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Tag Archive for: occupational therapy

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Cognitive Strategies Following ABI

People with an Acquired Brain Injury, or ABI, often have issues with memory or other higher-level brain activity after their injury, and suddenly, completing daily life tasks becomes very difficult. They may struggle with things like remembering names and faces, the things they need to do in a day, or they may even forget or lack insight that they even have an ABI.

Occupational Therapists have the skills to get many people with brain injuries back to everyday life!

Learn about some of the strategies Occupational Therapists use to help those who have suffered an ABI in the following episode from our OT-V series, Acquired Brain Injury – Cognitive Strategies.

 

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Treating Executive Dysfunction: There is No “One Size Fits All”

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

As a caring professional, I refuse to believe that my clients are not motivated.  All of my clients have goals or I would not be treating them.  However, their ability to achieve their goals independently remains the reason that they require active therapy.  Previously, I wrote about executive functioning (Brain Injury and Executive Functions – When the CEO is on Hiatus), the capacities we require to achieve a goal, and used the example of moving to highlight how people with executive dysfunction may feel on a regular basis when completing relatively simple tasks.

Treatment for executive dysfunction is as broad as it is specific.  It is broad because everyone experiences brain injury differently and comes into that type of trauma with varying levels of ability to start with.  However, treating problems with executive function is really as simple as taking a goal and breaking this down into component parts, manageable chunks, and smaller goals within the whole.

So, returning to the moving example, assisting someone with executive dysfunction with a pending move will involve making checklists, with time frames, and checking on progress frequently.  Personally, I like to take a project approach:  calling the goal “Operation Move” and mapping out – start to finish – the metrics for success.  Perhaps in month one an “apartment hunting worksheet” is created to help a client summarize all the places they are looking at, the pros/cons, address, and list of questions that need to be answered (price, utilities included, length of the lease, etc.).  Often I encourage my clients to use a smartphone to take photos of the options then we cross-reference these and catalog them to keep things organized.  From there, the process continues with checklists for calls to make, addresses to change, ways to organize packing and management of belongings.  Ensuring the client is responsible for follow-up via “homework” between sessions and holding them accountable for completion of this aids to developing independence.  Really, the therapeutic goal is more than just ensuring the client is able to move successfully.  Rather, it is demonstrating a model and method that can be used for any future transitions, goals or tasks.  This ensures success that is transferable to other events at later dates. 

 

Previously posted June 2013

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The Importance of Hope

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

June is Brain Injury Awareness Month.  For many who suffer a brain injury the road to recovery is long and filled with many twists and turns along the way.  I wanted to post this popular blog post as a reminder to not give up hope, no matter how difficult the journey may be.

A friend asked me to visit a colleague of his who was in the hospital following a spinal infection.  The spinal infection and resulting surgery caused paralysis and the gentleman was told he will not walk again.  During our visit we spoke of the non-profit organization “Spinal Cord Injury Ontario” and the client’s wife told me the story of their first meeting with a Peer Support volunteer.  She recalled that the volunteer (a paraplegic) entered their room and introduced himself.  The wife politely thanked him for coming but told him they would not need his services as they strongly believe that her husband will walk again.   The volunteer’s answer was brilliant – he told them that even though it has been years since his own accident, he too has not given up hope that one day there will be a cure for paralysis.  He explained that he keeps himself in great shape as to always be prepared for that day.  He told my friend’s colleague to never give up hope.

This conversation reminded me that hope is essential.  As a health professional, I realized early that one of the key roles I play in the lives of my clients is to foster hope.  Hope for a better future, for a solution to their current problems, and for a better way to manage.  Even just discussing problems and brainstorming solutions elicits hope.  Health professionals should never undervalue the importance of fostering hope – even if that is in the face of one huge challenge after another.  Where hope becomes dangerous is when people are so busy waiting for “the cure” that they forget to manage in the meantime.  Hope, like goals, is essential to survival, but so is survival in between.  To forgo opportunities, solutions and help in the hopes of a future “fix” will only cause secondary problems that may be larger than the initial problem in the first place.

This philosophy is supported by most Chronic Pain Programs – they will not admit people to participate if that person is banking on a surgery, medication, or other therapy to “fix” them.  Some problems are chronic, and learning to manage with the trials of life despite the problem is the only therapy.  This should not squish hope – but rather should allow hope to live and breathe among optimal function.  

I always try to remain hopeful.  Hopeful for a better world for my children, for resolution of pain and suffering for my clients, for the health of others, and for my industry to remain a place where injured people can be adequately supported during their recovery.  But I recognize that it is not always easy to feel hopeful.  So, if you ever find yourself running on empty in the hope tank, try calling a supportive friend or family member, looking online (or on this blog) for inspiration, watching a funny or uplifting movie, getting some exercise, changing your scenery, or seeking support from a health professional.  We are here for hope and help. 

 

Previously posted July 2013

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The Need for Occupational Therapy in Non-Traditional Roles

The following, written by an OT student whose placements included a homeless shelter and working with troubled youth, discusses the need for occupational therapy in these non-traditional settings.  Learn more about this particular OT’s experiences in the following care of The Guardian.

The Guardian:  There’s a place for occupational therapy beyond councils and the NHS

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Washroom Safety and Independence: OT Can Help!

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

For some people, the simple task of going to the bathroom can be a challenge.  This may be due to a recent surgery, mobility impairment or another medical issue that impacts the bladder or bowels.

In an episode from our OT-V series, we talk about some of the tools and methods Occupational Therapists will recommend when providing solutions for safe and effective washroom usage.

Watch the video below to learn more about how an Occupational Therapist can help an individual facing challenges in the washroom to ensure their safety, comfort and optimal independence.  

 

If you enjoyed this episode of OT-V please visit our YouTube Channel to see more informative videos about Occupational Therapy and the Solutions for Living OTs provide!

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Getting around: Transportation Made Easier

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

Have you ever wondered why the design of the objects we use and spaces around us are getting better and seem to relate to our bodies or the way we do things in a much more obvious way than ever before?

Barrier-Free Design allows the greatest majority of people equal access to the private and public spaces of our built environment. The aim is to minimize or eliminate physical, cognitive, and sensory barriers in our homes, businesses, and public spaces and even our streets.  

Consider the front entrance of a building. Sidewalk curbs, uneven walkways, multiple stairs, heavy doors, and lack of handrails. All these can prevent access because they can create barriers for individuals.

Universal design methods such as curb cuts, level and slip-resistant walkway surfaces, properly designed ramps, accessible washrooms, automatic doors, lifts, and colour-contrasted handrails are all examples of ways to support increased and barrier-free access not just for folks with a physical disability but for all of us, including children, the elderly, parents with strollers and many others.

Occupational Therapy promotes a wide range of barrier-free design and universal design principles that have helped to make better buildings and spaces in our communities.

There is a greater awareness in society that our buildings and spaces must be more accessible to the greatest majority of people. There are far more products and methods for creating barrier-free environments today than ever before which can be great for finding the right product or design solution for an individual. On the other hand, the vast and ever-growing range of products and design solutions can also be confusing, making choosing the right product a difficult one.  Occupational Therapists have the knowledge and experience to help facilitate the right approach by drawing on current research and best practices for creating barrier-free spaces.

Occupational Therapists provide helpful information and design advice to architects, designers, and contractors when it comes to creating barrier-free spaces inside homes, businesses, gardens, and even public spaces. And since there is a wide range of barriers that can contribute to preventing an individual from completing an activity such as reaching or bending, OTs help by determining what the barriers are for an individual and facilitating products and design strategies that can help surmount these barriers.

As OTs, we have the privilege to serve the needs of many people in the community and using our skills and practices to help people meet their individual needs of daily living and have productive and rewarding life experiences. For many, this may only be accomplished by implementing a barrier-free experience in their homes, businesses, and places they like to visit.

For example:

  • For individuals with visual impairments, spaces should have adequate lighting, colour contrasting surfaces where appropriate, tactile cueing and signage as well as audible alarm systems. For individuals with auditory impairments, visual signage and alarm systems (for example, flashing lights) are necessary.
  • For someone in a wheelchair, a barrier-free experience may include modifications to their workplace kitchens and washrooms. Fixtures such as light switches, sinks, paper towel dispensers, toilet paper dispensers and grab bars must be installed at a height that can be reached from a seated position.

Ultimately, the goal of barrier-free design is to promote equal access and participation for everyone. There have been many steps taken toward ensuring this type of design prevails in our communities. There are new laws supporting improved accessibility within Ontario as of January of 2015.  Is your building up to code? Consulting an occupational therapist can help to ensure your space meets the new criteria.

 

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A Place Called Vertigo

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

I am not sure what the word “vertigo” refers to in U2’s hit song, but as someone living with vertigo, I can tell you it is not a place you want to be.  Vertigo is highly unpleasant and can be caused by multiple factors including visual or auditory problems, or more commonly, head injury.  I best describe my vertigo as my eyes and ears sending different messages to my brain regarding the position of my body in space.  So, while my eyes tell me I am sitting still in a chair, my ears tell me I am on a boat in the middle of a hurricane.  The result of these mixed messages is spinning, nausea, dizziness, problems walking, and ultimately dysfunction.

For me, my benign positional vertigo (BPV) lives in my right ear.  As a result, I cannot lie on my right side, laterally flex my head to the right, lie flat with my neck extended, or look down into extreme flexion.    While I can tolerate these movements momentarily, I cannot hold these positions for more than a few seconds otherwise I am sent into a spin that can last for days.  I am fortunate to know my triggers and do my best to avoid them (no yoga for me).  I have also learned, after living with this problem for two decades, how to catch my symptoms early to prevent a slight episode of dizziness from turning into days of bed rest.

When my clients experience vertigo and describe this to me, I can fully appreciate where they are coming from.  The story is a book I too could write.   But, like other “hidden” ailments, I get concerned when the medical community does not take this complaint seriously.  This is especially true in my industry where insurers and their assessors often want “proof” of a health problem to support someone’s recovery. While I recognize that people can be dishonest, my experience is that people don’t make this stuff up.  Health professionals need to give people the benefit of the doubt, including insurance situations. To understand, or better yet, support someone with any “invisible” problem like vertigo, health professionals need to be compassionate and should care enough to listen, to research and learn, and ultimately believe.  Empathy, TRUST, and understanding will go a long way to support those that need it. I can only imagine how frustrating, devastating and angering it would be for someone to assume or opine that my “place called vertigo” is not a place at all: because, believe me, I live here.

 

previously posted August 2013

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Protecting Client Confidentiality in Public: Public Networks

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

Free Wifi?  Great…but what about having your device and its content available to others?  In our previous blogs we talked about confidentiality in public places with conversations (Confidentiality in a Coffee Shop? Conducting Business in Non-Private Places), phones and computers (Protecting Client Confidentiality in Public: Laptops and Phones), but what about accessing public and shared networks?  Care of Wired Magazine and our IT department, here are some tips to protect yourself:

  1. Know your network – only connect to networks you recognize and feel you can trust.
  2. Make the connection secure – choose HTTPS when on public networks.
  3. Only provide the bare minimum – when signing into public WIFI you are often asked to provide personal details.  It is advised to provide only the minimum necessary.
  4. Read the fine print – know what exactly you are signing up for before logging in.
  5. Use two-factor authentication  –  Basically, enabling two-factor authentication requires an additional password or code to sign into certain sites and apps.  Learn more about this extra security layer here care of PC Magazine.
  6. Disable file sharing – although file sharing may be a handy feature at home, as you can easily share files between devices when in public you definitely want to remember to disable this function so others do not have access to your files.
  7. Use a virtual private network (VPN) – although you may need to pay for this service, if you are working in public spaces often, it is worth it.  Basically, a VPN acts as a “middle man” between your device and its files/information and the world wide web, protecting your information from those who may want to see it.

See the entire Wired Magazine article here to learn more about protecting your information online.

Remember that if you are a professional and have access to confidential and private information, you have a responsibility to protect this from others.  At work, home, or in public, keep information safe.

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The Cost of Disability

The cost of disability due to injury or illness is significant and stems from lost work time, medications, equipment, costs of personal care, therapy and more.

When struggling to make ends meet, people encounter stress, anxiety, panic, excessive worry, loss of sleep, relationship issues, poor decision making, and can result in addictions as a form of poor coping.  You can imagine how hard it would be to heal from injury or trauma when significant money stressors are created as a result!

Our OT-V episode below provides insight into how an Occupational Therapist can help you or someone you love plan for future costs related to the specific disability, provide treatment to help you manage your finances more efficiently, and deal with any associated symptoms.

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Protecting Client Confidentiality in Public: Laptops and Phones

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

My recent blog Confidentiality in a Coffee Shop:  Conducting Business in Private Places” highlighted the things professionals need to keep in mind when having private conversations in public spaces.  But the issue of privacy does not just include conversations that can be overheard.  It also includes using our electronics to carry out business anywhere where our screen could be visible to others. 

I was at two conferences recently where I was able to clearly see the work of others who were multi-tasking.  At one, a psychologist was sitting beside me and was editing reports with his computer on his lap.  His screen was fully visible. I could see everything he was doing including client names, claim or personal identifiers, and the written account of each individuals’ psychological assessment.  Of course, I had no business reading the material so I glanced away, but had I been interested, I could have clearly obtained information that was not meant for me, and information that a client did not consent for me to have.  In another conference example, a professional was sitting in front of me at another table.  She too was working on her laptop and I was able to see, even one table over, what she was doing.  She was not writing reports, but I did see her managing some personal financial material which I am sure she didn’t realize was visible.  As a close colleague, I reminded her at the break to be careful with her computer and what she was working on.

I am also often on the GO train venturing in and out of Toronto.  That is a hotbed of people working while they commute – on both their phones and their computers.  In my interest about this topic of privacy, I have noticed that some people have found ways to protect the privacy of their devices.  With some help from a trusted techy-friend, I wanted to provide some of these strategies to you, in case you are using your computer or phone to manage confidential or private information in public places:

APPS

On Andriod devices (sorry iPhone users) there are applications (apps) you can download that will put a filter on your device that allows you to only see the screen head-on, leaving those at different angles unable to clearly see your information.  Some of these helpful apps are:

EXTERNAL PRODUCTS

Products exist to put over computer monitors, laptop screens and phones that will distort the view from different angles.  For example, take a look at the complete line of privacy screen protectors from 3M3M offers an entire line of screen protectors that work on multiple devices and offer varying levels of protection.

The big picture is that the protection of privacy is everyone’s business, but this is especially true in health care.  Taking steps to conceal devices and screens is just as important as storing other confidential information properly.  The more portable our work-life becomes the more we need to safeguard the information we possess.