Journey of non-traditional student in OTA

Monday, January 13, 2014

I have been busy working on a number of items

The Sensory blanket has matching bean bags filled with different materials, rice, beans, popcorn seeds. Besides having different textures of material the weight and fill for each bean bag is different.

I can spread the blanket out and the kiddos can toss the bean bag towards the matching square...sometimes we just use the blanket to be prone for tummy time activities and sometimes we just use the bean bags and pretend they are pigs.

We set the bean bags on top of blocks, empty plastic milk jugs and we stand a large cylinder bolster on its end and puts some pigs (bean bags) on top - this helps with overhand throws to have something that is at shoulder height to aim at. We take a dozen plastic balls from the ball pit and these become or angry birds. Place a hola hoop on the floor 3 to 5 feet away from the display of pigs (bean bags) and the kiddos have fun trying to hit the pigs. Of course when the dozen balls have been thrown they do like to physical rush the display and knock the remaining pigs down with their body...also acceptable.

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...

...walk around the house? ____%
...walk up or down stairs? ____%
...bend over and pick up a slipper from the front of a closet floor
____%
...reach for a small can off a shelf at eye level? ____%
...stand on your tiptoes and reach for something above your head?
____%
...stand on a chair and reach for something? ____%
...sweep the floor? ____%
...walk outside the house to a car parked in the driveway? ____%
...get into or out of a car? ____%
...walk across a parking lot to the mall? ____%
...walk up or down a ramp? ____%
...walk in a crowded mall where people rapidly walk past you?
____%
...are bumped into by people as you walk through the mall?____%
... step onto or off an escalator while you are holding onto a railing?
____%
... step onto or off an escalator while holding onto parcels such that
you cannot hold onto the railing? ____%
...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...

...stand on your tiptoes and reach for something above your head? ____%
...stand on a chair and reach for something? ____%
...are bumped into by people as you walk through the
mall?____%
... step onto or off an escalator while you are holding onto a
railing? ____%
... step onto or off an escalator while holding onto parcels
such that you cannot hold onto the railing? ____%
...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:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883646/ on February 6, 2013.

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

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

Saturday, January 14, 2012

Professional Behaviors

Chapter 3 from "The Successful Occupational Therapy Fieldwork Student" is all about professional behaviors and in reading the chapter I did not learn anything I didn't already now, but I think when it comes to OTA and working in any other field there is going to be a lot of similarities - because no matter what you do...you have to interact with people, clients, boss, co-workers and you run into people you are going to like and people you don't...the trick to making it in this world is making sure "people" don't know if they are on the liked side or the disliked side.

I know that my attitude is important and my job is to smile, listen, observe and instruct the client all in a positive way. And if asked how I am doing, I will respond with a phrase that has done a lot to shape how other view me...and remember me as always saying, "I am living the dream."

Doing fieldwork as an SOTA is not something I am concerned with: I have a professional demeanor, I understand about ethics and confidentiality because I was an administrative assistant in human resources.

Wednesday, January 4, 2012

Domain and Process

How do the Domain and Process differ? …work together?

The domain would be the areas that OT and client have identified to be an occupation, (ADL, IADL, Education, Leisure, Social Participation, Play, Work, Rest/Sleep) something that is important and adds meaning to the client’s life. The domain supports a client’s participation in a healthy life style which means their ability to participate in their chosen occupation.

The process includes evaluation, intervention and outcomes. The evaluation would include the profile, a client’s strengths, weaknesses and motivation along with the client’s concerns about why they are seeking service and what they hope will be the outcome. Also part of the evaluation would include observation of the client as he/she participated in their occupation. At this time the OT could determine if more assessments were needed or if they had enough information to create an intervention.

The intervention would include what services were needed and how those services should be delivered and what the outcome should be, during the intervention there would also be a review process where the outcome could be revised along with the services being delivered.

The final part of the process would be the outcome; “engagement in occupation to support participation” The outcome could include if the client was able to do their occupation easier/better, if the client was satisfied, if the client obtained health and wellness, or learned prevention or improved the quality of their life.

Without the Domain a person could create a Process for a client (at assisted living with a meal plan/or at home with a meals on wheel program) which could mean being able to cook/bake hot meals for themselves, but if the client didn’t want to learn to cook/bake and were content eating meals already prepared – the client might learn new skills but the skills would not transfer to their occupation. And without the process just identifying occupations a client wants help with but not having a plan or a way to determine if they are successful would be like giving every client in OT a library card and telling them all the answers are just through the door. Yes, the client would have the information but no way to apply the information to their own life.

• In your own words, what is the “occupational profile”?

The occupational profile is kind of like the 5 W’s the fundamental questions of journalism. (Who, What, When, Where, Why) The occupational profile will include (Who, Why, What, What, What…) Who is the client? Why is the client seeking services? What occupations have they been successful/unsuccessful at? What is the desired outcome? What concerns does the client have? What areas of their environment, culture, social, physical, personal or spiritual will help and what areas will hinder in obtaining the desired outcome. When would the client like to be able to achieve their desired outcome?

My definition of OTA

Occupational therapy is using meaningful, graded activities to help a person reclaim something they feel is missing or lacking in their lives. Occupational therapy helps a person reclaim independence through daily living skills, social interaction and meaningful occupation--making them feel whole once again.

Occupational therapy is allowing people to have their cake, make their cake and eat it too!

Below is my daughter's definition...

“Occupational therapy helps people return to doing activities that make up their life. Occupational therapists are experts at breaking down tasks and understanding how to change the task in order to allow a person to complete that task with the skills and abilities they have.”

Bridget Fyle, OTS from St. Catherine’s University

What I learned in Introduction to OT

According to renowned psychiatrist Adolph Meyer, 3 characteristics distinguish man from all other organisms?

Meyer stated the three characteristics are: sense of time, capacity for imagination, and need for occupation.

OT’s have the capacity to learn from the past—if I sit to long reading my neck and back will get stiff and store. If I get up every 30 minutes and move around, I can continue to read and study and not be in pain.

With imagination we have the ability to look at possibilities of what if--what if I only had the use of one hand and needed to floss my teeth, I could buy a waterpik to floss my teeth.

Being human we are not content to just lie on the floor in a sun beam and wait until someone gets home to put food into our bowl. We want to engage in activities that bring us a sense of fulfillment. We want to fill our own bowls.

What is the tie between human existence and occupation?

Human beings exist because we have sought out occupations which provide us with shelter, food and warmth. We have created occupations that challenge us mentally. We have sought answers to questions and when we know the answer to the questions, we create more difficult questions to answer. Human beings exist because we have engaged in occupations that allow us to socialize.

January 4, 2012

A couple of weeks to go before I am back at school...and I will be going through what is suppose to be the toughest semester. I have already completed my generals, Anatomy and Physiology, Developmental Psychology, Introduction to Occupational Therapy, Medical and Psychosocial Conditions and Activities and Analysis.

This semester I will have OT Performance Skills, Psychosocial Practice, OT Theory and Practice, Assistive Technology and Community Practice.

Which means out of the 70 credits required for this degree, I have taken 41 and need 29 additional credits.

The reason for starting this blog is I have to maintain an ongoing journal focused on Personal and Professional Growth and thought it might be fun to do it in a blog.