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OT Toolkit Blog by Cheryl Hall - 3w ago

Are you irritable with coworkers, do you drag yourself to work in the morning, have you become cynical about the occupational therapy profession?

Yes, yes and yes? You may be burned out on your job, and I know exactly how you feel.

I was working as an OT in home care and after a few months with a new agency, I was dreading going to work each day. I loved my job, but I felt exhausted before I even saw my first patient.

At the time I wasn’t sure what was wrong with me, but hindsight is 20/20, right? I was experiencing job burnout and there were three big contributors.

I had been assigned a string of patients with very challenges conditions where progress seems to move backwards more than forward. When circumstances are beyond your control, like your patient‘s health, you can feel defeated despite your very best efforts and that is emotionally draining.

My work schedule was chaotic. I was assigned cases across the region, so drive time was eating significantly into my day. On top of that, I had an unrealistically high patient load and the agency had just introduced a new software system for charting. I was working super long hours and going full blast all day just to keep up.

Finally, I was working without a support network. I had very little contact with my supervisor, fellow OTs or even the other members of the home care team – nursing, PT or aides. On top of that, I was pretty new to the city I was working in and hadn’t built up a social network yet.

While, my trip back to job happiness was more organic than deliberate, it did address each factor. I talked to my supervisor and scheduling was tightened to a more defined geographic area, my patient mix shifted to one where I could have greater impact (and satisfaction), I eventually got faster with the new charting software, and I started a dinner group with some of my fellow OTs at the agency.

I also started taking more time for myself. Sometimes you have to work to create more balance between work and the rest of your life. There is a wonderful quote by Anne Lamott, “Almost everything will work again if you unplug it for a few minutes…..including you.” So, take some time to sit in the sunshine, take a long bubble bath, or walk in the woods. You and your work will benefit from some time spent “unplugged” from everything.

Last month, the World Health Organization recognized job burnout in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon. For those who have experienced burnout first hand, you may be happy to be validated, but also wonder why it took so long! With this classification, more attention and resources are being devoted to the topic so reach out for help if you are struggling. OT is a wonderful, helping profession and sometimes we have to focus that help on ourselves.

Cheryl Hall, OT

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Each day I read a great article about the impact that occupational therapy has in the lives of our patients. Here are some of my favorite stories from the last couple of years. Be inspired and be proud to be part of an occupation that has such impact.

Enjoy,
Cheryl Hall, Author and Illustrator,
Occupational Therapy Toolkit

Chronic Pain
Millions suffer with chronic pain on a daily basis and while OT has been part of treatment plans for many years, there was little research on the subject. A recent study out of the University of Southern California demonstrated the positive impact occupational therapy interventions have for patients with chronic pain. This study used Lifestyle Redesign in an outpatient setting to design an individualized plan to address body mechanics, physical activity and planning for flare ups. Treatment resulted in significant improvement in quality of life, confidence and function.

Diabetes Management
Another study out of the USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy focused on young adults with Type I or II diabetes using the Resilient, Empowered, Active Living (REAL) with Diabetes model. Participants showed measurable improvement in controlling blood glucose levels, improved quality of life and developed healthier habits around diabetes management. The first OT study of its kind to be published in a diabetes journal, the research team is eager to expand the study which they are confident will show the powerful impact of OT.

Crafts and the Brain
OTs know that engaging in an occupation is important to healing and research reinforces that importance. There have been a number of recent studies about the benefit of textile crafts especially knitting. Studies of patients with chronic fatigue, depression, anorexia nervosa and other long term health issues show cognitive and emotional improvements when engaged in these activities. Crafts as occupations improve lives and OTs facilitate those activities.

Movement and Health
The connection between health and light physical activity was explored in a recent study funded by the National Heart, Lung and Blood Institute. Activities like folding clothes, walking to the mailbox and light gardening were shown to reduce cardiovascular disease among older women. Who better to help adults engage safely in these types of daily activities but OTs? Every time we help a patient regain and re-engage in an ADL, it contributes to improvements in their physical health.

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As we welcome April – the month to celebrate all things occupational therapy – I gave some thought to those reasons that I am still in love with my wonderful career as an occupational therapist after all these years.

Patient-Centered: I have always found it a little magical to learn about another human being. I love people, all kinds of people, old or young, like me or unlike me. I love to talk to people, share with people and learn what makes a person tick. So when I found a job that focused on the wonder and uniqueness of each patient, I was all in! The rigor of occupational therapy produces clinicians uniquely qualified to assess physical, environmental and emotional barriers and construct modifications and supports that are patient-centered.

Life Changing: The focus on ADLs and IADLs place occupational therapy squarely in the middle of a patient’s journey to independence. Accomplishments increase self-worth, pride and purpose and bring joy to a person’s life. Whether addressing walking, feeding, dressing/grooming, toileting, bathing, transferring or more complex tasks, OTs help patients help themselves. I love being part of a profession that, by focusing on the person and understanding their special set of circumstances, changes lives. There is nothing more satisfying than helping a person master even the smallest gain.

Creative: Each person’s goals, condition and environment come together to pose a multifaceted problem that OTs are tasked with solving. Providing solutions that center on the unique characteristics of each patient is a challenge and allows an OT to be a constant creator. My artist’s heart loves being continually tested to create one-of-a-kind solutions for my patients. Restoring function and independence in this environment satifies my desire to be creative. I also love listening to other OTs describe the solutions they have crafted for patients. Learning from fellow OTs inspires me to look a little differently at each patient and sparks my creativity.

I would love to hear if these reasons reflect why you love occupational therapy! Hope to hear from you soon.

Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit

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Look at the headlines and you will quickly see that the word “caregiver” is associated with a lot of negative words…burden…stress…crisis…burnout…exhausted. Caregivers play a vital role whether they are assisting with ADLs or IDALs, communicating and advocating with health care providers, providing some nursing care, or just staying current with health needs and management. So take time to mindfully build a strong relationship with the caregiver in your patient’s life.

Make Caregivers Part of the Team
As Occupational Therapy professionals, we can intentionally build a strong partnership with caregivers to maximize patient independence and well-being. Include caregivers in assessments and appointments; build rapport with the person who is central to the patient’s daily life, and approach the care as a team. Written materials and handouts will help the caregiver reinforce your patient’s goals between therapy sessions.

Teach the “Why” and “How” of Modifications and Adaptations
Instruct both patients and caregivers on all modifications and adaptations that you recommend. Patients may not have the capacity to even make the simplest modifications, like removing throw rugs to reduce the risk of falls, so caregivers are the key to carrying out the work. The use of adaptive equipment to increase mobility and independence benefits the patient and the caregiver, many times in equal measure, so the caregiver needs to understand the purpose and proper use of equipment as much as the patient does.

Provide Motivational Tools
The caregiver is the one that will be with the patient day in and day out and should be given the tools to motivate and encourage the patient to live the most independent and fulfilling life possible. When the caregiver understands and supports the short and long term goals of therapy, they can be the cheerleader at home to make sure the daily steps are taken to reach the goal. They are also in a great position to monitor and chart daily progress not only to report to the health care team but to motivate the patient.

Help Manage the Daily Details
Managing appointments, medications and lifestyle is many times up to the caregivers. Acute conditions in particular can leave the family in need of tools to manage the new reality. Occupational Therapists can provide strategies to manage medications and appointments, share the latest information on the condition or disease, and encourage positive lifestyle changes that the patient can implement with assistance from their caregiver.

Promote Self Care
Without the help and support of informal caregivers, many patients would be in crisis. Yet, each of us have only so much to give and that includes even the most dedicated of caregivers. To help, make sure your patient’s caregiver is well connected to the resources available like case management services, respite care, in home care, support groups or financial assistance.

Team building, explaining why, providing tools to manage and motivate, and promoting self-care all will help your caregivers. Ultimately, care for the caregiver will mean better care for your patient and better outcomes. Even caregivers need a little OT!

Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit

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When researching the 7th edition of the Occupational Therapy Toolkit, I found many outstanding supplemental resources. So I have curated and organized this information into over 30 categories that you can access on my website under Links/Resources.

I hope that as an Occupational Therapist, you find it useful to have all these resources vetted and in one spot. My mission has always been to share information about our profession to help you be a great occupational therapist who delivers outstanding care to all your patients.

Occupational Therapy Toolkit – Links and Resources

Activities of Daily Living
Alzheimer’s disease and Related Dementias
Aging
Amputations of the Lower/Upper Limb
Arthritis
Assessments
Assistive Technology
Burn Injury
Cancer
Cardiac Disease
Caregivers
Chronic/Persistent Pain Syndrome
Chronic Obstructive Pulmonary Disease
Diabetes Type 2
Dizziness
Driving
Therapeutic Exercise
Feeding, Eating and Swallowing
Functional Mobility
Health Management
Huntington’s Disease
Independent Living
Low Vision and Blindness
Medication Management
Mental Health
Multiple Sclerosis
Orthopedics
Palliative Care and Hospice
Parkinson’s disease
Pressure Ulcers
Rest and Sleep
Sexual Expression and Activity
Spinal Cord Injury
Stroke
Urinary Incontinence
Universal and Adaptive Design

So check it out today! All the content on my website is free including a selection of handouts and treatment guides from my book, Occupational Therapy Toolkit, Patient Handouts and Treatment Guides for Physical Disabilities, Chronic Conditions and Geriatrics.

Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit

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In February, the U. S. National Eye Institute raises awareness of low vision and highlights the day-to-day impact for patients. The most common causes of low vision include aged-related macular degeneration, cataracts, diabetic retinopathy, and glaucoma. NEI predicts that the number of people in the U. S. impacted by these four conditions will double by 2050. The NEI web site offers free educational and training resources for patients, care givers and health professionals.

Occupational therapy plays an important role in assisting low vision patients maintain their independence and their ability to enjoy their favorite activities. OTs can assess patients and then recommend and teach environmental adjustments, task modifications as well as compensatory techniques. The Occupational Therapy Toolkit includes a number of low vision treatment guides and patient education handouts. Samples of some of my favorite strategies are included below.

Enjoy!
Cheryl Hall, OT
Author, Occupational Therapy Toolkit

Occupational Therapy for Low Vision
Environmental Adjustments
Lighting Adjust task lighting below eye level
Glare Recommend sheers, blinds or light filtering shades
Safety Assess for tripping hazards
Task Modifications
Communication Teach eccentric viewing, scanning and page orientation techniques
Medication Use dark colored tray with lip when organizing medications
Money Teach how to pay bills by phone
Mobility Practice counting the steps between locations in the home
Eating and cooking Recommend cutting boards in a variety of colors to contrast with food
Recreation Teach how to download digital audio books from the public library
Compensatory Techniques
Using the other senses Coach to recognize changes in floor covering
Distinguishing objects Use magnetic letters on canned goods
Use of contrast Outline steps, switch plates or doorways with colored tape
Labeling and marking Recommend raised plastic dots to mark settings on appliances
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OT Toolkit Blog by Cheryl Hall - 6M ago
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What are your OT career resolutions this year? Are you planning to finish a degree, change jobs, become more involved in a professional organization or shift your practice to a different population? Setting resolutions is the easy part; to help you stay on track try these 3 simple strategies: create a vision board, download a to-do app and use inspiring pass phrases!

Enjoy!

Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit

Vision Board
Does anyone else find it ironic that vision boards are all the rage on Pinterest right now when Pinterest is a vision board! Despite all the electronic ways to see, save and share ideas, there is something about creating a tangible vision board that makes the goal more real.

  • Display in the Right Spot – Any corner can be used to display your vision board, but make sure it is where you will see it every day. If you don’t already have a sad, cluttered bulletin board that needs a makeover, try the inside of a cabinet door, the unused side of your refrigerator or a blank wall in your work cubby. You can even create a small board that can be tucked in a drawer at the end of the day.
  • Gather Inspiration – Pull together photos, memes, quotes, lists, images and other visual reminders of the goal you want to achieve. Print calendars, checklists and specific goals to focus your attention.
  • Have Fun – Take a trip to your local craft store and grab a display board, some paper, pens, lettering, and embellishments to make your vision pop.

Use a To-Do App
Have you ever heard the saying “A goal without a plan is just a wish.”? Well, it is true of your 2019 resolutions too. In order to achieve your goals, you need to take a series of steps. For example, if you are trying to change jobs this year, what needs to happen first? Should you spruce up your resume? Get your LinkedIn profile in shape? Attend some professional networking events? Contact a recruiter?

Using a To Do app forces you to lay out all the steps that you need to take to ultimately reach your goal. There are so many great To Do apps out there like Wunderlist, Todoist, Trello or Carrot. So check out reviews and download one today. Once you define your “ to do’s”, you can list the needed sub-tasks, add dates and set the calendar reminders to help you stay on track.

Pass Phrases that Inspire
Even protecting your devices and accounts can support your resolutions. Pass phrases are the new passwords in the world of cyber security. So why not come up with pass phrases that tie to your professional goals? After all, you are going to type it in over and over again – sometimes several times a day. For example, if you are working towards graduation, use the phrase “2019*OTD*graduation*here*I*come!” As you work through the last semester of requirements, you will be uplifted every time you type in your pass phrase.

I am heading to the craft store now to create a vision board for my latest project; I’ve downloaded Wunderlist; and I changed my email pass phrase! You need to get started too! Be sure to let me know if these tips helped you stay on course in 2019.

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The physical and emotional health benefits of a walking program are astounding! For patients recovering from an illness or injury, adding walking poles can provide stability, improve gait and posture, and strengthen the upper body. I was first introduced to walking poles while teaching the evidence-based falls prevention program, Stepping On, to community dwelling older adults. One segment used walking poles and I have been a fan ever since. My interest was renewed recently when I received a set of ACTIVATOR poles from Urban Poling. The ACTIVATOR poles were designed by a fellow OT practicing in Canada specifically for rehab and long term conditions. The design features a button locking system to adjust the height of the poles, a patented ergonomic grip, a Bell Shape tip to improve stability and is strapless to reduce the risk of injury. Check out their website at https://urbanpoling.com/ for more information.

Read on for a brief overview of the conditions that might be appropriate for the therapeutic use of walking poles, ways patients can benefit and some tips for use.

Enjoy!

Cheryl Hall, OT
Author and Illustrator, Occupational Therapy Toolkit

Conditions: Walking is a low cost, low barrier option for any patient that needs to improve functional mobility, but the added benefits of walking poles can be a boon for patients with the following conditions including:

  • Arthritis
  • Parkinson’s
  • Rehab after hip, knee, ankle or foot surgery
  • MS
  • TBI
  • Cardiac rehab
  • Stroke

Benefits: In addition to all the gains a walking program can offer a patient, the use of walking poles adds some specific benefits.

  • Relieves stress on low extremities
  • Improves stability and balance
  • Maintains better posture compared to a cane or walker
  • Actively uses arms and upper body
  • Promotes a more natural gait
  • Helps to navigate steps, curbs and slopes

Tips for Use: Patients should be trained in the proper use of walking poles to gain the greatest benefit. Instruction should include these key points.

  • Poles – When adjusted properly, the elbow should be at a 90° angle when the tip is resting on the ground.
  • Straps – If the poles have straps the hand usually goes up through the loop. Straps distribute some of the load to the wrists and the hand grip is loose.
  • Tips – Depending on terrain, a variety of tips may be available. For concrete or asphalt, a hard rubber tip is best. Basket tips are for softer surfaces like sand or snow.
  • Gait – Opposite arm, opposite leg is the pattern used with walking poles. There are different techniques depending on whether the poles use straps.

Do you have a success story using walking poles with one of your patients? Let me know.

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