My last blog, "Are we REALLY communicating?" focused upon the many ways in which we make contact with others without ever using our voices.  Well, sometimes the moon aligns with the stars and things just seem to come together.  I was reading the AARP Bulletin that very evening (it must have gotten mailed to my address by mistake) and there was a wonderful article in it titled, "What an Outrage:  Talking Dollars and Sense to Medicare.(1)"  The author, Michelle Diament, told the story of a former flight paramedic who was experiencing difficulty with slurred speech secondary to ALS.  The woman she talks about is truly an independent, take-charge person because she found an electronic device to connect AND communicate with others effectively.  The article's content focused upon government and insurance issues; however, as an OT, I found the ingenuity of the featured woman to be awesome.  Her name is Claudia and she is only 48 years old.  Apparently, she found the dedicated, Medicare-funded devices to be too cumbersome, limiting her ability to be as independent as she wished.  So, she did her research and found a simple, relatively inexpensive and readily accessible electronic device on the market that would allow her to "type her thoughts" and to communicate them via electronic voices!  It's the iPod Touch!  When I read that, I was so excited!  Yes, Virginia, there is a Santa Claus!  Electronic devices CAN provide us with quick ways to connect with other people "out there" with a bit of good communication thrown in for good measure!  After she purchased her iPod Touch, all she had to do was "Launch iTunes, log onto the App Store and purchase and download "Proloquo2Go" on iTunes. (2)" Apparently this application from AssistiveWare can "translate" your typewritten words into voices so that you can be understood.  That is so cool!

As I reread the article, I was also drawn to the meat of the author's writing.  She is outraged that Medicare won't cover electronic devices such as the iPod Touch since they are not designed to address a specific medical issue.  The author states that dedicated devices offered to clients sometimes cost as much as $8,000 and can be bulky and difficult to use.  Claudia stated that she spent $375 for the iPod Touch and was able to translate her slurred speech into an effective form of communication independently.  (From what I understand, the Proloquo2Go costs about $189.99 on iTunes.  I am not sure if Claudia paid extra for that.)  But, again, Medicare would not pay.  Well, let's face it, a bureaucracy that large is not efficient enough to research and verify all of the simple ways in which it could be saving money.  A bureaucracy needs to function on a much broader plane.  Its suppliers need to bid upon and be awarded contracts in order to participate in the Medicare program.  Their merchandise must be deemed appropriate and effective.   Individual clients cannot be handed reimbursements for items that THEY determine are the best for them.  A bureaucracy doesn't have the resources to send out representatives to investigate each client's individual needs and to authorize reimbursement based upon those needs.  No, a bureaucracy functions best with rules and regulations etched in granite and six degrees of separation.

So, with those firey thoughts continuing to smolder on the page, let's consider this:  where are we headed with the government being in charge of our healthcare?  Might we be looking at a bigger bureaucracy, one that may include hard-and-fast rules and regulations and many degrees of separation?  Could it be possible that it will actually be more difficult for our voices to be heard?  Sure, healthcare needs reform.  But, I'm not sure that a healthcare system whose policies are dictated by the government - a bureaucracy - would recognize that an iPod Touch could be the solution.   Perhaps, a reform of the procedures used by Medicare to determine the most economical and efficient way to address a client's individual needs would be a better way to make the system work. 

Well, now, there's some food for thought.  This week, before you fill your tummy with turkey and tryptophans, share with me your thoughts on bureaucracies and healthcare, paying more when we could get something better for less, or the six degrees of separation that keep us from connecting and communicating our government.

So, until next time,

Stay Connected!

Katherine

(1) AARP Bulletin, November 2009, Vol. 50, No. 9, p. 6.

(2) http://www.proloquo2go.com, "4 Steps to Proloquo2Go.

Hello, everyone!  I hope you are having a great day!  It's so wonderful to know that each day the sun will rise and that once again, we will be provided with opportunities to connect with someone.  Just this morning, I connected with my mom to wish her a Happy Birthday!  We had visited her in Central New York this past weekend to celebrate her birthday in person.  But I don't think that there is anything better than a personal greeting on your special day.  Thank goodness for the telephone; it's almost like being there.  No capability for hugs, however. 

Connecting with others requires the use of many forms of communication.  On our way back from our trip to see our moms this weekend, my husband and I had an amazing "OT Moment."  When we were nearly home, we were following an older man on a bicycle.  As he was about to turn left, he diligently put out his left arm and pointed his intentions with A LONG-HANDLED REACHER!  My husband was so quick - he said, "Now that's a creative adaptation for a long-handled reacher!"  After I stopped laughing, I thought, "What a great communication tool!"  We certainly understood his language!  Seriously though, good communication skills are keys tools in our personal and business lives.  Many of my past blogs have been about the very lack of communication in my attempts to connect with others.  The man with the reacher got me thinking:  "How are MY communications skills?  What are the methods of communication that I use to reach out to others?"

We are very fortunate to live in this dynamic electronic age.  We have iPhones, Blackberries, Skype, Facebook, Instant Messaging, twitter, blogging, voice chatting, email, and, thank goodness, TEXT MESSAGING!  What would I do without THAT!!  We can communicate and connect with our families, business associates, sales people and even our mothers without ever having to use our vocal cords!!  What a wonderful world.  But, wait...did I say communicate?  Yes, we can make a connection with a text message, an email or an IM; but do we actually communicate? 

My husband, John, is a virtual supervisor (now there ain't nothin' better than having your supervisor 900 miles away!).  He has nine employees, with experience ranging from intern status to seasoned experts.  Two of them are in Boston and have the benefit of having him close by.  The other seven need to rely on communicating with him via email and phone.  In addition, John is currently interviewing candidates located all over the US and in foreign locations for a vacant virtual position!  Phew, he certainly has his work cut out for him.  How does he do it?

Effective communication is based upon both verbal and nonverbal language.  When John is interacting with his two local employees, they have the benefit of observing each other's body language.  They can make eye contact, nod agreement, recognize when the other person is done speaking.  On the telephone, his virtual employees are listening only, unless they are also typing or reading their emails at the same time!  When we are listening only, we get easily distracted by others coming into our office, items on our desk or our own thoughts.  It's much more difficult to start fiddling with things on your desk if you are face-to-face with the speaker. At times, we even can misunderstand a message.  The employees at the remote sites cannot see John's facial expressions, nor can he "see" if they understand him or are confused. 

Time for a funny story:  A long, long time ago...waaay back in 1999, I was working at a "remote site!"  John was on Cape Cod and I was working in Albany, NY.  I was living with my daughter and using her computer to IM my hubby.  I was new to all of that high tech stuff and was excited about saving money on phone bills by using IM.  Well, John and I are about 10 minutes into our first IM'ing session and I say, out loud, "What did he MEAN by that?"  My daughter senses that there is tension and she suggests that I call him up and clarify his meaning.  I say that this is a funny story because we all had a good laugh at the fact that, even though John and I had been married for 27 years at that time, we STILL had difficulty communicating effectively without actually hearing our voices! 

Emails, text messages, instant messaging, twitter, facebook - all wonderful and exciting ways to connect with each other.  I find, however, that "remote site" communication is more effective with the benefit  of hearing as well as listening.  I enjoy hearing my daughter's voice, my son's "Hey, mom" and my husband's laugh.  I feel more comfortable when I can hear the inflection in their voices and can be reasonably sure that I understand their feedback.  I welcome the opportunity to hear my new daughter-in-law's special laugh or my daughter's fiance's deep voice.  No, there are no opportunities for hugs on the phone...but hearing their voices makes connecting more of a communicating event. 

So, here's a challenge to all of you fellow bloggers out there.  This week, as you are about to text, email or twitter someone - pick up the phone and call.  Surprise him or her with a "Hello, it's just me wanting to hear your voice!"  And, I just know that you will feel much more connected!  Let me know how it goes. 

So, until next time,

get out your long-handled reacher and

Stay Connected!

Katherine

Hi, again!  I'm afraid you caught me in another "I wonder how people can BE that way" mood!  I'll try to keep the frustration from weasling its way into my "voice" today; but it will be difficult.  So, let me tell you my story and get it over with.

As an occupational therapist, I have had the distinct pleasure of working in both the adult and pediatric populations.  It has been very clear to me over the years that connecting with clients and their loved ones is an integral part of a team's responsibility with both populations.  Right?   Maybe, however, it isn't as obvious to everyone in the health care field.  Perhaps I have taken too much for granted when I apply my values to other members of a health care team.  As an occupational therapist, I felt it my responsibility to provide clients, their families and fellow team members with an honest assessment of the client's skills and needs.  That was my connection with them...they could trust me to hold up my part of the bargain.  When one abuses that trust, it hurts those who were misguided.  And it is difficult to predict if they will ever trust in you again.

My mother-in-law had her 92^nd birthday on November 2.  Yeah!  She is currently residing in a nursing home in Central New York, about 5 1/2 hours from our home in Massachusetts.  Although our daughter and my mom live close to John's mom, and they visit her often, my husband and I have placed a great deal of trust in the staff at the nursing home.  We have to.  Short of moving back to Central New York, we don't have any other option.  We understand that no system is perfect and that there are times when necessity precludes the "nice-to-haves."  But, we do expect the team to be honest with us.  THAT is a necessity.

On mom's birthday, I participated in a conference call for her annual review.  Since we were planning a trip the following weekend to see her, we were unable to physically attend this meeting also.  We were confident that things were going along pretty well with her since we had not heard of any issues from nursing or social work in the past month or so.  So, I go into this meeting in a positive frame of mind, with only two areas of concern for John and myself:    We would like to see her walking more to keep up her strength and would like to ensure that she is reminded about church services, since she seems to feel that she is missing them each week. 

After the team members provide their individual reports - indicating that all is well and that she is doing fine - I bring up our areas of concern.   I state that we are concerned about her very limited ability to ambulate even short distances with the walker to a bathroom.  I emphasize to them that her greatest joy when we come to visit is to go out to eat.  We are a family that has always contributed to the economy by eating many, many meals out!  She misses that and we want to keep providing her with opportunities to dine out.  I mention my concern that "all handicapped bathrooms are not created equal" and that mom's weakness limits our choices of restaurants.  So, everyone jumps on the bandwagon, throwing out restaurant ideas and offering to look into accessibility for us!  Great, I think, they are soooo helpful! 

Later that evening, I email my daughter, Veda, who has visited mom three times in the past 4 days, and mention to her that we found a great new handicap-accessible restaurant to take Grandma to on Friday to celebrate her birthday!  Not two minutes later, Veda calls me.  Hesitantly, she says, "Mom, I dreaded having to make this call.  I had hoped that the nursing home team would have told you."  I'm thinking - What could it be?  Veda indicated that Grandma is having trouble with continence and would probably find it very difficult to go out to eat.  Well, ok, the team nurse did say that she was having a "bit of incontinence".  Well, I thought, she IS 93.  So, I ask Veda to expand on her concern.  Apparently, during Veda's visits, mom has experienced many periods of incontinence due to the medication addressing her CHF and has needed to change her clothing many times during the visit.

You can imagine my distress.  Here I was going on and on about finding a suitable restaurant to take her to the following weekend, and engaging in a search for a perfect location with the staff members, when it was all a moot point.  Mom was not going to be able to take that trip after all.  Why didn't someone tell me?  Why would anyone, health care professional or not, want our mom to be embarrassed in public and spoil her birthday?  If they felt they did not want to discuss this topic in front of her at the meeting, then why didn't someone call me back afterward and let me know the situation?  I can only describe my emotions as being "hurt."  I felt hurt for mom, who was in the meeting, and was led on to believe that we would be taking her out on Friday!  I felt hurt for myself, as a family member, that I was led so far astray in my good intentions.  I felt hurt for my husband when he came to realize that his trust had been abused.  Yes, hurt.  That's the only way I can describe it.

Connecting with others, on any level, requires a certain amount of trust.  Sure, connecting with the waste management team who collects your garbage every Thursday requires a different kind of trust than is required of a health care team.  If the waste management team forgets to pick up my garbage one Thursday, I will live to tell about it.  If the health care team fails to tell me important details about mom's needs, I will feel betrayed. 

Connecting....trust...what more can I say?

Until next time, I trust you will

Stay Connected!

Katherine

Happy Fall, fellow bloggers!  Brrrr...I have finally switched the summer clothes (oh, how I love them!) for the warm, cozy fall and winter ones (oh, how I NEED them!).  Actually, to be more accurate, my husband did the switching since our clothes are stored in the attic.  There was a time when I could have done this myself; however, the shoulder is healing rather slowly and I cannot get myself in and out of the attic without pain.  The healing process has taken a toll on a number of my daily activities.  But the one that has me the most irritated is the effect it is having on my handwriting. I have been able (and most of the time, willing) to transfer any household duties over to my husband when they aggravate my shoulder.  Ironing is a prime example.  No real loss there, right?   But seriously, there are some things that another person cannot do for you...and one of those is write for you.  Oh, I don't mean simply "writing."  I mean putting your thoughts to paper.   A case in point:  I am an ardent journal writer, faithfully recording my thoughts, experiences and family events each day in a neat, interesting logbook.  The entries are mostly for my own eyes; however, it is important for me to complete a chronology of sorts.    These past months have found me negligent in my entries.  I find it difficult to maintain the appropriate wrist and shoulder position without discomfort.  I am very limited in the amount of time I can sustain a grip on my pen and continue to fluently write down my thoughts.  So, I shift this way and that, put the pen down and pick it up again and take frequent breaks from the writing altogether...more often than not, never returning to it again.  Frustrating.

This experience has proven to have a reinforcing benefit for me as an occupational therapist and as a teacher.  Throughout the years, I have seen the sad decline of handwriting skills in our children.  Students are struggling with printing and parents are finding that the skill does not hold a key position in their children's academic curriculum.  Again and again, I am grateful for the educational system I was groomed in (way back in the 50's) where The Palmer Writing Method was actually not a four-letter word.  Allow me to brag a little here, if you will.  I am the proud owner of a beautiful handwriting.  Actually, I have been complimented on that handwriting.  It no longer depicts the purest form of the Palmer Method, as it has taken on a bit of my personality along the way.  In fact, I consider one's handwriting to be a presentation of who that person is.  Just like clothing can make the person, so can handwriting.  I am thrilled when I get a handwritten telephone message and I can clearly decipher the spelling of the caller's name and can understand the message without having to hunt down the message writer!  I consider the writer to be thoughtful and considerate.  I am really impressed when a person ends their note with a signature and I can successfully read their name.  (Pronouncing it may be another issue, however!)  But, the ultimate good impression is the handwritten Thank You Note!  Oh, yes, that is the top-of-the-line compliment in my book!  Remember the days when we actually sent out handwritten holiday cards, thank you notes and get well wishes?  Now, please don't get me wrong.  I am totally an e-mail and text message person.  I'm sure my family can vouch for the volume of messages they get from me!  But I digress.

Let me get back on track here...the point is that handwriting continues to be an essential part of our lives.  It continues to be necessary to fill out a paper job application form, even after one has completed the on line application.  A portion of the SATs require handwritten answers.  There are many opportunities in our day to jot a note to someone or to ourselves.  And even in this day and age, there continues to be times when writing a check is the only way that money can be transferred from one person to another.  I know, hard to believe, but it's true.    Hence, I feel that handwriting is a method of communication that we cannot afford to lose.  It helps us to connect with others in a very quick, accessible and personal manner. 

I can understand why a student who is struggling with handwriting skills would declare, "I won't need to write!  I'll just use the computer!"  When the mechanics of handwriting prove to be a battle, with each letter posing an opportunity for a fight, there's no doubt why a child would refuse to do his homework, daydream during classroom assignments, or fall behind in school despite his good intentions.  Children want to be proud of their work.  It means just as much to them, if not more, to have their fine penmanship displayed on the bulletin board or refrigerator.  The display of their successes is just another way to connect with their peers, teachers, and parents.  "Hey, this is ME!  Look at my great work!" 

And the beauty is...there are actually some simple ways to help our children with their handwriting.  It is easy to model appropriate sitting posture and to provide adequate chairs and desks.  The height of a chair can be modified easily by placing a couple of books under the child's feet to provide the necessary foundation for balance and posture.  Placing colored tape on the child's desk to provide a "placemat" for the position of her paper will allow her to be more independent with written assignments.  Allowing children to use small pencils facilitates their use of an appropriate writing grip.  An evaluation by an occupational therapist can provide teachers and parents with helpful, easy ideas that can be implemented with little energy and money. 

And what better way is there to connect with a child than to show him or her that we care about their success with handwriting!  When the handwriting struggle becomes the handwriting success, your reward will be a beautifully handwritten Thank You Note!

So, until next time,

Stay Connected!

Katherine

Good day, everyone!  I hope you are all keeping warm (no comment from you all in the perpetually warm climates!).  Keeping warm...now there's a challenge!  I have lived in cold climates for the majority of my life, which began in Rome, New York.  I remember the snow blizzard of '62 (that's 1962 for all of you born after 1970!).  The snow banks were so high that we could not see the gas station on the street in front of our house!  Even as a child, I did not enjoy the cold and snow.  I was all for enjoying the hot cup of cocoa without having to GET COLD first!  Ironically, 40 years later in 2002, I lived for 2 years in Presque Isle, Maine.  In case you don't understand the magnitude of the irony of this move, Google map it and you will be enlightened!  Presque Isle is a quaint town, with wonderful and friendly people, a state university, an excellent school system and a terrific hospital.  It is "nestled" about a 15-minute drive from the Canadian border and enjoys nearly 9 months of snowmobiling weather!  Caribou, Maine, the Northeast's barometer of just how cold it can get up there...is Presque Isle's neighbor.   When I described the climate to my mother that first winter, she asked, "Explain to me again why you would choose to move there?"  She's tough, my mom!

Why DID I choose Presque Isle, Maine?  Mostly, it was the people.  It isn't really true that people from Maine don't trust the rest of us.  They just take a little more time to assess our sincerity and trustworthiness.  In my case, the first people I met on my interview at The Aroostook County Medical Center (TAMC) were smiling, laughing and, in general, having a good time working together.  Maybe this was because it was summer!!!  No, really, they were especially anxious to help me and to have me live and work among them.  I soon realized that there was a lot I could learn from these gentle, if not doubting, Mainers. 

So, where am I going with this?  Well, recently I read an Advance Magazine article in the "Career Corner" titled, "How Not to Network."  In it, Ms. Koehler provides a valuable piece of insight that sent my memories of Presque Isle into a swirl.    It goes, "Networking is the key to building new contacts and resources.  You may be standing next to someone who can hire you for the next job, provide insight into a tricky problem you're struggling with or even become a mentor, but if you don't start talking, you'll never realize it."  The author of that quote, Margaret DeMarino, a corporate trainer, must have once lived in Presque Isle!  If not, then her advice couldn't be more appropriate for life in a small town.  One of the first "warning orders" I received from our bold and brilliant rehab center secretary at TAMC was "Be careful who you talk about because the person you are talking to is no doubt going to be his or her cousin!"  And she was SO right!  My hairdresser was related to the guy who did my snowplowing.  The gentleman who collected my garbage was close friends with the guy who built the small addition on my house.  And the secretary at the rehab center knew EVERYBODY! 

But, her advice actually helped me in a much more positive way.  As a member of her close-knit community, I provided school-based OT services to 6 local schools.  I interacted with their children - their most precious commodity.  I offered advice and asked for their support of OT.  I asked for their trust.  And I can tell you that, from the very beginning, it was evident that trust was the most important ingredient.  The parents, principals, teachers and staff needed to know that I would be consistent, open and compassionate.  They needed evidence, which they silently collected for the first 3 months.  On my side of the bargain, listening, observing and exercising patience were the key elements to success.

I soon learned that my progress was being shared by the parents and staff in each school (as they no doubt were neighbors and/or relatives).  How did I learn this?  Of course, from the rehab secretary, who was a neighbor or friend or relative with everyone!  Within a few months, I found that the staff was asking more questions, the principals were asking for my advice, and the teachers were demonstrating a bit more flexibility in their schedules.  (Please understand that these people were wonderful from the start!  So I knew that these extras represented their trust in our relationship.)

And then the day came when the true "rite of passage" was tested.   First, let's go over a bit of school-based history.  This was my first school-based OT position.  In my previous life, I was a teacher.  I was accustomed in that role to having my own "space."  Space is important.  It marks your territory, allows for privacy, gives you an identity, and in general, is hard to come by as an OT!  I had been informed at the interview that there was a definite lack of space at the schools and that obtaining a dedicated OT space would be a futile struggle.  (OK, don't say things like ‘futile struggle' to Katherine...only leads to an attempt to correct that!)  After the secretary had bestowed her compliments on me about my ability to "fit right in" and gain the respect of her neighbors/relatives, I decided it was time to "get my space!"

My mentor indicated that I should start by setting up meetings with the six principals.  This I did...arming myself with a well-thought out plan for their perusal.  And, low and behold, five of the six agreed to provide private space for OT sessions!  For some schools, a room was designated for OT use on the days when I worked with their students.  For other schools, a room was dedicated solely for OT.  Of course, I did a great deal of work in the classrooms, so the spaces allowed for privacy for testing, 1:1 therapy, and storage of equipment.

But here comes the best part!  Remember "school number six"...the reluctant one?  In all fairness, the school was crowded.  However, I found providing services in the hallway as totally unacceptable.  Well, the principal of school number one called the principal of school number six and provided some insight.  (Turns out that the principal of school number one was previously the Director of Special Education in that district!)  She persuaded him to allow OT use of the library for one day!  I was in heaven.  Sometimes, things just feel good!

Of course, although I'd love to take full credit for this success, I know that it was truly the work of the network of community members in Presque Isle, Maine, who made it happen.  Their dedication to the children and their belief in the benefits of OT set it all in motion.  In the end, all the neighbors and relatives came together to help the person from "down under" connect with them.  Yes, I did learn a lot from them!

So, until next time,

Stay Connected!

Katherine

And we meet again here in blog land, my friends!  I trust that you and yours are finding this fall season to be calming and peaceful after those busy, hectic days of summer!  (Remember when they used to be called the "lazy, hazy, crazy days of summer"?)  I am using this season to re-connect with family and friends.  Our summer gatherings were wonderful; but they were often squeezed in to fit our busy schedules.  This season, as we hover close to the holidays, I find that I'm looking for some personal time with people - time that is just for us.  And that takes some reaching out and commitment on my part.  I need to make the commitment to place that phone call, to make time for others and to be "in the moment" when I'm sharing time with them.   We are all busy but we relish the time when we can connect with our loved ones and friends.

That reminds me of a funny but poignant story about my youngest brother, Salvatore.  Salvatore was an incredibly talented musician.  He was able to reproduce music on the piano that he had heard in church that morning when he was 5 years old.  He was also an "introverted socialite" like myself (outwardly social but passionate about his personal space) but felt comfortable reaching out to others when he was ready for company.  Well, when he was about 6 or 7 years old, he became the proud owner of two walkie-talkies at Christmas.  For those of you who can only relate to today's modern technology, walkie-talkies had a limited broadcasting range and usually only allowed you to communicate between the two handsets.  The channel frequencies were very limited "back then."  Once in a while, you could connect with someone on another handset, if the person was very close in proximity and on the same channel.  Well, the story goes that my dad explained all this to Salvatore one cold day and my brother proceeded to test the limits of his walkie-talkies.  He left one handset in the house and went outside to see if he could raise anyone else on his or her walkie-talkie.  So, the rest of us are sitting in the kitchen and, through the handset he left inside, we hear, "Is anybody out there?"  We remain still.  And we hear him ask again, "Is anybody out there?"  Our eyes meet around the kitchen table and we secretly ask ourselves, "Should we say anything?"  At first, we laugh.  Poor Salvatore, he doesn't realize that it's only us that can hear him.  Poor little guy, he's out there looking for a connection and doesn't know that it's next to impossible to reach anyone but us.  Then, it dawns on us.  Maybe HE's the smart one and WE are the ones who don't realize the potential in reaching out into the unknown just to see if someone IS out there?  He wasn't afraid to take the chance, to put himself out there and to perhaps make a new friend.

It's simply human nature to want to feel connected to others.  We enjoy hearing from friends and family when we least expect it...for no particular reason....just to say hi.  When times are gloomy, our spirits can be lifted by simply hearing a friendly voice on the phone.  Our hearts are warmed when someone shares in our successes and takes the time to let us know how proud they are of us.  And that happened to me just the other day.  I was reviewing my blog comments Friday morning for my blog "Dream Big With OT" and was brought to tears by a comment from a mom who had allowed me to share in her daughter's successes over a year ago!  I have always felt connected with this mom and her family; but after she took the time to provide a comment, I was also touched and honored!  (Thanks, Tina)  THEN, in the afternoon on that same day, I once again reviewed my blog comments and found that my son had posted one also!  I was so excited about it that I accidently deleted it!  Yes, I did.  (You'd have to know me a little better to realize that this is not an uncommon type of behavior for me!)  I was beside myself!  I quickly emailed Jessica, our web editor, begging her to "get it back" for me!  I'm always quite confident that "web-people" can work miracles.  She, however, was a bit more realistic and promised to try her best.  Again, I was simply distraught.  Here was a heart-warming response from my son, and I messed it up.  So, I texted him, emailed him AND called him to apologize.  And in the end, I got the best comment of all.  He said, "That's ok, mom, I just wanted you to know that I read the blogs."  And isn't that what it's all about....connecting...letting others know that you are "out there".  Isn't it all about taking the chance and putting your thoughts and words out there so that a new connection is made or a current one is strengthened?  (Thanks, JB)

Friday was certainly one of my best "blog moments."  I shall treasure those comments and the re-connections that were made that day.  Friday was also an "ah-ha" moment for me when I realized that blog land is just like "walkie-talkie" land.  I'm simply using a more modern piece of technology to reach out to you all to make a connection! 

So, until next time,

Stay Connected!

Katherine

Welcome!  I want to take a moment to thank all of you returning bloggers, as well as those of you who are visiting my blog for the first time!  I enjoy your comments and your questions.  Keep them coming!  It is exciting to connect with people in New Zealand, New York, Pennsylvania...and never have to leave my living room!  The sky's the limitJ

Speaking of the sky, I came across a great quote on a funny quote website that I thought I'd share with you today.  It goes, "Last night I lay in bed, looking up at the sky, and I thought to myself, ‘Where in heck is the ceiling?' " There was no author credited with it; but I suspect that it was someone who could envision the endless possibilities of having no ceiling!  The freedom to dream big!  For example, imagine being offered the opportunity to enter any profession of your choice....don't worry about skills or training....you will automatically have them in this daydream.  Think about something that you love to do and the kind of work lifestyle you would relish each day.  Dream big...take your imagination to a higher level...without fear or doubt.  What would you be doing right now if I could wave my magic wand over you and make your dream job come true?

Don't wake up just yet.  But answer this question:  "For how many of you out there was occupational therapy your dream job?"  Aha, I thought so!  I figured that quite a few of you would raise your hands!  Congratulations on having an imagination that matches your reality.  Why is OT the job you love?  Why does it offer the work lifestyle you enjoy?  There will be a quiz later, so stay awake!

For me, and I can only speak for myself (which I do quite often), OT offers limitless possibilities - the sky's the limit - there is no ceiling.  When someone asks me where my interest lies on the OT spectrum, I most often cannot be specific.  The spectrum offers opportunities to work with people from birth to death, children and adults, healthcare workers and educators, insurance companies and politicians, as well as with a diverse population.  You name your interest and you can find a place to put your passion to work.  I enjoy the one-to-one interaction with clients and their families; however, I equally enjoy teaching and coaching.  For others, becoming involved in healthcare reform and public policy allows them to share their skills in bringing about much needed change.  Still others are most happy when they are involved with management and the creation of satisfying worksites. 

And yet another question:  Why DID you choose occupational therapy as a profession?  What led you to OT and healthcare?  I ask this question often (as much as I ask my other favorite question, "How did you meet your spouse/partner?") and I am always amazed at peoples' answers (to both questions).   For a number of people, their interest in OT began when they or a relative received occupational therapy.  Some of the people answered that OT satisfied their interest in things scientific.  I've listened to people describe the struggle they had in making a choice - OT, nursing, PT, physician's assistant.  They knew they wanted generally to care for others and they found that OT's philosophies and service models seemed a good fit.  Some followed in the footsteps of people in OT that they admired.  That was how I found OT.  When people hear that my daughter, Veda, is an OT (as well as a lawyer), they jump to the conclusion that she wanted to grow up and be like her mother (an OT)!  Well, she may have in other ways; but I actually became licensed in OT 3 years after her!  When I was teaching at the group home I mentioned in another blog, I indicated to her that I was investigating graduate programs.  As a NY State teacher, I needed to have begun a Master's Degree program by the end of my third year in teaching.  Although I enjoyed the students I was working with, I "so did not" have an interest in a traditional, structured classroom.  I'm a free-spirit don't forget!  She had been hearing all about my non-traditional style of teaching and labeled it as OT.  She said, "You are actually working with the students in an OT environment.  You should get your Master's in OT.  You'd love it."  I said, "No, I wouldn't."  She said, "Yes, you would."  I said, "I could never learn all that anatomy stuff."  She said....well you get the picture.  And here I am.  Thank you, Veda, for always showing me the light!

So, there are as many unique stories about becoming an OT as there are people.  That reminds me of another funny quote:  "Always remember, you're unique, just like everyone else."  Again the author was not identified but I figure it was my first grade nun.  She had a knack for letting you know where you stood (or sat)! 

And that brings me to my challenge quiz.  Are you still awake?  Good.  Here goes:  I would like to hear YOUR stories about becoming an OT.  Shoot me off a comment telling me about your journey toward a career in OT.  (And if you feel compelled, you can also share how you met your spouse/partner - only kidding!)  I am looking forward to reading about you and connecting with you.  There are bonus points if you can also tell us about how you helped someone else choose OT!

So, until next time,

Stay connected!

Katherine

Hello everyone!  I hope you are well and practicing "Carpe Diem!"  I am making every attempt to do so today after yesterday!  Did I hear you say, "What happened yesterday?"  I thought so.  Okay, let me explain and give you all the gory details.

My husband's winter, spring, summer and fall project has been to add a second bathroom to our basement.  And he is doing an awesome job!  We special-ordered a magnificent door with a window that gives the impression that you are entering a spa.  (This makes quite a statement considering that the bathroom is 24 square feet!)  We bought the door at a local, independent lumber yard that we are simply in love with...they have everything you could imagine for home improvements...and they are now opening this terrific Main Street with model kitchens and baths.  Well, we picked out the door, the window, and...now remember this part...the stain we wanted.  Ta Da...we are all excited and badabing...the order goes in.  Seven weeks later, I called and baboom...the door is in and they deliver it.   Fizzle...it is the correct door and window but it is unfinished!  So, I dig out my order receipt and place that fateful call to the lumber yard.  I say fateful because the lines of communication were apparently down that day!

Did you ever hear the funny saying, "The man who smiles when things go wrong has thought of someone to blame it on (Robert Bloch")?  Well, that gentleman was on the other end of the phone line that day. When I called and explained my concern that we had purchased (and paid for) a finished door, he explained to me that I was responsible for ensuring that his employee had, indeed, ordered a finished door.  Okay, okay, you're thinking, like I did, "Well, the customer does bear some of the responsibility for the correctness of the order."  So, I read over the copy of my order and it's written in "lumberyard-ese."  I had no way of deciphering if the stain was ordered or not.  Anyway, at this point, I'm a little hot under the collar (my husband would question the "little" part) because I JUST KNEW that the gentleman on the other end of the line was "smiling"!  Well, not 30 minutes later, the employee that prepared the order called to tell me that my door was in and wanted to set up delivery!!!  Huh?  (What's that expression about the left and right hand?)  Well, I explained the situation to her and asked about the stain.  She, in a calm and direct voice informed me that "You couldn't have ordered a door with stain because special order doors do not come finished."  Now, remember the part above where I indicated that we "picked out the stain we wanted?"  Silly me, I assumed that meant that we were ordering a finished door!  To make a long, long story finally come to an end, my point is that I felt not only foolish and confused but a little bit like the fall guy. 

Last week, I was reading a terrific blog site, http://writingroads.com/blog/, where Julie Roads writes about her experience with a cable repair guy.  It's titled, "Oh, you wanted me to thank you for being decent?"  I couldn't help but reflect back on that blog when I was attempting to communicate my confusion to the lumberyard employees.  It seemed that no matter which direction I came from, their answers were basically the same.  There was no mention of my feelings nor any attempts to reflect back upon the order to determine where things went awry.  I wasn't asking for blame to be placed; I simply wanted to figure out how I could have been so confused about picking out a stain that didn't exist.  Frankly, I would not have purchased a door that needed to be stained (because my hubby has this idea that I love to stain furniture and would have expected me to dig right in!). 

So where am I headed here?  It's all about connecting with the people you interact with each day.  The word, "connect", as I defined in my first blog, is derived from the Latin words ‘com' and ‘nectere' meaning ‘to bind'."   As we travel through each day, we are building relationships with others on many different levels.  Dr. Stephen Covey, an internationally respected leadership authority, writes that the most important principle for building interpersonal relationships is "Seek first to understand, then to be understood (The 7 Habits of Highly Effective People)."  He prescribes the use of "empathic listening", a combination of communication skills and awareness, as we connect with the people in our lives.  As OTs, we use our eyes, our ears and our hearts to listen.  We strive to be vigilant in observing our clients' body language, as well as their skill levels to determine their needs.  We recognize the importance of stepping back from the conversation to truly listen and hear our clients' words.  And, we are cognizant of the significance of therapeutic use of self to connect with them.  Achieving a high level of customer satisfaction is the rule versus the exception with us.  And blame shifting is not accepted.

True, we are not perfect (we aren't?), and there are days when our inner lines of communication are down.  But for the most part, we go to our workplaces feeling like we will do good things that day.  Some of my recent experiences as a consumer have been less than satisfying, however.  I find myself wanting to hug people that actually smile when I walk into their place of business.  Why should I be so excited over a simple smile?  I think it's because I feel that these people like their jobs and want me to be happy with the way they perform that job.  Homer Simpson (don't pretend you don't know who he is) commented:  "If you don't like your job, don't strike!  You just go in every day and do a really half-hearted job!  That's the American Way!"  Holy cow, Homer, I sure hope you are wrong.

Okay, now it's your turn!  I would enjoy hearing about the ways that you have connected with people in your lives.  What techniques do you use to make people feel important and heard?  What makes you feel listened to?  Food for thought....until next time -

Stay connected!

Katherine

Hello, all.  Welcome back to OT E-Connect!  Hope all is well with you this fine day.  And a fine day it is!  I can say that now that my session with the Physical Therapist is over for today!  I'm sure I haven't shared with you that I recently had shoulder surgery (of the outpatient variety) and I am in the process of rehabilitation myself.  Boy does it feel differently being on the other side of the fence, so to speak.  The surgery was to my right shoulder - naturally I'm right hand dominant!  Why make this simple?  So, between the pain BEFORE the surgery and the pain AFTER the surgery, I've been making many adaptations to my daily routine...by using my left upper extremity!  I remember as a young girl wanting to be "left-handed", as we called it BACK THEN.  I made many attempts to write with my left hand, to use a fork or spoon with it, even to brush my hair and teeth with it.  I thought, well, all I have to do is use my left hand and not my right and my left would begin to work "as well" as my right and, bingo, I'll BE left-handed!  Here I am, 7 or 8 years old, having enough challenges using my dominant hand, and I'm trying to get my left hand to cooperate in the bargain.  Well, I have come full circle.

Have you ever seen the guy (or gal) driving a car with a dog in his lap?  The cute puppy (hopefully not a German Shepherd!) is poking its little head out the window, sniffing the air, and giving us a bark in greeting.  The driver, on the other hand, is using one hand to steer, use the turn indicator, adjust the mirror, text a message to his wife, and drink a cup of java!  Now, I'm not here to judge this guy...I'm just saying that I feel like him...I feel like I'm driving a car with a dog on my lap!  One handed!  Have you ever tried using the long-handled reacher with your non-dominant extremity?  It's like having a shaking, wobbling stick loosely attached to your arm!  Little did I know I was so "not-coordinated" on my left side!  No wonder my yoga moves are so clutsy! 

So, woe is me and you can all feel my pain!  It's actually not as bad as it could have been.  Just think, a few years ago, this simple shoulder surgery would have entailed a much more invasive procedure, a hospital stay, and hospital-based rehabilitation.  Today, with our great medical technology, we are able to receive excellent medical care without the added expenses for hospital stays.  But more importantly, we are able to get back to our prior level of independence in outpatient clinics due to the amazing therapists that provide treatment there.  During this time of "in-and-out medical care," therapists in all arenas have been challenged to provide services using efficient, as well as economical, strategies.  Their creativity, knowledge and skills are put to the test, that's for sure.  But their passion for guiding their patients toward the highest level of independence is by far the driving force that makes this system of healthcare work.  I know, I know, there are many facets of this healthcare system that beg for revision; however, those of us in the rehabilitation field have flexed our muscles and honed our skills to meet the challenge.  We, as therapists, have connected with each other to form more cohesive teams, as well as with our patients and their families, to empower them in the quest toward their goals.  Let's put our hands together for us all!

I do want to say that my outpatient hospital experience was actually quite good!  I underwent my surgery procedure at Cape Cod Hospital, under the knife, so to speak, of Dr. John Willis.  The whole procedure was most definitely performed like a well-oiled machine!  The hospital's procedures, start to finish, were efficient and the staff was friendly and caring. And I am on the road to recovery!   What more could I ask for?

Well, guys and gals, it's time for me to push away from this computer and tend to my own dog, who by the way, is too big to be a lap dog.  He's a Welsh Pembroke Corgi named Ron who, at this moment, is sitting next to me, staring at me, which probably means he wants to connect with me!  (Or he has to go outside or eat!)  So until next time,

Stay Connected!

Katherine

Just recently, I had been introduced to an awesome author!  If you have an interest in exploring the culture of small-town life and becoming acquainted with characters that come alive on the page, Richard Russo's book, Bridge of Sighs, is definitely the book to check out of the library.  In fact, it's a book worth paying the price for because I'm sure you will read it again and again.  I cannot put it down!  However, I have taken a moment away from my reading to share a portion that I read last evening and to ask if you, like me, can somehow connect with Russo's characters.

Russo's characters are residents of a small town in Upstate New York (close to where I actually was born and raised!).  In this particular scene, they are high school seniors and it's the first day of school.  They have been enrolled (involuntarily) into an honors English class where, one student reflects,   "The best and brightest of the senior class seemed to have been purposely excluded from Mr. Berg's honor's seminar on the American Dream, which resembled some weird social experiment whose purpose wouldn't be revealed until the study was concluded. (Russo, p. 294)"   In addition, the students silently agree that their English teacher is "pretty weird".  

Mr. Berg (the teacher) begins the class with an electrifying and thought-provoking verbal exchange via a quick question-and- answer session that initially totally confuses the class.  He leads them toward defining themselves as "doubters or believers."  When one student, Lou, defines himself as "a little of both", Mr. Berg asks him why he thinks he is both a doubter and a believer.  The student questions that perhaps he is "still learning?"

And, ah, Richard Russo does not disappoint us with his response to this character's proposal.  For me, Mr. Russo/Mr. Burg has served up a giant bowl of food-for-thought.  Mr. Berg does not believe that Lou is still learning...at least, he proposes that Lou is not seeking new knowledge but rather is looking for validation of his perspective of the world.  He lays out the theory that the "real learning" takes place very early in our lives and that by the time we are in our junior or senior year in high school, ..."our characters and attitudes are mostly formed.  (p. 304)"   He challenges the students further with the thought that "We like the idea of change even though we know it's an illusion. (p. 304)" 

Of course, Mr. Berg has offered no answers during this first session, merely challenges.  As I finished this scene, as it were, I found I needed to put the book down and do a little reflecting of my own.  Are we really "too old to change" as they say?  Have we formed characters and attitudes so early on in life that we are left with a limited view of the world and ourselves?  As a result, is our ability to change limited as well?  Is change really an illusion, one that teases us with its opportunities but slips away when we think too hard about them?  Are we simply "doubters or believers" from the age of two or three, leaving little room for change? 

Phew, most definitely food-for-thought.  I've been around a few years (yes, really) and Mr. Berg's challenges got me thinking about my ability to accept new ideas freely, uninhibited by what I learned "way back when" in my early years.  How flexible and open to learning AM I as an OT?  In my practice, I have enjoyed the opportunity to teach and coach.  However, in order to remain an effective OT, I try to participate as an active learner, as well.  I feel continuing education is essential and have strived to seek out courses that not only expand on my interests and current skills, but also broaden my knowledge and skill base, challenging me to present my clients and co-workers with new strategies and resources.     I welcome in-service trainings and enjoy sharing ideas with co-workers.

With that said, I continue to ponder on how much of my "new learning" changes my attitudes and perspectives.  Am I a doubter or a believer?  How much of the information that I am offered do I take back to my workplace and put into use?  Am I willing to place myself outside of my comfort zone in order to challenge the new information and see how it plays out in my practice? 

My pediatric OT passions are vision and handwriting.  When I'm presented with new learning challenges in these areas, I tend to soak them up, run back to my workplace and put them into motion.  I like to teach others about them and observe their approach toward using them.  I find it rewarding to switch it up a bit and see if I can fit the new knowledge comfortably into my tool box.  I enjoy pushing my boundaries.  In this case, I feel I'm a believer.  However, when it comes to the more biomechanical strategies and therapeutic modalities, I find that my "abstract side" tends to push me into the doubter mode.  Not that I doubt their authenticity or their possible benefits to my clients.  I doubt my flexibility to master them and to include them into my tool box.  I tend to cringe when it comes to things concrete and structured.  I feel off kilter when I feel my creativity is constrained. 

Mmmm, food for thought:  Is my ability to change an "illusion," as Mr. Berg tells his students.  Have I been leaving useful skills out of my tool box because I am a doubter?  The Believer in me struggles to win this argument, stating that I have a great tool box!!!  The Doubter in me knows that "you can't kid a kidder!"

So, I leave you with this thought:  "...I'd hate to think you're losing interest already, because, I, for one, am very, very excited." (Mr. Berg/Russo, p. 305)  Until next time,

Stay Connected!

Katherine

Reference:   Russo, Richard.  Bridge of Sighs.  New York:  Alfred A. Knopf, 2007. 

I'm kind of a "loner" by nature.  I tend to confuse people:  my outgoing personality lies in definite contrast to my desire to be alone ("I vant to be alone!).  Study groups in college?  Not?  Going to the movies with 100 of my best friends?  Not likely.  Coffee groups at Mickey-D's when I'm retired?  Never!  I'm not complaining or criticizing.   That's just me!  So when the stress hits at work....I tend to push further away from others and internalize the stress.  Oh, yes, it's been a way of life for me!  I am a slow learner.  I can remember this being my reaction to stress back in high school (and, believe me, that was a LONG time ago!).  But I have managed to be able to recognize the signs of stress more quickly now since I've been an OT.  That could result from my working with people who had experienced strokes or spinal cord injuries.  I found it much easier to discuss how THEY could handle stress than my being able to practice what I was preaching.    And since I didn't possess a lot of first-hand knowledge about stress management, I needed to do a bit of research in that area in order to "advise" them!  There are some wonderful books and seminars out there that did the trick!  Of course, I continued to remain responsible for my own stress management...and, again, I'm a slow learner.

How about all of you?  Have you been able to recognize when your "Stress Meter" has pegged out and your body's "fight or flight" reaction is running on high?  Do you roll with the punches and thrive on stress?  If so, I certainly could use some of THAT!  Or do you find that you're frazzled and lose all the time management and organizational skills you've prided yourself on?  Do you have trouble sleeping or feel "down in the dumps?"  I hate it when the memory starts going and I find myself apologizing for having to ask the same question 3 or 4 times!  Ugh! 

As I said, I learn slowly; but I DO learn!   Over the years, I have been fortunate to have had family members and co-workers who have shared their personal de-stressing tools with me.  When I find that I am experiencing the aforementioned stress symptoms, I take some time to address them in my daily journal.  First, I outline the behaviors and try to match them to events or times of day.  Then I make an honest evaluation of the cause and effect and identify true precipitators (e.g., Does my back hurt from poor posture?  Am I not sleeping at night because I've eaten too late?  Am I feeling disorganized because I've been lax in putting together my to-do lists?).  In this way, I can separate them from the behaviors that result from simply being stressed out. 

Some things that stress us out cannot be eliminated.  If I'm feeling stress as a result from a work requirement or a personal responsibility, I know that I need to step back and take a moment to view things from a different perspective, look at options for making the requirement more workable for me, and, sometimes, make an attitude adjustment!  Networking with my family always helps me to put my head on straight.  Believe me, they don't allow for any self-delusion!  I know I can spend a few moments whining and then they will be more than happy to help me turn the situation around to a more positive perspective.  And for that, I am grateful.  But, sometimes that is not enough.

I have some other tools in my De-Stress Tool Box that help me to find my way through stressful situations.  First and foremost (my aunt always says that!), I take a moment to have a "Confidence Break."  I review the successes I have experienced, especially those that have resulted from a challenging moment.  Yes, I admit it...I pat myself on the back.  Exercise is a wonderful de-stressor - and I miss it if I don't perform some type of exercise each day.  During this time of year, walking (alone, naturally) is my exercise of choice.  But during the brrrr-cold months, I find that Pilates, Yoga, Curves, or simply the treadmill work for me.  I enjoy reading; however, if I have something really "eating" at me, I have trouble concentrating on reading.  (That's a sure sign of being overstressed for me!) 

That's all well and good (that same aunt says that too), but what about managing stress at work?   I work at a great facility; however, they frown on my practicing my Pilates while my clients wait in the lobby!  ("Oh, just give me a moment to de-stress!")  Laughing is good - especially with co-workers who have empathy for your plight!  I have to admit:  I do not do enough of that!  And asking for help...phew, that's a difficult one for me.  Super Woman!  Gotta' do it all!  But, when I finally reach the point where I need to ask for help, "Oh, what a relief it is"! 

As I go along in this search for a utopian, stress-free life, I welcome any suggestions that you all have to add to my Tool Box.  I'm sure that SOON, I will learn!  Until then, however, let's

Stay Connected!

Katherine

I love fresh, new classrooms!  I'm like a kid in a candy store when it comes to pouring over the fun items in "teacher stores."  And I'm forever trying to find ways to use them in my therapy sessions!  The "teacher" in me keeps struggling to break out!

I remember fondly my new-graduate teaching days when I worked as part of a team in a residential home helping children and families in need of support.  My students' ages ranged from 10-18 and their educational goals included life-skills (see, that's how I ended up as an OTJ) and a successful return to the public school system.  Initially, I struggled with finding the appropriate learning venue for these guys and gals.  The primary reason for their being in my classroom versus the public school was their inability to follow school rules:  sit in a chair, listen to the teacher, copy from the board, participate in group work, make effective transitions between activities...the list goes on and on.  So, I knew that a traditional classroom environment would be like trying to fit a square peg into a round hole.  So I utilized "occupation" to provide learning:  writing and acting out plays; starting a business and making and selling a product; taking turns teaching the class.  The children's participation increased and they displayed an increased level of self-confidence and an interest in learning. 

End of story?  Not hardly.  I found that, although my students enjoyed the new learning environment and demonstrated a fresh eagerness to learn, quite a few of them continued to struggle with their development of the essential behavioral skills.  I found that they preferred to lean on their hands or rest their heads on the table.  They seemed to gaze past me during conversations or class directions, seeming to daydream.  They often avoided eye contact altogether, offering what appeared to be a lack of interest or defiance.  Some persisted upon sitting sideways in their chairs, looking at me or the board from their left or right side.  Many of my students continued to find it difficult to sit next to others, to sit with their feet on the floor, or to copy from the board.  Some of them tended to over-react to redirection or suggestions.  Most of them avoided reading and writing at all costs. 

I wish to remind you all that at this particular juncture, I was not trained as an OT.  So, sensory integration and visual perception were not my strong suits.  Nevertheless, I could recognize the existence of a stumbling block!  There was definitely something ELSE working against us in the classroom.  If only I knew then about the role that vision plays in learning!

Let's take a moment to review vision and learning.  As we know, learning is a series of continuous adaptations.  Children learn by pushing their boundaries, by using trial and error and by putting together newly acquired skills that provide a functional outcome.  A key player in this learning process is vision.  Vision has been described as our most important sense, having the most influence on our learning and behavior.  Vision, as opposed to eyesight, involves the sensory-motor-perceptual process that allows us to attach meaning to what we see.  It allows us to identify and interpret the information we receive through our eyes.  Visual skills are learned through movement and practice.  Hence, learning through vision requires efficient and effectual movement patterns, such as the ability to maintain your body in midline, the possession of an intact body image, the use of efficient gross motor patterns, possession of functional sensory systems, to name a few.  Eye movement patterns are obviously key essentials in the development of vision skills.

As I look back on those students who continued to struggle with classroom rules and behaviors, I wonder if an assessment of their visual skills would have put some light on that "stumbling block" that was intruding into our classroom.  Since becoming an OT, working both in the adult and pediatric environments, I have been fortunate to work with OTs and behavioral optometrists who were willing to share their knowledge about vision and encouraged my passion for  a liaison between OT and behavioral optometry.  Through the years, I have come up with some "Red Flags" to alert us to behaviors that may be symptoms of visual skill impairment.  How about I share those with you!

As the child participates in daily occupations, watch for stumbling or walking into walls in familiar environments.  Check for awkward gross motor skills or frequent walking on toes.  Assess body awareness during activities such as Simon Says.  Check for reactions during gross motor sports, such as playing catch, that are too quick or slow (over- or under-shooting or reaching).  Watch for a tendency to lean on his/her hands or the table during fine motor tasks.  Observe eye movements, looking for the avoidance of eye contact or the appearance that the child is "looking through you" versus at you.  Watch for frequent rubbing of the eyes or head turning to use peripheral vision.  Assess a child's need to handle and manipulate items, sometimes roughly, before beginning to use them in a task.

This is not a comprehensive list, but it is a good start to pique your interest in the behaviors that may indicate the need for a vision assessment.  There are some wonderful courses for OT out there that address both adult and pediatric populations.  They are fun and very interesting.  If anyone is interested, I can put out a few suggestions for you.  And, most importantly, I welcome your sharing your experiences and knowledge of vision with me!

Well, it's been great!  Until next time,

Stay connected!

Hello, everyone!  Thank you for joining me today in "blog nation!"  I trust that all is well in your camp.  All is well here on Cape Cod, although I regret that summer is nearly over!

For the past week, I have been reflecting upon an awesome Advance Magazine article written by Jane Sorensen in the August 3, 2009, edition titled, "Rethinking Reform."  In it, she addresses the question of "re-designing our health care system."  Jane provides us with a huge "bowl full" of food-for-thought on what she describes as the "shoring up" of the health care system. 

Let me take a minute to revert back to my business management background to say that I, too, am a firm believer in the positive benefits of good business models and entrepreneurship.  Competition and "the bottom line" are not bad things.  As consumers, whether we are looking to buy a car or healthcare insurance, it is in our best interest to have choices.  The cornerstones of a successful business model are a clear mission statement and a concise set of goals.  These two essential components are best developed by people with experience and a solid background in that particular business field.  Too much" government" and too little "entrepreneurship" can lead to less creativity and fewer choices.

Of particular interest to me in Jane's article is her challenge to OT's to "pass the torch", as it were, to parents and teachers in an effort to educate and empower them, as well as to determine the quality of carryover from our treatment.  In addition, an added benefit could be a more efficient and cost-effective use of our time.  With insurance companies revising their reviewing process for short-term rehabilitation authorizations and with school-based OTs balancing increased caseloads, it is becoming increasingly imperative for us to be more efficient with our time and resources. 

With that said, in what ways can a therapist utilize precious time to transfer skills and empower teachers and parents?  The term "empowerment" is a favorite key word that has been used for a long time in arenas as diverse as mental health and the corporate world.  As defined on Dictionary.com, empowerment means "to equip or supply with an ability." Empowerment provides for a transfer of the power to make decisions regarding one's life or situation.   It is a word that places responsibilities in the hands of both parties involved in the relationship.   Goals aimed toward empowerment require careful planning and review.

As a pediatric occupational therapist, I find it good to schedule a recurring "wake-up call" during my involvement in my clients' lives - one that allows me to review not only their progress toward goals but my awareness of the clients' and families' wishes.  At the clinic where I provide OT services, the family-oriented approach drives the train, so to speak, in our therapy.  A therapist-friendly environment is provided that allows for sufficient time to spend with the family, as well as preparation time for coaching and training.  We're very fortunate.  I know from experience that this is not the norm.  However, the goal of empowerment continues, even in our clinic, to require planning and review. 

The parents and children we meet in our practice come to us already possessing knowledge about their needs (e.g., "Joey cannot sit still in class."  "Susie won't leave her shoes and socks on."  "Mary cannot print her name.").  When they cross our threshold, they are seeking some understanding about the "whys" and "what can we do about them"?  At times, they are so frustrated that they attempt to place their child's and their lives in our hands - "Here we are.  Please fix us."  Of course, we know that a more efficient treatment strategy uses a much more interactive approach, one that passes the torch of responsibility and power for rehabilitation back to the families.  Let's take a look at an overview of one proposed set of strategies for doing just that.

At the beginning of the relationship, be sure that the child and family are provided with a true sense that therapy sessions will be just that...a relationship.  The child, the family and you will be working together to formulate goals and plans, to provide carryover, and to assess progress.  Be honest at the start of therapy by letting the child and family know that eventually the "power" will shift to them, allowing them to be in control of the choices they make for their lives.  Talk to them; get to know them.  In this way, you will discover how much they already know about adapting their lives and the resources available to them.   In turn, you will be able to use the knowledge you've gleaned to help them to realize how much they already know - boosting their confidence as part of the team.  Utilize each session carefully to model behaviors and/or techniques, to provide time for hands-on practice, and to review information provided in previous sessions.  Ask open-ended questions to determine if the parent and/or child have a correct understanding of the information you are offering to them.  Use presentation methods that connect with various senses - pictures, hand-outs, hands-on opportunities, interactive sessions involving parents and/or family members, music.  Step back periodically to act as a "coach", observing the child and his/her family as they practice and model behaviors, providing objective feedback and praise.  It's important to remember that not everyone comes at a situation from the same perspective or background.  Allow them to be creative and use their own style to utilize the information and skills you have offered to them.  Continue to build their trust as you include them in the ongoing review of goals and plans, providing opportunities for them to make choices and decisions about the progression of treatment.  Acknowledge - frequently - the positive contributions they make toward their successes.  And, finally, let go of the power.  Hand them the torch.  Reassure them that they have the tools to continue to learn and grow, the capability to seek out knowledge and resources that will further their progress.     

And so, folks, I offer you this additional "bowl of food-for-thought," with the hope that you will share your experiences, ideas and comments with me and others in order to...

Stay connected!

Katherine

As a new member of the Advance blogging team, I am excited that you have taken a moment to "connect" with me on my first blog entry!  Let me introduce myself.  My name is Katherine Collmer and I have a wonderful family.  My husband, John, and I live on Cape Cod (hey, somebody has to do it).  He has been my "rock" and major "connection" for the past 37 years.  I have a daughter who is also an OT and has currently been admitted to the NY State Bar and a son who works in institutional equity sales.  I mention these three wonderful people because the love and support we share energizes my life.  And believe me, there are times when life requires more energy than others.   I have been practicing occupational therapy for 11 years.  Practicing and learning, I might add!  I am an adventurer by nature and have sought out OT opportunities that would satisfy that part of my personality.  Therefore, I have had the pleasure of interacting with clients and team members in the Eastern part of the country from Presque Isle, ME, to Knoxville TN; From Albany, NY, to Baltimore, MD.  I have finally LANDED in Massachusetts and have managed to stay put geographically for 3 years!   My experience is broad - ranging from adult rehabilitation to pediatric sensory integration.  That's what I love about OT - variety!!  The opportunities to connect with people within every age bracket and from every walk of life are there simply for the asking!

So, YOU may be asking, why does Katherine Collmer want to blog for Advance Magazine?  Well, let's begin with my blog title, "E-Connect."  The word "connect" is defined in Merriam-Webster's dictionary (on-line, of course) as "from the Latin words ‘com' and ‘nectere' meaning ‘to bind'."  The definitions offered included "to have or establish a rapport (as in tried to connect with the younger generation) and "to transfer (as in a step in travelling to a final destination)".    So, you're thinking, "That's good.  So?"

Let's take it a step farther.  One of my favorite authors, Deepak Chopra, in his book, The Seven Spiritual Laws of Success, provides the reader with the opportunity to explore the "Law of Giving."  He states that "The universe operates through dynamic exchange...giving and receiving are different aspects of the flow of energy in the universe.  And in our willingness to give that which we seek, we keep the abundance of the universe circulating in our lives."  We've probably all been taught that it's better to give than to receive.  But, isn't it true that IN giving we ALSO receive?  It's just inevitable.  Each time we share a smile, a positive word, a tear with someone, we have not only given a gift but we have received one as well.  As we connect with others, we experience joy, harmony, love, peace, knowledge. 

Let me offer you the Katherine Collmer definition of "connect":  To join with others for the purpose of transferring ideas, experiences, compassion and support in an effort to continue the flow of dynamic energy produced by giving and receiving.    Phew, that's a mouthful.  In short, let's share and learn together!  Yes, that says it all!

As occupational therapists, sharing and learning provides the basis for our connection with others.  We are teachers and students, offering and accepting knowledge simultaneously.  Currently, I am practicing at a clinic specializing in pediatrics and sensory integration techniques.  I have found, sometimes the hard way, that the parents of children with special needs are very savvy regarding the needs of their children and the resources available to them.  I have experienced the best "connecting moments" with these parents when I simply sat and listened to them, allowing them to "teach" me about their child.  (Believe me, anyone who knows me will tell you that my ability to simply sit and listen has been challenged quite often!)  Sharing, simply by definition, means to participate in an activity - to interact with others in an undertaking or a discussion.  And that leads me (finally) to why Katherine Collmer wants to blog in Advance Magazine!  I look forward to connecting with other occupational therapists in an effort to share and learn and grow together.  I'm sure there are many of you "out there in blogging land" that have a desire to explore new perceptions and concepts, to expand your horizons, and to just get to know some new people!  Well, that's what "E-Connect" is all about.  I look forward to exciting conversations as we blog along together and forge new friendships. 

So, until next time, stay connected!

Katherine