Tuesday, 29 June 2010

Wheelchair Accessibility - How YOU Can Help

One of the roles / tasks of an occupational therapist is to teach someone who requires a wheelchair how to be independent from the wheelchair. That means getting into the wheelchair, maneuvering the wheelchair, carrying out their daily tasks from a wheelchair, evaluating the work place for wheelchair accessibility and much more.

A wheelchair dependent person can be trained to regain function, however a large percentage of whether they will be able to carryout the tasks they need to are dependent on you, the able bodied population.

The video below shows you where your role comes in.



Next time you are out and about, stop and think of who else might need to use the sidewalk? Stop and think why there are ramps and are you providing those who need to use them with space in front of the ramp to access it with ease. There are many more areas that you can help. Come back to visit this blog and we will do our best to show you more of how you can make the life of a disabled person that much happier, easier and yes more accessible.


DID YOU KNOW?

Shoshanah offers private consultations both individually and in groups.

Consultations are available in person, via email correspondence, Skype or telephone.

To book a consultation, talk or workshop with Shoshanah, please contact her via her website or email.


Shoshanah is in the process of developing a very special Healing Centre.

Shoshanah has a number of other blogs filled with valuable life skills and information. See:
Should you wish to partner with Shoshanah
in developing her Healing Centre
giving you the opportunity to sponsor rooms or equipment
in memory of a loved one or in honour of family or friends,
please send an email to find out options for donations or sponsorship opportunities.

Sunday, 27 June 2010

Making a Cup of Tea – an Occupational Therapy Perspective


Can you make a cup of tea? Can you imagine not being able to? Can you consider any reasons as to why it might be difficult to make a cup of tea?

Let us take the task of making a cup of tea and look at how it is applicable to occupational therapy.

Making a cup of tea can be used as part of an evaluation to determine a person's level of independence in the kitchen. When would this be relevant and for who?

Firstly we take a look at the person's stage in the life cycle. Since a baby, a toddler and a small child do not make tea, we do not test their ability to do so. However, we might look at where a baby or small child is positioned while a mother, babysitter or caregiver is involved in making a cup of tea. Why?

There are two aspects of making a cup of tea that pose a potential danger, and therefore an important factor in the evaluation is safety. While some people use an electric kettle to make a cup of tea, others heat a kettle or metal tea pot on a fire or gas stove. In addition, when the water is boiling, the boiling water is a potential danger. The electricity too can pose a danger especially if the kettle is placed in a low electric socket that a small child can easily reach. Hence the first aspect of the evaluation is environmental. Is the person making the cup of tea aware of basic safety precautions and what needs to be done to make sure the kitchen or environment is safe? Does a baby need to be in a playpen, i.e. safely out of the way of a flame or boiling water. Does the table need to be elevated?

Related to safety, if your child is to be left in the care of another, can that person be trusted with the safety of your child? It might sound obvious or unnecessary to check. However, a child I treated while still a student came into a children's hospital with burns down her front from a domestic worker pouring boiling water over her in a fit of jealousy. What triggered the specific fit of jealousy I do not know, but what began as the domestic worker making a cup of tea, ended in a little 3 year old in hospital in pain with severe hot water burns. We don’t want this to happen, so keep your children safe, that way hopefully you can enjoy many cups of tea together.

Once safety has been dealt with, the OT can begin to look at certain physical factors. If the person is blind, can they structure their kitchen so as to find the cup, teaspoon, tea bags etc with ease and without breaking anything. How will they identify that a bag contains tea leaves and not spices? How will they know when the cup is filled or nearly filled; do they need a tea-level indicator?

If the person has arthritis, can they manage to pour the water into the kettle and the boiling water into the cup, or is there a need for a tap turner and kettle tipper which reduce the stress on the joints, thus enabling the task of making a cup of tea pain free and possible rather than a strain and aggravation on damaged joints.

If the person has a hand injury, do they need to strengthen their muscles? Do they have sufficient range of movement to grasp the kettle or to hold the cup? Can they pour the water without any tremor (a tremor can pose a safety risk). Does the person have use of both hands or just one hand? If only one hand is it his or her dominant hand or non-dominant hand?

If the person has a problem with their legs, can they stand for long enough to make the cup of tea, do they need a stool in the kitchen? Can they walk where necessary to gather the ingredients or do they need to use a trolley or have someone else bring the ingredients to where the kettle is? Can they stand or do they need to learn to manoeuvre a wheelchair in the kitchen.

If the person has an endurance, sensory or concentration problem, this too is important to evaluate.

These are just a some of the physical issues taken into consideration when evaluating making a cup of tea. Now let us look at perception, cognition and memory.

Does the person know the correct sequence that making a cup of tea requires? When is water placed into the kettle? Where is the water obtained from, a tap, bottle of water, a well? When is the kettle placed on the flame or the electric switch turned on? When does one place a tea bag in a cup? Do you always add sugar, if so how much and at what stage? These questions all come into perception, cognition and memory.

Of course there are basic questions, such as does the person like tea? Will they ever make a cup of tea? If they don’t like tea and perhaps don’t like the smell of tea, we don’t even evaluate, as these questions indicate the person will not need to use the skill of making tea, although another hot beverage might be applicable.

It is important to know whether a person uses tea bags or brews tea from the tea leaves. Do they make tea directly into the cup, or into a tea pot to brew and then pour the tea from the pot into a cup? Do they use a china cup, a mug, a glass, a glass mug or cup? All these factors and more about the persons culture, tastes, likes and dislikes are also factored into whether a person would actually make a cup of tea and if so what steps are involved that an OT would need to evaluate in order to help them to prepare that cup of tea themselves.

There are some for whom making a cup of tea is not a task of the personal care of daily living skills, neither is it for pleasure. Rather, it falls under the area of work. For those who work in a restaurant or in an office and need to make tea, there are other factors to take into consideration. Can they identify between different types of tea? How will they carry a number of cups simultaneously? Can they balance a tray or use a trolley? Can they remember an order from several people or do they need to write it down? If they need to write it down, can they write? Can they write quickly? Is their writing legible? Can they read their own handwriting, especially when written quickly? Where will they place a pad and pen / pencil or piece of paper with the order on or will they use a technological device? These and many more questions and factors will go into whether a person is capable of making tea in the work place.

As you can see, we have already covered quite a few areas and this has only been in evaluating whether a person can make a cup of tea and where an OT is needed, if at all to intervene. We have not yet entered into the area of therapeutic intervention.

In another post we will look at how to use the task of making a cup of tea therapeutically, including using it with new immigrants (specifically to Israel)

Have you enjoyed this post? Please post a comment at the bottom of the post. I'd love to hear from you.

Shoshanah

DID YOU KNOW?

Shoshanah offers private consultations both individually and in groups.

Consultations are available in person, via email correspondence, Skype or telephone.

To book a consultation, talk or workshop with Shoshanah, please contact her via her website or email.


Shoshanah is in the process of developing a very special healing centre.

Shoshanah has a number of other blogs filled with valuable life skills and information. See:
Should you wish to partner with Shoshanah
in developing her healing centre
giving you the opportunity to sponsor rooms or equipment
in memory of a loved one or in honour of family or friends,
please send an email to find out options for donations or sponsorship opportunities.

A Day in the Life of an Occupational Therapist

The video below is another well produced video found on Youtube. Although it demonstrates an occupational therapist working with a woman of about middle age, occupational therapists do work with all ages.





DID YOU KNOW?

Shoshanah offers private consultations both individually and in groups.

Consultations are available in person, via email correspondence, Skype or telephone.

To book a consultation, talk or workshop with Shoshanah, please contact her via her website or email.


Shoshanah is in the process of developing a very special Healing Centre.

Shoshanah has a number of other blogs filled with valuable life skills and information. See:
Should you wish to partner with Shoshanah
in developing her Healing Centre
giving you the opportunity to sponsor rooms or equipment
in memory of a loved one or in honour of family or friends,
please send an email to find out options for donations or sponsorship opportunities.

Sunday, 20 June 2010

Best Careers 2009: Occupational Therapist Job Description

The YouTube vidoe below has a very nice thumnail overview of Occupational Therapy. It was prepared as part of Best Careers 2009.

Thursday, 17 June 2010

Understanding Occupational Therapy - A YouTube Presentation

Sometimes visual images or a video presentation can provide that additional information and clarity required to really understand a concept. The YouTube presentation below was put out by AOTA the American Occupational Therapy Association.



I hope that this video has provided the insight you need to understand the wonderful profession of Occupational Therapy. Should you still have questions, you are welcome to email Shoshanah



DID YOU KNOW?

Shoshanah offers private consultations both individually and in groups.

Consultations are available in person, via email correspondence, Skype or telephone.

To book a consultation, talk or workshop with Shoshanah, please contact her via her website or email.


Shoshanah is in the process of developing a very special Healing Centre.

Shoshanah has a number of other blogs filled with valuable life skills and information. See:
Should you wish to partner with Shoshanah
in developing her Healing Centre
giving you the opportunity to sponsor rooms or equipment
in memory of a loved one or in honour of family or friends,
please send an email to find out options for donations or sponsorship opportunities.

Monday, 14 June 2010

TV and Kids - Is This a Good Babysitter Substitute?

Busy parents are always on the look out for how to occupy their babies and young children while they do what they need to do. Many of these parents will turn to television as a substitute babysitter. In this post we will look at some important facts that do have an effect on the development of your child. These factors should be taken into consideration when deciding whether to use television at all with your children and if so when, how, how long?

In his book Touch Points, The Essential Reference - Your Child's Emotional and Behavioural Development Dr T. Berry Brazelton, Paediatrician, outlines some very important factors related to your childs health and development.

What transpires when a small child sits infront of a television? Usually their eyes focus very  intently on the screen and their face, head and body will be still, immobilized. This intense concentration causes stress on the body, which will have an effect on the childs health. In addition, any loud noise, sudden interruption, someone calling him / her will result in a startle response. This startle highlights how deeply they were concentrating on the television. 

Such intense concentration is difficult for small children, especially over an extended period of time. If engaged in a different activity, a child concentrating with all their energy on the given task will let off steam by crying or throwing a tantrum, unless the parent knows how to re-channel the energy that has built up. A child that sits glued to a television is not experiencing any form of activity that will enable them to release pent up energy. As Dr Brazelton states "I worry about the cost of such intensity. A child's entire physical and mental capacity is involved in watching television. Her body passive but tense. Muscle tension reflects a stressed, not relaxed child. This combination of inactivity and tension is physiologically demanding" (Pg 410 in the book listed above)

If one is to place your child watching Television, watching with them and discussing various points does help to break up this deep concentration.

Psychologically there is also a price to pay. The high level of concentration will generally result in a child breaking down afterwards. Dr Brazelton states that parents should seriously consider whether with children under 4 years of age, this price is worth paying. In addition, children become fixated on items that are presente in advertisements. Unless a parent is ready to purchase whatever their child pressurises them into purchasing, it is better to keep adverts to a minimum or eliminate them all together.


For those who use television only for very short periods of time, 20 minutes at most, programs that are educational e.g. Sesame Street or a DVD with childrens nuresery songs in a ring and the children singing along, can have certain benefits, but only in moderation and with supervision.

When a parent places a child infront of regular television, with any program that is showing and intersperced with advertisements, in addition to the physiological and psychological effects of just being in one position engrosed in the television, the content also has an effect. Studies show that children watching something negative or violent will tend to have agreesive behaviour immediately after completing watching. If the program contains explicit language or negative speech, this will be acted out by your child.

The television does have a very strong impact on the thought processing and cognitive development including development of values and beliefs. If you wish to have a positive influence on your child, I would recommend preferrably not using the television, and where it is used, only for 20 minutes at a time, not every day and only with DVD that is appropriate for children.

Lastly, please remember, although children do need some quiet time e.g. when preparing for bedtime, children do need to play, run about, explore, interact with their environment. Immaginative play is a very important component of developing creative thinking. There must be adequate time allocated to these tasks and activities in order for a child to develop and grow optimally. Hence, other than the effects on the childs physiology itself, parents should be careful to ensure that the child will have time for the very important activities and play that will be of benefit to him or her and not use television as a means of escape for a parent. 

In another post, we will look at alternatives to provide quiet time and means for a child to relax in preparation for peaceful and effective sleep.

Tuesday, 8 June 2010

Early Definitions of Occupational Therapy

Occupational Therapy has been misunderstood since its inception. As the profession has developed and grown, so too the definition of Occupational Therapy has developed and become more structured and descriptive of the unique role of an Occupational Therapist.

 In order to gain some insight into the origins of the profession, here are 3 of the earlier definitions.
 George Barton in 1914 stated: "If there is an occupational disease, why not an occupational therapy" Barton G: Occupational Therapy. Trained Nurse Hosp Rev 54: 138 - 140, 1915

In 1922 Dr H.A. Pattison MD defined occupational therapy as " any activity, mental or physical, definitely prescribed and guided for the distinct purpose of contributing to and hastening recovery from disease or injury" Pattison HA: The trend of Occupational Therapy for tuberculous. Arch Occup Ther 1:19 - 24, 1922

In 1923 Herbert J. Hall MD describes occupational therapy as: "occupational therapy provides light work under medical supervision for the benefit of patients convalescing in hospitals or in their homes. The handicrafts are used not with the idea of making craftsmen of the patients, but for the purposes of developing physical and mental effectiveness at a time when courage and initiative are at a low ebb" Hall HJ OT. A New Profession. Concord, Mass Rumfrd Press 1923

As you will see from the above three definitions, each definition adds a few concepts or components that the previous one had not included. 

Stay tuned for further developments in the definitions of the profession of occupational therapy.


DID YOU KNOW?

Shoshanah offers private consultations both individually and in groups.

Consultations are available in person, via email correspondence, Skype or telephone.

To book a consultation, talk or workshop with Shoshanah, please contact her via her website or email.


Shoshanah is in the process of developing a very special Healing Centre.

Shoshanah has a number of other blogs filled with valuable life skills and information. See:
Should you wish to partner with Shoshanah
in developing her Healing Centre
giving you the opportunity to sponsor rooms or equipment
in memory of a loved one or in honour of family or friends,
please send an email to find out options for donations or sponsorship opportunities.
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