Let's hear it for Occupational Therapy!

I know I will be there! I am so excited to be presenting 2 posters. This is my first time to present at conference even though I have been an OT since 1988! I owe my re-entry into the profession in this manner through the teachings of the Online Post-Professional Masters Degree Program for Occupational Therapists at Boston University headed up by the amazing Karen Jacobs.

My poster topics are as follows:

The first poster is " Facilitating Health Promotion in Caregivers Of Community Dwelling Adults With Dementia The Caregiver Assistance Program (C.A.P.)" presented on 4/23/09 at the 1-3 pm poster session, poster # 153.

The second poster is "The Effectiveness of a Multifactorial Fall Intervention Approach on Fall Outcomes in Nursing Homes" presented on 4/25/09 9-11 am poster session poster # 424.

The goal of this poster is to appraise the research evidence regarding the effectiveness of multifactorial fall intervention programs in decreasing falls, injury and functional decline in nursing home residents over age 65 compared to usual facility care. A review and synthesis of current level I research was completed to determine the effectiveness of multifactorial fall intervention programs (MFFIP) on fall outcomes in nursing homes.

If you are an AOTA member registered for conference, both these poster handouts will be available for download when AOTA releases conference handout downloading.

Looking forward to seeing you all there "Living Life To It's Fullest"

For the details, check out the press release
http://www.aota.org/News/Media/PR/2008Releases/OT_RecessionProof.aspx

As an Occupational Therapist, I encounter elderly and middle age clients that demonstrate deficits in visual function. The most common causes of vision loss in my area of practice are due to macular degeneration diabetes, and glaucoma. Low vision negatively impacts the performance of daily routine activities, such as reading the newspaper, preparing meals, or recognizing faces of friends.

The inability to see well affects functional capabilities and social interactions which can lead to a loss of independence. OT's can provide verbal education through Vision Loss support groups, Senior Centers, and during treatment with clients and their families in a variety of health related practice settings. Written materials can be used, keeping in mind the needs of the visually impaired, especially contrast, glare and font/type size.

Home safety is especially important as aging in place becomes the norm. Education on proper lighting, use of tactile cues, high contrast colors and audio device introduction and use are all areas of adaptation that OT's address. Hands-on instruction in this area can be beneficial for those who may have lost their primary learning style tool. Senior Centers, vision groups connected with Ophthalmology offices, Assisted Living Centers and hospital-based volunteer groups are all excellent avenues to educate the public for improved safety and prolonging independence at home. Revisions to instructional techniques can be made as needed. Additional information can be provided based on the learning styles of the participants.

The following are some recommendations for lighting changes that can easily be made in the home to improve the light quality, thus improving the low vision client's ability to function in that environment.

Recommend the use fixtures that brighten walls and ceilings. Fixtures to light the reading area of the home can improve reading comfort and ability to see.

Recommend the use of "Task Lighting". A task Direct light to an area is essential to see small details. The closer the light is to the object viewed, the easier it is to see.

Place adjustable task lights, floor lamps, or table lamps near tables, desks, the bed, or objects with fine detail.

Place task lighting on the left side and slightly to the front if the client is right handed. Place it to the right and slightly forward if they are left handed. This reduces shadow cast from the hand on the task surface.

Place fixtures over the sink, stove, counter-tops, and other fixed work areas. Avoid placing fixtures on the ceiling behind the work surface. Fixtures located to the side and slightly in front will keep shadows off the task surface.

Light-colored décor reduces shadows.

If the client has upper cabinets, use under cabinet lighting to increase the available light on the countertops.

Mount swing arm lamps used for reading in bed above the head of the bed or to the side, below eye level.

Addressing the issue of Glare

To minimize glare:

Note the placement of bright lights against dark ceilings or walls. Recommend the use of light-colored walls and ceilings to soften the effects of the bright light.

Shield bright objects from lines of sight. For example, if you can see a light bulb when seated at the table, hide the direct view of the bulb by adjusting its shade or repositioning the fixture.

Avoid clear lenses or shades on fixtures; they do not shield the light bulb from view.

Spread light over large areas by lighting ceilings and walls, or by using fluorescent tubes shielded from direct view.

If the home uses recessed downlights or "cans" mounted in the ceiling, recommend a deeply recessed fixture to minimize direct view of
the bulb.

Place task lights to the side of the client not in front to avoid reflected glare from shiny surfaces, like polished wood or glossy magazines.

Recommend the use of shades, blinds, or curtains to minimize glare from windows.

Jeanne Marie Fusco OTR/L whoheals@gmail.com
Whole Health Objectives LLC

By Ashley Opp Hoffman

National School Backpack Awareness Day is September 17, and occupational therapy practitioners across the United States are gearing up to help students "Pack It Light, Wear It Right!" But occupational therapists work every day in virtually every school district, providing services ranging from behavioral help to proper posture for computer use.

National School Backpack Awareness Day focuses on just one area of occupational therapy expertise-ergonomics-but occupational therapy in schools is much more. Occupational therapists and occupational therapy assistants help children, youth, and families with a broad range of health and wellness issues that affect the ability to participate in and enjoy everyday activities. In schools, they help students develop the skills they need to learn, play, and interact with others.

"The training occupational therapists have in body structure, body mechanics, and purposeful activity give us tools to help students with everyday problems like heavy backpacks," says Karen Jacobs, EdD, OTR/L, CPE, FAOTA. "But that is not the only ergonomic issue we can help students with. Because occupational therapy practitioners understand how the body and mind work together, they often consult on ways to use technology and computers to compensate for or overcome learning disabilities. Therapists consult with teachers and evaluate children's attention and fine motor skills to determine solutions to problems such as weak handwriting or lack of organizational skills."

Occupational therapy practitioners also help students interact with others. "Behavioral problems often arise because of the way children respond in class or outside of class," says Jacobs. "Occupational therapy has its roots in mental health and [therapists] can analyze the psychosocial issues that may be affecting behavior." After evaluation, a therapist can institute a plan for interventions that will help control behavior problems.

Occupational therapy practitioners also work with children with attention deficit hyperactivity disorder (ADHD), which affects about 3% of the school-aged population. Children with this disorder are unable to pay attention, control their activity, and restrain impulsive behavior. These problems may interfere with a child's ability to hear or read instructions, complete school assignments, participate in games, and perform tasks at home. An occupational therapist can recommend a program that addresses the physical, behavioral, and emotional effects of ADHD. "Occupational therapy takes a holistic view of the child and is focused on enabling accomplishment so an occupational therapist is not looking at what a child can't do but rather what a child can be and do," says Jacobs, noting that the therapist will identify individual goals for each child.

Of course, children with more significant disabilities also benefit from occupational therapy. Autism, an increasingly common diagnosis for children, can present challenges for teachers, school staff, families, and the students affected. Occupational therapy practitioners help children with autism find ways to adjust tasks and their environment to match their needs and abilities. Such help may include using adaptations to minimize external distractions or finding special computer software that can facilitate communication for children with autism or other disabilities.

"The occupational therapy approach helps children with mental and physical disabilities identify and improve skills that build capabilities. This enables them to succeed in their roles as students, as growing children, as participants in the school community," Jacobs states. "Occupational therapy can help any student to improve and grow, I believe."

So although Backpack Awareness Day brings occupational therapy practitioners, students, and families together to "keep it light and wear it right," occupational therapy has many more roles in helping students succeed.

How Should You Wear a Backpack?

More than 40 million students in the United States carry backpacks. According to one study, six out of ten students 9 to 20 years of age reported chronic back pain related to backpacks.

The American Occupational Therapy Association has published ten tips to avoid backpack-related health problems:

1. Never let a child carry more than 15% of his or her body weight. This means a child who weighs 100 pounds shouldn't wear a backpack heavier than 15 pounds.
2. Load heaviest items closest to the child's back and arrange books and materials to prevent them from sliding.
3. Always wear both shoulder straps. Wearing only one strap can cause a child to lean to one side, curving the spine and causing pain or discomfort.
4. Select a pack with well-padded shoulder straps. Too much pressure on shoulders and necks can cause pain and tingling.
5. Adjust the shoulder straps so that the pack fits snugly to the child's back. The bottom of the pack should rest in the curve of the lower back, never more than four inches below the child's waistline.
6. Use the waist belt, if the backpack has one, to help distribute the pack's weight more evenly.
7. Check what your child carries to school and brings home to make sure the items are necessary to the day's activities.
8. If the backpack is too heavy, consider using a book bag on wheels if your child's school allows it.
9. Choose the right size pack for your child's back as well as one with enough room for necessary school items.
10. If a student is experiencing back pain or neck soreness, consult your physician or occupational therapist.

Do you have an older friend or family member who is finding it more difficult to manage daily tasks in the home? Do you worry about the health and safety of a parent living alone?

Watch for clues that certain daily activities have become too difficult because of physical or mental changes. Are bills going unpaid? Is the person neglecting grooming or skipping meals? Does the home appear unkempt?

As abilities and strength diminish, families and other caregivers must often help the older person obtain the assistance needed to maintain independence.

Investigate and suggest resources such as bill paying services, "meals on wheels," lawn care, house cleaning, and window washing companies. Some elders will prefer professional help to dependence upon family members.

Talking About Living Arrangements
Introducing changes to the person's living environment or considering a move to more accessible housing is best approached long before safety issues become paramount.
Too often, the individual is facing losses in other areas of life and resistance to change is increased.
Introduce the idea of change through small, less intrusive modifications in the guise of gifts or services when you notice a need. For example, while replacing hard-to-reach light bulbs upgrade the wattage for improved visibility.

If adaptations or repairs are needed such as adding railings on stairways or replacing worn or uneven floor covering, etc., offer to help the individual make choices and deal with contractors.

Modifying the Home Environment
The truth is that many aging people face limitations on independence in their homes only because the design and arrangement of resources no longer meet their needs.

Enlist the help of an occupational therapist to aid you in identifying ways to improve safety in the home, to arrange resources, and to modify the environment to help compensate for disabilities individuals may be experiencing.

Occupational therapists and occupational therapy assistants are specialists in helping people to deal with the effects of illness and injury on their ability to manage daily life.

Introducing and Supporting Change

The therapist can also help you and the older individual explore implementing changes in ways that may make them more acceptable.
For example:
Consider offering financial assistance. Many older people are highly concerned about conserving resources for future needs for themselves or their spouses. Others have little experience with current costs and may fear being overcharge for materials and services.

Try building suggestions for change around "I" messages. "I worry about you falling on those dark basement stairs. As a birthday gift, we are going to make sure your stairs are safe and well-lighted."
The purpose of this fact sheet is not to offer medical advice. To discuss your particular problem or condition, contact your primary physician. Materials may be reproduced for purposes of education.

Copyright 2000 American Occupational Therapy Association, Inc. All Rights Reserved. This page may be reproduced and distributed without prior written consent.
Last Update: 6/12/00

Open the cupboard under the dishwasher and put one foot up on the edge while doing dishes it really helps your back

Put cloth loops on drawer handles to make them easier to pull open

Put rubber grips on doorknobs to make them easier to turn

Sew on buttons with dental floss and they'll never fall off again

Use cheap non-slip shelf covering to hold a bowl still while stirring or a plate in place for one handed eating and cutting.

Use bright colored nail polish to mark important buttons on the washer, dryer, stove, TV, VCR, keys, to mark the line up marks on child proof medicine bottles, mend small holes in the window screen, and use more than one color to mark the on, off and volume on the TV remote so you don't need your glasses

Use drops of colored glue to make a raised mark on certain keys of a remote control and on the items listed above to make a mark that can be felt and seen easily

Make your own grabber for reaching to the floor and getting your shoes on. Attach a cup hook to one end and a coat hook to the other of a ½ inch wooden dowel cut to a 3 foot length

Attach the extra key to the dogs collar, strangers won't be able to get it but family will

Use cloth bags or pillow cases to carry laundry down steps, toss them down or let them roll rather than carrying a laundry basket that obstructs your view while walking

Poke a pencil through a foam curler or a foam ball to make it easier to hold if hands are tired

The above ideas were from Peggy McCourry, OTR/L an Occupational Therapist Pegtheot@aol.com
and also from the book Heloise Around the House, published by King Features Syndicate, Inc. 2003

By Rob Black

Amputations, combat stress, and traumatic brain injuries are just a few of the war injuries that Major Matthew St. Laurent has treated as a U.S. Army occupational therapist. Although he is currently assigned to a duty post at Walter Reed Army Medical Center in Washington, DC, the New Hampshire native also has served on the front lines of the war in Iraq, providing rehabilitative services to both soldiers and civilians at a combat support hospital in Mosul.

"Battlefield medicine is saving more lives than ever before, but these people still have devastating injuries to recover from," said St. Laurent. "Modern warfare is creating injuries and combinations of injuries called polytrauma that we could have never imagined. As a result, occupational therapists have a large role to play in restoring the health and well-being of our wounded warriors."

Occupational therapy is a proven, recognized therapy that enables people to overcome the disabling effects of mental, physical, developmental, and emotional conditions by helping to improve their ability to perform tasks in their living and working environments. Practitioners work with individuals to improve basic motor functions and reasoning abilities, compensate for permanent loss of function, and address the psychological aspects of injury and illness. The goal of occupational therapy is to help people lead independent, productive, and satisfying lives through participation.

St. Laurent's specialty is orthopedics (the skeletal system and its associated muscles, joints, and ligaments), and he uses that knowledge primarily to treat upper-extremity injuries to the arms and hands. St. Laurent evaluates factors such as range of motion, strength, sensory capability, and function as they apply to activities of daily living. Once a client's capability to do activities such as button a shirt or assemble and clean a weapon is assessed, a rehabilitation program can be developed.

Occupational therapy also can help clients overcome symptoms of combat stress. Working with a mental health unit in Iraq, St. Laurent managed a rest and relaxation center. Both military and civilian clients had the therapy prescribed by a psychiatrist. "We try to provide an environment where the only thing a client has to do is relax," St. Laurent said. "We evaluate how well they perform daily activities in order to restore the person to full functionality. Given the nature of the conflict in Iraq, everyone is at risk for combat stress, whether they're a soldier or a civilian."

Combat stress treatment also was preventative. St. Laurent would leave the combat hospital and attend to units in the area of operation. He provided information on topics such as anger management, communication skills, and stress management. "By using methods to reduce stress, soldiers can modify the larger effects of combat stress, which will help maintain their overall health," St. Laurent added.

Unfortunately, war also affects civilians; many receive medical treatment and rehabilitation services when they are injured. ABC News journalist Bob Woodruff is the most prominent example of how military medical personnel can provide life-saving measures to civilians. Woodruff received extensive occupational therapy to help him recover from a traumatic brain injury suffered in an explosion. Such treatment is not limited to Americans; Iraqi civilians also benefit.

"On Saturdays we would open our clinic to Iraqis," said St. Laurent. "Many of them had been injured in terrorist attacks. Once they were stabilized and released from our hospital, we would invite them back the next Saturday for rehabilitation care as needed. Our unit provided wound care, range of motion exercises, and special splints to allow function in an injured limb."

One particular Iraqi client touched St. Laurent's heart like no other. A 7-year old girl named Haneen was injured on her left arm in an explosion, and St. Laurent provided her a splint that enabled her to grasp items with her hand. Haneen needed further surgery on her arm, and thanks to a program called Project Hope, she and her father were flown to the U.S. for treatment at Massachusetts General Hospital. (Project Hope is an international program that primarily serves children, providing them medical care when local resources are limited.)

By the time Haneen arrived in the U.S., St. Laurent had already finished his tour in Iraq and was stationed at Walter Reed. Luckily, her travels brought her through Washington, DC, and the two were reunited for a brief visit.

"It was very moving to have Haneen and her father meet my three young children," said St. Laurent. "Here were kids from two different worlds that were able to play together. While the circumstances that brought them together were bad, I am gratified that as an occupational therapist, I could be a part of the health care team that enabled our children to meet and play together."

Rob Black is AOTA's public relations manager.