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Senior Safety and the Vital Role of Occupational Therapy

Canada’s population is aging. In 2015, there were almost 6 million people over the age of 65 – that is nearly 1 in 6 Canadians. As we grow older, we face an increasing risk of falls, accidents, disabilities, and illnesses.  As a senior how can you stay safe and healthy?

Why is Older Adult Safety Important?

Older adult health and safety is important for maintaining our ability to age in place of choice.  Statistics Canada has highlighted the following safety risks for older Canadians:

  • 89% of Canadian seniors had at least one chronic health condition. Arthritis and rheumatism were the most common.
  • 25% of Canadian seniors reported having 2 or more chronic conditions such as high blood pressure, arthritis, back problems and diabetes.
  • 63.7% of Canadian seniors reported to have been injured in a fall.
  • There are 3.25 million people aged 65 and over in Canada who have a driver’s license.
  • 92.1% of seniors live in private households.

These statistics demonstrate the increased risk to seniors for health and other safety concerns.

Occupational Therapists Can Help!

Occupational Therapists are trained professionals who address all aspects of getting people back to doing things they want to do, need to do, or have to do, but may be experiencing challenges when doing so.  Occupational Therapists can support older adult’s health and well being through providing supports for seniors to maintain active social connects, manage changes in health conditions, and to continue engaging in activities that provide them with meaning and joy.

These are the following areas that an OT can help keep seniors safe and healthy!

Fall Prevention 

Falls are the leading cause of injury among older Canadians with 20-30% of seniors experiencing one or more falls each year.

Occupational Therapy can help seniors prevent falls by assessing their functional status and reviewing the hazards in their environment that may put them at risk for falling. Strategies to prevent falls can be discussed, such as:

  • General Education on how to do activities differently to stay safe.
  • Equipment and devices to assist.
  • Home modifications such as lighting, flooring, organization, and layout.
Aging in Place

In 2011, 92 % of all seniors ages 65 + lived in private homes, and over 10 million seniors are living with a chronic condition.  Older adults also have disproportionately higher rates of unmet care at home. Thus, ensuring these individuals function safely and independently at home is a high priority.

Occupational Therapy can help by assessing the home and the homeowner to ensure a proper fit between the person and environment to promote overall health and safety.  Additionally, an OT can prescribe the proper assistive devices, education and help people plan ahead so they can “ age in place” without being at risk.

Keeping Senior’s Active

Remaining physically active as you age can help reduce, prevent or delay diseases and can help to manage stress, improve mood and boost cognition.  Statistics show that 57% of Canadian seniors consider themselves physically inactive.

Occupational Therapy can help seniors remain physically active by:

  • Creating custom activity plans based on health and abilities.
  • Helping seniors create a daily schedule that includes physical activation.
  • Helping seniors to find appropriate facilities and groups to join or other productive and meaningful activities.
Sleep

Sleep is important for recovering from illness and injury, staying healthy, and ensuring people have sufficient energy during the day to accomplish life roles. Difficulty sleeping is a common and detrimental issue for people in various life stages.

Occupational Therapy can help seniors reduce sleep problems by:

  • Reviewing sleeping positions and patterns to suggest improvements for both comfort and quality of sleep.
  • Assessing the bed, mattress, and pillows to ensure the body is sleeping in the optimal position for comfort.
  • Prescribing assistive devices to improve sleep positioning, bed transfers, and bed mobility.
  • Helping people to implement a new sleep routine that will improve your sleep quality and duration.
Cognitive Impairments

According to the Alzheimer’s Society of Canada as of 2016, there are an estimated 564,000 Canadians living with dementia – plus about 25,000 new cases diagnosed every year.

Occupational Therapy can help people with dementia or who have altered/declining cognition by:

  • Educating people and loved ones on how to maximize function while still promoting independence and safety in the completion of activities of daily living.
  • Assessing cognition, abilities, and environment to make suggestions on ways to compensate for declining cognitive skills through direct therapy or environmental modification.
  • Developing routines and schedules that promote independence and eases the role and need for a caregiver.
  • Prescribing safety equipment and devices to optimize function.
Transition Stages
  • Occupational Therapy can play a crucial role in helping seniors through live transitions this by:
  • Identifying, planning and helping people engage in finding new meaningful occupations outside of work.
  • Providing education on role changes, spending time with family and friends, healthy lifestyles and choices.
  • Helping discover new ways to occupy their time, participate in leisure activities and find new interests.
  • Improving quality of life through promotion of independence and pain management strategies.

 

For more information on how Occupational Therapists help improve the lives of older adults check out our infographic:  Occupational Therapy Works for Seniors.

 

Resources

http://www.statcan.gc.ca/pub/11-402-x/2012000/chap/pop/pop-eng.htm?fpv=3867

https://www.tc.gc.ca/media/documents/roadsafety/cmvtcs2013_eng.pdf

Turcotte, M (2014). Canadians with unmet home care needs.

http://www.statcan.gc.ca/pub/75-006-x/2014001/article/14042-eng.pdf

http://www.caot.ca/default.asp?pageid=1454

http://www.caot.ca/default.asp?ChangeID=1&pageID=621

http://www.caot.ca/default.asp?pageid=1501

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Enabling Clients in Lower-Risk Cannabis Use

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

Co-written by Kyra Posterski, MSc (OT) Candidate 2019 at McMaster University

 

In October of 2018, the Government of Ontario legalized cannabis in an effort to keep cannabis out of the hands of youth, keep profits out of the hands of criminals, and protect the public health and safety by allowing adults access to legal cannabis.

The number of Canadians who report using cannabis has increased since legalization. However, cannabis use is not without both short and long-term risks. These risks include cognitive and psychomotor impairments, hallucinations, impaired driving, and dependency, as well as mental health, pulmonary/bronchial, and reproductive problems.  One advantage of legalization is that it allows for a more open discussion of risk behaviours, and the steps that can be taken to reduce these.

Given that cannabis is being increasingly used by Canadians, it is likely that OT’s will continue to encounter clients that use this regularly as part of our practice. Knowing the actions that client’s can take to reduce their risk when using cannabis is thus important for clinicians to realize and understand.  The Lower-Risk Cannabis Use Guidelines has been developed as an evidence-based tool that offers recommendations for users of cannabis products to reduce risks and improve their health. Using these guidelines, occupational therapists are well-positioned to educate clients on the actions they can take to reduce their risk, enabling clients to engage in lower-risk cannabis use behaviours. These conversations are especially important for occupational therapists working with clients that are at an increased risk, such as adolescents, pregnant women and people with a family history of psychosis or substance use disorder.

These guidelines present 10 major recommendations for lower-risk use:

# 1 ABSTINANCE.  As with any risky behaviour, the most effective way to reduce risk is avoiding the behaviour.

# 2 START LATER.  Using cannabis at a young age (i.e. before age 16) increases the risks for adverse health and social outcomes.  It is recommended that usage not start until at LEAST the legal age.

# 3 and 4 PRODUCT CHOICES. It is recommended to use cannabis products with a low tetrahydrocannabinol (THC) content and to avoid using those with synthetic cannabinoids.

# 5 and 6 METHODS AND PRACTICES. Smoking combusted cannabis negatively affects respiratory health; therefore alternative, lower-risk methods, are recommended (e.g. vaporizers or edibles). Practices such as “deep-inhalation” or breath-holding should also be avoided since these practices increase the intake of toxic materials.

# 7 LIMIT USE TO OCCASIONAL (e.g. once a week). More frequent or intense cannabis use is associated with a number of health problems.

# 8 DON’T DRIVE. It is suggested that people refrain from operating a motorized vehicle for at least six hours or longer after using cannabis. Cannabis impairs skills that are critical for driving (e.g. attention) and driving while impaired from cannabis increases the risk of being involved in a motor vehicle accident.

# 9 CONSIDER YOUR UNIQUE SITUATION.  Some populations who are at a higher risk for cannabis-related health problems should abstain from using cannabis altogether. This includes pregnant women and people with a family history of psychosis or substance use disorder.

# 10 DON’T COMBINE.  Avoid combining cannabis use with other higher-risk behaviours—like those described already, as this may further amplify risks.

For more information about this topic, OT’s are encouraged to access the references below or to encourage clients to contact their treating physician for more information about safe use.

 

References

Centre for Addictions and Mental Health. (2017). Canada’s lower-risk cannabis use guidelines:  https://www.camh.ca/-/media/files/lrcug_professional-pdf

Fischer, B., Russell, C., Sabioni, P., Van Den Brink, W., Le Foll, B., Hall, W., … & Room, R. (2017). Lower-risk cannabis use guidelines: A comprehensive update of evidence and recommendations. American Journal of Public Health107(8), e1-e12.

Government of Canada. (2019). Cannabis act [PDF file]. Retrieved from https://laws-lois.justice.gc.ca/PDF/C-24.5.pdf

Statistics Canada. (2019, May 2). National cannabis survey, first quarter 2019. https://www150.statcan.gc.ca/n1/daily-quotidien/190502/dq190502a-eng.htm

 

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A Day in the Life of your “Occupations” — Bedtime Routines

Contrary to the traditional understanding of the word, occupational therapists define “occupation” differently. For OTs, 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 Occupational Therapy month, we will explore “A Day in the Life of Your Occupations” complete from morning to night, highlighting common important occupations and how OT’s can help when things breakdown along the continuum that is living.

This week we discuss the important occupations that arise before bed.  If you missed our “Rise and Shine,” “9 to 5 “Workday,” and/or “Eventful Evening” posts, we encourage you to view them here.

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A Day in the Life of Your Occupations: Eventful Evenings

Contrary to the traditional understanding of the word, occupational therapists define “occupation” differently. For OTs, 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 Occupational Therapy month, we will explore “A Day in the Life of Your Occupations” complete from morning to night, highlighting common important occupations and how OT’s can help when things breakdown along the continuum that is living.

This week we discuss the important occupations that arise in the typical evening. If you missed our “Rise and Shine” and/or “9 to 5 Workday” posts you can view them here.

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A Day in the Life of your “Occupations” — 9 to 5 Workday

Contrary to the traditional understanding of the word, occupational therapists define “occupation” differently. For OTs, 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 Occupational Therapy month, we will explore “A Day in the Life of Your Occupations” complete from morning to night, highlighting common important occupations and how OT’s can help when things breakdown along the continuum that is living.

This week we discuss the important occupations that arise during the 9-5 Workday. If you missed our “Rise and Shine” post, you can view it here.

 

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Mental Health Services for Youth

Nicole Kelday, Student Occupational Therapist (University of Toronto)

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

 

It is staggering to realize that 39% of Ontario high school students show active symptoms of anxiety and depression. And while there are a multitude of resources available to help students that may require mental health services, only 40% of Canadians aged 15-19 reported they have not accessed these when needed. This begs the question…why are these youths not seeking services?

Reaching out for help can be daunting and many report stigma related to mental health concerns, especially in high schools. So, how do we encourage youth to access the services available to them and talk to those who may be experiencing similar concerns? A new emerging trend in mental health care is the concept of youth-led groups. Youth-led groups involve a shift in thinking, instead of viewing youth as our clients; they are viewed as partners and leaders to improve the practice of youth engagement in the mental healthcare system.

Across the province, community agencies have begun to initiate youth-led groups by involving youth with mental health illness in leading each other to raise mental health awareness and fight existing stigma. With support from a clinical adult ally, youth have participated in the creation of youth-friendly services by designing waiting rooms in clinical environments to encompass the interests of this group.

It is known that participation in meaningful activities and roles can enhance emotional well-being and social competence. Occupational therapists (OTs) have the unique ability to evaluate and facilitate supportive environments in order to promote mental health amongst children and youth. By involving all key stakeholders, OTs are able to determine factors that influence the ability of a youth to fulfill their primary roles and occupations and provide interventions to promote maximal functional participation in such.

As a student occupational therapist, I could immediately recognize how this concept strongly resonated with the core beliefs of client-centredness. Youth-led groups truly highlight the client as not only an active partner but also a leader, in their healthcare experience. Youth are equipped with vast knowledge and perspectives that we as healthcare professionals may not immediately recognize, which may help to explain why youth are not seeking available services in the first place.

 

References

1. Centre for Addiction and Mental Health (2018). Transforming mental health for children and youth. Retrieved from https://www.camh.ca/en/camh-news-and-stories/transforming-mental-health-for-children-and-youth

2. Hartman, L., Michel, N., Winter, A., Young, R., Flett, G. & Goldberg, J. (2013). Self-Stigma of Mental Illness in High School Youth. Canadian Journal of School Psychology, 28(1), 28-42.

3. The New Mentality (2016). TNM Groups. Retrieved from https://www.thenewmentality.ca/what/tnmgroups/

4. The American Occupational Therapy Association, Inc. Mental health in children and youth: the benefit and role of occupational therapy. Retrieved from https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/MH/Facts/MH%20in%20Children%20and%20Youth%20fact%20sheet.pdf

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A Day in the Life of your “Occupations” — Rise and Shine

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

Contrary to the traditional understanding of the word, occupational therapists define “occupation” differently. For OTs, 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 Occupational Therapy month, we will explore “A Day in the Life of Your Occupations” complete from morning to night, highlighting common important occupations and how OT’s can help when things breakdown along the continuum that is living.

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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