Mentioning Dementia

I watched this Ted Talk by a woman named Beth Malone. A very sincere, and real talk about her father’s dementia. She explained that her father was in the later stages of dementia (a neuro degenerative disease) and was no longer able to care for himself as he needed anymore. So, he was brought into a care facility that would help him daily. Beth said that this was not a place where he would have delighted in with a sound mind, or a lack of better words that he would normally reside in prior to his dementia. Because of this, she felt compelled to take him from his misery, however, she knew she really could not do this for him. Instead she decided to keep her father/daughter dynamic and roles and just be there for him. During this video, you’ll notice she holds back tears on several occasions, and I remind myself that even though we treat client last specifically, these personal family accounts or perspectives of their loved ones remind me that empathy is such a huge part of this profession, not only for the client but their loved ones. Each person may be affected differently as well, and it is important to remain mindful of everyone’s feelings in a situation as sad as dementia is in any state or form, early or late. I am so passionate about the importance of considering others feelings in what you are doing, and I believe that is why I am meant for OT. Dementia is a very tough journey not just for a client but to anyone who is involved and especially has a close relationship with them. Empathy is just about everything.








https://www.ted.com/talks/beth_malone_how_my_dad_s_dementia_changed_my_idea_of_death_and_life

Let's Talk Neuro!

Have you ever experienced a person having a seizure? If so, what did you do? More importantly what were you thinking at that moment of that person? Well, after watching a Ted Talk about a specific chronic neural disease, I definitely learned a little more than I already knew. What I mean by that is, not only did I gain knowledge while watching and listening, but I gained an outlook, a perspective if you will about the subject because I think some of the best educational experiences come from testimonies. So, with that being said, the speaker in this Ted Talk was Claire Koster. In this video, she was 17 years young, and battling a chronic neural disorder called epilepsy. What I learned was that there are two different categories which are petit mal, and grand mal seizures. Petit mal was described as a "loss of control over the nervous system", while grand mal was defined as a "loss of control over the muscles" (Claire Koster, 2015, 0:33). Claire was diagnosed at the age of 2 years old, and experienced petit mal seizures whenever triggered. Another thing that I learned was that sugar can affect if someone is triggered into a seizure. Interesting. Other things that she must keep in moderation is alcohol consumption, and of course "party" lights or strobes. Other than this, because of her medicine, she can live and lead an independent life. I refrain from saying a normal life because the word normal is such a construct and has a different meaning to everyone. She further explained that like other disorders, there is a spectrum for this one as well. She observed other individuals who have the same diagnosis but were wheelchair bound and were not able to live as independently as her (which I am sure humbles her deeply, even at such a young age). So, when you hear that someone suffers from epilepsy, don't assume the worst. In fact, in her speech she gave out some astounding percentages of what people think about epilepsy. I won't name all of them because it is quite a lot but when it comes to children and love, it hits me the most. So, Claire brought to mine and the audience's attention that " 12% of people thought they should be isolated from other children, 23% of people would not let their future children integrate with them, 14% of people say they should not be allowed to marry/have children themselves, and 64% of people would not marry someone who suffers from epilepsy" (Claire Koster, 2015, 1:15). How should these percentages and statements make a person feel? Especially someone who suffers from it. My biggest take away from this Ted Talk, is the perspective that I gained because in OT I believe that as our main goal. Empathize with how someone feels and try to create a better standard an outlook for them to provide them with the best quality of care that you can. Claire explained that a lot of people think that their boundaries are considered a negative thing, but she says because of her boundaries, she actually has none. At the bottom, if you are interested, there is the link to her video which I recommend. Her confidence and courage are inspiring. 

Koster, C. (2015, December 9). Living with a Chronic Neural Disorder. YouTube.

https://www.youtube.com/watch?v=WYcuvtdvD88 

Social Determinants of Health

I watched a Ted Talk by Rishi Manchanda who spoke about social determinants of health (SDoH), and how this knowledge can change lives in healthcare. Well, what are social determinants of health you may ask? These are everyday factors that can impact your health such as where you live, where you work, accessibility to resources, and transportation to and from these places. Not only that, but more specifically the conditions in which someone surrounds themselves in whether it have to do with living, working, education, economic status, or leisure. These factors or determinants if you will, can all play a role in a person’s health, or expected health behaviors, a big role actually. Because social determinants are so influential to a person’s health, you can believe that it can impact one’s nervous system and overall being. Take stress for instance. We can experience stress at any age depending on someone’s circumstances, especially a child who grows up in an abusive home, or maybe just a low economic status and lacks simple resources that are beneficial to their well-being. Stress can affect your whole body, most importantly your brain. When a person is stressed, they are most likely feeling an overload of emotions. But when a kid who lives in a home or is in an environment that is constantly stimulated by the same stress because of some type of instability or lack of necessities (love, food, clothes, stability, consistency, etc.) that can and will play a role in their emotional states, and behaviors which in turn affects their nervous system. For example, stress is can have an effect on decreasing gray matter in the prefrontal cortex, which is a region of the brain linked to such things as self-control and emotions. This is just one example of many.

Lastly, UTHSC’s OT program requires so many hours of service and professional development hours and I think this helps prepare us OT students for the future in our profession because it is teaching us early on the skills necessary to become outstanding OT practitioners. It teaches us to take responsibility and pride in our work and I think most importantly becoming independent in self-awareness and self-motivation in anything that we do. I am extremely thankful to be in a program that is not only concerned about our education, but also the necessary skills for when we interact with coworkers and clients.

Assistive Devices

Assistive devices have come such a long way from how they have been made in the past, today, and for the future because technology is an ever-growing field along with healthcare. The great thing about assistive devices are that they are made to be adjusted to each patient and fit them appropriately to produce only productive outcomes. One of the reasons that assistive devices need to fit appropriately to a patient/client is for their safety. Safety is always our main concern with anything to do with a patient. Let’s say someone is on crutches, but they are not adjusted to the right height, whether it be too short or too tall, this is a situation that puts the client at a fall risk. Another reason to fit a client for an assistive device is for comfort. Again, let’s say someone is being fitted for a wheelchair. Now, not everybody has the same body type (long legs, short legs, long torso, short torso, etc.). If the width of the chair or the height of the chair does not fit, it could cause rubbing behind the legs, or create uncomfortable posture/hip flexion.  

One assistive device that you can be fitted for is a cane. This can be accomplished by telling the client to stand while look straight ahead with arms relaxed at their side. The handle should be in line with the wrist crease, ulnar styloid, or greater trochanter. If need be, you can adjust this by releasing the locking mechanism, pushing the button, and moving the cane base to the correct height. Another, assistive device that you can be fitted for are axillary crutches. The crutch length should be about the same length as the distance from the client’s forearm to the fingertips of the opposite hand, and the length of the crutches should be based on the height of the client. The arm pad should be 1 to 1.5 inches under the axilla or armpit area or 2 to 3 finger widths. The handgrips should be in line with the wrist crease when hands are resting at their sides. Along with those crutches, there are some called loftstrand crutches that allow for more dynamic movement and control in small spaces. To fit a person to them, the cuff of the forearm crutch should be three fingers width from the elbow and then lock the buttons in place. The handgrip should be adjusted to the height of the wrist and show a slight bend ion the client’s arm. Lastly, walkers are a very popular assistive device used for all kinds of injuries or the elderly. To get fitted for the platform walker, the platform surface should be positioned to allow weightbearing through the forearm when the elbow is bent 90 degrees and the client is standing tall and relaxed. An important note to avoid nerve damage, the proximal ulna should be positioned about 2 inches off of the platform surface, while the handle of the platform should be positioned medially to allow for a comfortable grip. For the rolling walker, the height of the walker handles should be at the hip joints of the client and their elbows should be bent at about 20 degrees give or take because everyone is a little different.  

Let's Get Moving!

The order for restoring confidence in mobility as activity demands increase are these listed in order: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet & tub transfer, car transfer, functional ambulation for community mobility, and community mobility & driving. I think the hierarchy is in this specific sequence because it allows a client to work and build on more basic and lower level skills (but imperative) in order to achieve higher level and more complex skills for everyday life for them to become more independent in their daily living. Their quality of life depends on it, so I agree with the lay order. I think of it as building blocks, and the more basic skills and activities, like taking care of yourself are the foundation, and like a house you build off the foundation. When you are able to take care of yourself it not only allows for independence, but as well as giving a person the ability to take care of others, or (like driving) being aware of yourself and others.

In my past observations, I never got to see this progression in mobility although I think that is the best part of therapy almost. I saw progress in different clients, but not to the degree of this type of regaining of confidence and independence in mobility. I do think that every person is different, and when you have one client who may not be in any worse of a medical situation but is more emotional or emotionally stable I do think that can impact progression in these steps.

I would love to see this type of progression in a client in the future, and honestly it is this type of impact on a client that I am eager to assist with in my profession as an OT.

Body Mechanics

Reasons to teach people/clients about proper body mechanics and posture are very important and include:

1.       Prevent injuries to the body such as muscle, joints, etc.

2.       Protect your body from back pain and or other parts from strain  

3.       Promote ideal balance and coordination

4.       Encourage safety for yourself and others

One way that I would teach a client on how to use proper body mechanics is by using something straight like a yard stick or something, and aligning it on my back along my spine, back of my head, and tail bone (to show them, and later allow them to try), and I will demonstrate how to properly pick a package up from the ground without bending over like most people do which is not proper body mechanics. The idea is that the stick stays on all those areas that I explained, and you lift with your legs when you grab the object from the ground.

Another way that I could show a client how to use proper body mechanics is informing on how to improve posture when sitting in a chair especially for long periods of time if that is your job. So, first adjust the height of the chair where your feet are nicely planted on the floor, and your knees are either in line or slightly lower than your hips (comfortably). Obviously sit straight up in the chair, and your hips all the way back in the chair as well. Lastly, the back of the chair needs to be slightly inclined also. This will reduce back pain, and promote good posture!

Interesting, Might I Ad!

So, I was trying to think of a popular ad, and it seems like every time I purposely try to think of something like a song, or anything specific, nothing comes to mind. So, I decided to look up popular ads, but then I thought they were too popular, so I went for something that I was wanting to connect with personally. A certain emotion I wanted to feel, and so that is what I searched and came up with... an ad that fit me. At the bottom I will post a link if you would like to watch it. In the ad, there are three individuals that are feeling stressed about just everyday life, and one trying to fall asleep. All three were wanting to experience some relaxation. This is something that I can relate to on a daily basis, and I may even get the app that they were advertising! Anyhow, in the nervous system you have your CNS and your PNS. The PNS (peripheral nervous system) connects the CNS (central nervous system) to the rest of the body. The PNS divides into the somatic (voluntary movement) and autonomic system (involuntary movement). The autonomic nervous system further divides into the sympathetic and parasympathetic nervous systems. I believe that this specific ad kicks both subdivisions into work. In the beginning there is immediate over stimulation, which quickly made my heart rate race a little because I could easily relate to the stressors given which is the sympathetic nervous system at play. It is your fight or flight response. Now, quickly into the ad they switch gears and advertise this app on the phone to help you relax and get away from all those stressors and connect with yourself again. This is where your parasympathetic nervous system comes into play. It is responsible for lowering your heart rate and blood pressure and bringing your body back down from a stress induced state. It is your rest and digest response. Both are very important and imperative. I hope this "Ads" to your knowledge!

https://www.ispot.tv/ad/dEi1/calm-reduce-your-stress