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Archive for category: OT Works Here

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The Experience of Occupational Therapy

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

Many people still don’t know what occupational therapy is and the benefits it can provide.  If you are a subscriber to this blog, hopefully we have helped you over the last many years to get a better understanding about our profession.  But I have always said that the best way to understand occupational therapy is to experience it.  Here in our practice lawyers and insurers “experience” occupational therapy through recognizing that we can help move people through a recovery or trauma process and they entrust us to do so honestly, ethically and professionally.  Families also “experience” occupational therapy through watching their loved one hopefully “do and manage better” because of our involvement.  But what about the clients themselves?  Those people that need our services and who build lasting relationships with us as we assist them through some very difficult and trying times?  What do they experience?

Well, the regulated health professions act does not allow us to use “testimonials” in “advertising” because these are not verifiable and are often biased.  This act is from 1991, long before the internet allowed us to “rate our anything” and review everything from face cream to shoelaces to our local restaurant using one to five stars.   We know we can’t tell you the stories of the people we help, but last October for OT Month we followed the lead of the Ontario Society of Occupational Therapists (OSOT) by embracing the challenge of asking the people we treat two very important questions:

“What do you value most about occupational therapy so far?”

 “How do you feel I have helped you the most in our work together?”

The answers from our clients were helpful, insightful and rewarding.  And while I can’t repeat them verbatim here, I can tell you the themes of people’s experiences with occupational therapy as noted by us:

The Most Value

A common response under “what do you value most about occupational therapy” was that we help clients to add “tools to the toolbox”.  Clients seem to appreciate that occupational therapy has provided them with new skills and strategies that they can put in their back pocket to retrieve when needed.  We have taught them how to help themselves and have given them the resources and support to do so.  And when they are not able to help themselves, we grab the tool for them and show them the way.  The tools they learn from us help them to expedite recovery and get them there faster.  Kind of like an accountant or bookkeeper doing your taxes – using a professional gets the job done faster and with greater accuracy.  We don’t know what we don’t know.

A second value related to the support we provide in helping them to navigate some very difficult systems.  The insurance system is complicated enough, but when two or more systems get pitted against each other the client is caught in the crossfire.  Insurers will argue they are the third payer after OHIP and extended health.  The CCAC will argue they are the third payer and “don’t provide service to people that have insurance”.  Extended health will say “we can’t talk to you, only the client” and then the client will be told “there is no coverage for occupational therapy” but the other insurer needs to have a denial from them to be sure.  How do you submit for services you are told you don’t have?  You can’t so the cycle continues.  Our clients value our role in helping them to get the services they need when they need them.  We understand these complicated systems and help to prevent people from falling through the cracks.  We also identify gaps in services and bridge these through connecting clients to other providers, services, supports and resources.

The Most Impact

The answers to the question about impact varied on a spectrum of education regarding injuries and symptoms to “you literally saved my life”. But the common thread included the more human aspects of the occupational therapist providing validation, understanding and teaching a recovery-minded thought process that people would not necessarily develop on their own.  People valued being heard and the unique approach the occupational therapist took to be practical, relatable, and progressive.  The value came in the customization – from person to person and visit to visit. 

My favorite quote from this qualitative gathering of feedback was this:

And don’t be fooled by the title occupational therapist. My occupation at the time of my injury was “retired” and it’s a lifetime job I take very seriously.

Occupation for us is about how you spend your time – all of your time – from sleeping to “retiring” it is all important for you and to you.  (check out our Occupation Is series to learn more)  If injury or disability is preventing you from spending your time the way you want, consider occupational therapy.

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Occupational Therapy and Physical Therapy: Key Differences and Similarities

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

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

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Returning to Work after Illness or Injury: OT Can Help

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

In 2011, Statistics Canada reported that 5.9% of full-time employees were absent from work due to illness or disability. The costs associated with workplace injuries are vast.  Studies have shown that the duration of work disability, as well as costs, are significantly reduced when the workplace has contact with a health care provider coordinating return to work interventions. In fact, well-designed return to work programs are now recognized as the best practice to reduce costs associated with worker’s compensation.

Occupational therapy is a cost-effective strategy to accelerate the client’s recovery and rate of returning to work. With an effective return to work plan coordinated by an occupational therapist, injured or ill employees can recover quicker and return to work faster, significantly reducing employer costs associated with workplace injuries.

In the following video from our OT-V series, we will discuss how occupational therapists can help to support the critical transition back to the workplace following an interruption of work duties due to physical or mental health issues.

For more information on promoting employee wellness in the workplace visit our Healthy Workplace blog page.

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Living with Cancer: OT Can Help

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

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

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

Previously posted April 2017.

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O-Tip of the Week: Ways to Prevent Sitting Disease

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

This week’s O-Tip of the Week focuses on ways to get you moving throughout the day in order to keep a healthy lifestyle and prevent sitting disease.

Bring a pair of running shoes with you to work and take a walk on your lunch and/or breaks.  Walking is great for cardiovascular and bone health and will help to prevent the negative effects of sitting all day.

Learn more ways to combat the negative effects of sitting disease in our post, Solutions to Stop Sitting Disease.

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A MUST READ New Guideline for Insurance OTs in Ontario

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

With all the legislative changes in the very contentious auto insurance industry, it can be hard to stay current.  Case law, reports, position papers, and of course the high-profile circulations of the Toronto Star.  But sometimes what goes unnoticed is the work of the Colleges or Professional Associations that spend time and resources trying to provide guidance and support to those of us working in this everchanging area of practice.

In the world of Occupational Therapy, one recent document has been posted by the College of Occupational Therapists of Ontario that thoroughly speaks to the challenges, college expectations and tug-of-war that OT’s experience in this difficult sector.  This circulation, entitled “Guideline for Working with Third Party Payers” is a must-read for OT’s in the insurance industry, and serves as a useful tool for anyone (clients, lawyers, insurers, other professionals) who retain, work with, or otherwise engage with an OT for assessment or treatment services.  The guideline (https://www.coto.org/news/new-guidelines-for-working-with-third-party-payers) covers all important aspects of practice in the world of third party work, and includes the following summarized sections:

Providing Ethical and Competent Client Care reviews the Ethical responsibilities of the OT to be transparent, fair and impartial.

Defining Your Role and Setting Expectations with Stakeholders addresses how important it is for OT’s to follow the Standards for OT Assessment and to understand the limits to their own competencies when accepting referrals.

Consent and Personal Health Information discusses how to manage difficult consent situations, for example if another person indicates they got “consent” for the OT, or if a client later withdraws consent during an assessment or treatment. Importantly, it also talks to an OT’s requirement to get new consent when presented with a request to review or comment on new information that was not received when initial consent was obtained.  The submission of reports in draft form to third parties is also covered.

Managing Records and Reports reminds OT’s of their responsibility with record keeping, privacy legislation, and of course the client’s right to access their records.

Managing Conflicts of Interest considers the challenges in this high-stakes industry that is fraught with important funding decisions, conflicting agendas, and relationships that can be formed with clients, insurers, lawyers and the like.  This section deals with these competing interests, conflicting standards and opinions, personal conflicts between oneself and third parties, companies or even other professionals.  Also covered in this section is referrals received from friends or family members, being requested to observe an independent medical exam, and treating clients that are related.  OT’s are reminded that practicing within a conflict of interest (perceived, real or implied) is considered professional misconduct.

Managing Professional Boundaries are addressed and this section highlights different types of potential boundary crossings with clients and referral sources / payers.  It speaks to monetary relationships and financial / gift incentives as a boundary crossing and one that can jeopardize client outcomes and breach professional boundaries.

Use of Title is discussed as a reminder to the different titles an OT may have in providing service, and how to be clear about their role at all times.

Independent Practice reviews the nature of being an “independent contractor or provider” and the resources available to set up, and run, an independent operation.

Lastly, the guideline covers the expectations for providing services to clients who Live Outside of Ontario and reminds OT’s that the client’s location, not theirs, is the jurisdictional boundary and practicing outside of Ontario is not permitted unless the OT has a license in that location as well.

Overall, this document is a useful tool and hard reminder to OT’s of their obligations and expectations as licensed professionals in Ontario.  It may also prove helpful for other stakeholders to review, such that they too understand the rules and boundaries on OT’s so that they can be mindful of these in their working relationships with us.

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O-Tip of the Week: A Smart Solution for Printing Success

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

This week’s O-Tip of the Week focuses on ways to assist children who are struggling with printing and handwriting.

Using a small pencil or broken crayon is a great way to help kids learn how to properly hold a pencil.  Learn more about how Occupational Therapists help kids with printing and handwriting in our OT-V episode:  Solutions For Printing Success.

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The OT Role with Medicinal Marijuana Use

Guest Blogger: Carolyn Rocca, Occupational Therapist

The current legislation on medical marijuana use in Canada greatly shapes our role as health professionals. Under the Access to Cannabis for Medical Purposes Regulations (ACMPR), Canadians who have been authorized by a physician to access cannabis for medical purposes can purchase safe, quality-controlled cannabis from the 52 authorized licenced producers in Canada (Health Canada, 2017). With the legalization of marijuana in Canada being on the horizon, we can anticipate that many more of our clients may turn to it when seeking relief.

But first, it is important to consider why people are turning to cannabis for medicinal use. While some risks do exist, evidence suggests that the use of marijuana can offer several benefits including: reductions in nausea, decreased pain intensity, and improved sleep quality (Health Canada, 2013; Whiting, et al., 2015). Additionally, some clients report experiencing reductions in anxiety, increased relaxation, and relief from tension, headaches, and migraines. With these benefits and relatively mild side effects, this paints quite an enticing picture for those who may be consuming much more potent medications with more serious risks and side-effects.

If more clients are beginning or continuing to turn to cannabis as a source of relief, we as healthcare providers need to identify what role we play in supporting their decision to do so, including the role of Occupational Therapy which is explored as follows:

  1. Focus on safe use of cannabis: As part of the OT role, it is important that we ensure that clients are utilizing medicinal cannabis under the care of a physician, and are using it within the parameters set out in their prescription. Clients should be advised to discuss their cannabis use with her physician, as they would with any medication, as this falls outside of our OT scope. However, OTs can be involved in the process of helping clients track their relief from symptoms and potential side effects, according to the strain, dosage, and time of day and can help people to direct certain questions / concerns to their physician as appropriate.
  2. Monitor the impact of cannabis on daily activities: Our role is to be aware of the potential risks and benefits of medicinal cannabis use, to identify when cannabis use may be impacting clients’ abilities to perform day to day activities, and to subsequently provide strategies as needed. For example, if a client typically becomes drowsy when taking cannabis which may then impact their safety in the kitchen, an OT may be able to recommend strategies such as the use of kitchen timers, or help to schedule cannabis use at safer times of the day.
  3. Review available pain management strategies: As cannabis use is only one option for pain management, our role is to ensure that clients are aware of other available pain management strategies. Some strategies include: pacing activities to conserve energy, resting, massage, exercising, stretching, other medications, staying active (counterintuitive but true!) as well as compensatory strategies. Our focus as OTs is on helping clients to resume increased function by utilizing the pain management strategies they are open to given all the options available and the training we can provide for each.
  4. Assist in navigating resources: For clients who wish to produce medicinal cannabis for personal use, our role is to ensure that clients are aware of the guidelines set out in the ACMPR. We may also have a role in assisting clients in completing required application forms (found here) and planning for safe production, use, and storage of cannabis if they become registered to do so with Health Canada. Further, under the ACMPR, it is a client’s responsibility to make sure that all medicinal marijuana plants or cannabis products in their possession are secure, and that other people, including children, cannot access them. Therefore, OTs can assist in developing strategies to ensure they can meet the grow, safety and storage requirements.
  5. Consider affordability: As clients can expect to spend about $7-$12 per gram of medical marijuana (Medical Marijuana, 2016), it will be important to consider if their prescribed cannabis is covered under insurance funds, or whether they require budgeting strategies for this expense. An OT can also assist in this process, along with ensuring that the affordability is monitored and budgeted for long term.

Considering how imminent changes to Canada’s cannabis legalization are, being aware of the legislation changes in our society is highly valuable in our line of work. The OT profession is well-positioned to support clients in navigating their medical marijuana options in the most safe and functional manner possible. Seek the assistance and guidance of your healthcare team, including an OT, if you are thinking about, or currently incorporating, medicinal cannabis into your healthcare routine.

Resources & References

Government of Canada (2016). Information bulletin: safety and security considerations when producing cannabis for your own medical purposes. Retrieved from https://www.canada.ca/en/health-canada/services/information-bulletin-safety-security-considerations-producing-cannabis-for-own-medical-purposes.html

Health Canada (2013). Information for health care professionals: Cannabis (marihuana, marijuana) and the cannabinoids. Retrieved from http://www.hc-sc.gc.ca/dhp-mps/alt_formats/pdf/marihuana/med/infoprof-eng.pdf

Health Canada (2016). Drugs and health products: Information for health care practitioners. Retrieved from http://www.hc-sc.gc.ca/dhp-mps/marihuana/med/index-eng.php

Health Canada (2017). Authorized licensed producers of cannabis for medical purposes. Retrieved from https://www.canada.ca/en/health-canada/services/drugs-health-products/medical-use-marijuana/licensed-producers/authorized-licensed-producers-medical-purposes.html

Medical Marijuana (2016). Frequently asked questions. Retrieved from https://medicalmarijuana.ca/resource-center/faq-2/

Minister of Justice (2017). Access to cannabis for medical purposes regulations. Retrieved from http://laws.justice.gc.ca/PDF/SOR-2016-230.pdf

Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., … & Schmidlkofer, S. (2015). Cannabinoids for medical use: A systematic review and meta-analysis. Jama, 313(24), 2456-2473. doi:10.1001/jama.2015.6358

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O-Tip of the Week: Save Time and Energy in the Kitchen

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

This week’s O-Tip of the Week focuses on ways to conserve energy in the kitchen by saving you time and effort.

When preparing meals we recommend that you gather ALL necessary  ingredients before beginning.  Doing so will save you time and energy by reducing trips back and forth from the pantry or refrigerator, and avoiding a last minute run to the grocery store for that missing ingredient!

Learn more about how to conserve energy in the kitchen in the following episode from our OT-V series:  Smart Solutions to Make Life Simpler (and Safer!) in the Kitchen.