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Archive for category: Occupational Therapy At Work

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Treating Executive Dysfunction: There is No “One Size Fits All”

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

As a caring professional, I refuse to believe that my clients are not motivated.  All of my clients have goals or I would not be treating them.  However, their ability to achieve their goals independently remains the reason that they require active therapy.  Previously, I wrote about executive functioning (Brain Injury and Executive Functions – When the CEO is on Hiatus), the capacities we require to achieve a goal, and used the example of moving to highlight how people with executive dysfunction may feel on a regular basis when completing relatively simple tasks.

Treatment for executive dysfunction is as broad as it is specific.  It is broad because everyone experiences brain injury differently and comes into that type of trauma with varying levels of ability to start with.  However, treating problems with executive function is really as simple as taking a goal and breaking this down into component parts, manageable chunks, and smaller goals within the whole.

So, returning to the moving example, assisting someone with executive dysfunction with a pending move will involve making checklists, with time frames, and checking on progress frequently.  Personally, I like to take a project approach:  calling the goal “Operation Move” and mapping out – start to finish – the metrics for success.  Perhaps in month one an “apartment hunting worksheet” is created to help a client summarize all the places they are looking at, the pros/cons, address, and list of questions that need to be answered (price, utilities included, length of the lease, etc.).  Often I encourage my clients to use a smartphone to take photos of the options then we cross-reference these and catalog them to keep things organized.  From there, the process continues with checklists for calls to make, addresses to change, ways to organize packing and management of belongings.  Ensuring the client is responsible for follow-up via “homework” between sessions and holding them accountable for completion of this aids to developing independence.  Really, the therapeutic goal is more than just ensuring the client is able to move successfully.  Rather, it is demonstrating a model and method that can be used for any future transitions, goals or tasks.  This ensures success that is transferable to other events at later dates. 

 

Previously posted June 2013

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The Importance of Hope

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

June is Brain Injury Awareness Month.  For many who suffer a brain injury the road to recovery is long and filled with many twists and turns along the way.  I wanted to post this popular blog post as a reminder to not give up hope, no matter how difficult the journey may be.

A friend asked me to visit a colleague of his who was in the hospital following a spinal infection.  The spinal infection and resulting surgery caused paralysis and the gentleman was told he will not walk again.  During our visit we spoke of the non-profit organization “Spinal Cord Injury Ontario” and the client’s wife told me the story of their first meeting with a Peer Support volunteer.  She recalled that the volunteer (a paraplegic) entered their room and introduced himself.  The wife politely thanked him for coming but told him they would not need his services as they strongly believe that her husband will walk again.   The volunteer’s answer was brilliant – he told them that even though it has been years since his own accident, he too has not given up hope that one day there will be a cure for paralysis.  He explained that he keeps himself in great shape as to always be prepared for that day.  He told my friend’s colleague to never give up hope.

This conversation reminded me that hope is essential.  As a health professional, I realized early that one of the key roles I play in the lives of my clients is to foster hope.  Hope for a better future, for a solution to their current problems, and for a better way to manage.  Even just discussing problems and brainstorming solutions elicits hope.  Health professionals should never undervalue the importance of fostering hope – even if that is in the face of one huge challenge after another.  Where hope becomes dangerous is when people are so busy waiting for “the cure” that they forget to manage in the meantime.  Hope, like goals, is essential to survival, but so is survival in between.  To forgo opportunities, solutions and help in the hopes of a future “fix” will only cause secondary problems that may be larger than the initial problem in the first place.

This philosophy is supported by most Chronic Pain Programs – they will not admit people to participate if that person is banking on a surgery, medication, or other therapy to “fix” them.  Some problems are chronic, and learning to manage with the trials of life despite the problem is the only therapy.  This should not squish hope – but rather should allow hope to live and breathe among optimal function.  

I always try to remain hopeful.  Hopeful for a better world for my children, for resolution of pain and suffering for my clients, for the health of others, and for my industry to remain a place where injured people can be adequately supported during their recovery.  But I recognize that it is not always easy to feel hopeful.  So, if you ever find yourself running on empty in the hope tank, try calling a supportive friend or family member, looking online (or on this blog) for inspiration, watching a funny or uplifting movie, getting some exercise, changing your scenery, or seeking support from a health professional.  We are here for hope and help. 

 

Previously posted July 2013

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The Need for Occupational Therapy in Non-Traditional Roles

The following, written by an OT student whose placements included a homeless shelter and working with troubled youth, discusses the need for occupational therapy in these non-traditional settings.  Learn more about this particular OT’s experiences in the following care of The Guardian.

The Guardian:  There’s a place for occupational therapy beyond councils and the NHS

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Don’t Multi-Task, Multi-Purpose – It’s Better for You

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

Like the word “busy”, the words “multi-task” had a few years of being “cool”.  People thought that “multi-tasking” was accomplishing more, being super-hero productive, and showing superior intellectual capacity.  But research into multi-tasking has proven the opposite and in fact, our brains are not able to multi-task at all.  In fact, trying to do two things at once is reducing our capability to manage either effectively. 

In the article “12 Reasons to Stop Multi-Tasking Now” it is highlighted that society has moved towards the implication that if you are not doing two things at once, you are wasting time.  It mentions the reasons to stop multi-tasking, including some important points like: “Moving back and forth between several tasks actually wastes productivity…because your attention is expended on the act of switching gears—plus, you never get fully “in the zone” for either activity”.  This causes activities to take “more time” so instead of both taking say 10 minutes each, together they take you 25.  Further, we miss things by trying to do too much.  Our skills become careless, or it reduces our ability to enjoy moments if we are texting and walking or emailing while also trying to watch the ballet recital.  Attending to two things at once actually drains our “working memory” which kills our creativity.  There is just not an upside.

My solution is something I call “multi-purpose”.  It is the way I try to spend my time when it makes sense to fit in multiple things.  But I apply this to chores and tasks at home, more than work.  For example, if I am out to get X, I will also survey my home and “to do list” to see if I can also do Y in the same errand.  Our orthodontist is beside the bike shop and seamstress, so every trip to get braces tightened also means pants with holes or bikes with slow leaks are also addressed.  The pet store is beside the Goodwill, so when the cats need food the donation bag in the garage is dropped off.  The grocery store is beside my favorite gas station, so stopping for one usually means stopping for the other.  With work, I, of course, try to book client visits that are nearby, and if I have time in between I want to know that I can stop at a coffee shop with my laptop for some charting (means I need to plan for this and bring my laptop with me).  I also bring a lunch, as stopping to eat (in my opinion) doesn’t benefit my time, wallet or waistband. I may or may not return calls in the car (hands-free of course) – it depends on whether my brain (or heart) just needs to “reflect and drive” or the urgency of the call.  Bottom line is that I don’t tend to go places without thinking “what else can I accomplish during this outing and how can my time be best spent?”  The things that fill my day tend to serve many purposes, but they are still done separately.  That is the art of multi-purpose without the troubles and inefficiencies of the misleading concept of “multi-tasking”.

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Reap What you Sow: Healthy Benefits of Gardening

If you haven’t planted your garden already, now is the time!  In recent years there has been a rise in the number of people growing vegetables and fruits in their backyards, patios and even on rooftops.  Why?  From health benefits to financial savings, there are many benefits of growing your own food and working in the garden.

Check out the following article from Reader’s Digest to learn about the ways gardening can benefit your health and get growing today!

Reader’s Digest:  10 Surprising Ways Gardening Is One of the Healthiest Things You Can Do

 

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Washroom Safety and Independence: OT Can Help!

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

For some people, the simple task of going to the bathroom can be a challenge.  This may be due to a recent surgery, mobility impairment or another medical issue that impacts the bladder or bowels.

In an episode from our OT-V series, we talk about some of the tools and methods Occupational Therapists will recommend when providing solutions for safe and effective washroom usage.

Watch the video below to learn more about how an Occupational Therapist can help an individual facing challenges in the washroom to ensure their safety, comfort and optimal independence.  

 

If you enjoyed this episode of OT-V please visit our YouTube Channel to see more informative videos about Occupational Therapy and the Solutions for Living OTs provide!

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Getting around: Transportation Made Easier

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

Have you ever wondered why the design of the objects we use and spaces around us are getting better and seem to relate to our bodies or the way we do things in a much more obvious way than ever before?

Barrier-Free Design allows the greatest majority of people equal access to the private and public spaces of our built environment. The aim is to minimize or eliminate physical, cognitive, and sensory barriers in our homes, businesses, and public spaces and even our streets.  

Consider the front entrance of a building. Sidewalk curbs, uneven walkways, multiple stairs, heavy doors, and lack of handrails. All these can prevent access because they can create barriers for individuals.

Universal design methods such as curb cuts, level and slip-resistant walkway surfaces, properly designed ramps, accessible washrooms, automatic doors, lifts, and colour-contrasted handrails are all examples of ways to support increased and barrier-free access not just for folks with a physical disability but for all of us, including children, the elderly, parents with strollers and many others.

Occupational Therapy promotes a wide range of barrier-free design and universal design principles that have helped to make better buildings and spaces in our communities.

There is a greater awareness in society that our buildings and spaces must be more accessible to the greatest majority of people. There are far more products and methods for creating barrier-free environments today than ever before which can be great for finding the right product or design solution for an individual. On the other hand, the vast and ever-growing range of products and design solutions can also be confusing, making choosing the right product a difficult one.  Occupational Therapists have the knowledge and experience to help facilitate the right approach by drawing on current research and best practices for creating barrier-free spaces.

Occupational Therapists provide helpful information and design advice to architects, designers, and contractors when it comes to creating barrier-free spaces inside homes, businesses, gardens, and even public spaces. And since there is a wide range of barriers that can contribute to preventing an individual from completing an activity such as reaching or bending, OTs help by determining what the barriers are for an individual and facilitating products and design strategies that can help surmount these barriers.

As OTs, we have the privilege to serve the needs of many people in the community and using our skills and practices to help people meet their individual needs of daily living and have productive and rewarding life experiences. For many, this may only be accomplished by implementing a barrier-free experience in their homes, businesses, and places they like to visit.

For example:

  • For individuals with visual impairments, spaces should have adequate lighting, colour contrasting surfaces where appropriate, tactile cueing and signage as well as audible alarm systems. For individuals with auditory impairments, visual signage and alarm systems (for example, flashing lights) are necessary.
  • For someone in a wheelchair, a barrier-free experience may include modifications to their workplace kitchens and washrooms. Fixtures such as light switches, sinks, paper towel dispensers, toilet paper dispensers and grab bars must be installed at a height that can be reached from a seated position.

Ultimately, the goal of barrier-free design is to promote equal access and participation for everyone. There have been many steps taken toward ensuring this type of design prevails in our communities. There are new laws supporting improved accessibility within Ontario as of January of 2015.  Is your building up to code? Consulting an occupational therapist can help to ensure your space meets the new criteria.

 

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A Place Called Vertigo

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

I am not sure what the word “vertigo” refers to in U2’s hit song, but as someone living with vertigo, I can tell you it is not a place you want to be.  Vertigo is highly unpleasant and can be caused by multiple factors including visual or auditory problems, or more commonly, head injury.  I best describe my vertigo as my eyes and ears sending different messages to my brain regarding the position of my body in space.  So, while my eyes tell me I am sitting still in a chair, my ears tell me I am on a boat in the middle of a hurricane.  The result of these mixed messages is spinning, nausea, dizziness, problems walking, and ultimately dysfunction.

For me, my benign positional vertigo (BPV) lives in my right ear.  As a result, I cannot lie on my right side, laterally flex my head to the right, lie flat with my neck extended, or look down into extreme flexion.    While I can tolerate these movements momentarily, I cannot hold these positions for more than a few seconds otherwise I am sent into a spin that can last for days.  I am fortunate to know my triggers and do my best to avoid them (no yoga for me).  I have also learned, after living with this problem for two decades, how to catch my symptoms early to prevent a slight episode of dizziness from turning into days of bed rest.

When my clients experience vertigo and describe this to me, I can fully appreciate where they are coming from.  The story is a book I too could write.   But, like other “hidden” ailments, I get concerned when the medical community does not take this complaint seriously.  This is especially true in my industry where insurers and their assessors often want “proof” of a health problem to support someone’s recovery. While I recognize that people can be dishonest, my experience is that people don’t make this stuff up.  Health professionals need to give people the benefit of the doubt, including insurance situations. To understand, or better yet, support someone with any “invisible” problem like vertigo, health professionals need to be compassionate and should care enough to listen, to research and learn, and ultimately believe.  Empathy, TRUST, and understanding will go a long way to support those that need it. I can only imagine how frustrating, devastating and angering it would be for someone to assume or opine that my “place called vertigo” is not a place at all: because, believe me, I live here.

 

previously posted August 2013

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The Cost of Disability

The cost of disability due to injury or illness is significant and stems from lost work time, medications, equipment, costs of personal care, therapy and more.

When struggling to make ends meet, people encounter stress, anxiety, panic, excessive worry, loss of sleep, relationship issues, poor decision making, and can result in addictions as a form of poor coping.  You can imagine how hard it would be to heal from injury or trauma when significant money stressors are created as a result!

Our OT-V episode below provides insight into how an Occupational Therapist can help you or someone you love plan for future costs related to the specific disability, provide treatment to help you manage your finances more efficiently, and deal with any associated symptoms.