition or clarification of information).  Refer here for further information.

4.  Transportation – The standard applies to conventional services such as the Toronto Transit Commission (TTC) or specialized transportation such as DARTS in Hamilton, certain ferries, public school buses, or hospitals, colleges, universities that provide services such as shuttles. Electronic pre-boarding and on-board announcement requirements must be in place by January 1, 2017.

5.  Design of Public Spaces – The Accessibility Standards for the Built Environment focus on removing barriers in two areas: buildings and public spaces. As of January 1, 2015 new construction and renovations will be required to abide by accessibility requirements. This includes recreation trails and access routes, outdoor public eating areas, outdoor play spaces/parks, outdoor paths of travel (sidewalks, ramps, rest areas, and pedestrian signals), parking, service counters, fixed queuing lines and waiting areas, and the maintenance and restoration of public spaces.  Specific measurements for development are listed in the policy guidelines.

Steps for Compliance

1.  Determine what you have to do with use of this helpful wizard –   This survey provides you with:

  • Accessibility requirements your company has already met
  • Upcoming requirements for January 2016, based on the information you provide.

2.  Assess your level of accessibility –   Does your company have barriers? Barriers are obstacles that make it difficult, even impossible, for people with disabilities to take part in society to do occupations such as working, shopping, attending appointments or taking public transit. Service Ontario provides a great description of barriers to accessibility.

3.  Develop accessibility policies and a plan –  Statement of commitment: All public organizations and private and not-for-profit organizations with 50+ employees are required to develop an available statement of commitment explaining their vision and goals.

4.  Train your staff on accessibility standards –  Training employees and volunteers about this law (Public sector organization of 1-49 employees AND private or non-profit organizations of 50+ employees by 2015, or private and non-profit organizations of 1-49 employees by 2016).

5.  Put it in writing – You can combine your statement of commitment, policies and plan in one document or in a way that best suits your organization. It’s also up to you to determine the level of detail in your accessibility policies and plan. It will likely depend on your accessibility goals and when you hope to achieve them. Check out this useful template with timelines.

6.  Let people know – Report your progress online and let customers know how to find your plan.  Consider using your website or other circulations or media to notify others about your compliance.

Lastly, consider Occupational Therapy.  As the profession that deals exclusively with helping people with disabilities to manage safely and independently at home, work, school or in the community, we have a plethora of knowledge about issues of accessibility.  Consult with an Occupational Therapist for creative and compliant solutions to this legislation, or to assist with staff training.

For more helpful tips on workplace health and wellness please refer to our Healthy Workplace page.

 

Resources:

The free accessibility compliance wizard and detailed information: http://www.mcss.gov.on.ca/en/mcss/programs/accessibility/.

The succinct schedule of compliancy dates: http://www.cfib-fcei.ca/cfib-documents/br1035.pdf. 

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Are you Complaining or Solving your Problem?

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

I am not one for complainers.  Those people that take time to vent about the wrongdoings in their life without putting that energy into solutions.  Every problem has a solution.  In fact, most problems have multiple solutions.  And many people often forget that “do nothing” is always an option.

Since my kids were little I have not tolerated complaining.  I feel that it just creates negative energy and serves no good purpose.  How will being good at complaining serve them as students, adults, in life?  I don’t feel it will, and as the mom in the very important role of being their “adults-in-training coach” I ask them when they are venting “are you complaining or solving your problem?”  I am all about solutions and engage them in solution-focused communication related to the challenges they face.

I see this at work all too often.  For example, the other day I had a complainer in my office.  This person spent 30 minutes venting about a situation about which they actually had full control to solve.  Yes, there were solutions in their rant, but these were extreme and unnecessary and in the end they told me how they expected me to solve the problem – without trying a solution themselves.  Not productive, adult-like, or mature.

I guess problem solving for me is an occupational hazard.  As an occupational therapist, I consider my role to ultimately be “options therapy”.  In that, we take any given problem related to function, analyze it, break it down into component parts, and help people to understand all the possible solutions.  Some solutions are easier, shorter and cheaper than others, and some can be elaborate and involved.  Either way, we are not in the business of “control therapy” and need to essentially just empower people to make solid decisions around suitable alternatives and to implement these with or without our support.

So when faced with a complainer, boldly ask them if they are complaining or solving their problem.  Help them to generate a list of possible solutions, including the pros and cons of each.  In the end you will be showing them that not only is complaining unproductive, but there are calm and thoughtful ways to work through problems that will bring clarity, reduce stress, and ultimately lead to resolve.

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Eating for Energy

Guest blogger:  Susan Culp, Certified Health Coach of Fresh Focus
www.fresh-focus.ca

Do you have an abundance of energy and vitality at work?  If the answer is no, then you are among the vast majority!  Imagine how much more productive and motivated you would be and how this would make you feel.  Unfortunately, most of us have fallen prey to a few very common culprits that drain our energy and leave us wandering through our work week in a tired fog.

One of the main factors contributing to decreased energy is poor food/lifestyle choices — caffeine, sugar, soft drinks, alcohol, processed foods, tobacco, artificial sweeteners, refined starches, etc.  Some of these ingredients (such as caffeine and sugar) give us an initial energy boost; however, they ultimately run us down by depleting us of minerals and nutrients and disrupting our natural rhythms and metabolic processes.  We end up experiencing cravings for these foods — not only for the initial “boost” they give us, but also because they are HIGHLY ADDICTIVE.

Ask yourself: what do you depend on to get through your work day?  As March is National Nutrition Month, we challenge you to identify one of your own “energy suckers” and then make the commitment to cut it out of your life, or reduce it, for at least 2 to 3 weeks.  You’ll be amazed at not only your increased energy, but also the empowering experience of accomplishing a goal and kicking dependency to the curb!

Try these 7 Tips & Tricks to help boost your energy during that mid-afternoon slump:

1.     Take a 5- or 10-minute walk down the hall (or up and down the stairs) — scheduling “walking meetings” (ideally outside in the fresh air) whenever possible is also a great way to get both your energy and creativity flowing.

2.     Chew mint-flavoured, sugar-free gum

3.      “Belt out” the lyrics to your favourite songs — this one may be more appropriate for your commute in the car, but singing really does work

4.     Snack on unsalted, roasted nuts & seeds to stabilize your blood sugar levels

5.     Massage the outer rim of your ear — sounds crazy, but it works!

6.     Drink plenty of water during the day — many people feel tired or lethargic when they’re even slightly dehydrated

7.     Having a plant on your desk can decrease stress and increase productivity

The best way to increase your energy over the long-term is to eat whole foods such as vegetables, whole grains, fresh fruit, and beans.  When foods have not been processed, they keep their natural fibre, vitamins, and minerals.  Try to also work in a couple of superfoods each day for an extra punch of nutrients — start with simple options like berries, greens, and seeds and work your way up!

Many of us already know what we need to eat (and/or what we need to stop doing), but still just can’t seem to break out of our current patterns.  Therefore, we encourage you to find a group of co-workers and do it together — the key is having enough support, not more willpower.  Create a challenge between groups (or across departments) to make it fun and motivating — the bonus is that you’ll also be creating a healthier and happier workplace environment.

Make this month the start of a healthier, more energetic you!

 

 

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Slippery Slopes: The Great Tobogganing Debate

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

Growing up as a kid in the era of “go outside and find something to do”, I always tobogganed in the winter.  We lived on the top of the escarpment with some great hills behind us.  I would venture out with my GT Snow Racer, and usually my dogs, and would find some great runs.  The combination of speed, fresh air and exercise made for a fun afternoon.

While we didn’t have social media at the time, the news would tell stories of people hurt tobogganing.  I remember one story in particular of a young Reverend who died tobogganing at the Burlington Golf and Country Club when he hit a tree.  I believe he was tobogganing at night with some kids in his congregation.  Other stories of broken bones, head injury and the like would circulate, but with all things slightly dangerous, these stories didn’t seem to change the fact that kids would still venture out to toboggan as a favorite Canadian past-time.

This winter has brought considerable debate regarding the tobogganing ban in Hamilton and other cities across Canada.  Many are outraged that enjoying this fun winter activity could come with a hefty fine.   As my own kids approach the age where the little “bunny hills” near our house are no long “fun enough”, and I consider the work I do in Brain Injury, I do find myself re-evaluating this pastime.

So let’s review the dangers: experts state that tobogganing is considered the 4th riskiest sport for catastrophic brain and spine injuries, behind diving, snowmobiling and parachuting.    A 2008 Ontario study showed that the instance of long term disability or permanent injury was 38 of 100 000 people with a death rate of 2.4.  (http://news.nationalpost.com/2015/01/05/national-post-editorial-board-the-freedom-to-toboggan/).  There are different types of toboggans that need different positions – from head first to feet first, lying to sitting, some take more than one person, and all go at varying speeds.  The risks are real and will depend on many factors including the hill and its surroundings, the number of people also sharing the space, the type of sled, the position, age, experience, and size of the rider.

So how can we balance these risks with the acknowledged fact that tobogganing is a fun, enjoyable, and a great form of winter exercise?  Here are some tips:

1.       Supervision.  The risks of injury with tobogganing will increase, not decrease, as kids get older.  The older they are, the more likely they are to make poor decisions, to go fast, to try and be “cool” around friends, or to forgo the use of safety equipment.  Supervising your child (at any age) while they partake in this activity is recommended so you can act as their “second brain” and can provide them with cuing and guidance away from poor decisions.

2.       Wear a Helmet.  Like skating and skiing, choose a CSA approved helmet that fits properly.  You don’t have to hit a tree to sustain a head injury – even just banging heads with another person, impacting the ground, or coming to a very sudden stop can cause the brain to be rattled.  A helmet adds protection and reduces the risks.

3.       Choose a “safe” location.  Consider that some locations are now illegal for tobogganing and so do your research before you arrive.  Find a hill that is not too crowded, that has lots of open space and plenty of room to stop at the bottom that is away from trees, roads or other hazards.  Ramps and obstacles, while fun, increase the dangers so teach your kid to avoid these.

4.       Use a proper sled.  Find a toboggan that allows for steering and stopping and requires your child to sit upright, feet forward, where they have a clear line of sight and can easily bail if things are going amiss.

5.       Feet first.  Teach your child to toboggan with their feet, never their head, leading their body down the hill.  A broken leg, while still a serious injury, is less life threatening than massive head or neck trauma.  Much like going down a slide, teach them the safest technique.

6.       When in doubt… bail out.  Tell your kids to forgo the sled and bail to the side if they are going too fast, are approaching a person or obstacles, or if they are losing control.  Just like all the training we give our kids – we need to teach them that if they are going to fail or fall, do it properly and safely.

My family has a secret spot for tobogganing.  It is a private golf course that we have permission to use.  The slopes are wide open with varying runs to choose from.  The trees surrounding the hills provide shelter from the wind without creating unsafe obstacles.   No one else is ever there.  We bring our dogs who enjoying running the hills with our girls.  Everyone comes home exhausted.  We were there last weekend and noticed that some other kids have also been using the hills.  But these kids seemed to have snowboards and had made a trail up into the forest with jumps and turns.  I walked those trails with my kids and we talked about how unsafe they were.  Too steep, too narrow, too many trees and a massive jump at the end.  It was refreshing for me to realize that my girls understood the safety risks involved and that I was there to help them make better decisions about what hills to descend.  While they were sledding I baked in some winter sun, threw snowballs to my dogs, helped my girls bring their sleds up the hills, and even took in a few runs.  We had a great time and followed it up with some hot chocolate.   That is how we enjoy our winter and I hope that in lieu of a ban or fines that cities can find a way to facilitate safe participation in this winter pastime, recognizing the value this brings to our culture as a country that spends a few months of the year in the cold and snow.

How do you feel about the tobogganing ban?  Will you and your family continue to hit the slopes for the remainder of the winter and moving forward?  If you do, please be safe!

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Could Your Organization Benefit From A Functional Capacity Evaluation?

Guest Blogger Samantha Langan, Occupational Therapist

In the world of return to work, there are a variety of different assessments that exist. With the many different types and crossover amongst them, it can be very confusing for employees and employers to know which sort of assessments they could benefit from in regards to return to work. This blog can shed some light on one such assessment, known as the Functional Capacity Evaluation or FCE.

Functional Capacity Evaluations have been used since the early 1970s as an objective assessment of an individual’s ability to perform work related activities. In the past, these were frequently performed by Occupational Therapists, Physical Therapists and Ergonomists. Today, Occupational Therapists remain optimally suited to conduct FCEs due to their strong task analysis skills. This is helpful considering the different purposes FCEs can have. FCEs can be used to set goals for rehabilitation and readiness for return to work, examine residual work capacity, screen for physical compatibility before hiring a new employee, determine disability status and assist in case closure or settlement. As such, FCEs can vary from all inclusive, such as when looking at case closure, job specific, such as when making a match between an employee’s abilities and the job description, or injury specific, such as evaluation for upper extremity demands after surgery for carpel tunnel.

When completing an FCE, the examiner will often begin by reviewing the client’s medical records and conducting an interview with them. Next, musculoskeletal screening is often completed, and if there are no contraindications, evaluation of the client’s physical performance in relation to static and dynamic tasks will be conducted. A comprehensive report is then compiled, which contains information regarding the client’s overall level of work, tolerance for work over the course of the day, individual task scores, job match information and level of participation (such as self-limited or cooperative). This report often also contains recommendations and interventions for consideration moving forward. It is important to be aware that thorough FCEs include all of the physical demands of work as defined by the National Occupational Classification 2011 proposed by Human Resources and Skills Development Canada. Furthermore, a well-designed Functional Capacity Evaluation should not only be comprehensive, but it should also be standardized, practical, objective, reliable and valid.

For more resources on workplace wellness check out our Healthy Workplace page.

Resources

Haruko Ha, D., Page, J.J., Wietlisbach, C.M. (2013). Work evaluations and work programs. In H. McHugh Pendleton and W. Schultz-Krohn (Eds.)
Pedretti’s Occupational Therapy Practice Skills for Physical Dysfunction (337-380), St. Louis, Missouri: Elsevier Mosby.

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Travelling with a Disability

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

I am fortunate in my life to have vacationed to some pretty great spots.  But my favorite remains our trip to Alaska in 1999.  We travelled in August when the Ontario summers were hot and humid, and the air in Alaska was 16-18 degrees (Celsius) – clean, crisp, and fresh.  Alaska is beautiful.  It has mountains, oceans, wildlife, great people, and you can’t help but feel small when watching a glacier, three miles high, calving off chunks larger than your cruise ship.  We hiked, biked, toured the local shops, and took the White Pass and Yukon Railroad along the gold rush trail back into Northern Canada.  We walked a glacier and flew in a seaplane along the fiords.  Incredible.

But my favorite part of all?  We travelled with my grandparents, both disabled and in need of our help to fully enjoy the experience.

My grandfather was diagnosed with polio in 1946.  He spent three years in hospital and rehabilitation, and was discharged with “Canadian crutches” having no muscle in his legs or buttocks.  His bones were essentially stilts, with some active tendons that would let him swing his legs through and lock his knees so he could mobilize.  He had lots of falls walking this way, most resulting in a broken something.  My grandmother was physically healthy, minus some arthritis, but suffered from hearing loss.  My grandparents had always talked about going to Alaska and thanks to my parents, who included us in the experience, we were able to make that happen.

Travelling with a disability is not easy.  It requires planning, a supportive attendant, and an open mind.  Our cruise ship was “accessible” which turned out to be a blanket term for “we try”.  After all, nothing can be fully “accessible” as each disability is different, requiring varying levels of accommodation.  Because my grandfather could transfer to standing, and was tall, he needed things higher – toilets, chairs, beds.  Well, when they make things “accessible” they often lower them – to accommodate a wheelchair user who does not stand to transfer.  Walking around a cruise ship deck (slippery from damp sea air) was not safe for my grandfather, so he would use his scooter most of the time.  But the best was the gangways.  We would dock in the morning, and the gangway was nothing more than a simple bridge.  Easy for a scooter to manage.  Well, six hours later, the tide comes in and the gangway becomes a steep incline, completely unmanageable by scooter.  We didn’t realize that until we were at the bottom looking up.  We had packed a manual wheelchair as well, so we were able to move my grandfather into that, some burly men essentially carried him up the steep incline (not safe, but the boat was leaving regardless), and another group of men carried the scooter.  We managed, but we had help and a cruise line that was interested in providing some customer service.

March break is approaching and for months my clients have been asking me about travelling with a disability.  I enjoy these discussions because I do believe that anything is possible – but here are some pointers:

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

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

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

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

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

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

I miss my grandfather dearly but am blessed to still have my grandmother in my life.  Our trip to Alaska served many purposes – we were able to see a beautiful part of the world, my grandparents got to fulfill a travel dream, and I made memories with them that span far deeper than any photograph.

Safe travels!

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Promoting Mental Wellness at Work

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

“There is no health without mental health.” –World Health Organization

This quote from the World Health Organization really drives home the importance of a holistic health approach. When it comes to health and safety in the workplace, we are often quick to think of work-related musculoskeletal disorders and other physical injuries, but just as with health in general, we also need to make mental health in the workplace a priority. Psychological health in relation to work is comprised of the ability to think, feel, and behave in a manner that allows employees to perform effectively in work environments, as well as in their personal lives and society at large. As an employer, here are some starting points to consider to help you promote mental wellness in your work environment.

Learn to recognize potential or existing problems:  Stress is often thought to be a typical part of any job. However, excessive stress can lead to mental health problems. Take a critical look at your work environment. Do your employees face high demands? Excessive pressure? Do they have low control or say in how things are done?  These can create unhealthy work conditions that lead to increased levels of work-related stress, which can lead to increased risk for mental illness.

Talk about mental health: People who experience mental health issues often face stigma, shame and misunderstanding. Often times, employees who are experiencing mental health challenges are fearful to approach their employer and thus keep their issues private. Whether you are already aware of employees dealing with mental illness or not, voicing your support for mental wellness at work helps to foster a trusting and open environment. This can make all employees feel more comfortable to discuss problems, or ask for help. Try posting a sign in the staff room or regularly mention that you support mental wellness. Leading by example sets a strong standard and helps develop a healthy work culture of acceptance.

Know your responsibilities: Do you know the signs and symptoms of common mental health issues such as depression or anxiety? Do you understand how these conditions impact an employee’s performance on the job? Are you aware of your legal responsibilities to your employees dealing with mental illness such as accommodations? Do you know what resources are available to you and your employees to support mental health at work?  You need to be aware of all these factors to be able to promote and support mental wellness.

An ounce of prevention:  Implementing preventative measures in relation to mental wellbeing at work can be achieved in a variety of ways and when done well, these can have a significant impact on improving productivity, reducing absenteeism, presenteeism, and employee turnover and associated costs. Look at creating a workplace wellness program that addresses all aspects of your employees’ well-being, especially mental health. Show your employees that you value their health and make this a standard component of your business decisions. Mental wellness also needs to be reflected in workplace policies and procedures and show that employee wellbeing is a core value of your organization.

Occupational therapists’ knowledge and skill set allows them to help employers and organizations with each of the four areas listed above and more. From providing education and training programs, assessing problem areas, supporting communication and developing policies, occupational therapists can provide essential information and assistance to enable you to support mental wellness at work.

 

Check out more of our healthy workplace posts here.

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Never Stop Learning

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

Over the holidays we were prepping for a family ski trip.  Our children are not yet skiers, and were asking us questions about our upcoming adventure.  My oldest daughter asked my husband “Daddy, have you ever fallen when you ski”?  His response was “Of course…that is why I am a good skier – if you are not falling you are not learning anything”.  So true.

His comment got me thinking about fear, risk and how people learn.  We need to fall to know how to get back up.  We need to fail to know how to succeed.  We need to make bad decisions to know how to do it right the next time.  We need to lose money to know how to keep it.

Humans seem especially good at falling, failing and learning as children, teens and young adults – provided the people in their environment provide them with these valuable opportunities.  As adults we tend to fall and fail in our early careers, social and personal lives while we learn how to behave as an adult and to manage our growing responsibilities like work, families, homes, etc.  Then we seem to reach an age where we become teachers, leading the younger generations to grow as we have.  We still need to gain knowledge during this time, but ultimately we might be revered as wise for all we already know.  But then do we stop learning?  Or stop having the will to learn?  Do we reach a point of “knowing it all”?

I will use another example to explain why I ask these important questions.  I have a close friend whose elderly grandparents are struggling to manage in their home.  They both have health issues and struggle to mobilize, access their upper level, get into the community, and cannot care for their home as they need to.  Family is providing a significant amount of support while living in a state of constant worry.  Really, the couple are one fall or new health problem away from losing their home and being institutionalized.  My friend mentioned to the daughter of this couple that an Occupational Therapist could provide valuable insight into how they might be able to manage more safely and independently so they can stay at home.  The daughter replied “Oh, they would never go for that”.  How sad.  This couple are unwilling to learn.

With a background in Gerontology (the study of aging), I understand fully the challenges most of us will face as we age.  And as an Occupational Therapist (the study of human function) I also understand the difficulties of living with a physical, cognitive, emotional or behavioral disability – age related or not.  But the big difference I see between my younger and older clients is their willingness to learn.  My younger clients seem to want to learn what I know, they appreciate how I can help, and engage in the process of working with me to make things better.  Yet my older clients are historically much less open to suggestions.  It is more difficult to get them to consider alternative ways to manage, devices that might help, or to accept assistance to do activities that are now unsafe for them to do on their own.  My funniest example of this was a 96 year old client that told me “scooters are for old people”.

I consider myself a life-long learner.  I recently finished my MBA, am constantly reading books about business, health and wellness, I take great interest in the stories and experiences of other people, take courses, attend conferences.  I just hope that when I reach that wonderful age of ultimate maturity I will continue to appreciate the value that other people can bring to my life and situation.  And hopefully I will accept suggestions, input and ideas proactively.  Because while falling is one way to learn – like when skiing – the older we are the harder it is to get back up again.