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When OTs Wore White Shoes

Occupational Therapy for Dogs
January 26, 2017 12:30 PM by Debra Karplus

My 50-year-old friend, Sam, called. His back and knees are hurting because he has been carrying his beloved pooch up and down flights of stairs since the elevator to his sixth floor New York apartment has recently been out of service.

But he is more concerned about his ailing 60 pound basset hound, Jamal. Jamal is nearly 13 years old and has problems with his hips - not unusual in that breed of dog. Because of these hip problems, Jamal wears a harness for his daily walk to do his business; putting Jamal in and out of this harness requires Sam to do a lot of bending. He pulls Jamal in a wagon for some outings which requires him to lift the pup in and out of his little vehicle. For longer journeys or during inclement weather, Sam resorts to hiring a pet taxi to transport Jamal.

Sam tells me that Jamal has been diagnosed with arthritis and takes an anti-inflammatory medication and periodically is treated with acupuncture. Our family hasn't had a dog since about 1987; we'd had our dog, Harold, since 1974, and he was a very healthy and sturdy canine until he died from leukemia. I am now beginning to understand that dogs have some of the same maladies that humans have.

I feel that both man and dog could use some help from occupational therapy. Sam needs some guidance on body mechanics, specifically to remember to bend at the knees. And at some point, dog or no dog, Sam, no longer a youngster, may want to rethink living on a sixth floor because that's a lot of stairs to handle on the occasion that the elevator may fail again in the future.

Sam might also benefit from some special services. Looking online, I was pleasantly surprised to discover that there are rehabilitative services for dogs with physical disabilities. I learned that, here in my own town, the University of Illinois, known for its top-notch school of veterinary medicine, offers therapy services for dogs. I was delighted to learn that programs such as this exist all over the country, including in New York City where Sam and Jamal are trying to make the most of every day.

This situation with Sam and his disabled furry friend made me wonder if there is a place for occupational therapy in the world of animals, especially dogs. I've been searching online and putting much thought into the possibility of adaptive equipment or mobility devices for Jamal to use to make life a little better - for both him and Sam.

I am very curious to hear from occupational therapists and other health care providers of man and dog on this intriguing (at least to me) subject of special equipment for the activities of daily living for dogs, specifically for their mobility.

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Reflections from a One-handed OT
January 20, 2017 12:15 PM by Debra Karplus
It's now been 3.5 weeks since I fell on my icy driveway getting into a friend's car to go swimming, fracturing my left wrist; I'm left handed. Typically I'm a very active person in terms of exercise, including walking, biking, swimming and racket sports. I also am a doer, someone who gets out with friends to the symphony and numerous local events. And as a semi-retired person, I spend a fair amount of time serving others through a variety of volunteer work that I really enjoy doing.

Being in a hard plaster wrist cast has made it virtually impossible to hand write anything legible and also has made me reluctant to get behind the wheel until I have a bit more dexterity and strength in a wrist that hopefully will be un-casted soon.

So how am I filling my days? Well for starters, I seem to be sleeping much more than usual. Possibly it's simply because I am getting older, or perhaps it's the response to long stretches of sleep deprivation from being caught up in my own busy-ness at the expense of quality shuteye. Or maybe my body just craves the extra sleep to perform the magic of healing a small bone that broke into two pieces.

But the remaining 14-or-so hours of being awake each day has created a new normal, at least for now. A bit to my surprise, I've turned into a bit of a homebody. When friends aren't transporting me to doctor visits or grocery stores, I have enjoyed having people visit. I can make a cup of herbal tea one-handed like nobody can, and have been improving my skill at word games like Scrabble.

I do know that friends have their own lives, and though limited, I am doing a fairly good job staying grounded and feeling content. Part of that is the fact that being relatively homebound has kept the usual distractions away, and I have felt much more mindful and in the moment. Doing daily tasks such as dressing, bathing and preparing lunch simply takes longer, but I am finding a new joy in them.

The rest of my time seems to be filled with listening to beautiful music on the local public radio station and reading books and short stories that have been sitting on my bookshelf unopened.

But writing for ADVANCE, Prime Life Times, a local publication for seniors, and The Dollar Stretcher, an online venue where I can write about health-related topics as well as other subjects applying my business and finance background as well as my passion for doing research, brings me great joy.

This stretch of time with my temporary disability and ample alone time has given me the opportunity to sit and ponder life, both personally and professionally. I think we as OTs generally do a phenomenal job on the physiological needs of our patients, be we should always remember what the word "occupation" implies in our profession's name.

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Aging in Place: An OT's Testimonial
January 9, 2017 11:22 AM by Debra Karplus
Last year I did something I never imagined I'd do. I bought a condo and sold my house. In 1978 with a newborn and a two year old, we bought a three-story home near the heart of downtown in our college town that had been built in 1907. I had so many wonderful memories of raising children there, the garden, the wood-burning stove, and the chance to use my creativity to problem-solve each time I wanted to repair or renovate, such as gutting the pantry to add a powder room in 2012.

So what prompted this move? About six years ago my neighbor fell at work and injured his, requiring surgeries and a long convalescence camped out mainly in his living room.  This got my occupational therapy brain in gear; if I were to be injured or disabled in some way, there would be no way I could function independently in that house. The gravel driveway and detached garage would have been difficult. All of the three entrances to the house were narrow and had four steps to get in. And though I did add the half bath downstairs, it was a tight fit to get into that tiny room.

At the start of 2016, I became serious about the idea that our family home of nearly 38 years was clearly not a good place to grow old in. I began searching online for homes for sale and started simply driving down different streets while doing errands to become familiar with different neighborhoods. In March I contacted a realtor and told her my age and motivation for wanting to make a move, and that I wanted a place in a relatively quiet neighborhood - all on a first floor with no upstairs or basement, 3 bedrooms, 2 full baths, an attached two-car garage, in an area where there were places to walk, parks, restaurants, shopping and a bus line.

The first three houses that the realtor told me about didn't sound like what I wanted, but when she emailed me about the condo in a subdivision called Ponds of Windsor, I took a look and 20 minutes later I made an offer. I moved on June 7, and never once have I doubted that this decision was the right one.

As I sit in the smallest bedroom which I use as an office, looking out at one of our two snow-covered ponds, I reflect on the days since I fractured my wrist. I have had nearly a month now testing out this place with my new and presumably temporary disability and it seems to be the best case scenario. I especially appreciate that I can kick the laundry basket from the bedroom to the laundry room just off the kitchen and wash my clothes without help.

When the cast is off and I can write and drive again, I am thinking of providing consultation to other baby boomers who want to age in place.

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Occupational Therapy for Daily Tasks
January 5, 2017 11:06 AM by Debra Karplus
Careful as I typically am, icy conditions recently got the best of me. I slipped and fell, causing me to break my left wrist; and I am left-handed. These few weeks since my injury have given me an increased appreciation for the challenges of daily life that our patients face, many for the remainder of their lives. Simple tasks like taking a bath become an evening's event, with each step deliberately thought out and planned. Everything takes so much longer.

In the early 1990s, when much of my work as an OT involved signing off on evaluations and progress notes, I had the wherewithal to have a rubber stamp of my signature. It has sat unused until this recent fracture and has been quite handy for signing checks and certain other documents.

Unable to neither drive nor tie shoes, a friend drove me to a nearby sporting goods and athletic shoe store, Body n Sole, where they put elastic laces in one of my pairs of shoes since all the shoes I own require tying. I asked another friend to bring me a bag of 100 dental flossers that make small work of flossing my teeth.

It's also cold here and I need to get out for doctor appointments. Even my largest mitten does not fit over the hard cast that extends over part of my hand. The clever OT that I am, I slip the affected arm into a stretchy legwarmer if I need to leave the house.

Kitchen tasks are tricky. It may be awhile before I can safely use a knife to cut up an orange for breakfast. And opening most containers, medication or food, is virtually impossible. Thanks to another helpful friend, my medication and vitamins sit in containers that stay open.

Meal preparation has been doable. For breakfast I can make hot tea and cook oatmeal with some yogurt and a glass of milk. Lunch or dinner can include salad from a bag and a handful of cherry tomatoes. I can make soup if it comes from a box instead of a can. I can toast bread one-handed, and can cook frozen veggies such as Brussels sprouts on the stovetop as well as put some kind of protein entrée in the oven. I have a cupboard filled with yummy canned goods, but for now they can only be opened by someone else.

I discovered that for those of us who are seniors there is access to free rides through a local social service agency. Also, several of the nearby grocery stores deliver, as do some of the pharmacies.

So what advice do I have for those reading this? Get a stamp made of your signature and a black ink pad. Own at least one pair of slip-on shoes or those with Velcro. Have at least one button-down shirt, a sweater and a jacket that fastens with something other than a zipper. Find a can opener that works by just using one hand.

And if the unthinkable happens, reach out to family, friends, neighbors, and your church community because people truly find joy in being helpful.

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Health and Wellness Fairs
March 3, 2016 2:45 PM by Debra Karplus

On more than one occasion, I have been driving around town on a Saturday morning doing miscellaneous errands and felt compelled to stop to check out some local health and wellness fair. There are several of these fairs each year around here; it seems that various different groups sponsor the fairs, such as the Disability Expo that is held annually for the past decade each fall at a mall or some other venue. These wellness fairs are generally free to attend, and various exhibitors pay a fixed amount of money to set up a booth at the expo to make the fair cost-effective.

Often the exhibitors are hospitals, rehabilitation facilities, chiropractors, physical therapy clinics, and often a bank or two and some of the media such as the local newspaper, radio or television station. You can expect to find various fitness screenings offered at one of these events such as a spinal check by a chiropractor or a blood pressure check. These fairs are designed to be both educational and interactive with the focus and purpose of being a combination of preventative medicine along outreach with a showcase of available community services and resources to offer opportunities for awareness.

What baffles me about most of the health and wellness fairs that I have attended, most of which have been events in my own town here, is that many or even most of the exhibitors, along with brochures and marketing trinkets, have a container of free candy such as Hershey's Kisses, Reese's Pieces and Tootsie Rolls on their table. Now I'm not at all saying that I don't overindulge on these free sweets; after all, doesn't "free" imply that there are no calories? Is the fact that they are offered at a health and wellness expo implying that there is something inherently healthy about these treats?

It's curious to me that physical therapists and rehabilitation clinics often have a strong presence at these wellness fairs, but I don't remember ever noticing a table with occupational therapists "strutting their stuff." The American Occupational Therapy (AOTA) has named April as Occupational Therapy Month to coincide with the annual Occupational Therapy Conference each spring. This has been occurring since 1980, according to AOTA. Because I have done much per diem work where my OT services were contracted by a variety of places rather than having one single workplace, I have never actually participated in Occupational Therapy Month anywhere.

I would enjoy hearing from other occupational therapy practitioners regarding their participation as exhibitors or sponsors of health and wellness fairs and/or how they and their work places have represented OT as part of National Occupational Therapy Month each spring.


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Explaining Disability to Children
February 22, 2016 1:56 PM by Debra Karplus

Growing up in Chicago and its north suburban areas in the 1950s and 60s, I have absolutely no recollection of ever seeing anyone in person, in television, or in movies who had a disability. In a way, it's ironic that I ended up choosing a career as an occupational therapist which involved helping people who have disabilities, both visible and not.

The first real person I ever saw in a wheelchair was at dinner in my college dormitory when I was a freshman, and I was already enrolled in the occupational therapy undergraduate program at the time. (In a strange series of circumstances, she and I have become close friends since then.)

But in so many ways, we live in a very different world, especially in all of the civil rights legislation for people with disabilities as well as other populations that has evolved in the over four decades that I have been an OT.

About 20 years ago, I remember one of the younger members of the family asking a woman in a wheelchair who had an amputated leg, as the result of an infection, if her leg would grow back. What an interesting thing for a young child to ponder. After all, hair grows after being cut, as do finger nails and toe nails, and cuts and scrapes on the body turn into scabs and heal - so why would an amputated leg not grow back?

Last summer, I took my two oldest grandchildren who are in middle school to play mini-golf while they were here in town visiting me. I was trying to determine, while scoring, if they should be given a handicap to make our scores more equitable. My granddaughter quickly corrected me that I should have used the word "disability" not "handicap." The conversation seemed to have no logical end to it as I tried to explain to her that the word "handicap" was being used in a completely different context when applied to a mini-golf score. (Now that she is older, we might need to re-visit that conversation!)

In a different discussion, I asked my grandchildren if they had any special needs kids in their classes at school. Their faces, with rolled eyes, showed me that they were thinking, "sure we have kids with disabilities at school, so what's the big deal!"

So, I am wondering what experience, either personal or professional, other occupational therapy practitioners have had related to explaining disability to children.

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Spinal Stenosis
February 17, 2016 12:16 PM by Debra Karplus

One of my relatives, who is in his eighties, shared with me that though he is in excellent health, he was recently diagnosed with spinal stenosis. He now uses a walker at times to keep him steady on his feet, but he does have a sense of relief that at least now he has a medical explanation for the frequent pain in his lower back, hip and leg. He feels unsteady sometimes and is very fearful of falling, as he should be, given the high incidence of falls in older adults.

To be honest, I don't really remember learning about spinal stenosis when I was in occupational therapy school in the early 1970s. And as a semi-retired OT, it is been a few years since I have worked in a clinical setting. So, I have little professional experience with spinal stenosis. But always curious, I started searching online to learn more about spinal stenosis in hopes of being helpful in some way to my relative.

I discovered that spinal stenosis involves the narrowing of the spaces in the spine (backbone). Of course, I already knew that was what happened to people as they age; I may have learned about it under some other name perhaps. In addition to an aging skeletal system, spinal stenosis can occur as the result of arthritis, either rheumatoid arthritis or osteoarthritis, in people of all ages. Trauma to the spine can lead to spinal stenosis. And like many maladies, there is a genetic component to the occurrence of spinal stenosis.

The lumbar region, the lower portion of the spine, is where 75% of spinal stenosis occurs, I learned. And I already knew that the compression of nerves from the closeness of the spinal bones, is what caused discomfort and pain in the leg for the sufferer.

They say that spinal stenosis is sometimes difficult to diagnose, as are many disorders with similar symptoms. The treatment, according to WebMD is to change standing, sitting and sleeping positions to aim for less discomfort. Medications such as anti-inflammatory products can help, as can simply resting the area that is in pain.

Given that spinal stenosis is very common, especially in our geriatric patients, I am wondering what occupational therapy practitioners are currently doing for these people in the clinical setting. It seems that the same regiment we use with our patients with arthritis would be appropriate with our patients who have spinal stenosis, whether it is their only documented diagnosis or one of many health problems.

Addressing activities of daily living, in my opinion, might be the basis for an OT program for someone with spinal stenosis with focus on work simplification, energy conservation, body positioning and adaptive equipment as needed. Also, I think a good OT program would involve upper extremity strengthening, especially if use of a cane, walker or wheelchair would require stronger arms.

I would like to hear from other occupational therapy practitioners regarding their clinical work with spinal stenosis.

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Stroke and Short Term Memory
February 8, 2016 9:03 AM by Debra Karplus
Though more of a lark than a night owl, and seldom staying awake late enough to enjoy late night television, I remember in the early 1990s people were talking about one of the comical characters on NBC's popular show Saturday Night Live, Mr. Short Term Memory. On some online lists, Mr. Short Term Memory was considered one of the show's most memorable characters. I believe a very young Tom Hanks played that character, a man who remembered very little from minute to minute. Viewers found this to be very funny.

I recently became friendly with a man, probably in his mid-sixties. He appears to have much energy, rides a bicycle around town, swims regularly, has seemingly healthy living habits, and is reasonably trim in terms of body build. He has the agility, coordination and dexterity to perform many of his own home improvement projects with ease. But if you talk with him for a bit, you might start to notice that something is clearly amiss. Though he speaks well and is fairly articulate, his ability to remember the names of people, even those he knows fairly well, seems notably impaired as is his ability to name some common places and objects. 

Recently, he shared with me that he had suffered a stroke in his late 40s that he attributes to being overly-stressed at that time in his life. Though he does not seem cognizant of the fact that he clearly has some memory issues, and some form of aphasia or agnosia, he does admit to being disorganized at times, which, let's face it, is a problem for many or even most adults and children.

As I have gotten to know him better, I have learned that in recent years his job history has been "shaky," and even with a Master's Degree he has been let go from several jobs over the past several years. I feel uncomfortable asking Mike why he thinks that holding down a job has been such a challenge for him. Perhaps he will share that with me at some point in time.

I know that Mike has no current drug or alcohol abuse issues; I don't think alcohol use has ever been a problem for him. And again, I never asked him if he was a drug user or abuser like many baby boomers were in the 1960s, 1970s, and even beyond. If I had known Mike before he had his stroke, it would certainly be much easier to sort this all out, but I value our friendship and don't really need answers to any of this.

As we work with our patients who have suffered strokes, it is essential that we discuss with them, and perhaps more importantly with their families, what they were like before they had the stroke. It would simply make it easier to establish individualized goals that are realistic for the patient based on their premorbid condition.

I would enjoy hearing from other occupational therapy practitioners about their experiences with this subject.

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Chair Yoga
February 1, 2016 10:47 AM by Debra Karplus

I've written a couple of other blogs here about yoga; one was a general article about the benefits of yoga for our patients and for ourselves, and the other blog was about my experience trying laughter yoga at a local park district event.

My personal interest in yoga comes from the fact that I sometimes attend a variety of different kinds of yoga classes offered by various places here in my hometown. I understand that it would be more correct to say that "I practice yoga," but being a bit clumsy and not participating with any real regularity or predictable frequency, I'm not sure I can even honestly make such a claim!

A good friend of mine was very excited when she earned certification to teach "chair yoga." She has started teachiong a business class around town which always fills with participants quickly. I believe that to be certified to teach chair yoga, one must first be certified in yoga in general, but I am not certain about this.

There are distinct styles or types of yoga, and my experience is that each yoga instructor has their own differences on how they lead a yoga session and what special equipment they use such as straps, blocks, balls, and other accessories.

Chair yoga is not unlike gentle yoga, but there are some subtle differences between the two. Chair yoga always involves sitting or standing in a chair, while using the support of the chair for yoga positions. Chair yoga is designed to improve overall physical and mental health and incorporates some of the same breathing techniques as regular yoga, along with postures, meditations and relaxation techniques. 

For seniors, or simply for people who are unable to get onto the floor on a yoga mat, chair yoga has many advantages over standard yoga. This has great implications for occupational therapists working in a variety of clinical settings. Many of our patients in rehabilitation facilities such as hospitals and long term care settings use wheelchairs either permanently or temporarily while they are working in therapy to become stronger and increase endurance. Chair yoga could be very beneficial to these people who receive our services. Children in schools, even the very little ones, are not too young to be in a chair or wheelchair and assume seated postures and practice chair yoga techniques and positions.

I would love to hear from occupational therapy practitioners who are reading this blog to share their own personal and professional experiences about using chair yoga with clients in various settings for people of different ages and diagnoses.

I welcome your comments.

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Body Mechanics
January 26, 2016 3:02 PM by Debra Karplus
A friend of mine had a successful career as a dental hygienist but ultimately needed to "retire" much sooner than she would have wanted to due to carpal tunnel syndrome and other problems in her wrists and hands which she attributes to the required body position necessary to perform the tasks of a dental hygienist. She pursued a completely different career as a librarian, which she insists has been far easier on her aging body than dentistry.

As I entered my dentist's office last week for a minor procedure, I thought back to my friend's situation and opted to pay close attention to the positioning of my dentist as he worked on my teeth.  But given the fact that he and his hygienist were literally "in my face", it was virtually impossible to pay attention to anything but the sound of the dentist's noisy little drill.

Occupational therapists and physical therapists presumably know the basics of body mechanics which fundamentally involves bending at the knees when lifting and being prudent while bending and twisting simultaneously.  But sometimes we are in a hurry, whether in our professional lives or personal lives; we don't pay attention, and we suffer a minor or more serious back injury.

In the 1990s, one of the jobs I performed as part of my occupational therapy practice was presenting in-services and workshops to companies, factories, and movers to train in proper body mechanics.  I had a sense that my services were requested not as part of some routine training but rather the result of some worker possibly having gotten hurt while on the job.  In any case, my services were well-received and I truly felt that I had made a difference, the underlying reason I chose to be an OT to begin with!

But recently, I have been wondering if training in ergonomics and body mechanics is part of the schooling of other health care professions.  OSHA ( sets guidelines for training in blood borne pathogens for people working in health care and other professions such as teaching in a public school; most of us receive this training when we start a new OT job, including a short quiz that must be passed.  But what about training in body mechanics?

Many of our work places also require testing for tuberculosis (TB), which still seems a little odd to me, given that TB is no longer prevalent, and the irony that many people with more common contagious illnesses such as strep throat, the flu, and even bad colds show up at work and contaminate co-workers and patients by leaving their germs on various surfaces.

I'm digressing here.  But I guess the point that I am trying to make is that if ergonomics and body mechanics are not part of the coursework of other professions, particularly those in healthcare, maybe a new market for us as OTs would be to provide this training to our colleagues.

I'm curious if any OTs out there are already doing this.

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Therapy on Wheels
January 18, 2016 9:24 AM by Debra Karplus
The other day I drove by the local Bloodmobile parked in front of a large downtown bank near my house. It brought to mind an old fantasy that I had entertained for years, but never actually acted on it. 

During most of my years working as an occupational therapist, my market niche was rural Central Illinois. My clients were basically facilities and agencies that were unable to find an occupational therapist that was willing to drive to the hinterlands to provide rehabilitation service to geriatric clients. I travelled in some of Illinois' worst winter weather and in the warmer months I drove amidst all kinds of heavy duty highway construction, to see patients in long term care facilities around the states. 

My practice later expanded to performing wheelchair evaluations, doing home visits for the birth-to-three population, and also evaluating students in schools and attending numerous Individualized Education Plan (IEP) meetings and team meetings at small town schools. My tiny station wagon, and more recently my Honda Civic, had so much therapy paraphernalia, as well as files on each of my facilities and each of the patients on my caseloads, in the back or in the trunk that a simple routine weekend trip to the supermarket was a challenge in terms of finding room in the car for groceries.

And though I don't think I have ever driven any vehicle much larger than a hatchback (I recall owning an AMC Gremlin, circa 1975) my fantasy involved owning and driving my own "therapy clinic on wheels", something about the size of the Bloodmobile or the library's Bookmobile, all around Illinois that was completely accessible for even a wide wheelchair. It would hold all the therapy equipment necessary to provide comprehensive services at that time, such as a Deltoid aid, and possibly even some parallel bars if I could squeeze them in.

As curious as I often am, I searched online to see if any occupational therapist or even physical therapist, speech and language pathologist, or other health care professional had taken the step beyond my fantasy and brought therapy services to the patient in a recreational vehicle type of transportation. Perhaps I didn't use the correct key words in my search, but I didn't stumble upon any mobile health care providers who were servicing out-of-town clients in this way.

With over forty years of therapy work behind me, and the fact that yes, indeed, I now drive like an old lady (I'm now in my mid-60s, so I think I have a good excuse!) I really don't see myself purchasing an RV and converting it into a therapy mobile. But I am darn curious if any of my readers know of a trailblazing OT or PT who is hitting the open road in a large vehicle and inviting patients into it for rehabilitation.


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OT and English Learner Students
January 12, 2016 2:43 PM by Debra Karplus

Passionate about genealogy, I learned a long time ago that my grandparents and those before them were immigrants -- mainly from Ukraine, Kiev, Pale of Settlement, Poland and Hungary. My ancestors came to America between 1880 and 1921 through Ellis Island and other American and Canadian ports, knowing little to no English. They were part of the "melting pot" that assimilated into American life, learning enough English to function in this country, start businesses, and contribute to American culture in very positive ways. 

These days, immigration is a hot topic of discussion that seems to gain much attention by the media and by politicians who often have strong opinions on the subject. People are coming to America from Spanish-speaking and other countries to make a good life for themselves and their families. How wonderful it is to those of us who only know the American culture to be able to share our world with others who can add so much to it!

As occupational therapy practitioners, we're likely to have patients or clients from other cultures in whatever setting where we might be working, such as geriatric, rehabilitation or school systems. While in college or beyond, it can be very helpful to learn at least a little Spanish or some other language; and better yet, to become fluent in both spoken and written components of the language. Your clients have much to benefit from your ability to communicate to them in a familiar language; which, consequently, makes your life richer.

If you're providing OT services in school systems, as many OTs are, knowing the terms and acronyms will help you become more effective in your work and especially in communicating to others on your professional team. "English learners" (EL) is the term used to describe a variety of people who are not primarily English speakers. English as a Second Language (ESL) or Transitional Program of Instruction (TPI) are types of school programs for students learning English. TBE refers to Transitional Bilingual Education, and DL is Dual Language. Students in these programs may spend part or all of their day in classes specially designed for them to learn more English to catch up with peers. The school where you work, or where your child is a student, may be staffed to offer none, some, or all of these types of programs.

Besides language, it is essential that you, the OT practitioner, be sensitive and aware of certain cultural differences. For example, making eye contact is not part of certain cultures when interacting. And, some cultures are more dependent on spoken rather than written communication. You may have a new student on your caseload with difficulty holding a pencil, for example, because in his or her culture, this was not a necessary skill.

How exciting that we live in times when our world can seem bigger and more interesting because we have the opportunity to share it with those who are different from us.

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The Paralympics
November 10, 2015 11:48 AM by Debra Karplus

I am a member of the Neighborhood Services Advisory Board here in my town. Via a recent city event, I met a lovely young woman who is employed by the city's public works department, specifically recycling. Over dinner, several of us started talking and I discovered that this woman was also involved in Paralympic Volleyball. Confused why that such a very poised and able-bodied ambulatory woman was involved in sports specifically for people with disabilities, my look of surprise obviously caught her attention.

That's when Nichole Millage #13 subtly handed me a colorful glossy postcard-sized business card listing the achievements of this two-time Paralympic silver medalist, a member of the USA National Sitting Volleyball Team since 2005. I was impressed! Her card states that she graduated from one of our local high schools in 1995, and lost her left leg below the knee after a 1998 boating accident when she was only 21 years old. 

Growing up in Chicago, I attended a fair number of Cubs games at Wrigley Field. But, frankly, I am not someone who follows any sports, and seldom attends any games, not even college football or basketball which are huge here in this Big Ten college community of Champaign-Urbana. So, I've never really given much thought to wheelchair sports either. As an occupational therapy student here at the University of Illinois, I was somewhat aware of wheelchair basketball, but that's about the extent of my interest in any kind of spectator sports.

Curious, I did some searching online about wheelchair sports. I was quite surprised at their long and extensive history. Wheelchair athletics emerged In 1944 in England. In 1948, the first Olympic Games were held in London. Sixteen men and some women competed in archery. By 1956, volleyball competitions were being held in the Netherlands for people using wheelchairs. By 1960, wheelchair sports, or Paralympics, had grown notably with 400 athletes from 23 different countries competing in archery, basketball, swimming, fencing, javelin, shot put, table tennis and several other sports. There were several web sites that told about different aspects of wheelchair sports including,, and

As occupational therapy practitioners, our ultimate goal, since the beginning of the profession in the early 1900s, has always been to turn disability into ability. Paralympics does exactly that. Many of the wheelchair athletes had in fact been athletes before they acquired a disability, but some became athletes after they became disabled.

I would enjoy hearing from occupational therapy practitioners who have had some personal or professional experience with wheelchair sports.

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Help Fight ALS
October 30, 2015 12:13 PM by Debra Karplus
You probably have never heard of either Ray Spooner or Lynda Holman but both could use your help. Ray is a 56 year old nurse midwife living here in Champaign-Urbana, Illinois. I have known him and his family for many years. Ray is a fascinating man with many interests. I attended his Bar Mitzvah earlier this year. He did an amazing job reading portions of The Torah. At times, he was difficult to understand, not because he was speaking in Hebrew, but because ALS (Lou Gehrig's disease) has impaired his ability to speak.  This deterioration has all happened in the few months since his December 2014 diagnosis.

An avid bicyclist, Ray set out to bike across America to raise money for ALS research. Sadly, fractures from a bike accident in Arizona early in his journey made it impossible for him to continue his ride.

But you can still donate to help fund further research for ALS and MDA via Ray's web site, Ray has received much local press and you can do an online search to learn more about Ray and his fundraising efforts to eliminate this very cruel disease.

Lynda Holman is a school occupational therapist here in Champaign-Urbana. She is a local Autism expert and has done wonderful things with some of the younger children in Champaign Unit 4 Schools. Linda is 50 years old and had to stop working after she was diagnosed with ALS in August 2014. The article in the Champaign-Urbana News-Gazette, asks for donations to help Lynda with medical expenses to be made to Central Illinois Bank in Champaign.

As health care professionals, both Ray and Lynda know the sad reality about ALS. Not too long ago, I wrote a blog about my friend's brother who has ALS; he too is in his fifties, and like Ray and Lynda, took good care of himself and was shocked to learn of his diagnosis.

I had never given much thought to ALS but as it impacts people so close to home, it has really gotten my attention.

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Helmets for Falls?
October 27, 2015 11:18 AM by Debra Karplus

It seems that I attend a lot of funerals these days, mostly of parents of my friends. At this recent funeral, the deceased had been a lively 93 years old. A bad fall at home and a nasty bump on the head lead to complications that ended her life rather quickly.  

At the meal after the funeral service, I shared with a few people that I was an occupational therapist and that many of my patients, particularly the geriatric ones, were victims of falls. One of the guests asked my why at-risk older folks did not wear protective helmets. That conversation really got me thinking.

I have a few older people in my family who are terrified of losing balance and falling, especially those who live alone. (One elderly relative shared with me that she sometimes wore a baseball cap around the house to protect her head in case she fell; right idea, but wrong kind of hat!) They are correct to be fearful, because falls are quite common in older people and can begin a chain of events that can shorten one's life quickly.

So why don't our patients who are at risk for falling wear protective helmets? Many people wear helmets as routine part of their gear for various activities. Football players, whether they are professional players in national leagues, or just young kids playing ball on a park district team, nearly always wear them - or at least they should. Responsible motorcycle riders and bicyclists, if they have any sense of self-preservation and safety, wear protective helmets. Equestrians often wear helmets in case of falling off the horse and getting injured. People, whether they are adults or children, on skateboards or skates should be wearing helmets.

As occupational therapists, helmets are sometimes part of our modality of adaptive equipment for certain medical situations. Babies and very young children often wear helmets, under our recommendation and supervision and monitoring for positioning. Some of the older ambulatory children that we see for therapy often wear helmets for protection and safety from injury.

So that brings us to patients on our caseloads that are especially vulnerable to falls. Might a protective helmet lessen the injury on the unfortunate occasion that they might fall, especially if they are living alone at home?

I would appreciate input from other occupational therapy practitioners and people reading this blog about your thoughts about protective helmets for seniors at risk for falling.


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