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Occupation Is: Managing Toileting, Grooming, Showering and Dressing

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

Remember: Occupational Therapists define the word “occupation” as the way people “occupy” their time. So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?). In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

Okay, so you are up, out of bed, heading to the bathroom. “Occupation” is also the process of managing personal care tasks involved in toileting, grooming, showering or bathing, and dressing.

Assume you have reached the bathroom. What happens if your back is too sore to bend you towards the sink, or the toilet is too low and you don’t have the lower extremity mobility or strength to crouch to that level? Or, maybe you have lost bowel and bladder abilities and you are required to toilet differently? What if when you look in the mirror your thoughts start racing to negative, derogatory or harmful comments about yourself? You want to shower or take a bath, but you can’t stand that long, can’t get your cast wet, or have hypersensitivity to the water hitting your skin. Maybe you can’t get to the bottom of the bathtub, or even if you sit to shower, can’t reach your shower head, lift your shampoo bottle, or lack the arm, hand and finger abilities to scrub your body or your hair. If you are using a wheelchair or commode, maybe you can’t even get into the bathroom in the first place, or if you can, can’t get into the shower, under the sink, or can’t see yourself in the mirror. Or, perhaps your depression limits your motivation to shower, or to brush your teeth or hair in the first place.

Maybe you have managed to do your grooming, toileting and washing. What if you can’t get dressed? Perhaps you are on the main floor because you can’t do the stairs, but all your clothes are in your upper bedroom. Or, your clothes are not clean because you lack the ability to do so. Maybe you dresser is too high, or too low, or you can’t reach the shelves in your closet due to pain, limited strength or mobility. Putting on a bra requires significant shoulder movements and putting on socks requires flexion and external rotation of the hips, or bending, and you can’t do any of that?

Occupation is all of that, and these things are addressed in occupational therapy. If you can’t use the toilet, perhaps you need education, supplies or help to manage briefs, urinals, catheterizations, bed pans, disimpaction, a colostomy, ileostomy, or suppositories. Maybe you need a commode beside the bed because your bathroom is not accessible, or you don’t have a toilet on the level of the home you are required to sleep on due to limited mobility. What if the commode you do have won’t fit over the toilet, or even through the bathroom door? If you can get in the bathroom, but the toilet and sink are not usable for you, perhaps devices would help to correct this, or you need education on alternatives. Perhaps your shower or bath needs some adjustments to help you transfer into / out, to sit to shower, or to reach the shower head. Maybe the shampoo and soap bottles need to be changed or relocated. A reacher may help you to access some of your clothing, or you need education and support to rearrange your things to promote your independence. Education and equipment for dressing may help to reduce your need for assistance with dressing your upper and lower body. No motivation to do these things in the first place? Solutions can include cognitive, emotional and behavioral strategies and supports to change thinking patterns, reengage the psyche, and to restore normal routines.

Spoken quite simply – occupation is going to the washroom, grooming, showering and dressing, and if these things are a challenge for you, occupational therapists treat that.

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It Pays to Be Proactive!

Recently on our blog we provided you with some insights on “sitting disease.” There is an increasing concern over the health problems that can be caused by our sedentary work lives including increased risk of heart disease, diabetes, obesity and the development of musculoskeletal problems. It`s estimated by Statistics Canada that the average Canadian spends approximately 50 to 70 percent of their daily lives sitting and another 30 percent sleeping. With numbers like this it`s no wonder there is a concern!

In the past, many companies have been proactive in their approach to assist employees who experience issues caused by prolonged sitting. However, studies show that being proactive can go a long way to improve the health and happiness of employees, reduce both absenteeism and presenteeism, and related costs. The following from Medical Xpress discusses how a proactive approach can increase job satisfaction, reduce costs related to absenteeism and health care, and help companies to retain talent long term.

Medical Xpress:  Proactive office ergonomics can increase job satisfaction and employee retention

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Serve Up A Healthier Thanksgiving Dinner

This coming weekend is Thanksgiving in Canada. A time for families to get together, create special moments and enjoy a delicious meal. The following from Reader`s Digest provides some ideas for delicious side dishes that are full of nutrients. We hope this provides you some inspiration to try something new this year and enjoy and happy and healthy Thanksgiving!

Reader’s Digest:  11 Healthy Thanksgiving Side Dishes

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Occupation Is: Getting Out of Bed in the Morning

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

Back by popular demand and in recognition of Occupational Therapy Month we are re-running our series “Occupation Is.”   I will be spending the month of October defining the word “occupation”. Why? Because, contrary to the traditional understanding of the word, occupational therapists define this differently. For us, the word “occupation” does not only include “paid” work, employment, or jobs. Rather, we define it as the way people “occupy” their time and as such it actually includes all roles involved in living (therapy for living, who knew?). So, for this month, I will explore the journey of “occupation” complete from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.

I assume the routine for most of us is the same. Morning hits, we hear the alarm clock, snooze it a few times, and eventually swing our legs over the bed, stand, stretch and head to the washroom. Sounds easy, right? But what if it isn’t?

What if you have had a terrible sleep? Perhaps you live with chronic pain and cannot get comfortable in your bed. Or, you have an acute injury and are trying to sleep on broken ribs, while wearing a cast or sling, or with bruises, scrapes, or swollen body parts. Maybe you live with anxiety, depression, or have trouble controlling your thoughts when you try to drift off. You have restless legs, or are on medication that makes you sleep too much, or causes insomnia. You are worried about something, someone, or have a child, spouse, or family member in your home that might need you during the night. Tomorrow is a big day and you are excited or nervous. You have neighbors that are too loud, or are spending the night in a shelter because you have nowhere else to go. Really, obtaining a restful sleep is actually difficult.

Assuming you have slept, and recognize the alarm is going off, what if you can’t just “throw your legs over the bed, stand and stretch”. Then what? Do you have or need support or devices to make the transition from lying to sitting, from sitting to standing, to a walker, cane or onto a wheelchair or commode? Perhaps your depression or anxiety makes it extremely difficult to transition out of bed to face the day, or to start your morning routine. Maybe you need to stay in bed for an extra hour because the amount of sleep you got just won’t cut it for challenges that day will bring.

Occupation is all of that and as such, these things are addressed in occupational therapy. Why are you not sleeping? Can we assist you to obtain a better sleep surface? Can we educate you on how to obtain a restful sleep position by suggesting changes to how you are lying, or through the use of pillows or wedges? Can we help you to shut your mind off through progressive muscle relaxation, meditation, natural sleep remedies, or by assisting you to obtain medical assessment and intervention? Can we aid in reducing your stress such that you are more at ease when trying to fall asleep, or so you won’t wake as much during the night? If you are sleeping through your alarm, or can’t motivate yourself out of bed in the morning, perhaps we can provide you with cognitive and behavioral strategies to re-frame that process to enhance your success. If there are physical barriers to positioning in bed, sitting, transferring or standing, we can prescribe equipment, aids, tools and support to ensure this part of your morning routine is safe, to promote independence, or to assist your caregiver.

Spoken quite simply – occupation is getting out of bed in the morning, and if this is a challenge for you, occupational therapists treat that.

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Weekly Mind Bender

In the middle of a round pool lies a beautiful water lily. The water lily doubles in size every day. After exactly 20 days, the lily will cover the complete pool.  How many days until the water lily covers exactly 1/2 the pool?

 

Answer

19 days.

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Back to… You!

This September we ran a series all about getting “back to you.” By now, we’re well back into the school year and new routines and we want to ensure you are taking time in your newly established routine for you.

To recap our “Back to You” series we want to leave you with the top 5 tips to ensure you are working towards a healthier lifestyle by focussing on you:

1. Schedule time for yourself.  Taking some me time each and everyday will go a long way to reducing stress, increasing energy and productivity and strengthening your overall health. So ensure, every day, you schedule time for yourself. Read a book, join a class, connect with a friend, or practice mindfulness techniques like meditation or yoga.

2. Keep Fit.   Ensuring your body is healthy through fitness at every stage of your life will help to keep you healthy and live longer. Try to schedule in some daily activities to promote fitness, but if you don’t have time for the gym or sports, ensure you sneak it in.

3. Eat Well.  You are what you eat! Food is the essential fuel for your body and mind, and without a balanced, healthy diet it’s impossible to function to your fullest potential. Take time to plan and prepare meals in advance so you ensure you are including the necessary nutrients on a daily basis and not needing to hit the drive-thru on your way home from work.

4. Keep Your Budget In Line.   Financial troubles or concerns can be a huge cause of stress in your life which can negatively affect both your physical and mental health. By taking time to plan, assess and modify your finances and spending habits you can alleviate stress, improve relationships and concentrate on you!

5. Keep Tabs on Yourself.  We’ve provided you with great ways to focus on you and your health, but with a busy lifestyle it can be hard to stick to your plans. If you notice yourself deviating from any of the plans you’re following to improve your mental, physical, and financial health, take a step back, reassess and devise a new plan that puts the focus back on you!

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Culture Creation

Focus on building a positive workplace culture is at the forefront of many business decisions as more and more employers are realizing they need to take care of their biggest asset, their employees. Creating a more positive culture and environment for employees is a process that cannot and will not happen overnight. So what’s the best way for employers to start? By empowering their people. By definition empowerment means “to give official authority or power to someone.” Of course it’s not suggested that employers forfeit all control and authority, however, but by empowering employees with more decision making and responsibility they can actually increase employee productivity and help to create a shift toward a more positive culture. The following from Forbes has more on this shift toward creating a people focussed place of work.

Forbes:  4 Ways To Build A Workplace Culture That Empowers People

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How Do You Like Them Apples?

It’s fall and the local orchards are full of apple trees with delicious fruit ripe for the picking. And you know what they say… “an apple a day keeps the doctor away.” Apples are packed full of nutrition as they provide a healthy dose of fiber, vitamin C and disease fighting antioxidants. Check out more of the health benefits of apples from Best Health Magazine.

Best Health Magazine:  15 Health Benefits of Eating Apples 

What’s the best way to enjoy these delicious and healthy fruits? Any way! Apples can be a great snack, dessert or addition to a salad. Try some of these tasty recipe ideas from Canadian Living and enjoy all that apple season has to offer!

Canadian Living:  Apple-icious

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Kitchen Safety – Hidden Hazards

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

I think I spend about three hours a day in my kitchen. Just when I get a meal or snack prepared, served and cleaned-up, it seems to be time to eat again. I guess that is the norm for busy families that are constantly on the go.

Yet, while the kitchen is one of the most lived-in rooms in the house, there are many hazards here that are often overlooked. These hazards can result in illness or injury if not addressed. For example, did you know that the dish cloth or sponge is the most dangerous item in your kitchen? That a child’s shirt can catch on fire while stirring something on a gas stove? That there are all sorts of bacteria (including fecal matter) on the rinds of lemons and limes (but we squeeze these and throw them in our drink!).

My blog today is going to highlight some of the under-estimated hazards in the kitchen, including:

1. Dirty Dish Sponges: Did you know that a dirty dish sponge can harbour and spread disease-causing bacteria? A study completed at the University of Arizona detected salmonella in 15% of sponges that were examined. As we age, it becomes more difficult for our bodies to fight off disease, making it important to be aware of how bacteria spreads and how to prevent it. A simple way to get rid of bacteria on sponges is to wet the sponge and zap it in the microwave for about one minute. Or for dish cloths, rotate and wash these regularly using bleach if available.

2. Cross-contamination of food: Ensure to thoroughly wash your hands, surfaces, and utensils after handling meat, poultry, or seafood to avoid spreading bacteria. Keep two cutting boards – one for meat products, and one for other food items. Purchasing cutting boards in different colours or labelling them can make it easier to discriminate between the two. Considering putting your cutting boards in the dishwasher after use to increase sanitation.

3. Spoiled Food and Storing Leftovers: Never leave raw meat, poultry, seafood or leftovers on the counter for longer than two hours. If defrosting food, defrost in the refrigerator or immerse in cold water. When storing food in the fridge, the temperature should be set to 4° C (40°F) or lower and your freezer at -18°C (0° F) or lower to avoid growth of bacteria. Ensure to keep meat, poultry, and seafood in sealed bags separate from the rest of your food items. The best place for these items is on the bottom shelf, so that juices can’t drip onto other food. If you are storing leftovers, use labels to record when each product was prepared. General guidelines for storing items in the fridge are as follows:

• Bacon: 1 week
• Lunch meat: 3-5 days
• Fresh beef, veal, lamb, and pork: 3-5 days
• Cooked meat, poultry, pizza, stews: 3-4 days
• Fresh poultry, ground meats, or raw sausage: 1-2 days

Go through your fridge weekly to throw out anything outdated or questionable. Always remember – when in doubt, throw it out!

4. Forgetting to Turn-off the Oven or Stovetop: This is extremely dangerous and can lead to fires or burns. To avoid this, stay close to anything cooking and use a timer or alarm. If you worry about forgetting to turn things off, consider using a visual checklist to remind you to check the stove. Place this at the exit to your kitchen, or post it at the door you use to leave your home. If you must leave the kitchen area while cooking for any reason (e.g. to answer the phone or the door), wear an oven mitt or carry a kitchen utensil with you to serve as a visual reminder to return to the kitchen as soon as you can. If using the oven, always wear long sleeved oven mitts to avoid burns. Alternatively, slow cookers are an easy and safe substitute to using the stovetop when preparing meals.

5. Supervise Children. Getting children involved in cooking and baking is a great way to increase their willingness to try new foods, and teaches them valuable life skills. But as with all things involving children, close supervision is mandatory. A child standing on a stool to stir something on the stove can lose their balance falling onto the burners and loose clothing can catch on fire. All knives (dull, sharp, large or small) can be difficult for children’s coordination, and small hands may have a hard time lifting heavier and hot baking pans. Even using a knife to get a piece of toast from a plugged in toaster is dangerous. So, supervise children in the kitchen and teach them the safe and proper way to prepare food and work around kitchen tools and appliances.

Although this is not an exhaustive list of kitchen safety hazards, the above are some of the most common and the easiest to avoid. Of course, there are other kitchen safety hazards that are created when people have physical, cognitive, emotional or behavioral disabilities. But the good news is there are many aids, devices and strategies that can help people to improve their independence and safety during meal tasks. Consider consulting an occupational therapist for suggestions on ways to be successful in the kitchen.

References:
1) http://www.chow.com/food-news/54707/10-kitchen-hazards/
2) http://healthycanadians.gc.ca/eating-nutrition/safety-salubrite/safety_home-maison_salubrite-eng.php#Refridgerator
3) http://www.foodsafety.gov/keep/charts/storagetimes.html