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Use Your Head: Keep Kids Safe on the Playground

Remember this? If you do, you were probably a kid in the 70’s or 80’s. I remember hanging on for dear life as some teenager would try to spin us so fast we would become sick or fly off at record speeds. I can only imagine the injury rates that prompted the removal of these from playgrounds.
As parents, we all have a different “danger zone” with our kids. Yet, there is a balance between letting them play recklessly and engaging in the new trend of “dangerism” where we are preventing our kids from taking risks – risks that can be so important to healthy growth and development. Playgrounds are a great source of physical exertion and outdoor exploration, but can also be unsafe. Playground injuries account for over 28,000 injuries per year in Canada (Parachute Injury Prevention) and that while many kids suffer only minor injuries, approximately 10% are hospitalized for a more severe injury often involving the head. So, how do we let our kids enjoy the playgrounds, have fun with friends, and explore independently while still keeping them safe? Check out the following from “Caring For Kids” to learn more about playgrounds safety tips.

Caring for Kids:

Playground Safety

 

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Feed Your Brain

How do you fuel the most important organ in your body? Research shows that a diet low in fat and cholesterol, filled with antioxidants from fresh fruits and vegetables, and omegas from fish and nuts, can help fuel your brain and ward off issues later in life. And these diets are also great for your heart and reduce the risks of diabetes. Check out some of these fantastic brain healthy food tips from The Alzheimer’s Association.

Alzheimer’s Association: Adopt

a Brain-Healthy Diet

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Give Your Mind a Check Up

Whether you think your memory is failing you, or other people are telling you so, or you just like brain games, the following “test” created by Baycrest Health Sciences provides an easy way for a quick “check up” on your memory functions. Of course, the results are not a medical diagnosis, but see how you score and if you are concerned, speak with a health professional.

Canada News Wire:  Baycrest memory experts launch ‘thermometer’ for the mind

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P is for Prevention

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

In recognition of Brain Injury Awareness month, I thought it would be fitting to start at the very beginning. PREVENTION. Really, it is the best medicine. For now, let’s forget about the symptoms of brain injury and its’ impact on work, home, school, and quality of life. Let’s not talk about how it is assessed and treated. Instead, let’s focus on trying to stop it from happening in the first place.

But even before that, we need to know what we are dealing with. It is well known that brain Injury is the leading cause of death and disability worldwide. In Canada, Traumatic Brain Injury (TBI) is more common than breast cancer, spinal cord injury, HIV/AIDS, and multiple sclerosis (MS) combined. There are approximately 18,000 TBI hospitalizations annually. In the province of Ontario, 25% of the two million people diagnosed with a neurological condition have suffered from a TBI. In 2000-2001 brain injuries accounted for $151.7-million in direct costs to Canadians (1).

By way of distribution, TBI is most common in children (0-19) at 30%, followed by seniors (60+) at 29%. In kids, falls are the most common cause followed by motor vehicle accidents and then sports. In adults, motor vehicle accidents cause the most TBI’s, and in seniors the causes include falls (76%) followed by car accidents (2).

Knowing the causes helps to look at how we can engage in preventative strategies. As an occupational therapist with a background in health promotion, a parent of four, and athlete, here are my thoughts:

Falls

Kids fall all the time, so how can we prevent that? Well, there is a difference between a child falling when walking, running or jumping, versus falling from, say, a shopping cart, off of a playground structure, or from a tree they tried to climb. Falls from bikes, skateboards and scooters are going to happen – and a helmet can mean the difference between a head injury and not. The bottom line is that falls in kids are best prevented by proper adult supervision. Yes, it is that simple.

In seniors, falls take on a different form. They are not from carefree or reckless behavior, but often happen when someone is just trying to go about their day by having a shower, coming down the stairs, or taking a leisurely walk. Seniors need to be attuned to the physical, balance and vision changes they are experiencing as they age, and need to consider the importance of anti-slip mats in the bathroom, removing scatter mats, installing grab bars or railings, and the benefits of a walking stick or cane when outdoors. Seniors need to engage in regular exercise and activity to maintain bone density, mobility and intact balance. They have to be very careful when living with pets or when trying to negotiate places that are cluttered or dark. Awareness of declining abilities is the first key to addressing these properly such that a prevention plan can be developed that will ultimately improve safety and reduce the risks. Note that the services of an occupational therapist can be pivotal in creating this safety plan.

Motor Vehicle Accidents

Like falls, despite our best intentions, these can and do happen. The issue here is trying to minimize the risk and optimize the outcome. Safe drivers are attentive, undistracted, and alert. They travel at safe speeds, approach intersections with caution, stop behind the line, pass when appropriate, and recognize that rushing to get somewhere on time is useless if it means you never get there at all. Safe drivers don’t text or hold a phone to their ear, don’t eat a hamburger and steer with their knees, and don’t drive when tired. If you are one of these drivers you are going to increase your chances of avoiding a collision, and lower your chances of being the cause. Unfortunately, however, not everyone is a safe driver. So, all the rest of us can do is wear our seat belt, buy a car with a good safety rating, make sure everyone in the car is buckled properly, make sure the headrest is at a proper height, put loose belongings in the trunk (I know of a child who got a head injury from a flying jar of pickles that escaped the grocery bag during a collision), and follow the rules for child seats.

Sports

I am an avid athlete and have pretty much played or tried every sport. There are very few sports I dislike and I honestly feel that sports can be the most positive and influential outlet for young people, and one of the most engaging and social outlets for adults. The issue is that sports seem to be becoming more and more competitive, kids and adults are getting bigger and stronger, and the culture of some sports has changed from friendly competition to all-out war. Preventing head injury in sport can include outfitting your kids with proper equipment (many hockey parents spend more on a stick than a helmet), ensuring they are playing at their level, monitoring the coaching influence and team culture to make sure this is appropriate, and my favorite is from the book “The Secrets of Successful Families” and includes that the only job of a parent in organized sport is to “shut up and cheer”. No parent should be on the sidelines encouraging reckless, mean or harmful behavior. The results can be devastating. And if you are concerned about your child’s risk of head injury in sport, know that there are many other sports that reduce the risk but are equally as challenging, competitive, fun and have the same physical, cognitive and developmental benefits.

So, let’s start our recognition of Brain Injury Awareness Month by practicing prevention. It does not have to be easier said than done.

(1) Brain Injury Association of Canada
(2) Canadian Institute of Health Information

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Gardening is Therapeutic—Make it Accessible for Everyone!

Gardening provides a therapeutic outlet mentally, emotionally and physically. It can provide exercise, fresh air and it is well known that spending time outside connecting with nature is good for your soul. Those with disabilities may find the bending, reaching and digging associated with gardening difficult. “Carry On Gardening” in the UK, in association with “Thrive”, is an organization that helps people with a wide range of disabilities to get into the garden. The following from their websites provides tips and guides on how to create and maintain an accessible garden.

Carry On Gardening:  Top Tips for Disabled Gardeners

 

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How To Promote Inclusion to Your Kids

The following from Abilities Magazine discusses great ways to proactively talk to children about disability and inclusion and how to react appropriately should your child ask an inquisitive question about someone they recognize as “different” when in public.

Abilities Magazine:  “Mom, What’s Wrong With That Man?”  Those Awkward Questions and How to Promote Inclusion and Acceptance Among Children

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Spinal Cord Injury 101 – Julie’s Picks

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

I think this is a great story.  My husband and I were in Orange County New York.  My husband was knocking “flying in a MIG” off his bucket list and I was there to watch (nervously).  The pilot of the MIG was telling us that the guy whose plane was in the neighboring hanger was an unassuming and humble Hollywood director with multiple Oscars.  Cool!  Well, just before take-off the director arrives.  Amazing!  He never comes on a Friday.  As my husband launches away at some crazy speed, I approach the director and tell him that I am a fan of his movies.  He is flattered and we enter into a conversation that he somehow turns into being about me.  When I tell him I am an Occupational Therapist he discloses that his son was recently diagnosed with a SCI after spinal surgery.  How awful.  I explained that this is actually my area of practice.  We spend the next hour talking about SCI and I filled him in on all the latest research from the Rick Hansen International Conference I had just attended.  I tell him about some of the great devices available, American organizations to talk to, and specialists in the field, and he gives me his personal email to send him links and to stay in touch.  He was elated.  He had no hope, no knowledge about his son’s condition, and didn’t know where to start.  I was shocked.  Shocked that a man with that kind of money, connections, and seemingly unlimited access to resources would not know where to turn, and more shocked that someone so famous found something I said useful.  Since then we have kept in touch by email and every once in a while I send him resources and magazines I think he will find helpful.  I am still blown away by that encounter, and definitely found that exchange more exciting than some plane that flies really fast.

According to Spinal Cord Injury (SCI) Ontario, there are 600 new cases of SCI in the province per year, and 85,000 people living with SCI across Canada.  Of new injuries, 42% are the result of trauma (falls, accidents, or violence), and 58% from non-traumatic causes (tumors, infections, diseases).  The extent of a SCI injury is classified by the resulting impairment, with tetraplegia (or quadriplegia) indicating that all four limbs and the trunk are involved, and paraplegia is when the trunk and legs are impacted but the upper extremities are not.  Contrary to popular understanding, quadriplegia does not mean “no use of the arms” it just means the arms are involved, and the amount of usage will depend on the level of injury.  The incidence of SCI is highest in adolescents and young adults from sporting injuries, car accidents and violence, then peaks again in seniors as the result of falls.

While the direct consequence of SCI is severe – mainly the inability to walk, bowel, bladder, and sexual dysfunction, and sometimes reduced use of the arms and hands, the secondary consequences can be just as devastating.  Physiological changes in temperature regulation and circulation, pressure sores from reduced sensation, weight gain, repetitive strain on the upper extremities as they become used for transfers and mobility, urinary tract infections, bowel issues, and of course the emotional side of adjusting to wheelchair use and reduced physical abilities are all common.

As a clinician with special interest in the field of SCI, spending the last 10 years of my career treating individuals with these problems, I have been able to gather a list of very helpful resources and equipment that most clients find useful.  In recognition of SCI Awareness Week, I wanted to share my top picks here.

Standing Wheelchairs – these chairs provide significant benefit to an individual with a SCI.  Allowing people to stand and bear weight through the legs is known to improve circulation and bone density, along with the added benefits of allowing someone to reach upper cupboards again, or to look people in the eye when talking (as an example, check out the Lifestand Helium chair online at http://www.permobilus.com/heliumls.php.

Free Wheel – for manual wheelchair users, terrain such as snow, gravel or sand can be difficult, if not impossible to manage.  The free wheel is a simple add-on that elevates the front wheelchair casters to make these terrains easier (http://www.gofreewheel.com/).

Smart Drive – manual wheelchairs can be difficult to use for long periods as our arms were never designed to be our source of mobility.  So, some people use a manual wheelchair indoors and for short distances, and a power wheelchair for longer distances and outdoors.  The Smart Drive bridges the gap between manual and power chair by providing a power-assisted method of propelling a manual chair.   This is helpful for long distances, up inclines, or to just get places faster. This is another simple add-on and only weighs 11 pounds making it easy to take on and off.  In Ontario it is also now approved by the Assistive Devices Program.  Check out http://www.quarthealthcare.com/index.php/smartdrive for more information.

Sensi-Mat – Pressure sores can be a significant problem for people with SCI as they lack feeling in their lower body that would normally tell them to shift their weight to relieve pressure.  Without pressure relief, areas of the skin can die due to lack of blood flow.  If not treated, the sore can bury deep into the skin and underlying tissue, become infected, and treatment usually involves sitting restrictions, significant bed rest, or even surgery to correct and cure.  The Sensi-Mat works to prevent pressure problems from occurring by providing the wheelchair user with data about their sitting patterns, including cuing about when to shift their weight.  If an ounce of prevention is worth a pound of cure, the Sensi-Mat is a must for all people with SCI.   This new product will be available in June 2014 (http://www.sensimatsystems.com/).

SCI University – This is an online resource created by people with SCI to help others understand how to manage the many aspects of this condition.  Covering everything from nutrition to catheterization, this is also a “must check out” anyone with a SCI (www.sci-u.ca).

Abilities Magazine – This circulation is packed with useful resources, inspiring stories, and solid examples of people with SCI who are achieving amazing things.  Each issue highlights things from travel to sports and work, and includes helpful tips for not only disabled people, but is also very informative for the general public and rehabilitation professionals (http://abilities.ca/).

People in Motion – this free show, held on the first weekend of June in Toronto is packed with vendors highlighting the many wonderful products that exist for people with disabilities, including those with SCI.  From vehicles to home accessibility and wheelchairs, this is worth the drive to Toronto (http://www.people-in-motion.com/).

Of course, no person will experience a SCI the same, and the recovery from this, and ability to function safely and independently following, will depend on multiple factors.  Custom problems need custom solutions so if you have a SCI considering contacting an Occupational Therapist with experience in your condition to get solutions for living!