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Archive for category: Seniors Health

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Stroke Recovery: “Knowing is Half the Battle”

Do you know the signs of a stroke? Sometimes these can be hard to see, and timing is of the essence, so you must think “FAST!” When a stroke is caught early and treated damage may be less and the recovery may be easier. May is Stroke Recovery Awareness Month and we want to share with you the following video which describes how to “FAST” – identify signs of a stroke.

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Life is a Terminal Disease – Palliative Care and Occupational Therapy

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

It was a life-changing experience. I was 19 and essentially never stopped. I had goals, drive, energy, and big plans for my future. I was a varsity athlete, had three jobs, was a full time university student, owned a student house, and had bought myself a dog. Knowing I wanted to work in healthcare, and after strongly connecting to some school courses in death and dying, I decided to pursue a volunteering opportunity at the local Hospice Society. This required a comprehensive training program followed by placement in the home of someone who had a terminal disease. My first (and only) placement was with a mom, age 37, who was dying of cancer. She had a 7 year old daughter and a husband who was also ill. I would attend their home once a week to spend time with the daughter, help to prepare meals, and would even assist with running errands and groceries. I provided emotional support and mentoring to a scared little girl, and was an extra set of hands for a dad and desperate husband. I was fortunate enough to be involved with the family for many years as the mother passed about a month after my wedding – four years after I met them. My husband and I tried to stay in touch with the daughter following, but dad really struggled and eventually his phone was disconnected.

The impact of this experience on me personally was huge. The things my parents had been telling me were true: “stop to smell the roses”, “don’t sweat the small stuff”, “make sure you have fun too”…I was intense and driven to the point of missing it. My experience in Hospice changed my outlook, my appreciation for my health, family and all those blessings that we take for granted daily.

Recognizing it is National Hospice Palliative Care Week, I wanted to showcase the role of Occupational Therapy in this challenging but

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rewarding field. To do this, I reached out to a colleague who has spent many years practicing occupational therapy in palliative care settings. Her reflections are as follows:

What I have learned is that Palliative Care is not particularly a specific intervention but rather a perspective of care that can be provided in a multitude of settings where end of life is faced such as our homes, hospitals, hospices or long term care facilities.

The Canadian Hospice Palliative Care Association defines End-of-life care as aiming to relieve suffering and improve the quality of living while dying for persons diagnosed with an advanced or terminal illness or who are bereaved.

Who defines how the client is suffering (physically, emotionally, spiritually) or that what we as healthcare providers do is indeed improving quality of living while dying? In a truly client centered approach, it is the client or their substitute decision maker that determines this. A collaborative interprofessional team has the potential to honour the client’s hopes and decisions in an identified plan of care.

The Canadian Association of Occupational Therapists identifies various interventions in palliative care, based upon clinical setting, that the therapist can provide including addressing activities of daily living (ADLs), psychological and emotional issues (including stress and anxiety), exercise programs, splinting and positioning, energy conservation, relaxation techniques, seating and mobility, comfort, adaptive and assistive equipment, support and education for the family caregivers, connecting the client with community services and supports, and conducting home assessments.

What this can look like is, for example, providing mobility devices such as a walker or wheelchair to address declining physical abilities while maintaining engagement with family in a safe manner. Considerations also include provision of therapeutic surfaces whether on a bed, wheelchair or favourite recliner to help reduce the development of pressure ulcers once time spent sitting or lying in bed increases. It can be planning and preparing with the client and the team to assist the client attend a final function such as a family wedding where comfort, endurance and being relatively symptom free are the goals.

Ultimately, as roles in life are challenged due to losses with life limiting illnesses, the Occupational Therapist attempts to facilitate meaningful engagement that reflects a client’s goals in a dignified manner.

Carla Floriani, OT Reg Ont

I want to thank Carla for providing this insight and for guest-blogging on our site. Personally, I miss my volunteer work in Hospice but know that this is something I will eventually return to as it impacted me in a way I have not forgotten. The harsh reality is that life is a terminal disease – but we should not need to be given a deadline to act that way.

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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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It’s Heart Month: Recognize The Signs

According to Statistics Canada, every 7 minutes someone dies from heart disease or stroke, making these two of the three leading causes of death.  (Statistics Canada)  February is Heart Month and we will be providing heart healthy tips, recipes and more.  But beyond prevention, understanding the signs and symptoms of a heart attack is essential to early intervention and could save your life, or the life of someone around you. The following video starring Elizabeth Banks, and created by the “Go Red For Women” campaign, is both entertaining and factual.  Please view this important video, it may save your life or the life of someone you love.


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Alzheimer’s Awareness Month: Keep Your Brain Fit

Alzheimer’s Disease International estimates that over 135 million people around the world will suffer from dementia by the year 2050, and are concerned of a looming global epidemic. How can you ensure you are doing the best for your brain in the hopes of preventing dementia? The Alzheimer’s Society of Canada has a fantastic website that outlines the signs and symptoms of dementia, how to care for someone with Alzheimer’s, and how to keep your brain fit through regular brain exercise and a healthy diet.

Alzheimer’s Society Canada: Brain Boosters

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Heart Smart Snow Shovelling

Winter has just begun and if the predictions are right there is a long snowy season ahead! Shovelling snow is a necessity to ensure safety for yourself, visitors and passers by. It can be a great form of winter exercise if done properly, however, if you have a heart condition or are at risk for developing one, shovelling snow can pose many dangers. The following article from the Heart and Stroke Foundation discusses how to shovel safely.

The Heart and Stroke Foundation: Shovel Smart this Winter

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Senior Safety Week

This past week has been dedicated to National Seniors Safety awareness in Canada and this year’s focus is on drug safety for seniors. It’s no secret that our aging population relies on a great amount of over the counter and prescription drugs for many ailments and conditions. With so many pills and vitamins in the daily regimen, it’s important to ensure you or whomever you may take care of is taking these properly and as directed.  The following article from Canada’s Safety Council discusses great drug safety tips for seniors and caregivers.  

Canada Safety Council: Senior Safety Week

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Put On Your Own Oxygen Mask First

If you have ever traveled by air you are familiar with the drill. Instructions on how to buckle and unbuckle your seatbelt, where the life vest is located, emergency exits, and “should cabin pressure change, an oxygen mask will fall from the overhead compartment…passengers should always put on his or her own mask before assisting children, or a disabled passenger”.

 

I read a mommy blog the other day that called this the “airplane example” and the writer related this to how moms should approach motherhood. Ultimately the message is this: as a mom, put your own health first because you are useless to your kids and spouse if you ignore your own needs. Really, you can’t help a child with an emergency escape from a crashing plane if you pass out helping them with their mask.

While I do agree that mothers (and fathers for that matter) need to consider their own needs in providing for the family, this is also true of people that provide care to a disabled person. My experience is that often caregivers do not really “elect” that role. They are not trained to be a caregiver, and really just try to do their best with the skills and resources they possess. However, where many fall short is maintaining their own health and well-being in dedicating their physical and emotional time to another person: a person with challenging and multiple needs. The job of a caregiver is often 24 hours, and resources don’t often permit, nor does the government provide, sufficient relief from this responsibility. Caregivers are often sleep deprived, suffer from muscle and joint pain in fulfilling their role, and can become isolated and depressed due to the changes they have made to take on these new responsibilities. Sound familiar? This very closely mimics motherhood (especially for new moms).

 

The answer? Put on your own oxygen mask first. What can you do to breathe easier? What helps you to feel clear-headed, energetic and optimistic? What gives you that ability to stay positive, appreciate and take on your responsibilities with some enthusiasm? The answers are often different for all of us. In the end, figuring out how to wear your oxygen mask first requires you to be honest about your abilities and skills, to utilize the resources available, and to ultimately ask for help if this is needed.

 

And for us health care professionals? We need to be very careful of the responsibilities we place on caregivers. This is especially true in the medical community where we repeatedly discharge people into the care of family, without family really knowing what the responsibilities will entail. As health care

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providers our responsibility is always to the client, yet we need to take that extra time to check in with the caregiver, talk about how they are coping and managing and if needed, offer them an oxygen mask.

 

 

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Alzheimer’s Disease

I learned early in life about the perils of impaired cognition.  I worked for Scotiabank for many years as a customer service agent.  In this role, I would assist many clients who I now assume had dementia with their finances.  I remember having to call family when one elderly woman replaced her visa card six times in one month.  The family found them all in the lettuce compartment.  Or, the other lady that paid the same roofer three times.  She was being taken advantage of.  In school, I read the book “The Man That Mistook His Wife for a Hat”.  What a great way to understand dementia and Alzheimer’s disease.

It is national Alzheimer’s week so I thought I would take some time to talk about this very sad and difficult illness.  Alzheimer’s disease, or related dementias, impact 1 in 11 Canadian’s over the age of 65, with three-quarters of these being females.  It is expected that within a generation, this will double, to around 1.3 million people (http://www.alzheimertoronto.org/ad_Statistics.htm).

Signs of Alzheimer’s disease or dementia include:

  • Judgment: such as forgetting how to use household appliances.
  • Sense of time and place: getting lost on one’s own street; being unable to recognize or find familiar areas in the home.
  • Behavior: becoming easily confused, suspicious or fearful.
  • Physical ability: having trouble with balance; depending upon a walker or wheelchair to get around.
  • Senses: experiencing changes in vision, hearing, sensitivity to temperatures or depth perception.

Assessment of this is often done medically by eliminating other factors that could explain these problems (such as poor sleep, medication use, other conditions, stress, etc).  Also, an Occupational Therapy Assessment in the home is very helpful at determining how the noted problems are impacting function, how these can be addressed or treated, if the person is safe to be at home (with or without supports), and what care is required.  Following the assessment, the Occupational Therapist can make recommendations regarding devices, strategies, and supports that can help to reduce the impacts of the disability, improve safely, promote independence, and ensure the caregiver is trained to provide the necessary support.  Such suggestions could include ways to:  

  • Remove hazards at home.
  • Prevent unwanted wandering.
  • Safeguard medications.
  • Reduce physical barriers that impact mobility.
  • Improve visual perception through aids, devices and care techniques.
  • Reduce against risks of unsafe food and beverage preparation or consumption.

As with most things, early diagnosis and intervention is key.  Seek medical attention and ask for an OT in-home assessment to gather information about how to improve function, and to safely prevent premature losses that can result from lack of information about the condition and its management.

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Gardening Ergonomics

Do you have, or are aspiring to have, a “green thumb” ?  Or do you simply enjoy spending time beautifying your home or spending time connecting with nature?  Whether you garden for pleasure or purpose you may from time to time suffer from a sore back and achy muscles brought on by the hard work and bending involved.  The following article from the Toronto Star gives helpful tips on how to ergonomically garden without ending up with a sore back.

 

The Toronto Star: How to avoid back pain while gardening