US Dept of Labor - Statistics on Occupational Therapists

Caption: It's 2:45 AM, I can't sleep, and I'm hungry, and I'm updating blog posts with pictures, and this bird seemed like a good one for a post on OT statistics....mostly because I'm hungry, yeah.

http://www.bls.gov/oco/ocos078.htm

All the stats/info you could ever want on OT and whether you should consider it as a career. It's from the US Dept of Labor statistics. Thanks Sarah for reminding me of this resource. :)

My OT skills were wasted today, but at least I had fun.

Caption: I have no idea who this is, but it made me laugh...I was searching Google images for "hyper kid"

The following is not really OT-related, but it's rainy and yucky and cold and I am feeling lazy and procrastinationish and have only done one good thing today, which is the following story, plus I think I'm allowed an occasional random post, but I promise I'm going to start doing more OT work in a minute or two. Plus the posts below this one are PURE *OT* baby, check it out.

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Today I braved the cold rain to go pick up a 13-year-old in 8th grade, let's call him Bob, from school. I took him to get Starbucks because I'm a bad person and was okay with pumping up with sugar, caffeine, and about ten thousand unneeded calories. And because he enjoys the experience and I try to take him there every few months. I think it's important to give kids one-on-time quality time with an older person, and while he wouldn't admit it, he really likes me because I'm more or less insane. I lived with his family during a semester of college, years ago. Long story. Moving on.

This kid is hilarious. We had our Starbucks, then went home and upstairs to his room to play with his Legos. He has a really nice Lego table his grandfather built. The last time he wanted me to play Legos with him (he has this whole village set up on the table and storyline behind it), I pissed him off because I tried to give a monkey a gun, and he wouldn't let me play anymore. (He is very mature and smart and understands a lot, although he is immature when it comes to play) Anyway, I thought I was hilarious, but he didn't.

Today he knew better and didn't directly ask me to actually play Legos and follow his storyline, but he showed them to me and talked about them (there was a recent explosion), and I offered crazy suggestions, all of which he didn't like. I tried to add in random things and he said "New policy: No non-Legos in the city". For example, he didn't like my idea of a giant dragon egg in the middle of the village, and putting all his villagers staring in awe at it. He also didn't like the idea of eating the Queen's pet lego shark for dinner. He also didn't like it when I put Lego flames in the Lego goblet in the King/Queen's bedroom, and started screaming "Fire! Fire!". He also didn't like it when I threw a weird Lego bug into their room and started shrieking in terror. He had to exclaim in frustration, "Do you want me to kick you out again?" as I tried out all these antics. I tried to convince him the bad guys should show up on the village island via his mini Fedex Planes and not just magically show up. He didn't like that idea either. He wanted to know a good occupation for a skeleton Lego. I suggested putting him in the cafeteria to detour anorexics. He didn't like that idea either. Apparently, I was not made to play Legos.

I made some joke at some point, the kind of joke that amuses me and used to go over his head, and he said, "You know, you used to make jokes that would go over my head. Now I'm in public school. I get them now." Guess I better watch it...

Then I asked him if he would rather have a monkey or a robot to help him do things, if he needed help (going back to an earlier OT post about this), and he said something about wanting a robot, because monkeys are messy. Then I asked him if he'd want the monkey if the monkey could clean up its mess, and he said no, he'd still want the robot, because robots can talk. Plus, he said, the robot can help him enslave the world. Later on I forgot what he had decided and asked him again and he said "depends on which one is more efficient". I laughed and said I needed to bring a tape recorder with me. He said, "you can get those at Ike's (drug store)." I said, "monkeys?" "NO! Tape recorders!" Oh.

Finally, I asked him for paper so I could write things down, and he handed me a sheet of reinforced binder paper, since apparently you can buy this, and I was impressed. He said he hates having to waste a sheet of paper for something small, and I said they should make paper like they do paper towels, where you can choose the length. He looked at me with an incredulous look on his face and I pre-emptively said "Shut up" before he could say anything. He said "You're starting to get the picture."

I love this kid. And believe it or not, he loves me back. :P

Bladders, Bowels, Sexuality...Geriatric OT Marvels

Wow. Wow. Wow. Wow. Wow. Wow.
***Warning**** Private parts are discussed in this post. You've been warned.****

We had a wonderful R.N. named Ruth come in and talk to us about bladder, bowel, and sexuality in the aging. She gave me permission to put up whatever I wanted from her handout, because she said it was all common sense things you could find on the Internet. But still listen to your doctor or OT or other licensed healthcare professional instead of me, the lowly student.


Bladder

• Loss of bladder capacity to almost half of previous capacity
  
• Reflex telling us to urinate comes later so older people have to rush to a bathroom
• There are multiple types of incontinence, including transient (like temporarily) or stress (muscle weakness)
• Neurogenic bladder is when the brain and bladder muscles don't communicate properly anymore. This is frequently seen in MS, Parkinson's....
• Overflow incontinence: Seen in men with prostate problems - the prostate gland enlarges and blocks passageway so man dribbles urine all day.
  

Treatments for bladder issues:
Seeing a urologist, stress tests, urinalysis, Kegel Exercises, Biofeedback, Dietary changes, Medication examinations, and more!

• Intermittent catheterization: having to insert a tube inside of yourself at regular intervals to make sure your bladder is emptied.
  
• Guys are lucky to have condom catheters, while girls aren't quite so lucky!
• Some condom catheters are held with a band, others with GLUE!!! ::cringe:: apparently it isn't that strong.
• OTs working in a rehab hospital will frequently encounter Foley catheters...the patient may have a bed bag at night, and then when the OT goes into the patient room in the morning to help with ADLs (activities of daily life), the OT can help the patient switch their bag to a portable leg bag
• Some people spend close to a thousand dollars a month on incontinence pads. In those cases a more permanent catheter may be a better solution.
  

Bowels

• Constipation is a big problem for the elderly, with many reasons, including slower digestive system, poor fluid intake, lack of exercise, certain medications, certain diseases...lots of reasons!
  
• Elderly people often are concerned with having the right amount of bowel movements a day, when in reality there is no "normal" - it can vary substantially
• Laxative abuse is rampant. Laxatives should not be used more than 4x a month or so, roughly.

Treatment can include dietary changes, drinking more, exercising (We saw part of a Richard Simmons wheelchair video!!), stool softeners, suppositories...by the way, she mentioned "Power Pudding" - you can google the recipe - to help with constipation.

• Complications of constipation can include hemorrhoids, anal fissures, and other not fun stuff. If you are helping a patient with ADLs and notice something very wrong with their stool, pass on the information!
  

OCCUPATIONAL THERAPY WAYS TO HELP PEOPLE WITH BLADDER/BOWEL PROBLEMS:

• Assess hand function and range of motion to make sure they can follow good hygiene
• Make sure the person is educated on possible assistive devices to help in the bathroom.
• Help them learn to wear easy-to-doff clothing so they don't have to fumble with their clothes when desperate
  
• Consider a bidet, popular in Europe
  
• Suggest clearing path to toilet, getting nightlights, grab bars
• Suggest Bedside commode, raised toilet seat, etc...
• Try to help the person get back as much dignity as possible
  

SEXUALITY

Wow. Did I mention wow? Wow.

• Women have fewer sexual hormones and lubrication
• Men have slower, quicker erections, less sperm, longer refractory period
• Surgeries, attitudes, alcohol, drugs, disease, depression, and more, can affect sexuality in elders
• Females might try education, counseling, hormone therapy, artifical vaginal lubricants, Kegel exercises
• Males can try education, counseling, penile blood flow studies, suction devices, penile injections, surgical implants, medications..

Side note: We were discussing vaginal lubrication and the nurse got off on a tangent and ended up saying "Wow. How did I get on that topic from vaginal lubrication?" And one of the girls in the class said "That's ok, I do it all the time!" AHAHAHAHA

• Sexual activity is still possible at older ages, but may require more effort, time, and positive attitudes. ("A woman is like a crock-pot...she needs to simmer...")
  
• Sexual activity can be good for the health
• Sex doesn't have to be just intercourse. Be creative.
• Follow the PLISSIT model: Permission, Limited Information, Specific Suggestions, and Intensive Therapy. Maybe PLISSIT stems from a play on the word Explicit? I don't know. Basically, don't shy away from the subject as an OT. Sex is on the forefront for many elderly people and it might be helpful if you bring it up.
  
• Sex is possible even with catheters and hip surgeries and more.
  
• If you are uncomfortable with this topic, or feel you have reached your knowledge limit, you can certainly refer the person to a psychologist or psychiatrist or the doctor or whoever needs to know.

Now for the extra amazing part, in my humble opinion.
X-RATED VIDEOS!!!!!!!!!!!!!!!!!!!!!!!!!
They were from a medical clinic, but still! We have a 7-foot screen. I don't care who you are, a seven-foot penis is scary.

The videos were about various ways males can achieve erection, including injections, suction, and implants. They had graphic descriptions of each one, clearly focusing solely on the penis as it became erect, filling up a 7-foot screen. We have Baptists and virgins and your average uncomfortable people in the class, shielding their eyes. I watched it like a train wreck, trying not to laugh. I know it's a serious topic, but it was a very cheesy movie and I don't think many people are used to watching these things on gigantic screens. They had cheesy couples who would say things like "I take it. It works." - "I even help with the injection. It's part of our lovemaking." My favorite part was when the cheesy announcer guy talked about how Viagra was invented in the 1980s as a heart drug, but..."It didn't do much for men's hearts, but talk about a happy accident." AHOSEEOHAHAHAHAHAHAH!!!!!!!! I love it!!!! It does kind of kill me though, that Medicare will not pay for shower benches but it will pay for Viagra.

So anyway...there are lots of ways to make sex possible and comfortable for elders (or those with disabilities in general and according to "Cookie Gimp" there is a better medical clinic video I need to see, showing couples with disabilities having intercourse.) It's important as an OT to be aware of the sexual needs of elderly people and not be afraid to discuss it. It's an activity of daily life and there are a lot of options.

Finally, I want to know if senior erotica exists. If it doesn't, I'm totally getting a part-time job, writing it!! Seniors are our fastest growing population and they need some good reading!

Update: There is an unmet need for senior erotica, based on my google searching...

An ombudsman in long-term care talks to us in OT class...

We had a lawyer named Sandy come in, who served as an ombudsman for long-term care in this region (I guess she specializes in geriatrics?). An ombudsman is a Swedish term for a person who serves as a citizen advocate. People can complain to her about long-term care via almost any media.

She pointed out that a lot of time, when investigating the claim, the problems were that very nice & good healthcare providers had gotten burnt out and overwhelmed over time, and ended up making big errors, at the expense of the client, obviously. I thought this was interesting but also scary. Right now we students are so "fresh" and enthusiastic and sure we are going to be so evidence-based, occupation-focused, client-centered, holistic, etc...but I know the healthcare system ends up jading a lot of us. I don't think anyone goes into an occupation saying "hey I think I'll get a master's degree so I can be a big giant be-ouch to everyone I meet and treat my patients like meat and make them angry!" This leads to her next point, which is that we need to be aware of our own boundaries and limitations - if we are not self-aware, we end up hurting not only ourselves, but others. And we put our occupation -as occupational therapists ha ha - in jeapordy. I can never spell that right. jeapardy. Jeopardy. There.

I asked if an ombudsman for long-term care had to have a certain type of degree, and she said that they are usually a social worker, nurse, or attorney. I thought that was interesting and wondered why an OT couldn't do that job.

She reminded us that while a lot of people have dementia and may say crazy things, we still need to pay attention - while it is not common, sometimes there ARE predators masquerading as healthcare providers. A little scary to think about - your interpretation of a person's rantings may make a big difference. Augh.

I'm kind of skipping around and just hitting on the things I found most interesting...my disclaimer as always is that it was y own understanding of the lecture and not iron-clad fact.

The final thing I want to talk about is she discussed a recent fad in moving out of large institutions and trying to get people back in their homes (Again via home modification, assistive devices, aging in place measures, etc)...or if not homes, maybe cottages or green homes where the place is MUCH smaller and made to be more like a house.

I enjoyed hearing about her job and it made me aware of all the people out there doing jobs I don't even think about. I am glad people like her are there to help protect our elderly. I think the main message I got out of her lecture was to be self-aware and try to treat our elderly people with the respect and dignity they all deserve. Because if we don't, people like her will come after us!!

Geriatrics, occupational therapy....gerontology...la la la

So I've decided I should drop out of OT school and go into advertising because today I thought of "Grannycam" (already invented, bummer), and then also "Crays of Our Lives" if you maybe, I dunno, happened to be a crayfish researcher who wanted to do a soap opera on Animal Planet? LOL

I've spent the evening working on my to do list and have been productive. I'm working on reading management chapters for the midterm, finished half another midterm, searched for a geriatric article, finished a proposal for our geriatric media project (having older people write advice on paper from their childhood, and wrap it up in easily-done felt fortune cookies, for a young class to open). And then SIGNED UP FOR AOTA CONFERENCE!!!!!!!!!!!!!!!!!!!!!!!!!! Got my plane tickets and hotel now too!!!!!!!!!!!!! And finished my Christmas thank you cards....cough. And more. Productivity, baby. Now I am lazy after working so hard and kind of want to give up for the night, but I am going to do my two lectures so I'm caught up. Again. I'm like the most prolific OT writer ever, but I have so much to share, it's bursting out of me yo!

Oh btw, I had a dream a few nights ago I was watching a girl pushing her mother's wheelchair and doing such a bad job that her mom's head kept on hitting the ground from it tipping over (not painful, just ludicrous, in the dream), and I was, as an OT student, all horrified and wanting to run over there and teach her what to do!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Photo cards and use in occupational therapy...

Caption: Virginia bravely sits on the most uncomfortable futon in the world, showing off the photo cards.

My OTS friend Virginia brought over a neat game the other day. She got it through Campus Crusade, and it is available through mysoularium.com. It's technically a "spiritual" game where you use pictures (50 of them spread all over as above) to answer questions like "What three pictures most symbolize what you want for your future?" etc. It seemed like it could potentially be modified to be a great OT tool.

Some possible uses (maybe taking your own photos instead of using theirs):

1. Elderly people -asking them questions about what symbolizes different parts of their past (reminiscing is a powerful tool)

2. Mental health - asking people questions that they can link to cards reflecting their emotions

3. Cognition - asking people to link cards using some sort of category such as "red", or asking them to describe the photos, etc.

4. Spirituality - its original purpose - depending on the situation and what the person needs - asking them about their spiritual hopes or issues. This is actually kind of touchy - I kind of wanted to cry when I was doing this with Virginia!

5. Tons of other things...be creative.

Anyway...it was neat.

Somewhat random somewhat OT-related, yes I'm procrastiningating, pictures

OT Students Allison and Meg are struggling with this door. They need OT.

OTS Meg and OTS Allison exhibit signs of post-traumatic stress disorder, seeing this Nexair truck just a few weeks after a Nexair truck had an oxygen tank explode in front of the school.

OTS Karen (me) and non-OTS but still cool, Christa, stuck in traffic for 40 minutes and surrounded by trucks...it was Saturday morning when there was ice and we saw tons of bad accidents.
Too many trucks, augh. .
OTS Meg and OTS Karen are totally twins. By accident. Because dressing like each other on purpose is SO third grade.

The studying days....are upon us OT students.

Last random picture, I swear.

The past year was pretty intense, work-wise...we had many a study marathon...now we've had quite a break from the insanity, but it's starting back up. February will be a very hectic month! This picture is from last semester...Brooke and Allison were at my house studying...probably for neurobiology, I don't know. It was painful.

Occupational therapy students learn about splinting...from the infamous Julie

One of the girls in the OT class below us has hurt her wrist, and needs a nocturnal resting hand splint. Guess what! My OT class knows how to make those!  When I was looking through my pictures trying to find a picture of Neal, since my search function in Windows Explorer KEEPS HAVING AN ERROR AUGH, I found this picture of us trying to draw out splint patterns....(you draw them on paper towels based on a person's individual anatomy, then you trace them bigger onto this material, then you dip it into warm water baths so you can cut it and mold it...)

Awww!!! My MOT class is amazing and I have proof!

Neal is our Distance Education SuperHero, and we love him, and he loves us OT students back!  This is what he had to say about our MOT class, after reading the recent NY Times Article on OT (this is where, if I were a good blogger, I'd link my previous post on it, but I'm not a good blogger, so well, sorry). PS: We do have two guys in the program, so when he says "girly girls", I'm sure he meant to include + boyie boys as well.

If there was ever a "sisterhood" at our UT campus, it is undeniably the girly girls of OT. Our class of '09 is top of the crop and downright entertaining. A year and a half ago this class came into a new environment of teaching thru video conferencing. With technical difficulties, walking blocks between classes, and bearing the weight of a masters level program, my "sisters" have survived and grown up before my eyes.
Neal "tech dude" Smith

Nobody...knows....the pain.....

http://www.jinx.com/men/shirts/geek/nobody_reads_my_blog.html?catid=1

Do I need this t-shirt? I want it!! Some days my stats make me think I do need it....other days I feel really popular. :) I'm almost at 25,000 page views for this OT student blog! Woot woot!
Regardless, I feel like if I wore it, I'd get some pity!

Hmmm.

So Neal, our "tech dude", wrote the sweetest thing about OT today for the blog but I'm going to wait to post it because um, I have to go shower now before I go enter in research data. Our online management meeting was quite successful - we're moving onto budgeting for a department as well as starting a project on "little people" aka LPs aka dwarves (old offensive term being midgets)...we had to pick a population that does not traditionally receive OT. I think it will be cool and potentially can really help some people!

OT....that's it, I've run out of titles.

Ok...I didn't get to write up my bladder, bowel, sex, talk...or my other post...but the good news is I went from about a 100 emails to exactly THREE, tonight, in my Gmail box. I had like 20 reader mails to respond to and that takes a while, but I still love it so keep sending them on. :) I try and weed down my email box DAILY but I get so much it's really hard to keep up. I guess I'd rather get too many e-mails than too few though. :) I need my constant reassurance.

Does anyone have some great geriatric sites they recommend for news/articles etc? Besides AARP?

I think now that I'm caught up on e-mail and such that tomorrow my goals are  to catch up blog lecture posts, do a ton of homework and work on a ton of assignments, and try not to cry due to being overwhelmed. Just kidding. Kind of. It's all snuck/sneaked/dunno grammar up on us...a lot is due in February! I want to share that stuff too tomorrow! So many wants, so little time!

Tomorrow I have an online management meeting with my OTS group to work on finishing up the first phase of our hypothetical project on having a rehab hospital recruit a new population...then meeting my OTS partner Julie to enter in research data....then have class, and then I guess I'm free to just work on assignments for the rest of the day, thank goodness.

I could also stand to do my dishes and some laundry BUT OH THE PAIN PLEASE DON'T MAKE ME! LOW PRIORITY ADLs!! NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO ::shrieks:::

Ok I just got off work 30 minutes ago and I need to probably go ahead and go to bed. I hope tomorrow is a VERY productive day to make up for my recent slackitude. And yes, I make up new words. With temerity. I think. I forget what that word means but I knew it a few years ago when I took the GRE.

Double amputee walks again due to Bluetooth

 

http://www.cnn.com/2008/TECH/01/25/bluetooth.legs/index.html

One of the rare guys in our OT class, Jason, sent this, and it seemed pretty interesting! Check it out!

And we thought we had it bad...

This is from my OTS friend Patti's blog...look at her assignment schedule. Good Lord.

http://thejourneyhasonlybegun.blogspot.com/2008/01/ahhhh.html

Here is her February, look on her site for March and April. YIKES!


February:
Monday 4th- Ped Evaluation: Item Eval Due
Tuesday 5th- Research Methods: Quantitative Proposal
Wednesday 6th- FIELDWORK 1 *LOG*
Monday 11th- Ped. Evaluation: QUIZ 1
Wednesday 13th- FIELDWORK 2 *LOG*
Thursday 14th- OT Skills II: Genogram Assignment
Friday 15th- Ped. OT Intervention: QUIZ 1
Tuesday 19th- Mental Health: Log #1 Due
Tuesday 19th- Research Methods: Quantitative Critique Due
Wednesday 20th- FIELDWORK 3 *LOG*
Tuesday 26th- Mental Health: EBP review of Eklund article due.
Tuesday 26th- Research Methods: MIDTERM
Tuesday 26th- Research Methods: Qualitative Proposal
Wednesday 27th- FIELDWORK 4 *LOG*
Friday 29th- Ped OT Intervention: Autism Reading Assignment

Bowel, bladder, and sexuality in the elderly. Wow.

I'm too lazy to type it all up right now, but WOW, we had quite the lecture today on bowel, bladder, and sexuality in the elder. Including videos. With full-frontal X-rated demonstrations. Wow. I hopefully can write it all up later on tonight. I think my eyebrows are three inches higher than they used to be.

My rainbow scrub challenge to MOT Class of 2010

Top picture: Our rainbow scrub pic of MOT Class of 2009. I'm the only one missing, since I took the picture. And looked like crap that day...

Bottom picture: A mini rainbow-picture stolen from Facebook of a few members of the MOT Class of 2009. I challenge them to make a rainbow picture like ours. :)

My most random OT post ever. Don't even bother reading it, it will make your head hurt and waste valuable minutes of your life.

I'm tired so I'm going to cheat and write like two sentences (update: oops). Today we had an ombudsman come in and talk about some of the issues she deals with in geriatrics and long-term care, and I wrote down some info to share later. Then I had my TB skin test read at the peds hospital (negative of course), and then I went to the sitting Tai Chi class....it kinda makes me mad that a bunch of 90 year-olds can do the Tai Chi better than I can! But happy too! I really think Tai Chi is a wonderful thing that all grown-ups should have to do. I'm not into martial arts or Chinese stuff or chakras or anything, but I do think there's a lot to be said about gentle, low-impact, repetitive movements....also it really does feel like you are handling balls of energy the way your palms end up tingling! Wow got off on a tangent. Anyway. Spent the evening with some friends, and now about to go to bed.

Tomorrow a bunch of us are going to yoga, then my research group will do data entry for the Tai Chi stuff, and then we have a class. I don't know which class though. LOL - our schedule changes every single day, every single week. Guess I'll get prepared for it in the morning. THEN I'm going to go do early primary voting for the FIRST TIME IN MY ENTIRE LIFE (yes I'm 25) with my friend Christa. And then I work tomorrow night 9 to midnight.

This is my most boring post ever. I have a bunch of random things floating through my head.

I have a bunch of reader e-mails to respond to.
I'm back to being way on top in Google searches again.
My OT Practice article comes out in the February 4th edition, it's the "Reflections of the Heart" column on the back page - I'm excited.
Penelope Moyers (AOTA president) & I are best friends and we conspire daily regarding "The Centennial Vision" - okay that was a total lie, but it made me laugh to write it.
Because I'm an OT freak.

I'm going to AOTA conference in Long Beach in April.....YAY! I'm so excited to network and hear cool speakers and get free Expo stuff! It is my first big conference! I have gone to TOTA conference and Student Conclave though. :)

My friend and I have finally started working on the blog project I promised way back, like months ago. I'm excited about it. It will be a challenge.

The MOT class of 2010 is so adorable. But I'm so glad I'm not in their shoes - this next year for them will be A LOT OF WORK! But fun too, you prospective OT students, so go apply. :)

I can't believe I wrote this much stuff. Next week I'm going to start writing pithy concise succinct non-redundant witty amusing non-bad-analogy-making posts that focus solely on occupational therapy, so that I can lure in new OT readers from OT Practice, like a spider making a sneaky web for a fly.

Good night. I'm delirious.

MOT Class of 2010 pics!

Hilighters + skeleton hand = first semester, anatomy class, 2010

Kendal (blonde hair) + Disha = new class president and vice-president for class of 2010!

Pictures courtesy of Dori & stolen with permission from Facebook...

Tomorrow I have a class 10am to noon, then have to get a yearly TB skin test read at the peds hospital, and then I have to go to sitting Tai Chi for arthritis at an assisted living facility! And a few other fun things! Have a good night

OT Ghost Busters...still vote for u :)

Brooke & Karen were two very different people. Brooke was cool and Karen was not. Slowly, Karen has become cooler. Somehow it now means Brooke & Karen look like identical twins, but it is only by coincidence. :) They are very close like sisters though, and so they would be great at working together in the AOTA ASD Steering Committee! Yay!

In Nashville for the night visiting some friends...my friend Christa and I left early Saturday morning...there was still ice on the road and we saw four massive accidents...one of which had us sit in traffic for 40 minutes before we ever got out of Memphis. Luckily Christa is a great driver and so it went fine after the initial scariness.

By the way, Christa complained of ghosts in her house that make her bedroom door creak (just kidding), and I came up with ideas on how to deal with the ghost. See how OTish I am? And how far-reaching OT can reach? We can even be ghost busters!!!!!!!!!!!!WHO YA GONNA CALL!! O T!

Got to hold babies today...yay for occupational therapy

I held babies and followed an OT this morning. I got to see an attempt at a speech/OT co-treat for feeding, an evaluation with a newborn who had been a 25-weeker (looking at reflexes, muscle, arousal state, transition states, grimacing, startle reactions, coloring, etc), and hold a baby in my lap while the speech therapist fed him. (Most of these babies have G-tubes and haven't gotten used to things in their mouth and have trouble with feeding). I also held one baby for about an hour on my tummy/chest (I was just tilted way back in a normal chair). The OT confirmed it's ok to pull out their mat and use it to give the babies tummy time - with permission of course.

Anyway - it was fun - it reminded me I have a lot to learn but it also was exciting. I'm going to try and go there more often during the week when there is opportunity to help more and see more. I love these babies.

I posted about 10 items yesterday so that will have to tide you over for the weekend - probably headed out of town if the weather doesn't get too nasty. My OTS friend Virginia is coming over tonight too if again, weather isn't too bad! For now I plan to just catch up on some random things, both school-related and home maintenance-related :)

Occupations of Elders...last post of the night, I almost promise

I'm almost done sharing new insights from lectures/readings and more. Now I'm caught up.

Today we discussed the Occupations of Elders. We talked about accessibility and how cruises are a popular destination for the elderly because the cruises are so accessible in terms of ramps, wide halls, etc. Also, that wellness & prevention are very important, and that elders shouldn't automatically accept "You feel this way because you are old" as a legitimate answer from a doctor. Sometimes it's true, but sometimes it's a lot more than that.

We discussed how elderly tend to be vulnerable to solicitations and advertisements, like for supplements that promise to give you energy - and how that can be dangerous when they are already on a bunch of other drugs! Also, the elderly metabolize drugs differently.

We talked about how ideally the elderly would be seen by gerontologists, geriatric consultants, and such - since the elderly have specific and unique issues.

One thing I thought was cool is she pointed out that a lot of times, nurses or CNAs or whatever, will bring a tray of food into the room for the elderly person, then leave, without setting it up at all in any way. Many elderly people can't handle all the opening of food containers, arranging the food, cutting up the food, feeding themselves...and so then the assistant comes back in to collect the tray and it is uneaten and they report that the elder has no appetite...when in reality it may be the person just didn't get the help he/she needed. I thought that was an interesting and important point. I know that when I followed an OT in a rehab hospital, she always offered to help set up the food for the patient, as needed.

We also talked about how important it is to reminisce - try to find things from decades past to talk about, or show....old movies, old songs, old products, whatever. Memories are so important.

Hmmm...we talked about lots of other things - how the elderly enjoy a lot of the same leisure everyone else does, their roles, what they can be vulnerable to, their attitudes, medication, and more. It's very fascinating.

It will be interesting to see how society adapts to there being so many more older people alive than ever before - maybe we'll see things in bigger text, with more contrast, better handrails and ramp access, wheelchair acceptance....the list goes on and on.

Ok...I think I'm caught up. Hope some of this was interesting to some of you. The thing I love most about OT is the diversity. We can work with anyone - a newborn, a five year old, a teen, an adult, an elder....we have something to offer them all. Work hardening, burn-care, education, hand therapy, handwriting, development, injuries, consultation, advocacy, efficiency, geriatric help...we can potentially do it all.

Monkey versus Robot & Caregiver Burden

We had a lecture on Caregiver Burden the other day, which I found fascinating. Again, this is all my own understanding - go google it or talk to a professional if you want more information.

We talked about the "Sandwich Generation" which is where the middle-aged are discovering they are taking care of both their own parents and their own children. Very difficult to do.

We talked about how stressful it can be to be a caregiver, and how caregivers need to understand taking care of him/herself is vital to being able to help the person he/she cares for. We discussed "compassion fatigue", which I think a lot of people get, due to having to constantly deal with so much.

We talked about how OTs can help caregivers by giving them education about stress relief, respite care, home modifications, assistive devices, and more, to make his or her life easier. Also, OTs can work in advocacy, as well as in hospice, or doing consultation. Our professor used the example of IHOP - you see young waiters waiting on a lot of elderly people. These young waiters could probably benefit from some training on how to best interact with their elders, in terms of respect, understanding of low vision, hearing issues, patience, etc.

I really wish Dear Abby/Ann Landers/Advice Columnists would learn about OT and recommend it - I constantly read Dear Abby articles about people stressed out about their parents, and OTs can help a LOT with that. But of course she never mentions it. I also think an OT could be a great advice columnist for all sorts of issues. But that's another post.

Finally, we had a discussion about "monkey versus robot", which started up because we discussed how some older people just require a LITTLE bit of help - something that is necessary but would be silly to have someone come out just for those reasons (like putting on a shirt). We discussed how robots might be used one day to help with these tasks, but also that most elderly people would probably not be comfortable with that. One girl, Mary, pointed out her father would probably go at it with a bat. We then talked about how monkeys are sometimes used, but that the thought of monkeys going into the fridge for food and such is a little unappetizing. Some of us preferred the monkey, some the robot. It was interesting...somewhat jokey, but also good points.

Speech therapy and feeding...geriatrics...occupational therapy...

We recently had a speech therapist who works at a local rehab hospital come in to talk to us about speech therapy and geriatrics. She talked about (and all the following is just my own, possibly wrong, understanding) how there are three major domains - cognition, communication, and dysphagia.

Cognition - a lot of overlap with OT
Communication - verbal expression, comprehension, voice, etc
Dysphagia - swallowing issues

Some of the cool things we learned about:

• The Passy-Muir speaking valve is used on the ends of trache's to help some people speak, and it's just a little cap thing that costs a few hundred dollars. Insurance usually covers it.
  
• Dysarthria is slurred speech - slow, loud, overarticulate
• We/they should look at the person's face for nonverbal cues and/or lipreading
• Amonia is trying to find the right word an it's a type of aphasia (the whole Wernicke's & Broca stuff)
• Receptive aphasia - trouble understanding
• Expressive aphasia - trouble sharing information (on one of my fieldworks, there was a young girl who had a stroke and had this - she couldn't figure out how to speak except to say "Toaster Strudel", which was her favorite food).
  
• People may have difficulty manipulating the bolus (the food) or forming the bolus, which is an oral issue, due to perhaps lip weakness or limited tongue movement
• People may show signs of aspiration such as coughing, which means food is going down the wrong tube, so to speak. Modified barium swallows can help find if this in fact happening
• People who do have problems with aspiration may need to be on thickened liquids - there is a powder you can use to thicken water, even. Gross!
• OTs/Speech can give tips like clearing out the throat, swallowing twice after each bite, and pointing out "pocketing" in the mouth where the person doesn't realize they still have food in their mouth...perhaps due to a stroke, or because of Parkinson's, etc.

I've also been in contact with an anonymous OTR/L who told me about her pet peeves with feeding. The following is a copy/paste from her e-mail, after I asked her about it.

I am glad you asked about the techniques with feeding. Next time you are at the nursing home if it's close to a meal stay and observe. even for 5 minutes. OH OH where do I start...

.Before the meal some staff walk around and say here Mrs. Smith here is a bib and put it on, or worse; don't say anything and just put it on. An OT would say Mrs Smith would you like me to help you put on an apron we are having spaghetti and sauce or some thing like that. We look at how they are positioned at the table, do we need a special chair, cushion, special table. We are big time into equipment, but keep it looking as close to "Normal". that can be a challenge. Hygiene at meal time is so important, some staff go from patient to patient without changing gloves,or washing hands that drove me crazy. Karen there is so much more I will just say a little more and then see if you notice anything, good or bad. Some staff just scoop a big pile of food and put it in,from the side of the patient, the patient gets startled and nearly chokes. A good OT like you would say Mrs. Smith what would you like next, the salad, bread or meatball?

Random OT student day update...

Today was fun, but I'm tired. I decided I'm not doing anything tonight but catching up on blog posts and I can catch up on things tomorrow. In the morning I'll be at a local peds hospital following an OT in what is basically a step-down ICU for babies. I'm excited. :) I better finish my leadership paper tomorrow or ELSE!

BTW - I hate to do the blog blizzards because I know regular readers can get frustrated with all the new material - but A) content is how new readers get attracted, and B) I have tons of ideas go through my head that I try and write down...and there are way too many to pace it to one a day, so I try to catch up when I can/feel like it.

Even the video engineers love OT students...

I've talked before about our amazing superhero tech guy....he is so cool and we all love him. NEAL!!!!!!!!!!!!!!!
I asked him the other day to write up a blurb about us OT students (he helps with all our live Memphis-Chattanooga distance education connections). I took out the specific departments he spoke about though - I don't want to get him in trouble.

"Ive done video-conferencing at UT for over twelve years with the
Colleges of X, Y ,and Z. What I've experienced in the first year of OT video-conferencing is that our OT'S adapted to this new form of instruction faster..way faster than any other College
before. It just goes to prove that OT's are the most adaptable, socially
and technically."

Celia - play therapy - my reason for being in OT school

This is Celia. I did (informal) play therapy with her for years, multiple times a week - she is why I am now in OT school. I love her so much. She moved away 1.5 years ago. She was probably 7 or 8ish in this video. She was talking to me about her "friend" (actually an adult) named LisaJo who she really has fun with, and how "she wished to the lord" she could play with her. I thought that was so cute and pulled out my camera - trying to prompt her to kind of repeat the story. She had a tendency to always try and run to the camera to see so I had to be careful. She has developmental delay, hypotonia, apraxia, etc. Notice her "high guard" - the way she holds her hands when moving. Also note the way she shakes her head, the way she holds her fingers, the way she interacts with me, how she is distracted, and how the phrases she speak seem to come from sources other than her own creation.

I ADORE her!!!!!!!!!!!!!!!!!!!!!!!!! She is one of my favorite people in the world and I really miss her.

She can be hard to understand for people who don't know her so I transcribed her parts.

Celia: Lisa Jo is so nice...Lisa Jo is so nice and so pretty. I wish that Lisa Jo could take us out... On a date. ..to the ball....my ???? ......Lisa Jo is going to wear a kimono....

Occupational therapy treatment project by Kerri

Kerri's occupational therapy treatment project from last semester, made for a young child with sensory defensiveness. She was the therapist and I was the young child. The cat is just a bonus.

Disability Blog Carnival catches my OT eye

I should be studying, but instead I'm reading this disability blog carnival over at ryntales.blogspot.com - its theme is "What Professionals Should Know" and most of the posts are by people with various disabilities and/or their caregivers. It looks fascinating!

http://ryntales.blogspot.com/2008/01/29th-disability-blog-carnival-what.html

Update: I just read the majority of the posts in full, and it kind of made me sad. Because the main theme, at least to me, was that most of the bloggers think that health-care providers (and other service providers) are just ignorant and mean people that need some basic etiquette lessons. I was appalled at the stories they all told. I'm not an expert and I'm just a student, but it seemed like all the things the readers thought "professionals should know" were primarily common sense things that apparently aren't so common sense. Things like parking a person in a wheelchair by facing them to a brick wall, laughing at a person who asks for their food cut up, and a ton of other horrifying stories. It's not that I think these bloggers are wrong - but it is sad to me that so many people have bad experiences. I'm not perfect by any stretch of the imagination, but I do my best to be thoughtful and compassionate to EVERYONE, disability or not. I do highly recommend people check out the carnival - pretty cool overall. Just wish there were more smart & nice people in the world. Occupational therapists, time to take over the world and make every thing better!

Rolling: Go watch it - perspective from people using wheelchairs

Go watch this documentary. Friends told me about it and it looks amazing. I'm going to try and watch it this weekend - it's viewable on the website listed below. The text is also taken directly from that website. It's based on three people mobilized by wheelchairs who video their life.


http://www.thirteen.org/rolling/experience/thefilm

Rolling

ROLLING was named best documentary at the Independent Film Project conference for works in progress, held in New York City. The film was also one of 14 new American films chosen by the Independent Film Project for screening at the European Film Market, which was held in conjunction with the Berlin Film Festival.

While Berland and her cinematographer both shot footage for ROLLING, the documentary is primarily filmed by the three participants via video cameras mounted on their chairs: Buckwalter, a clinical psychologist paralyzed at 17; Wallengren, a TV writer with five children who suffered from ALS (Lou Gehrig's disease), which stole his mobility and, finally, his ability to speak and breathe; and Elman, who was the business manager for a department at the UCLA School of Medicine until multiple sclerosis put her in a chair.

In the film, Buckwalter calls himself a "proud gimp" and says, "My blessings don't stop it from hurting." Each participant captures the joy of living as well as the pain. Buckwalter films himself practicing with his band, Siggy, camping with his wife and friends, stressing aching shoulders by repeatedly lifting himself in and out of his car, and during a frustrating doctor's visit.

Elman, the divorced mother of a daughter in medical school, is seen advocating for Californians for Disability Rights and a bill called the "V. Elman Community Living Act," which would make it easier for the disabled to live at home.

Wallengren is seen deftly coaching his sons' basketball team, dealing with awkward comments from well-meaning people at a birthday party, and using dry humor to deflect difficult situations.

"Even though the film started out as a way of understanding the experience of being in a wheelchair, in the end, it's really about life," says Berland. "It's not about feeling sorry for someone with a disability."

Karen and Brooke are soooo excited about OT student life

Karen and Brooke were fascinated by occupational therapy, and they loved being OT students. The day they learned their applications had been accepted to be candidates in the Assembly of Student Delegates Steering Committee was such a wonderful day, as evidenced by this picture. No aliens or artists in this almost true story! AOTA student members need to go vote at www.aota.org in the AOTA elections link. :)

MOT Class of 2010

The MOT Class of 2010 is getting into the swing of things...tons of anatomy, learning about Slagle lecturers, basic conditions such as cerebral palsy, and ten thousand definitions and explanations of the meaning of "occupation" (aka a purposeful, meaningful activity).

They all seem very sweet and I really like them!

You know you're tired when...

your bedroom light is on as you lie/lay/whatever in bed trying to get up the energy to get up, and you keep thinking - why do the lights keep going out? What's wrong with the electricity? And then realize it's just your eyelids slowly opening and closing.

Gonna be a long (but hopefully pretty fun) day! Yay OT school :) Time to get ready for the online management meeting in 20 minutes! Have a great day everyone!

PS: I'm as always a little behind yet again on e-mail/Facebook/any other method of communication - I promise to respond soon - maybe tomorrow! Woot woot!

Monkey vs robot will have to wait another day...OT school beckons :(

So...I had an intention of doing another blog blitzard, because I have a lot of small random things to share...but I just got home since being gone for 14 hours and I have to work on my management class strategic planning stuff and my leadership paper + deal with about a bazillion new school-related emails that need immediate attention. Seeing as how it's 11pm and I'm tired, I guess I have to prioritize for once! Boo!

Tomorrow or soon you can look forward to the age old OT question: "Monkey or Robot?", Caregiver Burden, a picture of the MOT class of 2010 that just started at my school, our superhero tech guy's glowing review of OT students, some e-mail copy/pastes from some fun readers, etc etc. Plus, of course, a crazy story with a picture, all about how you should vote for Brooke & me.

My tomorrow list:

830am: online management meeting
10am: class
noon: total body conditioning class w/ at least 5 other OT girls at the gym
2pm: learn to input our research data into research database
5pm: go to a fancy dinner with some very nce people who are treating lol
7pmish: Possibly hang out with OTS Virginia :)

Rest of the time: work on assignments! Stuff is starting to creep up!

PS: I thought it would be a good idea to do campaign songs American Idol-style and post them on YouTube, but my friends nixed the idea and said it would be annoying! :O

Mother of child with autism talks about her experience with occupational therapy...

A friend of mine has a nephew with autism. I asked her if she would ask her sister-in-law to write a little blurb about her perspective of OT as the mother of a young boy with autism. Here is word for word what she wrote. Thanks so much!!

Ethan only had OT  once a week for a month for an hour each session.  I had hoped it would have gotten started quicker but it was through the state and they had to do all the paper work to get it going.  Anyhow he really enjoyed going there...when we got there he wanted to go back immediately.  We liked the therapist real well and she seemed to know what to do and how to do it.  Ethan usually has to warm up to people but with her he was fine. 

She had him swing a lot in an airplane swing and on a flatform swing (I hope that is what it is called)  She would put in the airplane swing and do things like make the swing hit the wall to see what kind of reaction she would get from him and he liked it,  he thought it was fun.  She said some kids get scared and want out soon after.  On the flatform swing she would get on with him and there was a mirror that he could see his self in and she would sing to him and he loved it,  he just watched him self and laughed.  She would have him stand holding on to a bar and then sit holding on to the side ropes and then sit on his legs and then even put him on his belly some which he was nervous about but got used to it after awhile.  He also crawled through tunnels and went down a slide and she had him crawl back up the slide to make sure he could.  She helped him alternate this legs as he climbed.  She also got into a ball pit with him and it was deep and he couldn't touch the bottom...he hated it.  He wanted out every time they got in...he screamed with this activity.  She made him get out on his own which was hard but he got out.  She did lots of puzzles with him, which he loved and had no problems doing them.  She tested his hand/eye coordination and had him play with different things like blocks, shaving cream, scissors, markers/crayons ect.  She wanted to make sure he could stack so many blocks and she worked on him drawing horizontal and vertical lines.  She worked on using scissors and other activities like clothes pins to get him to use that sort of hand motion  She usually put him in those chairs (forget the name) that was like a highchair.  He did ok with the chairs but when he was done he was done.  She had him use this thing (again not sure what it was called) but it was to have him rotate his feet like he was riding a tricycle but he was standing while he did it and he had bars at the top to hold on to.  He really liked this and could do it just fine after he realized how to do it.

I always stayed with Ethan as she worked with him but I did see other Mother's leave but I was never given the option to do either or but I wouldn't have left him for anything because I am a worry wort and he has somewhat of an attachment to me (I have been told) That is about it unless I have forgotten something.  I was really impressed with the facility,  it was very professional yet comfortable.  Ethan really enjoyed going which also made it enjoyable for me.  I hope in some way this helps you.  I hope that you enjoy what you will be doing and I am so glad to hear that there are people who really want to help these kids.

The aliens want OT

I'm writing this from outer space. A few weeks ago, aliens came down and said that the only way they would leave peacefully without pulling "Independence Day" stunts was if occupational therapy students would go back to their home planet with them. You see, they observed our entire planet, and got jealous because these aliens have a lot of anatomical deformities that could helped with adaptive devices and home modifications. Of course, they wanted occupational therapy students that were enthusiastic and motivated - (cough the exact kind of OT students that would be great in the Assembly of Student Delegates Steering Commitee cough). So they flew here in their ultrared infrared maaxlox V30202 space cruiser and picked us up. They were nice enough to snap a Polaroid shot of our terrified faces because they had learned we liked photo documentation through their observations. Now we're used to this alien lifestyle, and we've made a ton of changes for them, and they say we can come home around February 20th, the last day AOTA student members can vote.

Ha, in your face, other professions...occupational therapy rules.

Breaking News Update, courtesy of my new friend Keith!

OT was #21 of the 31 best careers in 2008 by US News and World Report magazine!!!!!!!!!!!!

The OT world loves Brooke & Karen. So does Andy Warhol.

It was 1963. Karen and Brooke were but negative 20 year old twinkles in their parents eyeballs. Yet they already knew, way before they were ever born, that they were destined to become famous OTs. When finally born in in the late 1970s (Brooke) and early 1980s (Karen), they set on their path to OT famedom. They helped save the world many times over. Especially with their hard work for the Assembly of Student Delegates Steering Committee in the 2009-ish times. They were so inspiring that Andy Warhol used time travel to do his amazing artwork using their faces. Because Andy Warhol loved OTs. Just like everyone else should.  We should note that due to how the time-space continuum works, if Brooke and Karen are in fact not elected to ASD, the world may crumple in on itself and turn into a massive black hole. So. Perhaps people (and by people, we mean AOTA student members) should go vote for us within the next month.

http://www.aota.org/News/AOTANews/VoteHere.aspx

Rebuilding Together...OT students + home modification

A fellow OT student and blogger, Mama Chill, left the comment below on my Aging in Place Post. I want to share it. I had never heard of this organization, but it does sound like a great way for an OT student to gain some awareness and learning, while also helping others - a win-win! :)

Glad to see the posts again :) Hope classes are going well; mine starts tomorrow (just when I started getting relaxed too, I guess break is never long enough). Anyway, you may already be aware of this organization Rebuilding Together. Their focus is low-income, elderly, disabled and to help them stay in their homes by making home modifications and also ensuring homes are safe. Their website does a much better job explaining it; go check it out!

One of our professors is on the board for the local chapter and last semester we helped two families clean up/modify their homes. It was a great experience and gives great perspective that every OTS would benefit from. I know I learned quite a bit.

Finally...an update...gerontology continues.

Caption: I just got a drastic new haircut and I'm struggling with the swoopy bangs!

I'm sorry I haven't updated much lately. I normally go overboard and post TOO much and now I'm going underboard. Which probably means I'm drowning. Hmm.

Anyway...here are a few tidbits of things I've learned or thought about lately.

When you see someone sign their name Bob Smith, OTR/L....the R is referring to the fact they are certified through the national body, NBCOT....while the L stands for your state licensure, which not all states require.

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I was recently at a Mexican restaurant w/ a bunch of OT girls and when I went into the bathroom, I noticed it was not very ADA-complaint... somewhat unaccessible. The handicap sign was on a normal stall instead of the handicap stall, and the angles were so sharp that it would be very difficult to get in to the stalls. That's the kind of thing I never would have thought about before OT school. It's all about universal access!
------------------------

This is our geriatric semester, so we've had several lectures pertaining to the topic. One of our lecturers explained that in old age, we continue to be who we always were, only more so..." I took that to mean our personality characteristics become a little more exaggerated. We also did a chart of stereotypes of older people, looking at both positive and negative stereotypes. Typically, OTs are going to see the elderly person at their worst, since it is usually at a time of crisis/stress. We need to remember that we are just seeing one side of their personality at that time! I've talked about this before, but it's so important to do some decorating of an elderly patient's hospital room. Flowers, cards, PICTURES - things that remind the staff this person is loved and a real person, regardless of how low level he/she currently is.

We also learned about the difference between dementia and delirium - to condense a lecture into a sentence, dementia is more chronic and delirium is more acute.

We learned that white males over the age of 65 are most likely to commit suicide after a loss, and it is usually via violent means. As OTs we have to be aware of this statistic and look for warning signs! This is kinda scary to me.

Finally, we learned a little bit about Medicare/Medicaid. Honestly, this is still very confusing to me!!!!!!!!!!!!!

Part A - Medicare covers 80% of approved charges
Part B - out patient services
Part C - private Advantage programs like fitness?
Part D - prescriptions


*Typical student disclaimer: This is all my own understanding and I could be totally wrong. Don't trust me as a source!

UPDATE: My friend Suzanne sent me an e-mail with her more in-depth understanding of Medicare, which I am copy/pasting here.

Part A - This is the coverage for INPATIENT expenses only -- it pays 100% of approved amounts after a deductible, and is good for the first 60 days of hospitalization that are NOT broken up by a period of 60 days out of the hospital. If the patient is re-admitted within 60 days of their last hospitalization, they don't pay another deductible. However, if they then are hospitalized for days that add up to over 60 without a break ( i.e. days 61-90), the patient is in what's called their "Co-pay" days. For each of these days, the patient is assessed a "co-pay", I don't know the amount any more, but I think it's about 20-25% of the deductible. If the patient remains hospitalized beyond 90 days, they go into what are called "Lifetime Reserve" days, which are finite. If you use Lifetime Reserve days, you never get those back, and you are charged 1/2 of the inpatient deductible for every day in the hospital. You could use some of your Lifetime Reserve days, stay out of the hospital for more than 60 days, then your "normal" days would start again (deductible at the beginning of the stay, good for 60 days, etc.). I could be wrong about some of this
Part B - Out patient and PROFESSIONAL (doctors, etc.) services covered at 80% of approved amounts after the yearly deductible.
Part C - This used to be for children whose parent's status qualified them for Medicare. For example, a retired person who has a retarded, dependent but adult child -- the adult child would be the one who qualified for Medicare Part C, with the ID # being the parent's SSN + the letter C after.
Part D - prescriptions

Medicare numbers with an A after have full inpatient and outpatient coverage; with a B means they ONLY have Part B (no hospitalization); C used to mean child, and is the equivalent of having full coverage; I'm not familiar with Part D now, though I do know that's the prescription drug part of it.


NEW UPDATE: My friend wrote the following regarding the statistic above of men over age 65 being most likely to commit suicide.

I can't speak for the Gen Y people - the ones your age and younger and how they will behave when they grow older, but I feel pretty comfortable talking for those who are now in their 30's and older. Guys are "doers" and when they can't "do" anymore then life loses the majority of its meaning. Doing can mean anything too. It is something special and unique to that person. It could be carpentry or driving or even something really esoteric like being able to multiply three numbers by three numbers in your head. Life without meaning is not life.

It does not mean much to us just to hang around and watch the grandchildren and great grandchildren if we can't "do" something with them. Part of it is culture and upbringing and part of it, I swear, is genetic.

Also a "loss" usually means someone has to take care of the individual. Unless the individual is wealthy, that usually means the spouse. No male at 180 pounds wants to inflict looking after them over the long term on their 120 pound spouse. The nuclear family and/or extended family is no longer there. They are spread to the winds, so only rarely are you going to see brothers, sons and nephews participating. No loving husband wants to inflict this on his spouse. Also, suicide is not the "sin" it used to be. You don't go straight to the really warm place anymore.

As to why it is predominately true for whites, I can only speculate. In the Asian culture, the male is still so predominant that it may not occur to them that the caregiving is such a sacrifice to the spouse. Also families are still more close than in the non-Asian cultures.

In African culture, I believe there is still a greater religious and cultural intolerance to suicide, at least in African Christian culture. Past that I do not know.

As to the violent means, that's because we know what works. It may be messy but you can control where the mess is, i.e. the backyard or an interstate bridge abutment. You control the where and the when. Pills and alcohol or sticking the head in the gas oven is too easy to screw up where you either fail or screw yourself up worse to where you are still alive but now are totally incapacitated. A round through the back of the throat or aiming the pickup at a bridge abutment and going to warp works every time.

You need to read "Born Fighting - The Scots-Irish in America"; it will give you some good cultural insights.

These are just my thoughts with no scientific basis to back it up. A lot of the conclusions come from the suicide a long time ago of a great-uncle who was a M.D.

Occupational Therapists Kick Some New York Times Bootie :)

This was copy/pasted to the Tennessee Occupational Therapy Association (TOTA) listserv, and I am again copy/pasting it, since it is a great example of OT. This article is from the New York Times and there are links to it are at the bottom, since full articles are accessible online.

In the Trenches the Occupational Therapist
Coaching the Comeback

By JAN HOFFMAN
Published: January 15, 2008

WEST ORANGE, N.J. - In the therapy gym for the minimally functional, Jodi
Levin props a patient between cushions, kneels behind him and then braces
him with her arms. She directs his mother to select photos of his brother
and his father. At the coaxing of Ms. Levin, an occupational therapist on
the brain injury unit of Kessler Institute for Rehabilitation, the mother
holds one photo to the left side of the patient's head, the other to the
right.

"Look at Dad's picture," Ms. Levin urges. "Dad's on the left. Find Dad. You
can do it!"

The patient, wobbly and glazed, tries mightily to understand her command and
then heed it by compelling his neck to turn. He almost makes it.

Gently letting him go, catching him as he flops, Ms. Levin explains to his
mother, "Now I'm working on trunk control." The man flinches. "It's the
basis of everything," she continues. "For getting in and out of bed,
brushing teeth, getting dressed."

Eight weeks earlier, the patient, 18, wearing a helmet and protective
leather gear, had been riding his motorcycle to community college. As he
came over a hill, the car in front slowed abruptly; to avoid hitting it, the
teenager swerved and was hit by an oncoming car.

Remarkably, his body survived relatively unscathed. But he suffered a severe
traumatic brain injury. He cannot yet swallow food, control his bowels or
regulate his body temperature. His brain cannot yet send messages to his
limbs. He cannot speak.

When he arrived here, his eyes were open but unseeing. He has already come a
long way.

His care is overseen by neurologists and physical medicine doctors. But it
is the job of Ms. Levin, his occupational therapist, to plan exercises that
will help him develop or adapt skills to live as safely and independently as
possible. She also educates and supports family members as they adjust to
their loved one's new normal.

Now Ms. Levin puts her grimacing patient, who wears nerve stimulators 12
hours a day, onto a therapeutic exercise bike. The machine moves the pedals,
but as he initiates more movement, it will calibrate. She straps him in,
jesting, "I can't wait for you to yell at me and tell me this stinks."

The boy's mother watches Ms. Levin tearfully. "Some people talk around my
son as if he's not there," the mother says. "But Jodi talks right to him."

Ms. Levin, 28, has worked on the brain injury unit here for six years.
Daily, she confronts the fallout from behavior that has been reckless or
cruel, with injuries caused by drug overdoses, drunken drivers and drive-by
shootings. Many of her patients have had strokes or brain tumors. She has
also treated Iraq war veterans, who are now trickling into nonmilitary
facilities like Kessler largely because of the persistence of their
relatives.

Her treatment plans adjust to the serendipity or horror of a split second: a
hit during a football game, a slip on an icy patch, a veering car. Annually
in America, there are 1.5 million traumatic brain injuries, a category that
includes external blows to the head but excludes damage caused by illness.

The extent of destruction to a brain, the possibility of recovery for each
patient, hinges on so much - and so little. Ms. Levin's definition of
optimism for one patient may be regaining the ability to drive. For another,
it may be the ability to blink in assent.

When patients sustain frontal lobe injuries, their personalities can be
affected. They may unexpectedly become agitated or angry and have difficulty
filtering inappropriate language. On occasion Ms. Levin's hair has been
pulled. She has been kicked, groped and bitten. "The families are so
embarrassed," she says. "I keep explaining that it's the brain injury, not
the patient."

Yet even in her brief career, there have been advances in occupational
therapy, which can address many mental and physical disabilities. Ms. Levin,
who has a master's degree in the field, has been adding computer-generated
programming to her capacious toolbox, which includes blocks, flash cards and
cutlery adapted for stroke victims. The prognosis for many patients is
improving.

At the same time, though, insurance companies are demanding more frequent
updates, with proof of functional rather than cognitive progress. Otherwise,
requests for further therapy may be rejected.

In reality, Ms. Levin says, cognitive ability often precedes functional
progress. "A young brain won't plateau at month two or three," she says in
frustration, during lunch break. "Recovery from a brain injury is not like
the flu. It takes a long, long time."

On this early day in the new year, Ms. Levin has seven patients. Three are
18-year-old men. The winter holidays often bring a surge of adolescent
patients and their victims to acute rehabilitation centers. Elsewhere in the
unit's two gyms, therapists work with patients who were passengers in car
accidents. Another influx of this kind of patient tends to arrive shortly
after spring break.

Her second teenage patient, a bright high school athlete, went to a party at
which prescription and illegal drugs were swapped. He was the only youth
there whose body reacted starkly. He went into cardiac arrest and his brain
lost oxygen, before doctors were able to revive him.

During his session this day, Ms. Levin places her face close to his, and
makes simple, cheery conversation, trying to hold his gaze. "Hi!" she says.
He stares back, eyes widening, eyebrows raised in concentration and effort.
His jaw lowers. "Hi," he mouths silently.

"That's a breakthrough!" she says joyfully.

Ms. Levin sets weekly achievable goals for her patients. "I invite families
to watch my sessions," she says, "so when they visit, they don't say, 'Is
that all he can do?' I want them to see how hard the patient is working to
achieve holding up his head."

She sees her third 18-year-old in an adjoining gym for more functional
patients. The boy is healing from an operation in which doctors temporarily
removed a section of his skull to accommodate brain swelling. His jaw is
wired shut. He has visual and cognitive impairment.

In early December, he drove after having a couple of drinks, crashed, flew
through his windshield and hit his head.

But last week, after interviewing his family about his activities, Ms. Levin
had him playing tennis with a balloon. A few days ago, he halted his
wheelchair before a vending machine, correctly counted his coins and got a
soda. On this day, holding a trained therapy dog by a leash, he walks
haltingly across the gym. She hands him a word-search exercise: he picks out
three-letter words. By the end of the month, Ms. Levin expects him to go
home and to start outpatient therapy.

"He's a miracle," she says.

As for her feelings about his own role in his injury, Ms. Levin says,
"Everyone deserves a second chance to redeem themselves." Nonetheless, she
adds, she would like to show videotapes of her patients to high school
students.

One patient in particular haunts her. He was a 21-year-old drunken driver
who survived a terrible accident. After many months, he left Kessler in good
shape, mentally and physically. Ms. Levin happened to work a rotation in an
outpatient clinic and continued treating him.

"He'd come in and boast, 'Hey Jodi, I was out drinking last night, blah,
blah, blah,' " she recalls. "He was my biggest failure."

She glances around the gym, at therapists and doctors working with patients
in various states of alertness. A father tenderly kisses a young woman on
the forehead as she stares vacantly. An elderly woman tries to sort plastic
knives from forks.

"I had a young boy, about 20, who had been in a car accident," Ms. Levin
says. He had been driving at night, was blinded by headlights and, in the
ensuing crash, was ejected.

He was in a coma. He had brain surgery, plus broken legs and wrists. Ms.
Levin treated him for three months. He left Kessler with a walker. During
her outpatient rotation, she continued working with him.

"He still has memory deficits," she says. "He repeats himself. But he covers
it well. He can drive now, and he has a job stocking shelves."

The accident was three years ago. He talks of going back to college, perhaps
to study occupational therapy. "He called recently and said, 'Can you help
me find an O.T. school that will accept me?' "

She smiles tremulously. "When you have one good patient like that," she
says, "he sticks in your head. He gives me my drive. I think, 'It can
happen.' "

---2008 The New York Times Company

See Audio Slide Show (Flash) --- "Retraining the Brain" / "In the Trenches
the Occupational Therapist"

http://tinyurl.com/39nksg or

http://www.nytimes.com/interactive/2008/01/14/health/20080115_TRENCH_FEATURE
.html#section1

Also find photos and a link to email the author with the article online
here: http://tinyurl.com/3cy7dv or

http://www.nytimes.com/2008/01/15/health/15tren.html?_r=2
<http://www.nytimes.com/2008/01/15/health/15tren.html?_r=2&oref=slogin&ref=n

Hola, occupational therapy students... Yo soy Karen...no me gusta Muzzy...

I was in the Special Care Unit of the local pediatric hospital, holding a fussy baby less than a year old. I was standing up with him in my arms, next to his crib since the tubes only go so far. I was kind of gently dancing with him as his TV (which I forgot to turn off) showed Pooh & his friends dancing. He hadn't been very responsive to my coos and singing.

Then my eyes were drawn to some sort of game near the crib - it was in Spanish. Anyway, inspiration struck, and I realized maybe he was more used to Spanish. So I said to him the only thing that popped into my brain at that time...

"Hola, donde esta la biblioteca?" (Hello, where is the library?)

Yeah. It didn't work...



*I've had Spanish most of my life...but when I spent my year in Norway it took over the Spanish part of my brain and now when I try to think in Spanish, Norwegian words come up instead...ugh.
*This was while volunteering - although I get to shadow an occupational therapist next Friday morning there! Yay! I cannot wait to both shadow AND volunteer there!

Vote Karen Dobyns for OT Vice-Chairperson!

VOTE Karen Dobyns for OT Vice-Chairperson!

Occupational Profile

Name: Karen Dobyns ("Miss OTPF 2008")

A/S/L: 25 year-old 2 ^nd-year MOT student at the UTHSC, Memphis.

Reasons for Service

Strong desire to be OT Vice-Chairperson for the Assembly of Student Delegates Steering Committee

Occupations, Performance Patterns, and Roles:

· Reigning "Miss OTPF 2008" & its required duties

· Promoting the Centennial Vision as an enthusiastic OT student

· Holding an online job that require communication with colleagues nationwide

· Blogging daily about life as an OT student at otstudents.blogspot.com

· Serving as Co-VP of Academic Affairs for her dual-campus program

· Uploading OT videos to YouTube & OT pictures to Facebook

Activity Analysis of Role of OT Vice-Chairperson
Assisting the chairperson, serving as historian and parliamentarian, helping communicate student concerns, and facilitating communication between OT schools, delegates, and Steering Committee members.

Evaluation of Karen's potential ability to meet these activity demands:

Karen shows great strengths in the areas needed to perform this role successfully. She is dedicated, efficient, and has a lot of experience in communicating with others all over the country. She cares deeply about occupational therapy and truly believes in promoting the Centennial Vision. She would do a good job of making sure communication lines stayed open. I believe she has the occupational experience, process skills and client factors necessary to be OT Vice-Chairperson!

Signed, Voticia Forme, OTR/L, 1/17/2008

AOTA Student Members Can Vote January 14^th – February 20^th, at http://www.aota.org/news/aotanews/votehere.aspx

Vote for Brooke Ward, AOTA student members!

Brooke Ward is the Class President of our MOT class, and she is an amazing friend! She manages to efficiently handle everything that is thrown at her, and she is frequently chosen as a representative for the school. She is running for Communications & Advocacy in the Assembly of Student Delegates Steering Committee elections. Please vote for her, AOTA student members! You can get to the voting site by clicking the AOTA elections link on the main www.aota.org site, then clicking "Vote here" for ASD Elections.

Here is a link to her facebook group...
http://tennessee.facebook.com/group.php?gid=8498876629

And check out the cool flier above!

ASD Elections Start Today - AOTA Students, vote!! Please!!

If you are an AOTA student member, PLEASE go vote for Karen Dobyns for OT Vice Chairperson, and Brooke Ward for Communications & Advocacy!!! For the Assembly of Student Delegates Steering Committee!

 

http://www.aota.org/News/AOTANews/VoteHere.aspx

 

Fliers tonight, I am at school right now!!!!

AGING IN PLACE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! OCCUPATIONAL THERAPISTS CAN HELP!!

Dum dum dum...AGING IN PLACE! FINALLY! Most of you have probably aged considerably since I first promised this post a few days ago. Or weeks ago. I have no concept of time. Anyway.

We had a recent lecture on this, and I'm just going to hit a few high points in terms of interesting stuff...just my own understanding on how "aging in place" works based on lecture, textbook, and my own ideas....

First of all, we all hear in the news about how the Baby Boomers are aging and since there are so many of them, that's an issue we need to really face. And it's not like people beg to go into nursing homes - ideally, it seems like most people would want to "age in place" and have their home be accommodating to their growing gerontological needs. People thrive in their own homes, with their own furniture and their own memories, rather than being in sterile and impersonal (or at the very least, unfamiliar) environments. If architects, contractors, and the general population started asking for universal designs or homes that could easily accommodate changes, life could get a lot easier for people. Most people just don't think about it until it is too late - either they no longer have the money, or the energy, or the ability.

Some modifications are simple and somewhat cheap - non-concrete wheelchair ramps, grab bars in the bathroom, lever handles instead of door knobs elevated toilet seats, firmer and higher furniture, etc. Other modifications go a lot more in-depth and can include widening hallways for wheelchair access, concrete wheelchair ramps, raised dishwashers, enlarging the bathroom, building a roll-in shower, making counters that can go up or down with a button, and more.

Basically, someone could go to an OT (especially one who specializes in this kind of thing) and say, hey, I have these issues, or my house is like this - how can we make my house universally accessible, or how can I at least make some changes that will make the aging process a little easier to handle? Based on the person's budget and remodeling possibilities, the OT can take various routes with it, from recommending certain assistive devices to a huge remodel. Obviously, the OT is not the one actually doing the construction - an architect and trusted contractor are needed for this part of it.

Home modification can seem pretty simple, but it can be the difference between being able to live at home in peace for many more years, or having to go to a nursing home. This is especially huge for the growing population of Alzheimer's patients, who do best with old memories and routines - the change to a new routine and house arrangement can be very confusing and difficult.

So...my post was possibly rather anti-climactic after the big build-up...go Google "Aging in Place" to learn more, and realize that occupational therapists can play a big role in helping with transitions, adjustments, modifications, suggestions, etc. Dear Abby needs to start recommending OTs for all the concerned sons and daughters who write in about their parents!

I'm going to c/p several comments I got when I first mentioned "Aging in Place", because I really appreciated the input!

aginginplace has left a new comment on your post "Part 2 of our 1st few days of OT school...with OT ...":
I am an "aging program specialist" with the U.S. Administration on Aging. My expertise is in neighborhood programs for older adults living independently regardless of their challenges in doing so. I use the Google feature of tracking web information on the topic of "aging in place" and your blog appeared in my report this morning. I am glad you found the topic of interest! Sometimes students in the health professions see only older adults with physical and mental health limitations. I work full time at age 66, but in my small agency of less than 100 professionals, we have two full time WWII veterans - one 86 and the other 90! However all of us "older folks" are really appreciative of what you are learning and what you will be doing for seniors (and others) in the future!
-------------------------------------------------

From Keith, who also appreciates OT students, and keeps giving me ideas for posts!: It was great to read about the aging in place discussion. I'm a proponent of that concept and live it every day. Well, not the aging part, LOL, but the concept of having attendants in the home, workplace, home modifications, etc. This past summer, I had a semi-automatic door installed at my house. The remote control is velcroed to my wheelchair's control box. Velcro is a miracle fabric!

I'm going to go for the night. Tomorrow, be prepared for REALLY COOL ELECTION FLIERS!!!!!!!!!!! OT STUDENTS, GO TELL ALL YOUR FRIENDS!