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Tag Archive for: occupational therapy

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Overcoming Eating Disorders: OT Can Help

Guest Blogger:  Carolyn Rocca, Occupational Therapist

According to Statistics Canada, in 2012 over 130,000 Canadians over the age of 15 years old reported that they have been diagnosed by a health professional as having an eating disorder. Considering these high rates, and the likely underestimation of reported diagnoses, eating disorders remain a form of mental illness that are not openly talked about.

Eating disorder is an umbrella term for several categories of diagnoses, with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified being the most common. Although symptoms vary based on the diagnosis, some overall symptoms experienced with eating disorders include a pre-occupation with body weight, body dissatisfaction, behaviours to prevent weight gain, perfectionism, emotional dysregulation, depressed mood (including suicidality), anxiety, and low self-esteem. Naturally, these symptoms can lead to secondary impacts such as physical adverse effects, social isolation, and a compromise of occupation in the areas of self-care, daily living, leisure, and productivity (NCCMH, 2004).

The treatment and recovery of adolescents with eating disorders involves the collective work of many healthcare professionals including physicians, dietitians, nurses, psychiatrists, psychologists, social workers, teachers, child and youth counselors, and, yes, occupational therapists(Norris et al., 2013). Each of these team members works collaboratively to deliver the best practice approaches of pharmacotherapy, nutritional rehabilitation, and psychosocial interventions, including cognitive behavioural, dialectical behavioural, interpersonal, and family based therapies, among others (APA, 2006; NCCMH, 2004). Several of the healthcare professionals working with adolescents with eating disorders can deliver these therapies, including occupational therapists.

This means that occupational therapists work effectively with several disciplines to deliver best practice approaches, while also integrating their unique focus on occupational functioning to the team. Occupational therapists’ unique contribution is their ability to holistically address the physical, cognitive, behavioural, and psychosocial aspects of adolescent eating disorders through occupation-based approaches to improve adolescents’ self-worth and self-esteem (Kloczko & Ikiugu, 2006). As mentioned previously, eating disorders commonly have a substantial impact on adolescents’ function in the areas of leisure, self-care, daily living, and productivity (NCCMH, 2004), meaning many youth have difficulty balancing their family and social lives, education, employment, extra-curricular participation, ability to regulate their own activities, and thus overall health.

Occupational therapists have the expertise to work closely with adolescents and their family to help them with their goals around succeeding in school, work, leisure, and overall re-engagement in meaningful activities. In fact, Occupational Therapists are skilled at using meaningful activities as a vessel to get to the underlying problem of the eating disorder.  Sessions don’t focus on eating, food or binging behavior, but on being productive, enjoying life, and accomplishing things that matter.  The indirect influence is better choices in other areas (including diet) and recognizing the link between mental and physical health, quality of life and wellness.

If you know a teen (or adult for that matter) that may be dealing with an eating disorder, encourage them get help.  There is a team of professionals, including occupational therapy, that are skilled at assisting teens to recover from these, and other mental health issues.

 

References & Resources:

American Psychiatric Association (APA). (2006). Practice guideline for the treatment of patients with eating disorders (3rd ed). Retrieved from https://www.guideline.gov/summaries/summary/9318/practice-guideline-for-the-treatment-of-patients-with-eating-disorders

Kloczko, E., & Ikiugu, M. N. (2006). The role of occupational therapy in the treatment of adolescents with eating disorders as perceived by mental health therapists. Occupational Therapy in Mental Health, 22(1), 63-83. doi:10.1300/J004v22n01_05

National Collaborating Centre for Mental Health (NCCMH). (2004). Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. Retrieved from https://www.nice.org.uk/guidance/cg9/evidence

Norris, M., Strike, M., Pinhas, L., Gomez, R., Elliott, A., Ferguson, P., & Gusella, J. (2013). The Canadian eating disorder program survey–exploring intensive treatment programs for youth with eating disorders. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 22(4), 310.

Statistics Canada: http://www.statcan.gc.ca/pub/82-619-m/2012004/sections/sectiond-eng.htm

 

previously posted March 2017

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Book Review: Better Now: Six Big Ideas to Improve Healthcare for All Canadians

Guest Blogger Lauren Heinken, Student Occupational Therapist

For anyone with an interest in how Canada’s single-payer medicare system works and how it may be improved, this book written by Dr. Danielle Martin and released earlier this year is a must-read. Although it is written from a medical perspective, the author appreciates that an individual’s health is dependent on much more than biology, and the active role individuals need to play in their own medical care is emphasized throughout the book. Dr. Martin takes the time to acknowledge the psychosocial factors that can impact well-being, and as a whole her perspective aligns well with the profession of Occupational Therapists. Better Now: Six Big Ideas to Improve Healthcare for All Canadians is written in such a way that it can be appreciated by anyone who reads it, but those who have direct contact or personal experience with Canada’s medical system may benefit the most from it’s content.

The book’s introduction showcases Dr. Martin’s rational stance on many issues that at times provoke excessive fear amongst Canadians. An example of such an issue is the economic impact that the country’s aging population may have on the healthcare system. This book is able to provide an alternative, and often more optimistic view, on these “hot” issues compared with the fear-provoking opinions that are often shared through other media sources.

Each of the “six big ideas” discussed in this book form a chapter, and each chapter begins with Dr. Martin introducing a real-life patient case that demonstrates and supports the idea. Aside from providing a human component to the systems-level issues discussed in this book, these patient cases are useful in providing an opportunity for readers to apply chapter content to an actual user of the healthcare system. This helps facilitates readers being able to wrap their heads around what truly are “big ideas”.

You may be questioning what the relevance of this book is to OT practice. An issue identified within the book is that our medical system tends to be one that is largely disjointed, with different parts of the system often not communicating clearly with one another. This lack of connectivity comes at a cost to both individuals who use the system and those who fund it. Although implementation of better communication technology will play a large part in addressing this problem, I would argue that it could at least be improved if health practitioners and those administering the system knew a little bit more about what each other did. This book is a good way for OTs to learn more about the medical system, and they may potentially use this knowledge to influence a smoother and more cohesive system experience for their clients. It also better equips OTs to provide appropriate answers to questions they might be asked that relate to navigating the healthcare system.

The only disappointment in this book is the absence of the OT profession when Dr. Martin speaks to “other healthcare professionals”. OTs have the potential to make big contributions to proactive healthcare, but also to improving how the system functions and these are not explicitly considered in this book. However, OTs know their scopes best and have the skills to advocate for their contributions, so their absence in this book creates an opportunity for them to fill the gap.   How?  Stay-tuned for this to be discussed in a later blog post. 

 

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O-Tip of the Week: When Creating Goals Use Proactive and Positive Language

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of January our O-Tip series will concentrate on creating achievable resolutions and goals for the new year.

When creating your goals try changing the phrases “I hope to” or “I want to” to “I WILL.”   Let the power of a proactive and positive mind guide you to success this year!

Learn more about how the phrases you use can help you achieve success this year in the following article from our blog.

Solutions for Living:  Say “I Will…” this New Year

 

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Blue Monday and Beyond — How to Beat the Winter Blues

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

I made a comment after the Holidays that I was slowly recovering from Christmas Affective Disorder.  For me, Christmas is stressful, hectic and challenging.  I struggle with it every year.  After the seasonal rush, it takes me days, or even weeks, to get back to my normal equilibrium.  However, really, winter despair is not a joke and for some, can be debilitating.

In fact, some research suggests that up to 15% of people in Ontario experience the “winter blues”. These leave you feeling tired, groggy, and maybe even sad or irritable.  While this causes discomfort, it is not incapacitating.  However, a more serious form of the winter blues, known as Seasonal Affective Disorder (SAD), can be.  While occurring less frequently at 2-3% of the population, the symptoms can prevent individuals from leading a normal life.  Symptoms of SAD include decreased energy, changes in appetite, especially leading to cravings for starchy or sweet foods, oversleeping and weight gain, among other things.  If you feel this is you, talk to your doctor and have your symptoms investigated.

The problem is not always the blues, but how these create a negative behavior cycle.  When you feel down, you revert, avoid, or change habits.  This leads to feeling worse and the cycle continues.  Occupational therapists (OTs) recognize the importance of being engaged in activities that are meaningful, active and productive, and understand how these contribute to health and well-being. In fact, one of the best treatments for beating the winter blues involves just “keep on keeping on” by doing what you normally do every day.  Some tips include:

  1. Use behavioral activation to keep your normal routine.  Make the bed, have a shower, prepare a decent breakfast, walk to the mail box.  Don’t change habits that are ingrained just because it is winter.  Never underestimate how damaging it can be if you avoid even small things that ultimately add up to a productive day.  Gradually try to get back to those important tasks if you have found that your daily behaviors have become unproductive.
  2. Stay active. Those that love the winter do so because they get outdoors.  Walk, ski, skate, toboggan – something to help you appreciate how wonderful a change of seasons can be.  This is best facilitated by proper clothing that will keep you warm.  If exercise is tough for you, build it into your day by default – park farther from the door, use the stairs, make a few trips from the car with the groceries to get the blood flowing.
  3. Consider light therapy. Sit by the window at lunch, get some fresh air when the sun is out, or consider purchasing an artificial light for your use at home.
  4. Up the nutrients. When some bad eating habits creep into your winter these can be hard to break come spring, and only contribute to further mood declines.  Shop in the fruit and veggie isles, and avoid the isles that house the bad foods you seem to be eating too much of.

Finding ways to help you do the things you want to, need to, or enjoy, is at the heart of occupational therapy. While the winter months can be long, dark, and cold, ultimately how we adapt to the seasonal change is up to us.  If moving or going south is not an option, consider some of the above tips to make the winter bearable, or dare I say, even enjoyable?

 

Resources:

Seasonal Affective Disorder. (Canadian Mental Health Association, 2013) http://www.cmha.ca/mental_health/seasonal-affective-disorder-sad/
Beat The Winter Blues (Readers Digest, no date) http://www.readersdigest.ca/health/healthy-living/beat-winter-blues
Kurlansik, SL & Ibay, AD. (2012).
Seasonal Affective Disorder. Am Fam Physician. 2012 Dec 1;86(11):1037-1041.
10 Winter Depression Busters for Seasonal Affective Disorder (Borchard, no date) http://psychcentral.com/blog/archives/2012/12/30/10-winter-depression-busters-for-seasonal-affective-disorder/

 

Previously Posted January 2017

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HIV/AIDS and the Role of Occupational Therapy

Guest Blogger:  Samantha Langan, Occupational Therapist

Today people around the world will be wearing red ribbons to support World AIDS Day. This day of recognition started in 1988 to provide people with an opportunity to unite in the fight against Human Immunodeficiency Virus (HIV), show support for those who are living with HIV and to also commemorate those who have died. According to the Joint United Nations Programme on HIV/AIDS, 34 million people were living with HIV worldwide in 2011. In 2012, The Public Health Agency of Canada reported 2062 new cases of HIV, but it is expected that others are also living with the condition, not yet knowing they have been infected. There continues to be many myths and stereotypes around how HIV is transmitted and stigma remains for those living with HIV. Unfortunately, there isn’t yet a cure for this, but the disease is preventable.

Human Immunodeficiency Virus is a virus that attacks our body’s immune system, and over time, weakens our immune system to the point where it can no longer fight off bacteria, viruses, parasites, and even cancers. These diseases, known as opportunistic infections, can progress in the body of a person living with HIV and become what is known as Acquired Immune Deficiency Syndrome, or AIDS. While those living with HIV do experience difficulties, HIV is now considered a long-term chronic illness that can be treated to help prolong and improve quality of life for those living with HIV/AIDS.

HIV is known to health professionals as an “episodic disability”, which means that for people living with the virus, symptoms can fluctuate unpredictably. Some common symptoms include muscle weakness, fatigue, changes in sensation in the hands and feet, decreased concentration and thinking, digestive problems, chronic pain as well as depression or anxiety. As symptoms can vary, people with HIV / AIDS can experience difficulty carrying out everyday activities like taking care of themselves, managing at home and attending work.

Occupational therapists support and empower people with all forms of disabilities and can assist people living with HIV to better manage in their desired activities despite unpredictable and on-going symptoms. In fact, occupational therapists work with those living with HIV by helping them to: manage their energy despite pain and fluctuating symptoms, find ways to adapt to tasks to make them more manageable, obtain devices that can improve safely and independence when completing daily tasks. Occupational therapists can also help people manage the emotional consequences associated with the condition, and can develop strategies to assist with cognitive changes should these exist. Another great way occupational therapists are helping those with HIV is through education and by providing strategies for them to be able to self-manage their disease. This is essential since HIV is a long-term illness. For more information about HIV/AIDS, check out the links below, or talk to an Occupational Therapist about how we help.

Resources
http://www.worldaidsday.org/about-world-aids-day.php
http://www.phac-aspc.gc.ca/aids-sida/publication/survreport/2012/dec/index-eng.php
http://healthycanadians.gc.ca/diseases-conditions-maladies-affections/disease-maladie/hiv-vih-eng.php

 

originally posted December 1, 2014

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What Does the Current Housing Market Mean for Those with Unique Accessibility Needs?

Guest Blogger Lauren Heinken, Student Occupational Therapist

The Current Market

Over the last few years housing prices have been on the rise throughout most of Canada. The GTA in particular has seen soaring real estate prices, but this done little to deter buyers. Houses are selling quickly, and sellers often receive multiple offers that are well above asking price. This makes purchasing a home difficult, and those with accessibility needs may face additional challenges throughout this process.  This, combined with an aging population of people trying to downsize or find more “suitable” homes, makes for a unique opportunity to enlist the expertise of an Occupational Therapist (OT) for buying consultation.

An Unlikely Partnership

It is not often that one would think of an OT partnering with a real estate agent or broker to provide homebuyer services.  However, this synergy, as I will explain, could have beneficial outcomes for all involved.

OTs are all about helping people function, and our homes are at the core of where we spend most of our time.  The home can be a support or a barrier to our physical, mental and emotional health.  It can help us go about our daily activities easily, or can make managing a struggle.  It can impact our mood – positively or negatively and either be a determinant of good health, or a cause of injury, sickness or death.   Therefore, finding the right home is essential for reasons beyond just aesthetics, price tag and neighborhood.   Yet, homes vary greatly, and the current real estate market moves quickly, so finding just the right fit, especially for those with a disability, can prove difficult.

An OT is well suited to assist in the home buying/modification process, and can bridge the knowledge gap that may exist in addressing the unique needs of the person with realtors who have their own knowledge of homes, the housing market, and the buying process.  Realtors and OT’s joining forces has the potential to change the way people with unique accessibility needs shop for, and purchase, their next home.

The infographic below summarizes a potential service delivery model involving OT and real estate:

Payment for Services and Benefits to the Real Estate Agent or Brokerage

Funding for this service could come from multiple sources, including the real estate agent or brokerage, the customer themselves, and there are also grants and charitable funding options that might be available.  If the real estate brokerage is providing payment they will incur OT fees as part of their cost, so as to provide an accessible home buying experience for their clients.  Having this service as an available option may help the agent or broker to attract a new segment of the home buyer population, thereby increasing their own marketability and profitability in this area. This would ideally produce positive economic gains for the brokerage that far exceed the costs they will be paying for OT consultation.  Or, at the least, the OT should be a “vendor” on the list of other vendors the agent typically supplies to clients during the buy / sell phase (i.e. like movers, stagers, painters etc.).  Then, the client can call the OT to discuss pricing as they would any other supplier.

As the OT profession grows over time, opportunities for partnership with other professionals outside of the usual allied health circle are going to become increasingly common. Thinking forward to opportunities that may exist creates the opportunity for OT’s and other professionals to work together for optimal service outcomes.

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Being an Advocate – Prompting Change as an OT

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

As Occupational Therapists, we spend a significant amount of time with people in their homes and in the community.  In this role, we witness daily injustices, challenges or problems that our clients unnecessarily or unfortunately experience due to vendors, landlords, or business owners / operators failing to understand, care, or address the needs of people with disabilities. 

Recently, a student I was supervising on placement experienced an accessibility challenge with a client as they attended a local coffee shop.  We blogged about this in our post, Accessibility Issues in Our Daily Lives.  As her mentor, I discussed with her the need to advocate for change and to send the owner a letter about the problems that client experienced.

That situation made me reflect on my history of advocacy as a person and an OT.  I remember as a teen writing a letter to a restaurant who would not book us a reservation on the “main floor” such that my two disabled grandparents could attend my birthday dinner.  As a young adult, I wrote a letter to an Alaskan cruise line about the challenges my grandfather experienced using his scooter around the boat and on the gangways.   Then I became an OT and the advocacy continued.  I have written, and continue to write, letters to equipment vendors, drug and department stores, public and private places, major banks, landlords, the CCAC, and fast food restaurants.  Sometimes my letters are specific and highlight an “incident”, while others speak more to general accessibility or service problems.  My advocacy initiatives even resulted in me building a training program aimed at helping the “average Joe” best service people with disabilities.  I personally feel that advocacy is how I will make my mark on the world, regardless of how small, with the hope of leaving this world in better shape than how I found it.

For this blog, I wanted to take the spirit of advocacy further, and to embrace our human responsibility to try and be catalysts of social, environmental and institutional change, by sharing a guide of sorts that could be used by other therapists, clients, caregivers or really anyone who wants or needs to bring an issue to someone’s attention.  Give this a try and keep us posted on your outcomes:

DATE

Name of Person / Establishment

Address

Dear Representative/Manager/Person:

I am X.  On DATE (I, my family member, client etc) experienced the following problems (when accessing your establishment, using your services, interacting with your staff, etc):

In bullet or paragraph format, list the problems you had.  Be factual, truthful and professional.  Avoid judgement, anger or threats as these will not result in change.

Provide some input on how you feel the problems you had might be impacting their service, business, etc.  Try to hit home with how the issues you experienced will turn people away, or jeopardize their reputation. 

Next, explain what you feel the solutions are or how it can be better for you next time. Help them to know what to do.  You don’t have to be prescriptive or specific, but maybe they need to consider some building modifications, better trained staff, to understand disability codes or acts, an easier to navigate website, consultation with someone who can develop solutions with them etc.  This is where you can really try to be helpful.

End the letter by thanking them for considering your feedback and provide your contact information.  Be prepared to have a discussion with them about it.  Some might ignore your letter, but I hope most will not.  Either way, if your letter stays friendly and is perceived as helpful, they may want to thank you for your time or seek more input.

Of course, add a final sign off like “sincerely” and your name.

I hope this format / suggestion will be helpful as you venture forward and try to educate, share and advocate for the change you hope to see in the world.

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OT Improves the Quality of Life for Those with Chronic Pain

Pain is real.  It can prevent people from engaging in activities that are important to them, or at the least inhibit enjoyment and full participation in those things they want and need to do. It doesn’t matter if the cause of the pain is fully understood — the person’s experience of pain is what is important, and is what affects function.  As the role of an occupational therapist is to enable clients to engage in activities that they want, need, or are expected to do, OT’s have the capability to help individuals with chronic pain to better manage their lives.

The following from article from Medical Xpress sheds light onto the benefits of OT for managing chronic pain and helping sufferers maintain a better quality of life.

Medical Xpress:  Occupational therapy shown to improve lives of people in chronic pain

Learn more about how OT can assist with chronic pain in the following episdoe from our OT-V series, Managing Chronic Pain.

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O-Tip of the Week: Shed Some Light on Fall Prevention

Our O-Tip of the week series we will be providing valuable “OT-Approved Life Hacks” to provide you with simple and helpful solutions for living. 

For the month of November, Fall Prevention Month, our O-Tip series will concentrate on preventing falls at home and in the community.

This week’s O-Tip of the Week focuses on a simple, yet often forgotten aspect of the home that can prevent falls:  proper lighting. 

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 proper lighting to help them navigate and reduce the risk of falls in their living spaces.  Helpful and simple lighting suggestions may include:

–        Night lights around the home

–        A bed side lamp

–        Illuminated light switches

–        Storage of flashlights in the bedrooms, the kitchen and bathrooms

–        Change of light fixtures to provide both ambient and task lighting based on needs

An Occupational Therapist can assist in assessing the living space to suggest lighting modifications and more.  Learn more about how OT’s assist in fall reduction in our OT-V Episode, Fall Prevention.

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Accessibility Issues in Our Daily Lives

Guest Blogger: Carolyn Rocca, Occupational Therapist

As I stroll into my favourite coffee shop to start my morning, I am reminded that this is a part of my day that I take for granted. Particularly, I am reminded of an observed experience that I encountered with a client who had a personal goal around using his walker to go into his favourite local coffee shop, something he had not been able to do since his brain injury.

After weeks of working up to this goal, it was finally time to assess his mobility in the community. As soon as we arrived at the coffee shop’s parking lot I could tell that this was going to be much more challenging than I had anticipated, as it quickly became apparent that there were several accessibility issues we would need to navigate.

Although the accessible parking spots provided us enough room to safely transfer out of the vehicle, and the ramp onto the side walk was graded appropriately, once up on the sidewalk, the client could sense a shallow slant in the pavement causing him to panic as he felt he was going to fall over. What became even more challenging was that there were no automatic doors at either entrance, and that the front entrance had a tightly-spaced vestibule with two sequential, single-passageway doors. On top of all of these challenges, there was about a 2-inch difference in the threshold of the door meaning the client had to lift his walker while already feeling nervous about the slanted pavement. Ultimately, the inaccessible nature of this establishment meant that it took over four people to safely get the client into the coffee shop, which not only increased his nervousness but also completely decreased his level of independence.

Although this experience was largely a success and the client was incredibly proud of what he had accomplished, it also brought to light some issues in our society. It was shocking that a well-established company (who shall remain nameless) had not yet invested in making all of their franchises accessible.

According to the updated accessibility requirements of the Ontario Building Code, buildings are required to have a barrier-free path of travel by having powered door operators at their entrances, meeting minimum requirements for doorway widths and ramp dimensions, and having adequate turning space (Ministry of Municipal Affairs, 2015). The unfortunate part is that these requirements do not affect existing buildings, and are only applied to newly constructed buildings or those undergoing extensive renovations.

What this means is that the current level of accessibility of this coffee shop will not be improved until this franchise decides to undergo major renovations. As a result, this franchise is not only impacting those who use gait aids or wheelchairs, it is also impacting individuals who have mobility challenges, low vision, and parents with strollers, to simply name a few. Additionally, according to the Royal Bank of Canada, people with disabilities have an estimated spending power of about $25 billion annually across Canada (Accessibility Ontario, 2017), meaning this franchise is also losing valuable business from a population who happens to love their coffee.

In being reminded of this experience, it also brings to light the impact that the profession of occupational therapy can have in terms of advocating for their clients needs and promoting equal access for all. Occupational Therapists (OTs) have a unique skill set in terms of assessing the needs of individuals, and identifying barriers in their environments that prevent their access or ability to engage in occupations that are important to them, such as grabbing a coffee. OTs teach people how to be proactive in their own lives, but bigger than this, also have the ability to communicate their clients’ / societies needs to others, and to offer solutions to barriers by involving appropriate stakeholders.

As such, I have written a letter to the coffee shop to bring awareness and attention to the challenges my client experienced while at their establishment. Moreover, in the future, I plan to examine buildings and public spaces beforehand to make sure I am helping my clients to be familiar with, and access, places that have the appropriate supports in place to maximize their level of safety and independence.  In doing so, I will increase my clients’ future independence as they venture out without me, while also supporting businesses that have dedicated their time, effort, and resources to creating welcoming and barrier-free environments.

 

References

Accessibility Ontario (2017). About the Accessibility for Ontarians with Disabilities Act (AODA). Retrieved from https://accessontario.com/aoda/

Ministry of Municipal Affairs (2015). Overview of updated accessibility requirements. Retrieved from http://www.mah.gov.on.ca/Page10547.aspx