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Archive for category: Seniors Health

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Changes to Ontario’s Accessible Parking Permits

Someone with an illness, injury or disability often will require an accessible parking permit allowing them to park in the marked, accessible spaces closest to the building they are wanting to access.  Unfortunately, these spaces are often misused by those who do not need them which inhibits access for those who require them.  Some new changes to accessible parking permits in Ontario will help to reduce misuse and make parking more accessible for those who really need it.  Take a look at the following from the Ontario Government explaining the important changes which have come into effect.

Ministry of Government and Consumer Relations:  Ontario Introduces New Accessible Parking Permits

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AODA: Making Ontario Accessible. How Can an OT Help?

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

As an occupational therapist, business owner, and MBA, I can’t help but to reflect on the colossal legislation that is the Accessibility for Ontarians with Disabilities Act, or AODA.  If you are not familiar, this is Ontario’s way of making the province accessible by addressing the following key areas so that people with disabilities can more fully participate in their communities:  customer service, employment, information and communication, transportation, and design of public spaces.  This a catch-all legislation aimed to create a culture of acceptance for people of all abilities.

So where does occupational therapy fit into this and why is this legislation important?

Occupational therapists help people with disabilities to function more safely and independently in any environment in which they need to manage.  That includes at home, work or school, for leisure pursuits, and in the community, and often involves helping people to obtain devices, products or services.  Based on my own experiences, I thought I would share my thoughts on the importance of this legislation by sharing real examples of situations where a company or employee got it wrong when trying to provide service to a consumer with a disability:

Example 1:  A few months back I was taking an ailing relative to an appointment at a lawyer’s office.  We arrived and the building was poorly marked.  We tried a couple of entrances and walked around the building a few times.  We finally found the entrance and were met with three flights of long and windy stairs.  We climbed these slowly and when greeted by the lawyer he said “you should have told me stairs were a problem and I could have met you at home”.

Example 2: The other day I was at the bank waiting for an appointment.  A patron with a cane ventured in and tripped on the scatter rug that was not lying flat on the floor.  Two staff quickly ran to her side and started pulling her up by her shoulders to get her back into standing.  The teller told me that people trip on those mats “all the time”.

Example 3: Also recently, I ventured into the community to help a client purchase an appropriate bed.  The salesperson at the store told my client (who uses a wheelchair) that he “knows about people like him”.  When my client transferred onto one of the beds in the showroom, the salesperson tried to physically assist him, and continued to try and assist even after my client told the salesperson he did not need help.  Then, after the transfer the salesperson (standing behind my client) pulled the transfer board out from under him suddenly causing my client to lose his balance.

Example 4: Or, the story of a client of mine who uses a wheelchair and ventures into a large department store where an employee at the front of the store puts a sticker on him that says “I am special”.

These scenario’s highlight why the AODA legislation is necessary.  Everyday people with disabilities are poorly serviced, spoken down to, underestimated, or encounter barriers when trying to access a product or service.  With an estimated 15% of Canadians having a disability, and the number growing rapidly with the aging population, this equates to millions of consumers that are not able to access products and services, or who are being poorly treated or physically or emotional jeopardized when they do.  Or, expanding this further, these poorly serviced consumers often shop with an attendant, family or friends, doubling the number of people witnessing this problem.

Can you see the problems in these examples?  Would you handle these situations differently?  Has your employer provided you with the education and training to know how to provide proper service to people with physical, mental or emotional impairments, visual or hearing disorders, or how to optimally service someone who may be unable to speak or write, or who shops with a support person or service dog?  Can people with physical disabilities access your building, use the washroom?  If not, your employer is already missing the mark on the AODA legislation.

While many business owners may feel that the AODA legislation is unimportant or does not need sufficient attention, I would argue that this is not something to ignore.  Not properly training staff on the ways to service all people well runs the risk of impacting a business’s reputation, sales, and overall profitability.  Imagine, for example, that I disclosed the names of the businesses above?  What would you think of those establishments?  Or, perhaps worse, if my clients went online following and shared their experiences with others on social media?  Complained to a manager?  Or got hurt and decided to sue?  Or, looking more positively, we can turn this on its head and talk about how companies would be perceived, talked about, and celebrated for getting it right.  People share great stories too and many people with disabilities have a network and community of others that they liaise with for support.

Occupational therapists have the skills, training and experience to show others how to properly service people with disabilities, from barrier-free environments to effective communication and respectful and caring interactions.  Much like you hire a plumber to fix a tap, a mechanic to fix your car, or a lawyer to draft your will, hire an occupational therapist to help you and your business become AODA compliant.

Visit our AODA Training and Education page to learn more on the services we offer.

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How’s Your Posture?

Repetitive activity using improper posture and body mechanics can result in excess energy expenditure, fatigue, pain and even injury or damage to muscles and joints over time.  Therefore, it’s important to know the proper body mechanics required when completing everyday tasks and activities, at home, at play or at work or school.

The following episode of our Occupational Therapy Video Series:  OT-V discusses how to ensure you are using proper body mechanics with respect to:

  • workspace design
  • lifting and repetitive muscle use
  • excessive standing
  • excessive sitting
  • hand movements
  • excessive energy output.

Take a look to learn how an OT can help you improve body mechanics and reduce the risk of injury and pain in the long-term.  Remember to subscribe to our YouTube channel for access to this and other great OT-V videos!

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Occupational Therapy’s Important Role in Heart Attack Recovery

February is Heart Month and while many of our blog posts will focus on prevention through good health habits, we want to also provide you with some tips for recovery.  Below is some excellent information from the Canadian Association of Occupational Therapists (CAOT) on the role of Occupational Therapy in heart attack recovery.  As a heart attack is a life-altering event, often requiring permanent lifestyle changes, occupational therapists can help people to recover from the initial incident, to rebuild a life of function, and to promote change that will help with prevention.  Thanks to CAOT for your great description of how we help:

Take Heart. You can still do what’s important to you!

Heart disease has a major impact on an individual’s quality of life. It can lead to discomfort or chronic pain, activity limitations, disability and unemployment. “An estimated 345,000 Canadians aged 35 to 64 reported living with heart disease. More than a third (36%) of these reported needing help with household tasks or personal care” (Heart and Stroke Foundation of Canada, 1999). Heart disease requires lifestyle changes to prevent progression of the disease, further cardiac events and activity restrictions.

An occupational therapist in conjunction with other team members will help you determine what activities you can safely perform and how to modify activities to decrease the amount of energy required. This is important in achieving the maximum result from limited exercise capacity.

Try these occupational therapy strategies…

1. Use body mechanics: Smooth, rhythmic and repetitive motions are easier on your heart. Remember to breathe regularly. Avoid lifting or carrying heavy objects. Sit to work whenever possible, for example when ironing or chopping vegetables. Avoid lifting or carrying heavy objects. Slide objects or use a cart if possible. Change position frequently; this allows different muscles to work, increases circulation and prevents fatigue.

2. Simplify tasks: Break the activity into small steps, i.e. preparation, activity, clean-up and final phase. Take frequent small breaks throughout the activity rather than fewer long rest periods. Adjust work heights and areas to fit you. The most frequently used items should be located between waist and chest heights. Avoid working with arms above shoulder level.

3. Remember physical conditioning: Follow a regular cardiovascular exercise program as approved by your physician. An important element in maintaining cardiovascular activities is enjoyment; be creative – park a distance from work and walk in, join a mall walking program, exercise with a friend.

4. Recognize emotions: Anger, frustration, anxiety, and stress all increase the heart rate. Be aware of what creates stress for you and how you handle it. Try not to bottle up feelings – build your supports and talk to them. Decide on your priorities and learn when to say “No”. Pay attention to the activities that are stressful and schedule yourself accordingly, i.e. avoid unnecessary driving in rush hour and bad weather. Get enough sleep, rest, and maintain healthy eating habits. Work off tension appropriately.

http://www.caot.ca/default.asp?pageid=3703

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Be There For Someone Who is “Still Here”

According to the Alzheimer Society of Canada in 2011, 747,000 Canadians were living with Alzheimer’s disease and other dementias – which represents 14.9 per cent of Canadians 65 and older.  January is Alzheimer’s Awareness month and the Alzheimer Society has launched a powerful campaign reminding us to be there for those who are “Still Here.”  Check out this campaign and learn about the many ways to be there for someone you care about.

Alzheimer Society of Canada:  Still Here

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Tough Conversations

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

My grandmother always used to say “once an adult, twice a child”.  She was referring to the fact that we start life dependent, and through the aging process, tend to end our life that way as well.  So, what happens when the grown-up “child” needs to become the caregiving adult in a relationship with an aging parent?  It leads to many tough conversations about some pretty big topics.  Recognizing that some conversations are not only difficult, but could cause relationship-changing outcomes, I wanted to give you some pointers for handling the big ticket items adult children might encounter with their aging parents:

Driving

We all have a societal obligation to ensure that the roads are safe.  Just like a parent not giving the keys to a teen that has not demonstrated adequate driving skills, adults need to look for this in their older parents too.  While some seniors self-retire their license when they feel they are unsafe, some are not as willing, or able, to make this decision.  I remember my grandmother stopped driving when one day behind the wheel she “woke up and the light was green”.  While we joked about this as a family, we applauded her for making a responsible decision.

Making sure your parents are able to drive safely is important for them, and the general public.  So how do you manage this?  Next time you are out with your parent drive separately and follow them, or get them to drive with you in the car.  Watch for the following:

  • Are they driving to slow or too fast?  Note that driving too slow can be just as dangerous as driving too fast.
  • Are they obeying the traffic signs?
  • Do they have the range of motion to look both ways and check blind spots?  Are they looking around at stop signs, when merging lanes?
  • How are they negotiating directions, are they getting lost frequently?
  • Do they seem to be driving aggressively, or do they seem oblivious to other drivers, cyclists or pedestrians?
  • Do they obey right of ways, manage one-way streets, can they park the car safely and easily in a lot or on a side-street?

If you have concerns about any of the above, you have a moral obligation to bring your concerns to their attention, or to the attention of their treating physician.  If you choose to have this discussion with them directly, be caring and compassionate, but direct.  Tell them about your concerns but instead of just telling them they shouldn’t drive, suggest the involvement of a professional like their doctor, an occupational therapist, or driving assessment.  If you are not comfortable having this conversation with them, bring your concerns to the attention of their treating physician so they can do their own assessment.

Home Modifications

Most seniors want to remain in their own home as long as possible.  Many recognize that some small changes to the home could have a big impact on their safety and function, and some are very hesitant to consider modifications.  I remember I once had a call from a physician who was calling about his own parents, expressing concerns about his mother and how she was managing at home.  We talked about the value of OT and he agreed that a home assessment would help her.  He then asked “so, what should I say to her to get her to agree to this”?  I found that surprising as even as a physician who is required to have difficult conversations with people all the time, he struggled to know how to approach his mom.  I suggested he tell her that he recognizes it was very important to her to stay at home as long as possible, and that he is concerned that if she falls, staying home might not be an option.  I told him to tell her that he wants to have an occupational therapist come and talk to her about her safety to make sure they are doing everything possible to keep her living at home for as long as she can.  He called his mom, and like a kid planning a sleepover, called back and said “it worked, she said yes”!

I think it is important for adults of aging parents to demystify the home modification process and stress to their parents that most changes are minor, removable, or will actually increase the value of their home, while keeping them there for as long as possible.

But honestly, the best approach is usually letting a professional explain to the aging parent what can be done, and what they should consider either now, or in the future, to ensure their home continues to work for them.  In that case, the difficult conversation is more getting the professional in the door, instead of trying to convince the parent of the changes that you feel (without full knowledge of the options) might be needed.  Occupational therapists are great at getting a sense of what people need, explaining the options, and coming up with a plan.  I always chuckle when I meet with seniors and the first thing they say is “I know my son says we need X, Y and Z, but just so you know we are not doing that”.

Relocation

There may come a time when being the primary caregiver of an aging parent who is trying to live at home, may become too much. Caregiving is a difficult task that often requires time, knowledge or a level of commitment that a working adult-child who might have children of their own, just does not have. Having a discussion with your parent about the need to relocate to get access to skilled or more available care, is difficult.  Like the other conversations, tell your parent that their safety is your primary concern and that you are willing to do all you can to help them get the care they need.  Remind them of your own capabilities and the other responsibilities that you are also trying to balance.  Framing your conversation this way will go a long way to show them you are being supportive, and not just trying to tell them what to do or how to do it.

In the end, yes these conversations will be difficult, but your parents need your love, support and guidance as they navigate the aging process.  I remember having a difficult conversation with my grandmother about her decision to use a walker instead of her wheelchair, when the wheelchair was much safer for her.  She was giving me a hard time and I reminded her that she taught us to care about each other so the fact that I care about her safety was actually her own fault.  She laughed and we had a great conversation about her fears about declining mobility and reducing independence.

I wish you the best as you navigate these difficult conversations with your parents.  But remember, sometimes involving a professional (like an OT) who can assess the situation, come up with solutions, and develop a plan may go a long way to maintaining the parent / adult-child relationship, while keeping the parent safe at the same time.

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Aging in Place

Co-written with Claire Hurd

If you are an “empty nester” you may start to think how this phase in your life relates to your home and ongoing need for a larger space that previously accommodated a growing family.  Or, for some with kids out of the house, married and with their own families, they want to start spending time in a warmer climate, or want to move closer to their grandchildren.  Some will even consider moving in with their children to help raise the next generation, or because financially this is the most suitable option.  Whatever the reason, housing can be a massive contributor to function as we age, and there are several things to consider.

Universal design:
Universal design, or inclusive design, has the goal of maximizing usability for all, without sacrificing aesthetics when possible. You have probably seen universal design in many public spaces, but it can be incorporated into homes as well.  Examples of this may include lever door handles rather than knobs, raised outlets and lowered light switches, and large flat panel switches rather than small toggle versions. Many new homes are being designed to be “visitable,” with a basic level of universal design, including a smooth, ground level entrances without stairs, a wheelchair accessible main floor bathroom, wide doors, and wide hallways with room to maneuver a mobility device. When touring a potential new home, see if principles of universal design have been included. If you are renovating, consider including universal design elements in layout and fixtures.

Layout:
 Bungalows and condos are usually the most accessible options. Stair lifts are expensive, and the more landings or turns there are, the more they cost. It is also difficult to install them on curved staircases. Some side split designs may be conducive to elevator installation, but side or split-level homes are more difficult to accommodate in the event of mobility decline.

Bathrooms:
Bathrooms should have room to maneuver a mobility device. “Comfort height” toilets are a few centimetres taller than standard toilets, more like a standard chair, and make sitting down and standing up easier. A walk-in shower, or, better yet, a roll-in shower with no ledge to step over, will be accessible by family members and guests who may have temporary or more permanent mobility challenges.

Kitchens:
If possible, have variable counter heights in the kitchen, to make food preparation easier for taller adults, shorter children, and individuals who need to sit. Recessed areas underneath countertops and appliances can accommodate mobility devices or chairs. Ensure that lighting is good in all task areas. Rounded corners prevent injuries. Casement windows are more readily opened than the traditional double-hung styles.

Outdoors:
Gardening is a great activity for mind, body, and soul, but bending and kneeling on the ground can be difficult for many people. Raised flower beds and container gardens are a great solution.

Location, location, location:
Even if a house or apartment is otherwise perfect and accessible, if it’s in the middle of nowhere or in a neighbourhood that feels unsafe, it may not promote its occupants’ wellbeing. Proximity to services, such as grocery stores and public transportation, not only prevents social isolation, but may decrease potentially unwanted dependence on others.

Accessibility can benefit health, wellbeing and safety for anyone – regardless of physical or cognitive limitation. If you have more specific questions about how you can help yourself or others age comfortably in place, consider consulting with an occupational therapist.  Occupational therapists are trained to assess the person, their environment and the tasks they need to complete in the places they live and work.  So, before you make potentially costly mistakes in planning how you can better manage the “job of living”, give an OT a call.

 

For more information on Aging in Place and other helpful topics for Senior’s please visit our Senior’s Health page.

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Seniors: Take Advantage of Renovation Tax Credits

In Ontario the Healthy Homes Renovation Tax Credit is helping many seniors, age 65 and over, take advantage of necessary home improvements at a lower cost.  Many seniors, opting to age in place as long as possible, are modifying and renovating their homes to make them safer and more accessible for their changing needs.  The tax credit from the Ontario Government provides up to $1500 for eligible renovations.  Take a look at the following from Senior City for more on the program and why it pays to hire a professional.

Senior City:  Home Improvement or DIY Disaster – Renovation Tax Credits

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Fall Prevention Toolkit

Falls are the leading cause of injury amoung older adults in Canada and the number one cause of brain and spinal cord injury in seniors.  November is fall prevention month and to assist others in working to prevent the dangers the Ontario Injury Prevention Resource Centre has compiled a toolkit.  Check it out to help seniors prevent falls.

Ontario Injury Prevention Resource Centre:  Fall Prevention Month