A Snooze-worthy Subject

Happy World OT Day!!
October 27th, in case you're like me and can't keep track of what day we're on.

And, today we also return to the world of occupations! As promised, this week is Rest & Sleep. Two beautiful words. Beautiful, but often elusive.

Most people have, at some point, experienced difficulties with sleeping. Whether that be problems with falling asleep, problems with not waking up on time, problems with sleep quality--the list goes on and on. And, many people don't think about the ways they can change their sleep patterns or prevent/eliminate some of these issues. Lots of healthcare professionals can help with this. As OT's, we aren't able to prescribe medications or sleep devices. But, we can empower our clients by helping them pinpoint the problem and think of functional and accessible ways to improve their sleep quality. And, of course, as OT's, these strategies often involve occupations.

You're having problems falling asleep? An OT might go through your nightly routine step-by-step. (This is called activity analysis, and OT's do it all. the. time. Sounds simple, but it's actually quite complex. More about that another day!) As a result of this activity analysis, your OT might recommend you stop using your phone an hour before going to bed. Or do some deep breathing and stretching exercises.

Maybe you have a lot of aches and pains when you wake up. An OT might show you alternative sleeping positions that will put the least amount of stress on your body.

What if you're an elderly person with low vision and poor balance and you get up at night to use the bathroom? An OT might do an environmental assessment of your home and recommend you rearrange your furniture to make your nighttime adventures safe. (Yes, this falls under the home mobility section of ADL's, but it flows into this area of occupation as well.)

And, what if you're in a Nightmare on Elm Street movie and Freddie Krueger is terrorizing your dreams? An OT would definitely fight Freddie for you. 100%.
(Sorry, what with the proximity to Halloween, and my love of horror films, I couldn't help myself.)

What about rest? Don't worry, I hadn't forgotten about it. Also, it's not the same as sleep, although the two words are often used interchangeably. In OT world, rest is composed of two things. The first part is recognizing the need for withdrawal from activities in order to recharge your batteries (both mentally and physically), so to speak. The second part is the occupation that you choose in order to recharge. And, like all things, it's different for everybody! Reading, watching Netflix, listening to music, exercising, coloring--the list is infinite!

Here's a cool thing. The role of OT in rest activities is also extensive. We might help a client find restful activities in order to improve their mental health. We might help someone participate in their favorite restful activities after something has happened that makes it difficult for them to do so. For example, take someone who has experienced a spinal cord injury and is unable to hold a paintbrush, and painting is their favorite restful activity. An OT could figure out alternative ways for them to hold the paintbrush. Pretty cool, right?

Happy resting (and snoozing)!!

All Rest & Sleep occupation areas information borrowed & adapted from: Occupational Therapy Practice Framework: Domain and Process (3rd Edition). American Journal of Occupational Therapy 2014;68(Supplement_1):S1-S48. doi: 10.5014/ajot.2014.682006.

A Necessary Tangent

I have debated, at length, with myself about the topic of today's blog. I had something I really wanted to share, but I wasn't sure if my readers would be ready for (or interested in) a more personal post. And then I figured, after all, this is my blog. I can do whatever the heck I want! Otherwise, I was going to be talking about sleep & rest. Which, as thrilling as that sounds, can wait for another week. While today is, in fact, the perfect day to talk about what I am about to talk about...

And that is bullying. Of course, how it relates to OT (of course), but, more importantly what anyone and everyone should do to combat this.

October is National Bullying Prevention Month. It's something that I have a lot of strong feelings about (just ask my family, they've been audience to my righteous fury on the subject more than once). I'm not here to vent or rage, but to speak about this honestly and seriously.

The relation between OT and bullying is quite simple, really. When a child is bullied, or bullies, it has a huge effect on their performance in, well, all areas of occupation. Which, obviously, we haven't covered all of them yet, so here's a list:

• Activities of Daily Living
• Instrumental Activities of Daily Living
• Sleep & Rest
• Social Participation
• Education & Work
• Leisure & Play

And not just short term effects. Bullying creates permanent changes in how people view themselves and the world around them. I would love to go through each area of occupation and how each can be affected by bullying, but this would end up being an incredibly long--and, quite frankly, depressing--post.

Honestly, I'm having a really difficult time writing this post. There are so many things that I want to say, and I want to give this subject the full attention it deserves. But, at the same time, I would probably go on and on, metaphorically forever if I did that. And it still wouldn't be enough. 

So, I'm going to ask two things of you. 

First of all, I want you to take a look at this website and educate yourself:

https://www.stopbullying.gov/ 

Educate yourself so that you can recognize bullying and know the proper steps to take in order to put a stop to it. 

Second is a request for kindness. As with everything else (and to quote Zootopia), change starts with you. It's important to examine our own actions and thoughts before trying to change those of others. And for the issue of bullying, it can be as simple as being kind. Kind in all things, to everyone that we meet. Making sure everyone feels loved, respected, and included. If we can do that, we are on our way to changing the world. Which, I understand, is a super cliche thing to say, but I firmly believe it to be true.

Cookies & Cars

Last week I talked a bit about Activities of Daily Living, or, ADL's. All of those foundational things you do to maintain your health and well-being, and function in daily life. Like brushing your teeth, tying your shoes, all that good stuff. Yes, of course, you remember, you're not stupid, I get it. Just thought a review would make a good segue into the focus of this week...

...Instrumental Activities of Daily Living. IADL's. Yes, I know, it's so completely different from ADL's, because we added an I (for instrumental, if you follow me). Very complex and fancy. And, actually, IADL's can be fairly complex and fancy.

IADL's also happen on a daily basis, like ADL's. However, they are more complex than ADL's, and consequently require more thought. They're difficult to define, but easy to give examples of. Here are a few:

• Cooking & cooking clean-up
• Child rearing
• Caring for a pet
• Talking on the phone, sending emails, anything that involves communication
• Managing finances
• Shopping
• Community mobility (driving, using public transportation, etc.)

So, basically, we're still talking about those necessary activities that keep you successful in your daily life, but we're widening the scope into those areas that require more steps, more resources, and (often) more work (mental and/or physical). You can differentiate them from ADL's by thinking about the amount of thought you put into something like tying your shoes, in contrast to balancing your checkbook. Caring for just yourself, versus caring for your child. Getting around your apartment, versus getting around the city.

And, here's a big surprise: OT's are all over the IADL business. This can take an infinite number of forms, but one of my personal favorites in the IADL biz is community mobility. As alluded to above, this means getting around the community. An OT focusing on community mobility with a client may help them learn how to use the bus system, taking bus trips with them to practice. For someone who uses a wheelchair, an OT might help them map out the wheelchair-accessible spots in town, and devise plans for navigating those that are less-accessible.

Another quickly growing area is driving education and re-education. Currently, I am completely enamored with this last one. I never really thought about how much of a privilege driving is, until I spent time with some people who were waiting to be cleared to drive again after having a stroke. When they were finally able to get back behind the wheel, it was like passing the driving test in high school all over again. Going out to lunch was a big event, because they could drive themselves. If they wanted to make cookies, they could get in the car and drive to the grocery store to get the ingredients. They could go visit their friends and family whenever they wanted. It was huge. 

Of course, this got me thinking about how not being able to drive would be. And I don't mean before taking the driving test in high school, because if you haven't driven before, then you don't really know what you're missing. But being able to drive, and then suddenly not being able to drive. It would mean giving up a huge amount of independence. Relying on other people for errands of any kind. Relying on other people to visit you, instead of you visiting them. Having to stay at home alone because no one's available to drive you to your book club meeting. You get the idea.

So, imagine the thrill of being able to help someone regain that independence! Whether it's helping them re-learn driving, or helping them figure out the public transportation system. Pretty awesome, right?

All IADL information borrowed & adapted from: Occupational Therapy Practice Framework: Domain and Process (3rd Edition). American Journal of Occupational Therapy 2014;68(Supplement_1):S1-S48. doi: 10.5014/ajot.2014.682006.

The Complexity of Daily Activities

New direction for this blog! The first few posts will be mainly OT-educational, for those readers who may not know what OT is, or what OT's do. Those of you who know all the things about OT can skip these first few weeks, or follow along for kicks and giggles, and the satisfaction of reading stuff that you already know!

First, I will be covering the "areas of occupation", as delineated by the Occupational Therapy Practice Framework, 3rd ed. (American Occupational Therapy Association, 2014). Yes, "occupation" refers to your job/profession, but it also means So. Much. More. As occupational therapists, we use the term "occupation" to refer to any activity or task that occupies a person's time. Think about that for a minute.
If you became overwhelmed just thinking about that, then you're on the right track!

And, fear not, because OT has your back when it comes to the vast territory of occupations!
OT has them all nicely grouped into categories (called "areas") of occupation.
And that is what I will be covering in the coming weeks.

We'll start off with the building blocks: Activities of Daily Living. We refer to them as ADL's, because, of course, everything's cooler when it has an abbreviation. Now, I want you to visualize your morning routine. For me, it takes a good 10 minutes to get out of bed because the will is weak in the morning. But once up, I use the bathroom, brush my teeth, get dressed, eat breakfast, make coffee, and stumble out the door. Or some variation of that. If I'm feeling particularly daring, I might eat breakfast before getting dressed, or even, *gasp* go without coffee.
But that's beside the point.
All of you probably have some similar variation of morning behaviors. And it's a pretty simple deal, right?
Those are your ADL's. Self-care, like brushing your teeth, showering, brushing your hair, etc. Dressing, as in buttoning a shirt, putting on socks, that sort of thing. For the sake of being concise, I'll abridge. Eating = ADL! Getting around your house or apartment = ADL! Sex = ADL!
ADL's are the building blocks of our lives. They are necessary to survive and thrive in this world.

Pretty simple, right? Many of these things we may do without thinking about them. They become part of our routine, and that's about it. These activities are nothing special, they just are.

Now, I want you to imagine that you've experienced a stroke, and one whole side of your body is affected. That arm, leg, trunk, and side of your face isn't working.
Now, think about brushing your teeth. How would that task change, if you lost functioning in half of your body?
Fairly drastically, I would imagine. At first, you'd probably need to sit in a chair at the sink, rather than stand. With support, because your trunk control may not be very good. You'd have to figure out a way to unscrew the toothpaste and apply it to the toothbrush with one hand. What about the faucet? Are you able to reach from a seated position to turn the water on? What about getting to and from the sink? What if you lived alone and had no one to help you?
It's not quite so simple now, is it?

It's incredibly easy to take ADL's for granted, until something happens and you're forced to completely change the way you perform these activities. And that's where OT's come in! We're there to collaborate with our clients to creatively problem-solve and find new ways of performing ADL's. We're there to help them regain the strength and skills to return to their original ADL routine. We're there to educate them on use of adaptive equipment like shower benches, and transfer boards for toileting. Aaaaand, I could go on and on. But you get the idea.

So, to wrap-up, I hope this gives you a bit of a new perspective. If you have a slightly greater appreciation for your morning routine after reading this, then I will be quite happy. I also hope this wasn't completely dull and yawn-worthy. But ADL's are pretty cool, so I'm guessing not. Tune in next week for coverage of another thrilling, exhilarating area of occupation! Thanks for reading!

Occupational Therapy Practice Framework: Domain and Process (3rd Edition). American Journal of Occupational Therapy 2014;68(Supplement_1):S1-S48. doi: 10.5014/ajot.2014.682006.