Tuesday, July 9, 2013

Passing the NBCOT...

I am a COTA. After two years of school and studying to pass the NBCOT it all comes down to trying to find a job.

Wednesday, April 24, 2013

Home Sensory Diet for Kids


 The following information was provided to me by a COTA in the CESA 4 school districts

Home Activities

·        Wall pushups while counting to 10, 15…/reciting alphabet
·        Jumping jacks (can spell words, count…while jumping)
·        Crab walk
·        March from one place to another
·        “seat walk” while sitting on the floor with legs extended
·        Play doh-squeeze, search for hidden objects such as beads, buttons
·        Walk around the room while balancing a small object on head or shoulders.  Can use a small stuffed animal, rolled up sock
·        Crawl around the room while balancing a small object on shoulder or on back
·        Stand in a doorway, place right hand on the right side of the door frame and left hand on the left side of the door frame and push.  This can be turned into a game by pushing for each letter of the alphabet, counting to 10…
·        Carry laundry basket/box with something inside for weight (not too heavy-less than 5 pounds). 
·        Push a box (with something in it) with feet while seated on the floor.  This can be turned into a game by designating a “finish line” and timing how long it takes from start to finish
·        Put weight (books) on a blanket and pull around
·        Roll up into a blanket and unroll (“like a taco”)
·        Crawl under sofa, chair cushions
·        Dig in sandbox
·        Rake
·        Sweep
·        Chew on crunchy foods (as diet permits) such as carrots, celery, apples, nuts…
·        Chew on chewy foods (as diet permits) such as raisins, dried fruit…
·        Eat foods with strong flavors (as diet permits) pineapple, grapes…
·        Drink through straw (as diet permits) milk, juice, water,(especially thick liquids) smoothies, shakes,

Tuesday, April 23, 2013

Sensory Tunnel

My second fieldwork rotation is with CESA 4 school districts in Wisconsin and for a project I created a Sensory Tunnel.

Hint (learn from my mistakes) diameter and circumference as not interchangeable words.

20 inch diameter is too big for most children 3 to 10 years old. 18 inch diameter works well.

My tunnel has lycra and swim suit fabric - because....

Either I am cheap - swim suit fabric is cheaper than lycra.

Or I didn't purchase enough the first time and when I went back to the store they didn't have any lycra to match left.

The kiddo's have been having a great time getting proprioceptive, vestibular and tactile input while improving their motor planning, body awareness, and balance.



Saturday, March 23, 2013

Morning Cares


Morning Cares....

As a non-traditional (aka old) OTA student on my first FW II rotation - I have found that instead of setting a 8 1/2" x 5" sheet of white paper onto the clients table top stating

Dear ____________
     Tomorrow _______ morning __________ from Occupational Therapy will be assessing you for morning cares at _________ A. M.  She will help you wash, dress and get ready for the day. If you wake up early, feel free to eat some breakfast.

Thank you



An 8 1/2" x 5" sheet of yellow paper displayed with a photo clip works is easier for residents at the SNF to see and remember. Also by changing the wording those residents with test anxiety seemed to be less intimidated.

Dear ___________________
  Tomorrow- ___________ morning__________ 
  from Occupational Therapy will be in your 
  room at _______ A.M.   She will help you 
 wash, dress and get ready for the day.
If you wake up early, feel free to eat some breakfast.                                             
   Thank You




I also added a few simple morning ADL graphics to serve as a visual cues for those with lower cognition.

Non Traditional Student



What is an non-traditional student?

A non-traditional student
could be a 52 year old woman enrolled in an occupational therapy assistant
program.

No, I didn’t lose my job.
I retired. After 30+ years of key strokes, copies and coffee... I was restless
and needed to embark on a new career. I
will always write, but I also wanted to do something that brings me into
contact with people, do a job or perform a service that makes a difference in
someones life.

In May of 2011, I began my
journey with a summer class - Anatomy and Physiology. I learned why there is a jar of peppermint
wrapped candies outside of the cadaver room.

The Fall semester included:
Written Communication, Introduction to Occupational Therapy, Activities and Analysis,
Developmental Psychology and Medical & Psychosocial Conditions.

I learned

Which of the following is a reason why men and
women cite satisfaction with their marriage
?

The answer I Selected: they stated that their spouse is their best
friend

And I got the big RED X

According to the test
results the 
Correct
Answer
 was:



They state that their spouse has sex with them as
often as they want

And this is why I write
Romance.

Who's at risk for falls in SNF?


Who's at risk for falls in SNF? ABC Confidence Indicator


On FW II rotation I have notice that some patients are worried about falling and I had a couple of clients complete the ABC confidence indicator - but what I noticed was the test did not give me any information on how to increase their confidence.  

I was also a little concern because this is a smaller town and some of the questions didn't seem to apply. There is no escalators any around this area nor are they any malls, so I wasn't so sure how well the clients could relate to all the questions.  So, I did a little research and discovered there was also a shorten test and I was excited until I read the questions...   again 2 of the 6 questions were about escalators. 

ABC Confidence indicator 16 questions.

The Activities-specific Balance Confidence (ABC) Scale*
For each of the following activities, please indicate your level of self- confidence by choosing a corresponding number from the following rating scale:
0% 10 20 30 40 50 60 70 80 90 100% no confidence completely confident
“How confident are you that you will not lose your balance or become unsteady when you...
  1. ...walk around the house? ____% 
  2. ...walk up or down stairs? ____% 
  3. ...bend over and pick up a slipper from the front of a closet floor
    ____% 
  4. ...reach for a small can off a shelf at eye level? ____% 
  5. ...stand on your tiptoes and reach for something above your head?
    ____% 
  6. ...stand on a chair and reach for something? ____% 
  7. ...sweep the floor? ____% 
  8. ...walk outside the house to a car parked in the driveway? ____% 
  9. ...get into or out of a car? ____% 
  10. ...walk across a parking lot to the mall? ____% 
  11. ...walk up or down a ramp? ____% 
  12. ...walk in a crowded mall where people rapidly walk past you?
    ____% 
  13. ...are bumped into by people as you walk through the mall?____% 
  14. ... step onto or off an escalator while you are holding onto a railing?
    ____% 
  15. ... step onto or off an escalator while holding onto parcels such that
    you cannot hold onto the railing? ____% 
  16. ...walk outside on icy sidewalks? ____% 
*Powell, LE & Myers AM. The Activities-specific Balance Confidence (ABC) Scale. J Gerontol Med Sci 1995; 50(1): M28-34

There is also ... 

The Short Activities-specific Balance Confidence (ABC-6) Scale
For each of the following activities, please indicate your level of self-confidence by choosing a corresponding number from the following rating scale:
0% 10 20 30 40 50 60 70 80 90 100% no confidence completely confident
“How confident are you that you will not lose your balance or become unsteady when you...
  1. ...stand on your tiptoes and reach for something above your head? ____% 
  2. ...stand on a chair and reach for something? ____% 
  3. ...are bumped into by people as you walk through the
    mall?____% 
  4. ... step onto or off an escalator while you are holding onto a
    railing? ____% 
  5. ... step onto or off an escalator while holding onto parcels
    such that you cannot hold onto the railing? ____% 
  6. ...walk outside on icy sidewalks? ____% 
* Peretz, C., Herman, T., Hausdorff, J.M., Giladi, N., 2006. Assessing fear of falling: can a short version of the Activities-specific Balance Confidence scale be useful? Mov. Disord. 21, 2101–2105.


5. Conclusion
These results not only indicate that the ABC-6 is a valid and reliable measure of balance confidence in community-dwelling older adults, but also that the short scale shows stronger relationships to falls than does the ABC-16. The ABC-6 may be a more useful balance confidence assessment tool than the ABC-16 in busy clinical or research settings, where timely, valid, and reliable assessments of balance confidence and screenings for balance impairments and falls risk assessment measures are necessary.

Retrieved from website:

Letter to my daughter


Letter to my daughter an OTR


My daughter is an OTR and talked me into going to school to be an OTA.  One day she called me and complained of an especially tough day... Being her mom and an OTA student, I sent her the following hoping to add a little humor to day:  

Top ten reasons for not meeting productivity.

I failed to meet my productivity standards today because...

10:  I left my de-coder ring at home and was unable to decipher illegible daily notes of co-worker.

9:  I was counseling co-worker on how daily notes without tears begins with properly formed and spaced letters.

8:  I was collaborating with colleagues on how to decrease co-worker's death grip on black inked instrument.

7:  I spent excessive time writing cognitive goal to improve the memory of my computer to increase the computers ability to recognize my user name and password.  

6:  I was reading through Obama proposed relaxation techniques to increase the governments ability to wrestles the guns from our NRA clients.

5:  I was administering the "Time Up and Go" and patient up and went...I lost productivity tracking patient down.

4:  I suggested proper positioning for Hilary while negotiating treaties in Kashmir.

3: I was consulting with Clay Matthews on sock aid removal for Colin Kaepernick's helmet.

2:  A short pencil is better than a long memory and I jotted down those items that will help me, help my patient live life to the fullest.

1:  I took a bathroom break.

Fun Activity - bilateral hand and standing tolerance


For less than $7.00 I purchased the children’s socks and the laundry basket. (70% off valentine day socks and 3 packs from the dollar store).

This activity worked well for the three patient I had try it - they were able to perform the task by matching the socks and rolling the socks together while standing. To perform the task they had to let go of the walker and use both hands, they were engaged in matching the bright colors and the different patterns. One of the patients has very low cognition secondary to Alzheimer's and when given one step directions had trouble matching a red block to a red square, yet when given the socks she was able to stand and match 13 pairs. 






Dynamic standing with w/w (CGA, SBA) and unilateral and/or bilateral integration hand hold, to increase ROM and Independence for ADL’s. Stood for  ______ minutes with ____ rest breaks with ______ balance*.  

Dynamic balance, SBA with w/w performing 2 handed task with G/N balance, stood 10 minutes with rest breaks.

Peg Board 
Cooking
Washing Dishes
Folding Clothes
Matching and Folding Socks
ADL’s standing at sink for _____minutes  - brushing teeth, combing hair, washing face.
Catch With A Ball (harder and faster to catch)
Hitting A Balloon, (lighter, unpredictable)
Cards, solitaire, war (matching suits or colors, sequencing numbers)
Word Search
Arm Bike



  • Balance Grades (static & dynamic)

N 100% intact

G may be slightly imparied, but “never” loses balance - may stabilize self
G- occasional loss of balance, but able to independently regain balance

F+ occasional loss of balance, but able to indptly regain with occasional contact  guarding  (CGA or FIB)
F requires constant guarding to maintain balance
F- requires minimal assistance to maintain balance

P+ requires MODERATE assistance to maintain balance
P requires MAXIMAL assistance
P- is nearly dependent for maintaining balance
P-- is completely dependent for maintaining balance

I no assistance at all


Standing Balance

Static Maintaining a posture without movement
Dynamic Movement in a posture
Supported Sitting - Patient has back support or at least one extremity touching a  surface.

Standing - Patient has more than 2 extremities (i.e. assistive device)  touching the floor.

Unsupported Sitting - Patient is able to sit without back support or support of extremities on a surface

Standing - Patient has only 2 extremities touching the floor. Close supervision - Stand right by the patient


Contact guard or F.I.B (finger in belt) hand on person
MIN A - pt does most of procedure (90%)
MOD A - 50/50%
MAX A - therapist 80%, patient 20%
D - Dependent patient is of no help at all

SNF daily notes for UE Exercises and Increase Standing Tolerance


SNF daily notes for UE Exercises and Increase Standing Tolerance


UE Exercises Activities

Arm pulleys
Thera-band
Dowel
Arthritis ROM exercise
Hands on Wall
Walk fingers up the wall

(One of my daily notes:) Bilateral UE exercise with arm pulleys to increase I safety with ADL’s, transfers to toilet, bath and car. 5 min x 2, O2 levels 94-92 and HR levels 60-63. Dynamic standing 10 min with rest breaks and bilateral hand task. )
Dynamic Standing Activities


Peg Board 
Cooking
Washing Dishes
Folding Clothes
Matching and Folding Socks
ADL’s standing at sink for _____minutes  - brushing teeth, combing hair, washing face.
Catch With A Ball (harder and faster to catch)
Hitting A Balloon, (lighter, unpredictable)
Cards, solitaire, war (matching suits or colors, sequencing numbers)
Word Search
Arm Bike


(My Notes:)Dynamic standing with w/w (CGA, SBA) and unilateral and/or bilateral integration hand hold, to increase ROM and Independence for ADL’s. Stood for  ______ minutes with ____ rest breaks with ______ balance grade*.  


  • Balance Grades (static & dynamic)

N 100% intact

G may be slightly imparied, but “never” loses balance - may stabilize self
G- occasional loss of balance, but able to independently regain balance

F+ occasional loss of balance, but able to indptly regain with occasional contact  guarding  (CGA or FIB)
F requires constant guarding to maintain balance
F- requires minimal assistance to maintain balance