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

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.

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.