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Archive for category: Solutions For Living

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Healthy is a Lifestyle, Not Just a Behavior

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

In my work as an occupational therapist I am often asked to help people learn to manage or improve their behavior.  Things they want to stop or start doing, and how to get there, become the topic of our treatment sessions.  But my response in these situations is often the same and my approach is to encourage people to make “lifestyle” and not just “behavior” changes when it comes to improving function or health.  After all, if behavior (be·hav·ior) is: “the way in which one acts or conducts oneself, especially toward others” and a lifestyle (life·style) is: “the way in which a person or group lives”, then there is a difference between acting and living.  My job is to coach the latter.

The difference in linguistics might seem small, but I would argue it is huge when actually implementing change.  I was reminded of this the other day when taking my daughter to the doctor.  Our doctor’s office is on the second floor.  She entered the building and moved towards the elevator.  I said “sorry Abs, we take the stairs”.  She made a disapproving face and I said “we would take the elevator if we needed to, but we don’t and the stairs align with our healthy lifestyle…race ya…”

I wanted her to know that our decisions need to align with our lifestyle and that deciding to take the stairs is not just a behavioral choice (“how should I act given my choices”)?  It is a way of living that will create the life we want as a family.

I still maintain that the best course I took in University was “Behavior Modification”.  Our project was to modify one of our own behaviors over the four months of the course.  As a dog owner, I chose the behavior of “dog walking” with the goal of making this a more regular routine.  Over the next four months I mapped out routes, increased walking distances and times, monitored my progress, and made a list of great dog walking locations in my community.  By the end of the four months I had adjusted my behavior from walking 20-30 minutes to two hours per day, spread over the morning and evening.  This is a routine I maintained for years – adjusting it as needed to accommodate my life changes along the way.  But my point is that in hindsight, the course did not allow me to modify my “behavior,” because in the end, I modified my “lifestyle” as this ultimately became the way I lived.

When taking that course I was told that it took four months to modify a behavior.  I have since heard that it takes three weeks to develop a new routine.  Perhaps the difference between these is that three weeks is a consistent period to make behavior change, but four months is needed for lifestyle adaptation.

Working with my clients I explain that lifestyle change is a commitment and like many things, requires daily practice.  We need time to reach the goals together, and change cannot and will not happen overnight because if it did, it would not be sustainable.

Spring is here, the sun is out, days are longer…a perfect time to ask yourself what lifestyle you want to have and to develop a plan to take you in that direction.  Don’t over think it.  Go big.  If “healthy” is on your mind, commit to a full out lifestyle change and make your daily decisions align with that.  Take the stairs, adjust your schedule, cut out the sugar, run the marathon, train for the Paralympics, but ultimately commit to a lifestyle and dedicate your energy towards living that way.

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Be Prepared

The phrase “be prepared” may be the Boy Scout motto, but it’s for everyone! Disaster can strike at any time. While the size of these can vary, the one common denominator is that you never truly know when it will hit.  With the climate change we are experiencing, natural disasters are becoming more common. It is Emergency Preparedness Week in Canada and the Federal Government is reminding you and your family to create a plan and ensure you have an emergency kit prepared that will help ensure your survival for 72 hours. (www.getprepared.gc.ca) This kit should include the basics of:

  • Water
  • Non perishable foods
  • Medical supplies (like bandages, alcohol wipes, gauze pads)
  • Candles and matches
  • Blankets and extra clothes
  • Activity books and toys to entertain young children
  • And don’t forget about the animals in your home—ensure you save food and water for them as well!

We have written about Emergency Preparedness and specifically how this relates to people with disabilities in the past. We encourage you to please take a look at this valuable information: Emergency Preparedness.

Remember… always be prepared!

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40 Years 40 Gratitude’s

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

Milestones are important.  They frame a lifetime.  Whether you are taking your first steps, graduating high school, getting married, or retiring, these life events symbolize where we are at on our journey.  Personally, I am at that mid-life crossroad we call 40.  For some just a number, for others a crisis, or a time to pause, reflect and make a new plan for the next four decades.  For me this is a bit of both.  If 40 is the new 30 I have nothing to complain about.  In fact I think I might be at the top of my game as I turn this corner.  But the transition comes with thoughts, feelings and emotions that have taken time to process.

I started planning 40 at 35.  I wrote a bucket list, developed a five year plan, and started looking forward to this event.  But as it approached my feelings varied between “so what” (who cares) and “so what” (what will I do to celebrate that is memorable and meaningful).  I wanted to celebrate then I didn’t.  I wanted to go away then I wanted to be alone.  At one point I just thought “I am going to own this mid-life crisis and stop perseverating on what it all means”.  Then I got clarity reading the wonderful book “Be Happy”.

One of the exercises in this exceptional book is called 100 Gratitude’s.  Simple but effective, you write down 100 things you are grateful for.  After all, being grateful is above all else on the list of ways to live a happy life.  So I made my list of the things I am thankful for and realized a theme:  it included people, experiences, and simple life pleasures.  Nothing material, vain or things I bought.  Just things I have lived, valued and appreciated in my 40 years.

This gave me an idea.  For my 40th I would write 40 letters of gratitude to those people in my life that I truly cherish.  These letters would be nothing but a positive reflection of how important that person is to me and what it is about them that I am grateful for.  It was important to me that these were “letters” – the old fashioned hand-written and mailed with pen and crafty lined paper.  I am not sure why, but there is something personal and ageless about our handwriting – sloppy or legible.

I did decide to vacation for my birthday.  I had a strong urge to have my feet in the sand and my eyes on the ocean while soaking in the sights, smells and sensations of being alive.  I will be disconnected from the hectic virtual world we all now occupy and will savour the mental clarity this will offer.  Maybe I will make a new bucket list, or a new 5 or 10 year plan, or maybe I won’t.  Perhaps I don’t always have to be so driven and this milestone is about slowing down. I will mail my letters before I leave so these become special surprises to those that know I have reached this milestone with their love surrounding me.

Whether you are over or under the magical number of 40, perhaps consider creative and impactful ways to make life events truly meaningful for both you and the people around you.  After all, the best way to feel grateful is to be grateful.  My exercise of 40 Years and 40 Gratitude’s will cost me some paper, ink, stamps and my time.  Priceless if you ask me.

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Trust Your Intuition

We all have that gut feeling from time to time—the one that tells us to be wary of certain situations or on the other hand to jump in with both feet!  Do you trust it?  New research tells us we should.  Check out the following article from Medial Daily discussing the science behind our gut feelings and why intuition should be an important part of your decision-making process.

Medical Daily:  Your Gut Feeling Is Way More Than Just A Feeling– The Science Of Intuition

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Setting Tech Boundaries: Saying i-Don’t

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

I don’t think I am alone when I say that I am becoming completely overwhelmed by technology.  Not being a techy person, it took me a while to warm up to email, then to the internet, cell phone use, texting and lastly social media.  Now I have two email accounts, three phone numbers, three websites, a cell, blog, and business and personal Twitter, Linked In, Google+, and Facebook accounts.  I bank online, shop online, do most of my communication by email, manage my business with my phone and computer, and even use an app to meditate.  My life is organized into files and folders that are populated with faxed, emailed or scanned documents that are backed-up, saved to disc, or exported to secure places.  My car can answer my calls, direct me to new places and even tell me when my favorite songs are playing.  My cat has an automatic feeder and my phone is accessed with my fingerprint or voice.  Sometimes people send me an email then text me to tell me they emailed me.  Or, they leave a voicemail then repeat the contents in an email or fax.  Or call me at home, then work, then on my cell. Craziness!

So how many people are ready to tech-out?  I know some days I dream of a home in the wilderness with no Wi-Fi, TV, computer, or cell service.

My love-hate relationship with technology has been an ongoing emotional versus productive battle inside my head for some time.  While I am trying to model appropriate technology behavior for my children, the pace at which the world seems to be operating, and the time sensitive nature of my clinical work, requires me to work-from-home some nights, visit the office on a weekend, and respond to texts afterhours.  I am not proud of this, and feel that I failed miserably in 2014 to keep an appropriate balance.  So, I have vowed that this year will be different.  While I cannot change the pace at which people try to reach me, I can change the pace of my response and can learn to reduce the guilt I often feel when my response is delayed, or when a nice evening at home took priority over my inbox.

Even society is starting to get fed up.  In France it is now illegal for employers to email their employees after hours.  I am not sure such behavior needs to be “illegal” beyond ensuring that the employee cannot be fired or demoted if they don’t respond after-hours, but this law shows the extent to which people feel pressured to communicate at all times – whether it is the right time or not.

I had a comical interaction with a friend one night that highlights this.  Working late, I had sent him an email asking a question about a service they provided.  He responded quickly with a “yes”, while failing to answer my other questions.  I humorously responded with a “thanks for your wordy response” to which he added “considering that I am out with my wife for our anniversary I think I said too much”.  Agreed.

So in an effort to not repeat my mistakes of 2014, I have set some firm tech boundaries for 2015.  Some of my strategies include:

1.  Work at Work.  I have an office at which I am extremely productive.  Lugging my computer back and forth from work to home is not good for it, my back, and tends to anchor my evenings to work when I have a list of other things I would like to be doing.   So, in 2015 I am leaving my computer at the office.  So far this means I am behind on my emails and have not tackled many things on my “to do list” but my family is enjoying my presence and my evenings are much less stressful.  And the real secret here is that I have noticed a definite DECLINE in the amount of emails I am getting since I started getting behind.  I guess people are finding other ways to solve their problems versus asking me.  Perfect.

2.  Phone Off.  In speaking with my techy husband, I asked about ways I could set some firm boundaries with my phone.  I wanted to limit texts from work contacts and stop my business email from surfacing on my phone after 5pm and on weekends.  Low and behold with an iPhone you can’t do that. Sure I can use airplane mode, or do not disturb, but this limits contacts from all people, and there are some people (my friends and family included) that I would like to be able to communicate with at any time.  So, I visited Roger’s and they too confirmed that I can’t be selective about who, how and when people can reach me.  My options then were just to behave differently (don’t check email or texts from work contacts), or to get an entirely different phone with a new number and “personal email only” set-up for after-hours.  While I still believe that one email or text can completely derail an evening or weekend, for now I have decided that when home my phone will be anchored to a spot in the kitchen on airplane mode.  When out, I will do my best to not read or respond to work messages until the following business day.

3.  Go Public.  To get the support of my team, I told them my plans for 2015.  This included my work hours and desire to set firm boundaries around my technology time.  We realigned our operations to divide roles and duties to reduce the triplication of emails to multiple people, and to ensure that people had clear lines of accountability – instead of their habit of going to the person they thought would respond first (typically me).  My team was very supportive and I have noticed a sharp decline in after-hours emails since I told them of my plans.  I also involved my family in my decision to leave my computer at the office and to limit after-hours phone time so that they too can encourage me along the way.

No, I am not perfect and will slide at times with the boundaries I am trying to set.  But even if I can accomplish half of my intention, I am 50% better than my experience of last year.  In the end, I guess I just want my enjoyable life to include a reasonable amount of technology, and not for technology to result in an unenjoyable life.

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My Grandma Versus Parkinson’s Disease

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

In honour of Parkinson’s Awareness Month we are re-sharing our popular post from last April:  “My Grandma Versus Parkinson’s Disease.”

I can’t remember how old I was when I was told that my grandmother had been diagnosed with Parkinson’s disease. I was very close to my grandmother and, selfishly, was most worried about how long she would live. We were told around 10-15 years. To a kid that seemed like a really long time, but as an adult I now recognize those years can, and will, pass in a heartbeat.

Parkinson’s results when the brain is not able to absorb dopamine – the neurotransmitter that helps to control movement and movement patterns. Often, this presents as tremors, difficulty initiating movement when walking, slowness, and loss of balance. Diagnosis is often by exclusion of other problems, treatment is offered via medication and therapy, and the life expectancy can vary based on many, often unpredictable, factors.

For my grandmother, her Parkinson’s was not really noticeable for many years. But eventually, her tremors became more pronounced and the ataxic and shuffling gait more obvious as her medications became less and less effective. What seemed to help her immensely though was a positive attitude, stubborn drive to be independent, and the decision to stay active. My grandmother loved jokes, was quick witted, and was always one for a funny story. I remember helping her off the toilet one day and she said “I have the privacy of a goldfish”. She was remarkably independent – my favorite was when she stuck the gum she was chewing to her back-scratcher so she could get a piece of paper off the floor. She stayed active by continuing to curl and golf for as long as she could, then turned to water exercises and found Tai Chi. Within a few months of Tai Chi she was raving about how much better her balance and flexibility were, despite making jokes that in her classes she was always the one facing the wrong direction. She was always trying to teach me her moves (see photo of her and I when I was 16 – apparently perms, Cotton Ginny Track Pants, and Mickey Mouse t-shirts with your name on them were cool back then). I ended up taking Tai Chi myself in University for a while and we would often share the “art” together.

Yet, despite her best efforts, eventually the disease took its toll. Her desire to be independent resulted in a strong aversion to using a wheelchair which meant several falls that caused two broken hips (six months apart), and a year later a skull fracture and brain surgery. She survived these, but her capacity to physically manage would deteriorate after each event and subsequent hospitalization. Eventually her and my grandfather found a wonderful nursing home that provided many social and recreational outlets for both of them. One day I was visiting her and she told me she had been petting a lama the day prior. I went to the nurse’s station to ask them if she had been hallucinating and they said “no, there was a lama in here the other day”.

But the final display of her true character was the day she died. Told she was in congestive heart failure, she used her walker (forbidden by the family) to walk to the end of the hall where she sat down and passed away on the couch. It was her last display of independence, stubbornness and determination – the traits that had actually allowed her to happily live life “her way” despite Parkinson’s.

Today we celebrate Parkinson’s awareness. While my grandmother had this during a time when it was relatively unknown, this has become better understood and studied thanks to people like Michael J Fox who has turned his diagnosis into a crusade for a cure. I see many similarities between how Michael J Fox approaches his illness and how my grandmother did. Sense of humor and a positive attitude (see his books “Always Looking Up” and “Lucky Man”), and continuing to live his life by creating a new “normal”.

If you, or someone you know, has been diagnosed with Parkinson’s disease, stay informed. Contact the Parkinson’s Society of Canada for local supports and information. Stay active in your community through modified programs, Tai Chi , or even Dance for Parkinson’s offered through the National Ballet School or locally at places like the Hamilton City Ballet.

And consider – if you or someone you know has Parkinson’s (or any disability for that matter) and needs creative and proactive strategies for managing well at home and in the community, consider calling an Occupational Therapist. We can, through education and equipment, help you or them to manage as safely and independently as possible.

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Employment for Autistic Individuals

In celebration of Autism Awareness Month we are thrilled to bring you this guest post from our colleague Bill Wong.  Bill is an Occupational Therapist, speaker and Autism advocate who lives and practices in California.  For more information on Bill please check out his recent Ted Talk: “Fighting On: Overcoming Autism Diagnosis.”

Employment for Autistic Individuals
Guest Blogger:  Bill Wong, OTD, OTR/L

Unlike many occupational therapy experts in autism, my expertise in autism comes from a combination of clinical and theoretical knowledge and my lived experiences as an autistic individual. Since I was diagnosed in 2010, I have been working on trying to understand my lived experiences from an occupational therapy perspective.

Employment can be tough for autistic individuals. There are 3.5 million autistic individuals out there in the United States, myself being one of them.  Of the 3.5 million autistic individuals, 35% have never held a job, and before occupational therapy, I was part of that statistic.

Fast forward to my occupational therapy career, my first occupational therapy job lasted 3 months and I had an unsuccessful attempt at private practice for 8 months. That said, I am now employed for 7+ months in the skilled nursing facility setting and poised for a pretty good performance review if I were to have one today.

What have I really learned?

1.      Networking is really important. Every real connection in your life counts. You never know when will these connections come into play. If you are a parent of a young autistic child, encourage them to learn to play with other children or join extracurricular activities where they can be with others and make friends. If you are a parent of an autistic adolescent or adult, encourage them to make some close friends that they can rely on in the future. As an autistic individual, I understand that making connections spontaneously can be difficult. However, inviting them to participate in social opportunities that interest them can be a good start for facilitating such connections.

2.      It is important for autistic individuals to know about themselves well– from their strengths and weaknesses, to sensory preferences, to their abilities in stress and anxiety management. Unless autistic individuals are in supported employment or sheltered employment, they won’t have access to support workers around them constantly. Understanding such things can help maximize the length of time these individuals are employed, or leave on their own terms if better opportunities come along.

3.      Don’t overlook volunteer opportunities or internships. Autistic individuals can learn about working as a team and many other job related skills. Expectations might be lower than an actual job. However, they can be important job-skill building experiences prior to actual paid employment.

4.      Social media can be a double edged sword for autistic individuals. On one hand, it can be an avenue to develop strong professional networks and support systems. On the other hand, it can be a key reason why autistic individuals might not get employed if their employers study their social media accounts. For autistic individuals, that means they have to be aware of their social interactions online so that they don’t put themselves in disadvantages that they are not aware of.

5.      Once employed, building rapport with colleagues is vital. That can set the tone on whether a job can be a successful and enjoyable one. In order to do so, this means autistic individuals must have at least adequate social communication and rapport building skills. Performance skill development will come with time at any job.

6.      The first paid job can be learning experiences for future jobs. Getting fired or having to resign are not fun feelings. But reflecting upon objectively the reasons why can lead to opportunities to improve and make adjustments for the next job.

7.      Mental flexibility is extremely important in many jobs. Job environments can produce many unpredictable situations. There also may not be enough time for transitioning from one task to another. Training autistic individuals how to deal with such from an early age will go a long way in preparing for their futures.

8.      Working at a paid job doesn’t mean sacrificing all the things that are meaningful to you or can bring balance to your life. Having a job that can pay the bills is important. However, if this comes at an expense of not doing things that autistic individuals can either relax or serve as a change of pace for what they are doing, it may be is time to switch to a better job situation.

9.      Never be ashamed to ask for help on job related matters– from people at the autistic individuals’ current jobs, to those in their social circles who are also working in the same profession. As an autistic individual, I understood it can be tough to ask for help, especially to my peers who have accomplished more than I do. That said, once I realized I was struggling in my current job after I completed my observations, I quickly turned to social media unashamedly asking my peers for help. My proactive actions helped me settled into the flow of my job within two weeks.

In conclusion, maintaining paid employment can be a daunting challenge for autistic individuals when they become adults. However, with great preparation in childhood and helping them learn generalizable skills will carry them a long way to succeed. Even if they have to learn these skills in adulthood like me, being intentional about attacking these problems can increase chances of successful employment.

 

photo care of:  www.tedxgrandforks.com/press

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Hidden Disabilities

For many of us “seeing is believing,” but what about the things we cannot see?  Millions of people across the world suffer from “hidden disabilities” such as brain injuries, autism spectrum disorders, mental illness and more.  Though these disabilities may not be visible on the outside, they are serious and life altering. Laura Brydges, a Canadian living with the effects of brain injury, has started a campaign to create a hidden disability symbol to bring awareness to those who live with these disabilities.  Check out this article from Brain Injury Society of Toronto’s blog (BIST) and help Laura in her quest to make this symbol recognized around the world.

Brain Injury Blog Toronto:  Is it the right time for a hidden disability symbol?

 

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Light It Up Blue!

Today, April 2nd, is World Autism Awareness Day.  A 2010  study conducted by the U.S. CDC found that approximately 1 in 68 American children are on the autism spectrum.  Furthermore, they estimate that autism spectrum disorders affect more than 2 million Americans and tens of millions of individuals across the globe.   World Autism Awareness Day began as a day to honour those with autism and is celebrated with the annual “Light it up Blue” campaign.

Check out the following article from Autism Speaks to find out more about this campaign and how YOU can “Light it up Blue” for autism awareness.

Autism Speaks:  5 Ways You Can Light It Up Blue on World Autism Awareness Day!