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Safe Travels

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 www.travel.gc.ca. 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: (Westjet or Air Canada )?  Or that Easter Sealsoffers a Disability Travel Card for buses and trains (Easter Seals)?  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 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.

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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Supporting Autism, One Amazing Mother at a Time

Julie Entwistle, MBA, BHSc (OT), BSc

According to Autism Speaks, Autism now affects 1 in 88 children and 1 in 54 boys. The 2012 numbers reflect a 78% increase in reported prevalence in the last 6 years (www.autismspeaks.ca).  This is a growing problem, impacting more and more families each year.

Autism is a spectrum disorder, meaning that the signs, symptoms and severity can vary, making this difficult to diagnose and sometimes treat.  Yet through therapy, children with Autism can learn to function and communicate as independently as possible at home, school and with their peers.  In April, Entwistle Power is sponsoring the Burlington Autism Gala – a fundraising event being organized by Jessica Langdon – a mom motivated by her son’s journey with autism who has a vision to find answers and to obtain support for families faced with this diagnosis.

In support of the Gala, Occupational Therapist Justine Huszczynski wrote the following about her experiencing working with Jessica’s son Spencer, and in doing so, highlights some of the features of Autism, and the value of occupational therapy for these children:

When I first met Spencer I was introduced to one of the most intelligent little boys that I think I will ever come to know. He impressed me with his ability to read at such a young age.  He could print his name and spell many different words that I had never seen another child his age be able to do.  I think it was this intelligence that could easily cause a child like Spencer to slip under the radar. He was smart. He could print. He could speak. But beyond this lay a child who couldn’t handle loud noises, busy rooms, or being lightly touched.  An extreme meltdown was constantly on the brink of being unleashed at any given moment – triggered by a change in routine, being told “no”, or being overwhelmed by the environment around him.  Spencer didn’t make consistent eye contact, he had difficulties with social cues, taking turns, and coping with losing at a game.  Although he was verbal, he couldn’t express his feelings, which often caused a minor issue to turn into an explosive meltdown – sometimes lasting for over an hour at a time.

And then there was Jessica. A mom who was dedicated to her son and on a mission to get him the help he needed and deserved.  Jessica knew her son’s needs inside and out. She came to me with a wealth of information about Spencer and she just wanted to make sense of it all.

We started Occupational Therapy with Spencer immediately.  Jessica was in attendance for every session. She participated, asked questions, provided me with information, and was involved every step of the way.  We targeted goals based on self-regulation, social skills, and sensory processing.  We helped Spencer explore new sensory experiences and used strategies to help him cope with overwhelming situations.  Along the way, Jessica and I sat through countless meltdowns but we worked through them.  Spencer learned how to tell us when he was feeling overwhelmed and he could eventually choose strategies to help calm himself down.  It became easier for him to cope with changes in routine and he improved on his ability to follow instructions.  He was changing before our eyes.

Autism awareness led Jessica to seek help for Spence and his early intervention is what I believe helped him make so many gains in therapy.  To me, Spencer exemplifies the positive outcome that can occur when a child is given the supports they need and are surrounded by a family and team that works towards common goals.  Spencer is by no means “cured”. There is no “cure”.  But there is love.  There is support.  There is awareness.  But we still need more answers.  Constantly we are searching for answers.

justine

Justine Huszczynski
jhuszczynski@solutionsforliving.ca

For more information about the gala, please contact Gala Founder, Jessica Langdon at jlangdon@live.ca.  We hope to see you there!

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Dog Awesomeness

I have always had dogs.  We had two when I was a kid, and when they died, we had two more.  When I moved to University I bought myself a Golden Retriever and two years later purchased another one.  When they passed away we adopted another Golden, and this December brought home a Golden puppy (Timber – photo above) to join our family.  I will say I am totally in love with this breed, and really with dogs in general (we have an adopted cat too but after owning a cat I can officially say I am a dog person).

Yes dogs are hairy, poop in your yard (lots), lick themselves, have eye goop, and occasionally have accidents or barf in the house.  They can chew stuff too, are expensive to feed and even more expensive to train, groom and keep healthy.  So, why bother?  Because animals are amazing for your health, and are becoming more and more recognized as being able to offer therapeutic and functional benefit.

According to Web-MD the health benefits of owning animals are immense.  People that own animals tend to have lower blood pressure, less anxiety and depression, better immunity, and less allergies.  Animals in the home are proven to reduce angry outbursts by people with Dementia, prolong the lifespan of seniors, heart-attack patients fare better in their recovery, and dog owners walk an estimated 68% more than the general public.

Then, there are service or guide dogs.  These dogs are professionally trained at a young age to assist persons with disabilities. While service dogs initially began helping the visually impaired, training programs now exist to teach service dogs to assist persons with a variety of conditions including hearing impairments, seizures, physical disability, autism and diabetes. For example, guide dogs can be taught to distinguish sounds, make physical contact with their handlers, and lead them to the source of noise; be it someone at the door, an alarm clock, crying baby, or a ringing telephone. Guide dogs who assist their handlers with a physical disability retrieve objects, flick switches, open and close appliances, and doors. They are also trained to bark or activate an alert system when help is needed.  They can warn of an oncoming seizure, and some are even trained to protect victims of violence from a perpetrator.  Together guide and service dogs can increase someone’s level of independence, safety, security, and reduce the impact of disability on a daily basis.

It is important to highlight, however, that service dogs are not just pets – these are working animals, highly trained that need to be 100% attentive to their owner at all times.  Distractions can lead to mistakes, and this can harm the dog and handler.  This is why people and children are told to not pet service dogs however tempting that may be.  Ultimately, service dogs should be treated by the public as an assistive device – there to help maximize safety and function, but not to be tampered with.

While the cost to raise and train a puppy to be a future service dog is about $25,000, the Lions Foundation of Canada Dog Guides, and Canadian Dog Guides for the Blind, provide guide these for those in need at no cost.  As part of the process, they match the person to their dog, provide training for the handler, including supply of the appropriate equipment, such as the guide dog’s identification harness or collar.

Beyond the health benefits of pet ownership, Occupational Therapists recognize that guide dogs can play a key role in supporting a handlers’ ability to be more independent, mobile in the community, and safe both indoors and out.  For more information about guide dog programs, talk to your occupational therapist, or visit the Lions Foundation website at http://www.dogguides.com/programs.html or the Canadian Dog Guides for the Blind website at http://www.guidedogs.ca/index2.php.

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Against the Odds

Julie Entwistle, MBA, BHSc (OT), BSc

Every day I witness how an accident or trauma can derail someone’s life.  And size does not always matter.  A small accident can have catastrophic results, depending on who it happens to.  My clients, searching for answers, often want dates and timelines to map out their recovery and to try and understand for how long their life might be disrupted.  They are often faced with financial hardship or ruin, jobs on the line, families that are not coping, and independence lost.  They need to emotionally prepare for the road ahead.

In physical rehab, answers are easier – doctors are skilled at predicting when people can weight-bear, when the cast might come off, when they might be able to return to some form of normal function.  But what is difficult to predict, always, is the emotional consequences of an injury, and the length and completeness of a cognitive recovery.

In my world, optimal recovery comes from the combination of many things:

1.    A body that is given the optimal fuel, resources and environment for healing.

2.    A motivated client.

3.    Funding for rehabilitation, including a supportive insurer.

4.    A lawyer (if present) that supports and fights for treatment approvals.

5.    An external environment that fosters recovery (family, friends, employers, financial security, and a suitable living environment).

If one of these things is lacking, the entire process suffers.  So, while I always want to provide hope and encouragement for people in their recovery, I cannot control any of these factors and they can mean the difference between weeks and years of disability.  For some, the odds of these factors aligning are often stacked too heavily against them and the outcome does not look good.

And then there are the people that surprise us all and beat the odds.  Those people that return to work more quickly than we thought possible, can walk when they were told this would be unlikely, and whose family unite and become stronger when faced with a challenge.

Right now we are in the middle of the Olympics.  I thought it would be appropriate to share some Olympic stories of athletes that overcame adversity to fulfill their Olympic dreams (revised from Oxygen Magazine, Winter Olympics Issue):

Betty Robinson was 16 when she competed and won gold in the first Olympics that allowed women to participate in track (1928).  In 1931 she survived a plane crash that left her in a coma for seven months.  It took her two years to walk again.  Yet, she returned to the Olympics in 1936 and won another gold.

Melissa Stockwell lost her left leg in Iraq while serving in the U.S. Army in 2004.  Four years later she completed in the Beijing Paralympics in swimming.

Quanitta Underwood suffered years of childhood abuse by her father.  At 19 she discovered boxing and went on to compete in the 2012 London Olympics.

Silken Laumann was an accomplished rower when she broke her leg badly months before the 1992 Olympics.  After five surgeries and three weeks in hospital, she returned to training six weeks later and captured bronze in the summer games that same year.

So, if you have been injured or endured trauma that has set you back, don’t ever count yourself out.   Odds are just odds…made to be challenged, defied and broken.  While I can’t control anything on the list of things that promote an optimal recovery, you can.

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Can the Ontario Government Suck AND Blow?

So your spouse, child, mother, brother, friend is injured in a car accident.  They broke both legs and have been quickly discharged from hospital.  An Occupational Therapist visits the home and prescribes some equipment, sets them up on the main floor, makes sure they have options for bathing, toileting, sleeping, can eat and get out of the house if they needed to, and calculates the amount of care they need in order to safely survive at home in this state.  This is calculated in minutes of care, and converted to a dollar benefit based on pre-determined (government) hourly rates. 

Prior to 2010, this money (attendant care) would be given to the client, and they could use this to pay the providers of their care.  They could choose the provider based on many factors, with most selecting the person that they were least embarrassed with in the washroom and shower.

In September 2010, FSCO decided that this benefit would only be provided when the care provider could prove an “economic loss”.  I get why they wanted to do this.  Too often, attendant care monies were “improving” the financial position of the injured (extra income) and was not always being used for care.  As it is inherent in the insurance act to not “advantage” people, the industry decided they needed to make some changes.

Proving an “economic loss” became a hot topic.  Some insurers wanted to only pay the amount of the loss, and others would pay the amount of attendant care benefit (as calculated by the OT), as long as a loss existed.  This issue was tried in court, and in Henry vs Gore (2013) the decision was that “the extent of the economic loss was irrelevant…as long as there was any economic loss during the period in question the person can qualify for the services they provided…”

Then, just last month this decision was overturned by the Ontario government, the SABS were amended, and now people providing care cannot receive more “than the extent of the economic loss sustained by the attendant…as a direct result of providing the care…”

So, I ask, can the government really suck and blow?  I guess so because there are so many elements of this that both defy logic and are clearly unfair.  Here is my list:

  1. So, if my economic loss is $100 / week (I work part time at Tim Horton’s), I get $100 / week even when the care needed is calculated at more.  So, if the care is calculated at 24 hours / day (as it can be) I get paid .59 cents per hour.  Is that legal?
  2. Then the reverse must also be true.  If I make $10,000 / month (as some people do) then I would get paid $10,000 / month (my economic loss) to provide care, right?  WRONG.  The max is $6000 regardless, and I suspect the insurer would only pay me the amount of the benefit which is often less than the max.  So, they cannot “advantage” me, but they can “disadvantage” me?
  3. So, I guess they will pay the full amount for private care then, right?  WRONG.  The form calculates at rates of $10.25, $13.19 and $19.35 per hour (for recent accidents) but the agencies charge $25 / hour or more.  So, the amount of hours I need is irrelevant as I can’t get the hours anyway in the calculated amount.
  4. If an agency is the only option (as my family will not work for .59 cents per hour), and most have a three hour per shift minimum, but my care is calculated at 2 hours per day, then I have to go without?  Or I guess I will just use the toilet tomorrow instead?
  5. If I was making $30 / hour and worked 40 hours / week, but now need to provide care for 80 hours / week, they will pay me at my “economic loss” hourly rate, right?  Nope.  They will pay the amount of the benefit, again calculated at up to $19.35 / hour.  So, I prove the loss, then take a loss following.
  6. If my family can’t live on .59 cents per hour, and an agency declines to work with me because of my behavior, complicated needs, or because my house is a health hazard, the insurer will change their mind and pay my family, right?  Doubt it.
Then, there are policy limits.  So, regardless of my economic loss, or the care needs of my family member, there will still only be $36K available if they are seriously injured, or $1M if they are catastrophic.

If the government wants to truly suck here, then they should not be able to blow.  Either pay an agency the number of hours needed, at the agency hourly rate, without monthly or policy limits, OR pay an unqualified provider the amount of care needed calculated at the pre-determined rates.  If you cannot advantage people, then you should not be able to disadvantage people either.  Their accident already disadvantaged them enough.

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Wash Your Car!

Working in auto insurance makes me slightly paranoid about issues of vehicle safety.  Ideally, it would be great if car accidents could become extinct and people could go about their business without running the risk of becoming injured in their travels, but currently these remain one of the main causes of adult and child injury, death and disability.  So, maximizing car safety should be on the top of everyone’s list.

Years ago, in the middle of winter, I was driving home from seeing a client at night.  I was on back roads that were not lit.  My headlights were on, but I could barely see the road in front of me.  I struggled with this, assuming I had a headlight out, and managed to get to a gas station.  There, I investigated the problem and realized my headlights were just covered in the road sludge so common in Ontario winters.  I cleaned up my headlights with a window squeegee and voila!  I could see again

Prior to this, the thought of washing my headlights never occurred to me.  Why would it?  Unless you encounter a problem, this is not something I remember being taught in driver’s ed, nor something my parents mentioned to look for as I was learning to drive.  Some things we just learn in life the hard way – hoping to not be hurt in the process.

I remember when cars started to be manufactured to have headlights on automatically and all the time.  I said to my brother “I don’t get why headlights should be on during the day, they won’t help a driver to see better” and he responded with “it is so other people can see you better”, I am sure adding a brotherly “dummy” in there too.

The other day I was reminded of these lessons again.  It was a sunny day, but the roads had been a mess a few days prior.  I was driving in the right lane and needed to change into the left lane to make an upcoming left turn.  I glanced in my dirty side mirror and my rear mirror which was looking out my dirty back window, and I didn’t see anyone.  I checked my side mirror again, and noticed something that looked odd.  I focused more clearly and realized that there was another car to the left of me after all.  This was a black car, covered in the grey muck of winter.  The lights weren’t on, and what struck me was how much this car was essentially the color of the road.   The road was a grey, dirt covered mess, and this car blended right in.  Had the lights been on, or the car clean, I would have spotted this easily.

Really, both these issues with visibility when driving – to see and be seen – could be tackled with a simple car wash.  Even if this seems futile with ongoing weather coming, the short-term benefits are immense.  A clean car is easier for others to see, gives you better visibility when the windows and side mirrors are clear, and washes your headlights to make sure these are most effective.  Besides, of course, the other benefits of washing road salt and sand from your paint job.  Many gas stations have a quick car wash adjacent to the pump, and allow you to pay at the pump for convenience.  Or, some car washes are even a drive-thru format and you don’t even have to leave your car.  In the end, when it comes to road and driving safety, the added expense of giving your car a rinse could be “priceless”.

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How do YOU do it?

I received a lovely email recently whereby the writer was painting me as some form of saint. But the question of “how do you do it” is one I have been asked before. Four kids, a business, house, dogs, a strict fitness regimen, clean-eating, volunteering, part-time MBA. This is my life and to me, nothing to be awarded a cape over.

Ironically, the question of “how do you do it” is one I too ask other people. I am inspired all the time. How do you have a job that is rigid and requires you to show up at a certain time, leave at a certain time, eat at a certain time, prevents you from seeing your child’s Christmas play, picking them up when sick, and restricts your vacation plans? How do you commute 1 hour or more to work in consistently terrible traffic? How do you manage the demands of your stressful job as a police officer, lawyer, adjuster, doctor? How do you manage the demands of caring for a sick or disabled child or an ailing parent? A medical or mental health condition? Single parenting? How did you lose 50 pounds, quit smoking, overcome cancer, beat rare odds, or kick an addiction? How did you cope with the death of your mother, father, child, sibling or spouse? How do you survive on such a restricted income, or with no support from others? Homelessness? Lack of education? How did you deal with the sudden loss of your job, the trauma you experienced as a child, or the daily struggles you might experience as someone with a disability?

We all need to remember that our own tolerances for the trials of life are very much determined by the experiences we have had up to this point. We are all saints – worthy of superhero status – for something. Our behavior, thoughts, beliefs, and practices are all explained by our past, our upbringing, and our genetics. We are all doing our best. And our future, I believe, will be ours to create with the choices we have. Perspective is everything. So, while I go about my day thinking about all the wonderful people that I encounter and that inspire me, do the same. And tell me, how do YOU do it?

 

 

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Become Smoke Free in 2016

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.   Also you can find some helpful apps by visiting checking out Healthline’s Top Smoking Cessation Apps.

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

 

Originally posted January 19, 2015.

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Operation Simplification

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

Being honest, the fast pace of this world is starting to wear on me.  And according to Ray Kurzweil, the pace of change is expanding exponentially.  Ouch.  Things are going to get faster?  I can see why Yoga, Mindfulness, Soul Retreats and Vacations are so revered by those who get to enjoy them.

While I am a type-A, goal driven, never-slows-down Taurus, I have vowed to simplify this year.  Perhaps that is my reaction to a crazy last year of opening a new office, starting a blog, finishing my MBA, redoing my basement, getting a puppy, merging my business, or maybe it is just a sign of my maturity as I reluctantly approach middle age (well not that reluctantly because I suppose the alternative to aging is death).

So, what is simplification?  Not sweating the small stuff?  Saying no more often?  Not taking on any new responsibilities?  Not engaging in any new capital projects?  Limiting the constant brain activity that results from obsessive technology use?  Restricting the kid’s activities to my tolerances, not theirs?  Knowing my limits and being disciplined about maintaining them?

I believe that simplification is FOCUS.  Successful people focus their time on the things they are good at or love, they set boundaries, and participate in the intriguing, high reward things they find intellectually, physically, and spiritually uplifting.  Everything else is left behind.  So if you find yourself searching for the next thing, seeking out endless possibility, tangentially changing your mind or direction, perhaps happiness is actually in front of you, simple and clean, but the clutter you are creating in your efforts is clouding your view.

Zenhabits has some wonderful pointers for simplification (see them here).  My favorites include:

  1. Make a list of the top 4-5 most important things in your life.  These should dictate your schedule.
  2. Evaluate your commitments.  Do these align with # 1?
  3. Evaluate your time.  Keep track of this to see how you spend your day.  Do these align with # 1?
  4. Limit communications (personally I am bad at over-communicating.  This year I am making a solid effort to restrict this and to set boundaries – especially with email).
  5. Limit your spending.  Less spending means less stuff.  Less stuff means less clutter.  Less clutter means simple.  I am up for that.

So, contrary to my usual habit of writing down my long and exhaustive list of goals for the year, this year the list is decidedly simple.  In the end, as Zenhabits suggests, I am going to evaluate what is most important to me and try to eliminate everything else.

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Winter Got You Down?

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

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

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

 1.       Use behavioral activation to keep your normal routine.  Make the bed, have a shower, prepare a decent breakfast, walk to the mail box.  Don’t change habits that are ingrained just because it is winter.  Never underestimate how damaging it can be if you avoid even small things that ultimately add up to a productive day.  Gradually try to get back to those important tasks if you have found that your daily behaviors have become unproductive.

2.       Stay active.  Those that love the winter do so because they get outdoors.  Walk, ski, skate, toboggan – something to help you appreciate how wonderful a change of seasons can be.  This is best facilitated by proper clothing that will keep you warm.  If exercise is tough for you, build it into your day by default – park farther from the door, use the stairs, make a few trips from the car with the groceries to get the blood flowing.

3.       Consider light therapy.  Sit by the window at lunch, get some fresh air when the sun is out, or consider purchasing an artificial light for your use at home.

4.       Up the nutrients.  When some bad eating habits creep into your winter these can be hard to break come spring, and only contribute to further mood declines.  Shop in the fruit and veggie isles, and avoid the isles that house the bad foods you seem to be eating too much of.

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

Seasonal Affective Disorder. (Canadian Mental Health Association, 2013) http://www.cmha.ca/mental_health/seasonal-affective-disorder-sad/

Beat The Winter Blues (Readers Digest, no date) http://www.readersdigest.ca/health/healthy-living/beat-winter-blues

Kurlansik, SL & Ibay, AD. (2012). Seasonal Affective Disorder. Am Fam Physician. 2012 Dec 1;86(11):1037-1041.

10 Winter Depression Busters for Seasonal Affective Disorder (Borchard, no date) http://psychcentral.com/blog/archives/2012/12/30/10-winter-depression-busters-for-seasonal-affective-disorder/