A Voice in the OT Wilderness

Saturday night’s alright for fightin’

2009-11-10T01:10:00Z

Back in August, I blogged about my mother and her attitudes about death. Recently, we had the opportunity – if you can call it that – to examine the subtleties of her perspective, and how it is reflected in her advanced directive. Mom was taken to the ER around 10 p.m. on Saturday night with severe back pain that turned out to be the symptom of a leaking thoracic aortic aneurysm. She was aware of an abdominal aneurysm that her primary care doctor found a couple of years ago; but she has been telling...(read more)

Phoenix Rising

2009-10-26T20:44:00Z

"What strategies are occupational therapists interested in mental health going to develop to both assert the field as an effective treatment and practice it as such?" This question was posed by an OT student in her comments on my assertion that advocacy groups such as the Icarus Project can provide new ideas - and "re-emergent" practice opportunities - for OTs who want to focus on mental/behavioral health challenges. How would you address this student's question? What have you done to overcome the...(read more)

Got Wings?

2009-10-12T18:23:00Z

This blog is ostensibly about emerging OT practices, of which case management is but one example. But there are also existing OT practices that can become "re-emergent" if more OT practitioners consider them in the context of new information. In the U.S., few OTs work in programs specifically for people with mental illness - when formal programs even exist in the current reimbursement system. But one of the themes of OT "identity and public recognition" - and increasingly, U.S. health care in general...(read more)

Still Impressionable

2009-09-29T20:50:00Z

What experiences in your career have awakened you to beliefs you didn't know you had, and/or made you change your mind about any of them? For me, it took providing disability case management (DCM) services to injured workers to find out how elitist I was as a result of my upbringing. Although my parents overtly taught me not to automatically judge people on the basis of things such as race, gender or nationality, they themselves subscribed to various "-isms", mostly related to social class. Consciously,...(read more)

Po-tay-toe, Po-tah-toe...Tuber

2009-09-21T21:36:00Z

What strategies do you use to remind yourself to use person-centered language in your professional communication? I still see the word "patient" used a lot in the health care literature, even though the concept of "person-centered service" is becoming more familiar to the general public via phrases such as "consumer-driven care". The cartoonist Randy Glasbergen recently drew a panel in which a woman says to her doctor, "You have to learn about thousands of diseases, but I only have to focus on fixing...(read more)

The things I find via Facebook!

2009-09-14T21:30:00Z

Of all the misunderstandings I’ve heard or read about what OT is and/or what we supposedly do, this one is a real corker: According to a blog by a British OT with whom I’ve connected on Facebook, a member (I assume by her title: Baroness Finley) of the House of Lords suggested in 2008 that OTs should be involved in evaluating the mental capacity of people requesting assistance to die! But wait: that isn’t what I consider to be the misunderstanding! Usually it’s non-OTs thinking we’re less than what...(read more)

ADL activity: baking a file into a cake

2009-09-08T20:04:00Z

As I mentioned in my 8/24/09 post, some people consider being placed in a nursing home (long-term care/LTC facility) tantamount to a life sentence in a prison. The stereotype is powerful enough to make some people view even assisted living facilities as a '"sneaky back door" into LTC, thus fueling resistance to discussing alternatives to current living situations as part of the aging process. Various organizations and publications develop guidelines for the general public to consult when considering...(read more)

What more could an OT have done?

2009-08-31T21:17:00Z

An article in Aging Well Magazine 1 tells the story about an elderly woman named Margaret who, for nearly 8 years, managed to stay in her own home despite strenuous efforts to assign her to long-term-care (LTC) "before her time". The article describes Margaret as an intelligent woman with strong self-advocacy and creative problem-solving skills. She hired the author, a social worker named Carol Heape, to help her continue to live in a house that Margaret had bought and remodeled according to her...(read more)

Where's the OT advocacy in LTC?

2009-08-24T20:08:00Z

I've seen several articles this year that make me wonder how many OTs working in Long Term Care (LTC) settings are incorporating advocacy into their daily practices. Advocacy is an integral part of OT practice in several domains and processes described in the second edition of Occupational Therapy Practice Framework: Domain & Process 1 ["Practice Framework" for short]. I consider OT advocacy in LTC to include intervention planning and implementation that makes sure that every resident of the...(read more)

(Not) In the Mood

2009-08-17T21:25:00Z

I have tried to stay away from writing in this blog about the political mess masquerading as “health reform” efforts; but the media din has given me writer’s block on any other topic. Maybe I’m just intimidated by the spectacular capacity for fiction-writing coming out of the mouths of some members of Congress: “Death Squads” coming to homes of the elderly to tell them their date and method of death? Doctors getting paid by Medicare to encourage euthanasia for the elderly as a way to save money?...(read more)

[Open-faced] Sandwich Generation

2009-08-10T21:25:00Z

I am one of millions of baby-boomers directly helping a parent deal with the challenges of aging. Probably unlike most of my cohorts, however, I am lucky to have a parent who isn’t in denial about her fading abilities. Additionally, my parents were never shy about talking about death and dying – in fact, over the years we’ve had some rather morbidly funny conversations about The Inevitable. After my father died at 92, my mother started talking about maybe moving to a Life Care community, where whatever...(read more)

Adjectives-schmadjectives

2009-08-03T20:31:00Z

If you see a work of art and then find out that the artist is "disabled", does that change your opinion about the art? I got to thinking about this question after I posted last week’s blog on "suffering". As you know, the word "disabled" has its controversies, which include the "pity factor" the term evokes in many "non-disabled" people. I mentioned in the "suffering" essay that there can be secondary gain from using the term, and I believe that is true for "disabled" as well. I periodically get...(read more)

Another word-bone to pick

2009-07-27T20:58:00Z

Pain is inevitable; suffering is optional .- Unknown Anita, a reader of this blog, recently asked me what I think of the term "suffer" – as in "the woman ‘suffered a stroke’, the person ‘suffers from schizophrenia’ .…" My short answer is that we should be careful about assigning "intensity" descriptions to another person’s experience based on how we think we’d react to or interpret the situation. We could end up making things worse for a person trying to tap into his/her resilience to maintain hope...(read more)

A New Model for OT Consideration

2009-07-20T15:44:00Z

In my house I'm the boss. My wife is just the decision maker - Woody Allen In her article in OT Practice (7/28/08, pgs 15-18), "Working With the 'Difficult' Client", Costa states (pg 16), "Clients who arouse negative feelings are often those who do not respond to treatment, fail to comply with treatment recommendations, or challenge clinicians' authority. " I'm surprised to see the concepts of "compliance" and "clinicians' authority" still being presented to health and human service professionals....(read more)

A different kind of success

2009-07-13T19:35:00Z

How many of us OTs have proposed arts and crafts activities to people who are resistant to the idea because they believe they'll really stink at it? Or how often have our clients done really well with the component skills of a creative project, only to produce something they don't like the looks of? Well, as Apple, Inc. says, "there's an app. for that": The Ugly Necklace Contest . This is an annual event, sponsored by a jewelry-making supplies store called "Land of Odds." The entries (not to mention...(read more)