Friday, October 2, 2015

Have Heart

I recently celebrated my two-year anniversary as an occupational therapist and have found myself reflecting many times during this period on what I have learned and felt during my tenure in a skilled nursing setting.  Over this period, during which I have gained invaluable experience helping individuals function at their highest possible levels of independence, I have laughed, cried, and experienced many bittersweet moments.  While a small percentage of my patients have been able to return home with adequate support systems in place, most of the individuals with whom I work are destined to live out their days at one of the three nursing homes in which I provide occupational therapy services due to progressive physical and/or cognitive conditions.  In these cases, I strive to facilitate the development of skills that support optimal independence in order to preserve the dignity of each individual as well as decrease caregiver burden regarding often over-worked nursing staff.  While I must take into consideration the concerns of family who may be resistant to the realities of a patient's physical and/or mental limitations, it is my responsibility not to give false hope about rehabilitation potential.  The process of developing realistic goals for each individual under my care can be daunting as I strive to consolidate prior levels of function with current medical prognoses while taking into consideration the hopes and dreams of patients and their loved ones.  Although the limitations associated with a certain medical condition may be obvious to me, I realize that an individual who is dealing directly with the realities of a disability may need time to process the stages of grief that accompany a new or chronic diagnosis.  In these instances, it is helpful for me to imagine how I would feel if the individual were myself, a member of my family, or a close friend.  In any case, I would want to know the truth.  However, I would want the message to be relayed in a heartfelt way that demonstrates compassion and a sense of hope within reason.  From this perspective, I strive to offer the best of both worlds:  an evidence and experience-based evaluation of an individual's prospective need for assistance with recommendations of resources that will meet both the caregiver's and patient's needs for support on a variety of levels.                  

Tuesday, December 16, 2014

Embracing the Process

As the old adage states, all good things take time. Concerning the process of rehabilitation and other objectives of therapy such as the effective use of compensatory strategies, progress towards goals can take a great deal of time as well as effort on behalf of the therapist as well as the individual whom treatment is intended to help.  Just as a tiny rosebud slowly but decidedly unfolds and evolves into a magnificent rose despite the often harsh forces of nature, each individual embarking on a journey towards his or her therapeutic goals will face challenges on the way to reaching full potential.  Because the realization of goals often requires gradual transformation, key elements involved in the process of therapy is a clear vision of the desired outcome as well as the acknowledgment of progress regardless of how incremental it may be.  As an occupational therapist, it is my duty and pleasure to collaborate with those under my care in order to co-create a vision of the future in which they are able to safely and effectively exercise the highest level of independence possible while participating in daily activities, celebrating each step in the right direction.

Saturday, November 16, 2013

Life as a Practicing Occupational Therapist

Prior to my first job, I gained experience providing occupational therapy services as a student while working towards my master's degree.  For the last three months that I have been practicing as a licensed and registered occupational therapist (and the only one at my facility at that), I now fully realize the honor and responsibility of being a member of this profession.  As much as I enjoy my work at a skilled nursing facility, every day presents challenges concerning honoring residents' autonomy while seeking to improve the quality of their lives, communicating with coworkers and team members from other disciplines, feeling confident in my ability to create and implement resident-centered plans of care, and utilizing my clinical judgment within company guidelines.  These challenges may be overwhelming if I did not find serving the geriatric population tremendously meaningful, but I have had a special interest in this area since I became involved in hospice work years before returning to college to pursue this career path.  Although I take my position as an occupational therapist very seriously and seek to approach each resident with dignity and respect, I strive to create an atmosphere of levity when appropriate in a setting that is often heavy with suffering and have found that a joke, hug, smile, or listening ear can go a long way towards providing comfort in the face of confusion, fear, sadness, and loneliness as well as physical pain.  All in all, I feel that I have made the right career choice and look forward to adding practical experience to my growing base of knowledge as I pursue my career and sources of continuing education.

Sunday, July 28, 2013

Animal-Assisted Therapy

          
          I have been an animal lover since I can remember, so imagine my delight when I discovered the intervention approach called animal-assisted therapy (AAT).  As a volunteer for the Vanderburgh Humane Society, I participated in the pet therapy program at a local skilled nursing facility through which I offered the residents (and many times the employees and visitors) the benefits of positively interacting with one of the shelter animals, usually an adorable and very well-tempered puppy or small dog.  In contrast to these visits, which were purely for enjoyment, individuals participate in AAT in order to make progress towards established therapy goals.  For example, an individual may brush a dog in order to develop greater upper extremity strength, range of motion, and endurance.  Likewise, a group of students may interact with a cat and its handler in order to increase social interaction skills within the classroom.  Therapy animals are carefully screened and trained in order to offer a safe and effective alternative to traditional therapeutic modalities.  At the 2008 American Occupational Therapy Association's Student Conclave in Louisville, Kentucky, I discovered a volunteer organization called Animal-Assisted Therapy OT and PT Pups.  The following website offers a wealth of information about this organization as well as AAT in general: http://www.otandptpups.com/   


Wednesday, July 17, 2013

Activities of Daily Loving

         
          In occupational therapy, tasks individuals accomplish throughout the course of daily life in order to ensure physical well-being are referred to as activities of daily living, or ADLs.  While it comes as no surprise that activities such as grooming and feeding are ADLs, some people may not acknowledge or even realize that sexual activity is also included in this category.  While a dialogue on this topic may be awkward for patient and practitioner alike to initiate, there are ways in which an occupational therapist may tactfully determine the need to address this area.  For example, the therapist may administer a questionnaire that allows an individual to indicate various areas of difficulty, including sexual concerns.  In any case, it is important to realize that a physical deficit does not have to prevent an individual from being able to engage in sexual expression.  Because occupational therapists are skilled in rehabilitation as well as activity modification and other compensatory strategies, they are equipped to provide therapeutic intervention in this often overlooked area of daily life.  


Sunday, July 14, 2013

Occupied at the Farmer's Market

          In the field of occupational therapy, an occupation refers to any meaningful pursuit in which an individual engages.  A common misconception is that occupation is limited to employment, although work can most definitely be an occupation in the therapeutic sense.  For example, if an individual views work solely as a way to obtain a paycheck, he or she may not find meaning in its associated activities. Therefore, the thought of returning to a job may not serve as motivation for engaging 100% in therapy. However, someone who enjoys collecting and restoring antique items may consider this pastime to be an occupation, even if it generates no income, and therefore miss each day he or she is unable to pursue this interest.     
          On a recent visit to a farmer's market with my husband, I was struck by the vast array of occupations represented by vendors within a single city block, which ranged from growing produce and baking to crafting soap and volunteering on behalf of a local food co-op.  Likewise, as supporters of this event, the patrons were actively pursuing their own occupations such as shopping, healthy meal preparation, and, yes, even good old-fashioned people watching.  As an occupational therapist, I am challenged to see beyond the walls of the clinic and visualize individuals performing occupations such as these with increased comfort, effectiveness, and safety.