Driving and Community Mobility Reflection

     The guest speaker on driving and community mobility in our Older Adults course was very interesting and engaging. One thing that I took away from the lecture is that all occupational therapists, no matter what population they work with, should have at least some knowledge on driving and community mobility. I also learned that we must be sure to avoid giving clients false hope on being able to drive, as this can be a huge disappointment for them if they likely will not be able to, as well as a waste of their time and money.
     One occupational therapy intervention for driving and community mobility that can be done with a group is a "field trip" in which the group learns to navigate their community using public transportation. A group that may benefit from this is those in a group home for individuals with moderate intellectual disabilities. With one therapist or other professional per three or so clients, the group can practice the skills necessary to take public transportation, such as a bus system or the subway.
     An OT intervention for driving and community mobility that may be done with an individual client is simulated driving to improve the client's physical abilities related to driving. One area to address is the ability to turn their neck to either side in order to check their mirrors and to the side when changing lanes. Another area that should be addressed is active range of motion of the upper extremities. The client must be able to turn the steering wheel, move any levers for blinkers or windshield wipers, and reach the gear shift.
     No matter where an individual is in the lifespan, driving is a very important indicator of freedom. This is true for the teenager just learning to drive, as well as the aging adult whose cognition may be declining. Because of this, all OTs should have a basic understanding of interventions to address driving and community mobility.

Nutrition and Aging Reflection

     The guest speaker on Nutrition for our Older Adults class was very informative. I learned a lot about how important it is to make sure individuals in the hospital are getting enough calories for them to heal properly and that it is quite common for patients to be malnourished. We also learned that if we work at a hospital, we should get to know the registered dietitian on our floor so we are able to work with them to ensure our clients are getting the nutrition they need.
     One intervention that occupational therapists can do with an individual in regards to nutrition is to educate the client on how to check nutrition facts while grocery shopping. You could start by bringing in food boxes to the clinic or client's home to first go over what is on nutrition facts and how to make sense of it. After the client understands the nutrition facts, the OT and client could go to a grocery store and assess their ability to grocery shop independently while also checking the nutrition facts.
     A group intervention that could be done by an occupational therapist that relates to nutrition is a support group for individuals with type two diabetes and how to manage nutrition for these individuals. During the group the OT and group members can discuss proper nutrition for diabetics. The OT may also want to have a registered dietician present for the meeting, but allow the group members to have plenty of discussion amongst themselves.
     While it is not commonly thought of as an area that is within the scope of practice for occupational therapists, nutrition is within our scope of practice to an extent. Making sure you know a registered dietitian in your area can be helpful for both you and your clients. This will give you a resource to gain more knowledge as well as someone you can refer clients to for nutritional needs.

Glyph Reflection

Early in our OT school career, we were asked to make a "glyph" of ourselves based on our views of leadership, and we just recently made another of the same glyph to determine if our view of leadership has changed while being in school. Some examples of the meanings of the shapes were pointy eyebrows if you see yourself as a behind-the-scenes leader vs. curved eyebrows if you see yourself as an out-in-front leader and round ears if you think technology is often an important part of leadership vs. pointy ears if you do not. 

As you can see, both of my pictures are pretty similar. The two things that changed were the addition of glasses and an accessory to my more recent glyph. The meaning of the glasses is that I now think I have had more leadership positions than others my age, while I did not believe so at the beginning of OT school. Over the past year and a half I have taken on quite a few new leadership positions, both in school and outside of school. One in-school position I have taken on is a family liaison for Go Baby Go, a program where physical and occupational therapy students and engineering students modify toy electric cars for children who may not typically be able to use them. This position has helped me grow my communication skills tremendously, both between the parents of the children and other students and professors.

Having an accessory in the drawing shows that I see myself as a leader. I have definitely pushed myself to be more involved in OT school and I am so glad that I have! I know that these opportunities are helping me become a better person and future occupational therapist; I am so grateful for being in a program that gives students so many areas to be involved with the school and community.

LI FWC Debriefing

Neuro Note: Brain on Fire

     The book Brain on Fire: My Month of Madness by Susannah Cahalan is a memoir about and by Calahan, a journalist for the New York Post in her mid-twenties. Typically an intelligent, outgoing, and friendly woman, she starts experiencing strange symptoms that first seem like the flu but then become more psychiatric in nature and much more concerning, such as hallucinations, seizures, and behavioral outbursts that were very unlike her normal self. After visiting several different doctors and a month-long stay at the hospital, Susannah is finally diagnosed with anti-NMDA-receptor encephalitis, a rare and likely under-diagnosed autoimmune disease. The disease has a roughly 75% chance of normal recovery or mild side-effects, and a 25% chance of severe side-effects or death, even if it is caught early and treated. Luckily, Susannah makes a full recovery and is later able to return to her life as a journalist and continue in her relationships, both with her boyfriend and other friends and family.

     I chose Brain on Fire because it was a book I had read my freshman year of college for an introduction to psychology class. (Funnily enough, it was for extra credit in that class, as is this neuro note that I'm writing. I've always been a sucker for extra credit points.) I enjoyed the book back then, and when I saw it on the list of resources, I thought it would be interesting to reread it now- five years later, with a bachelor's degree and a semester of occupation therapy school under my belt. I now have a much deeper understanding of many of the neurological terms used in the book and I have a greater appreciation for the book and the doctors mentioned in it.

     While Susannah did not see an occupational therapist, there were a few places I could see her benefitting from occupational therapy. As she is recovering from the disease, a months- and years-long process, Susannah is very nervous to return to living by herself after living with her parents during this time, but she is also desperate for the freedom that it will allow her. I think seeing an OT would have helped her re-learn her usual occupations and also increase her confidence about living by herself.

     Something that I took away from this book is that it can be incredibly helpful to get a second opinion as practitioners when we are working with a client who is outside our area of expertise. Susannah saw several different doctors and got several incorrect diagnoses until her neurologist at the hospital sought the help of someone who had experience in cases like Susannah's. This doctor was finally able to correctly diagnose Susannah and get her the treatment needed to start on the road to recovery. While we as OTs will not be diagnosing people, we can learn from this and refer clients to other therapists or get ideas from them to best help our clients when we may not know exactly what to do. I am so glad that I chose to reread this book, and I highly recommend others to read it as well.

Cahalan, S. (2012). Brain on fire: My month of madness. New York, NY: Simon & Schuster
     Paperbacks

Memphis Rollin' Grizzlies

     Last week, some of our class went to watch a practice of the Memphis Rollin' Grizzlies, a local wheelchair basketball team. The team is made up of men with varying levels of disability and a wide variety of ages. The coach- who used to play on the team- talked to us quite a bit to tell us more about wheelchair basketball and answer our questions. We learned that there are different levels that wheelchair basketball teams can play on competitively, and the Rollin' Grizzlies are on a fairly high level and do well in this level. Watching the team practice was very interesting, but also not much different from a non-wheelchair basketball practice. Just like any other basketball team, the players were not afraid to play hard and run into each other, and we saw quite a few players fall over in their wheelchairs. While this made a lot of us students pretty nervous, the players did not seem too phased and just got back up, often with the help of other players (again, not unlike what you see in a "typical" basketball team).
     We also got the chance to try out the sport at the end of the practice. This was a lot of fun and showed us how hard it is to play basketball in a wheelchair. While I am definitely not good at basketball anyways, I found out that it was even harder to shoot while sitting in a wheelchair. You are not able to get momentum from bending your knees and pushing off the ground like you would while standing up. It was also very difficult to maneuver the wheelchair while also controlling the ball, and I can imagine it may take awhile to get the hang of that. The players were all so friendly and encouraging while we tried our hand at this sport that they are all fantastic at.
      The biggest takeaway I got from watching this practice and then participating is that these guys are really no different than regular basketball players. I think that I sometimes start to feel sorry for people with disabilities and forget that they are people outside of their wheelchairs or other assistive devices, with different hobbies, talents, and interests. While we need to keep in mind any specific precautions for people in wheelchairs, we also need to remember that they are not glass dolls and they may be comfortable being rough and occasionally falling over. It is so important to recognize clients as their own individual and not just see them as a disability, condition, or illness.

Media Project

     Doing the media project (where we were each assigned a random household object and then a "client" to make something out of the object for) has been an eye-opening experience. It has made me use my creative skills, something I am not very confident in, to come up with a way to use my item, which was cotton balls, for my client Paula, a 76-year-old woman with Parkinson's disease. I decided to use the cotton balls as either pretend "buttons" to practice buttoning with or to cover actual buttons with a piece of the cotton ball to give Paula something larger and more textured to hold on to, as well as to serve as a visual cue since she also has cataracts. I think that realizing there was a practical way to use the cotton balls (covering the buttons as opposed to just practicing doing buttons with the cotton balls) was the most meaningful realization I had. When I first read about Paula, I was frustrated because all of the uses I could think of for cotton balls were crafts or games, and in the information given about Paula, it states that she thinks the games and activities done in the skilled nursing facility where she lives are boring and she seemed to think she was above those types of things. I didn't really think she would like to practice buttoning with the cotton balls either, but when I finally thought of how to incorporate them into the actual act of dressing, I realized I could explain that to Paula so she could work up to using the cotton balls practically.
     From completing this project, I have learned there are hundreds of ways to use everyday objects to help our clients, which can be especially important if we do not have access to resources that cost more money. This has encouraged me to change my thinking to be more outside of the box. The project also reminded me that we have to always be client-centered. While I may think it would be a lot of fun to use cotton balls for arts and crafts or to play games with, I will have clients who might not think it is so fun and I will need to come up with other ways to help them. The project has definitely had an impact on how I will work in the future, both while in school and once I graduate. It will remind me to think of different ways to help clients that may not be typical. I will also remember that assistive devices do not have to be high tech, and low tech can sometimes be the best way to work around a problem. The media project has helped me see things more creatively as well as practically, and I can't wait to put these skills to use in the future!