Tuesday, February 28, 2012

Assisted Living Facility

I had the opportunity to visit an assisted living facility during Mardi Gras break, well actually on that Tuesday. I visited as a guest and not an OT student, but it was a cool experience so I wanted to share. My brother and step-father have an elder care business where they arrange sitters for older adults in assisted living and home environments and they were putting on an event at this facility to promote their business. It was actually all my brother’s idea (I was quite surprised and impressed). He had his friend who plays in a blues band (a very very good one) come play a Mardi Gras concert for the residents. I was less impressed with the business promotion aspect and more with the super fun event for the residents to attend. Many had family members there and all the staff showed up. There was food and dancing. My younger sister loved dancing with all the residents and they LOVED her - she was so cute! I saw her helping a man go from standing with his walker to sitting and my heart just melted. She should be an OT and I told her this much!

I loved seeing the environment – I am immensely curious as to how they spend their day, their schedules, freedoms, etc compared to a nursing homes (especially the one mentioned in my previous post.) My mom is a PA (physican’s assistant) and sees some of the residents there, so I may go observe her to see the facility on a normal day or even better maybe I can get in with an OT there (I think they are home health from different companies so it might be hard – I won’t hold my breath). Either way I am interested in learning more about assisted living.

I LOVED that they had animals there. I was not allowed to take pics of any of the residents, but I snagged one of the dog, which was allowed, as well as one of the band. The dog was so old and sweet! I played with him the whole time using him as a way to talk to the residents. I heard there was another one roaming around as well as a few cats. I also spotted that they had a rather large TV, a collection of books and magazines, and a hobby corner with things like knitting equipment. The residents seemed to love the music and many of them danced off and on all night including the Mardi Gras King and Queen who totally sported their plastic golden crowns. It was a really fun event and I was glad I went. Hopefully I can visit again soon and learn more about assisted living!

Community Mobility

Two(ish) weeks ago, my partner, OT student KFlan , and I did our community mobility assignment and it was quite the experience! We had to ride a streetcar or a bus with a wheelchair one way and a vision impairment on the way back. We choose to ride the Canal redlady streetcar near school in the business district to a mid-city Mexican restaurant. I was the first one in the chair and navigated it from school to the streetcar stop. Well, I tried to navigate it that it. As it turns out, our school and the surrounding areas are not very accessible. The lack of curb cuts, broken sidewalks, and steep slopes made it near impossible to get to the stop. We also had a lovely man talk to us along the way who proclaimed, “You’ve got it made. I wish someone would push me around all day.” My legs were covered… he clearly could not see if there was anything “abnormal” about them but even if there was what if I had MS and I was too fatigued to walk. This guy had NO clue why I was in that chair and what I wish I had done was shouted out “Yeah, well I wish I could walk!” However, due to the fact I can walk I felt like I should not do this… but still he had no idea if I could or not. It was just lovely.

After that encounter we made our way to the stop only to realize that the streetcar was not coming that far down due to construction. She had to push me through the grass and along the tracks to get to the next stop. When we got there, a lady did tell me that she saw me and was going to send a special bus for me. She was really nice, but leaned down very close to my face and talked very, very loud. She and the streetcar driver loaded me up on the lift so I could get in the streetcar. The driver tried to strap me in, but he only fastened 1 of the 4 straps to the chair and did not even do it correctly. He was very nice though. We were supposed to get their badge numbers because we had to fill out an RTA form on how they did. I was actually kind of glad his was not showing because he was so nice, but did everything so wrong. I know he needs to know the correct protocol, but I was glad to not get him in trouble.

The rest of the ride there went pretty smooth. I felt a little awkward because I knew I did not really need the chair and people kept staring at me. When we got to the tiny restaurant, it was raining and there was no room inside to wait. About 4 guys offered to stand in the rain so I could get inside and not be drenched. It was really nice but again, awkward for me because I did not need the chair, but felt I needed to stay in it because if people saw me in it and then saw me just get out and push it, it would be making a mockery of the whole situation. Maybe not, but that is how I felt. I also think it put the risk of creating negative thoughts about people in wheelchairs as in they would think I was in one and could get up and walk around so other people that are in them might be like that too. Maybe I was overthinking it, but nonetheless I stayed in the chair.

After lunch, we went behind the building a switched so my partner could experience the chair on the way back. To simulate a vision impairment I taped the left side of my sunglasses with scotch tape to simulate left homonomyous hemianopsia. It was really difficult to see the signs as to where to get off and the driver never called out any stops. This driver did strap my partner in the wheelchair correctly, but would not have picked us up had I not gone on board and asked her to. She clearly did not see KFlan in the wheelchair and would have left us. Part of the assignment was to wait until the next one came and see how long it took for you to get picked up, but it was raining and at a rare temperature of about 42 degrees so I hopped on and asked her to get us. While on the bus things were pretty tame for me, but KFlan had a weird encounter. This man who was clearly trying to be nice, came up to her, put his arm around her back, started rubbing it, and proceeded to talk to her like a child. In a creepy voice I quote, “Hey. What’s your name? You going to go out to the Mardi Gras this year and see the pretty floats? Catch some shiny beads? You should really try to make it out you would like all the pretty things.” What she should have said is. “Hi my name is K and I am a graduate student. I live on the parade route. I enjoyed all the parades last year and plan to watch them again.” But she was too taken aback and mildly creeped out to reply much… I would have been too. It was awkward.

When we got off it was raining hard so we raced back to school. I’m sure we looked like quite the pair as we were two young girls running and rolling through a pretty bad area of town in the pouring rain laughing hysterically – couldn’t be helped at that point. Our last brush with drama was crossing the street at South Claiborne and Poydras. A taxi driver sitting at the red light (while we had green to walk across) started revering her engine at us and literally came within a few inches of running us over. Then she pulled over to curse us out. Lovely.

We had to do a write up about this assignment which was not really an informal reflection as I have provided here, but more a paper on how this related to OT. I focused on OT’s role in community mobility at the individual and community level, why public transportation is important, what is wrong with it, and why this assignment was an important experience for us. One of the biggest most important things I noted while writing this paper was the OTs educate and advocate for their clients to use these services, so in my opinion, they have to be flexible when temporal contexts prevent clients for adhering to their own agendas. Many people rely on public transportation and they have little control over timing. Sure, they can plan according to the supposed schedule put out by the company, but accidents, delays, and detours can put people behind schedule which makes things like jobs and appointments hard to hold. I am glad I experienced this assignment and came to that realization, however obvious it should have been to me before!

I did not take many picks of us during the assignment (again did not want to make a mockery of it) but I did snag one of KFlan from behind when no one was looking!

Picture Queen, OT Student Kristin, took these when the people from RTA came and talked to our class, so I figured I would post them as well!

Mardi Gras Mambo

I have not been in school for a week and I STILL have not found the time to post like I want, but I have a few interesting ones coming I promise!
I ended up having a week off for Mardi Gras – usually we only have Monday and Tuesday, but because the group schedules had to be changed for those going to the mental health facility and nursing home this week, if we weren’t in the group going we were off. The Monday and Tuesday are given because, for those of you who have never experienced Mardi Gras, the city practically shuts down and it is hard to get anywhere! You would think I would be rested but oh how I am not! See there is such thing as a personal life outside of school and whether it is going good or bad it can be quite time consuming. I ended up making an unexpected trip home for much of the week as I had an unexpected family situation that I needed to attend to. I also caught several parades and they were fabulous! Again, I wish I was good at taking pictures so y’all could see it though I am sure it would not compare to anything you would experience in person. Maybe I can get some from my photographically inclined class mates.
In OT news, I completed my community mobility assignment (post to follow), have been working on an ortho case study, and planned my own funeral for an assignment in principles of practice (quite possibly an individual post to follow as I think it is worthy). I also had an opportunity to visit an assisted living facility not as a guest not an OT student (surely a post to follow)

Since this is a rather personal update I will note that I am on day 41 of P90X and still going strong! I have not missed a work out yet (yep not even during Mardi Gras!) but I have found it RATHER difficult to adhere to a strict diet… well any diet for that matter. I always eat super healthy foods everyday… I just eat a little junk on top of it. I have come to the conclusion that in Louisiana, there is NO good time to diet, so I will just make consistent lifestyle changes of working out more and eating tons of healthy food in addition to the occasional sugar or salt poisoning… crawfish boil season is right around the corner y’all!

Friday, February 17, 2012

Empowerment Group – Mental Health Facility and Nursing Home

Last week for my principals of practice class we got to go to a mental health facility and a nursing home and run a group. For 7 weeks this semester a group of 4-5 student s go to these facilities and run a group related to the recovery model. Our group’s topic was empowerment so we did a group activity centered around that. I wish I had taken a picture of the board we created to give y’all a visual of what we did. We basically gave an overview of what empowerment was, did a short warm-up breathing exercise, and did the empowerment board activity. We made a poster with pictures representing different topics like mediation, alcohol, group participation etc. We had a “good” picture and a “bad” picture. We also created an empowerment board for the facilities to keep that the good pictures and a description of them were placed on. For each set of pictures we had a discussion about how choice could empower you to lead a healthy lifestyle. For example, on the topic of medication we discussed not only the importance of compliance, but also the right that clients have to question and talk to their doctors if they are having side effects and/or not doing well on the medications. Then we would ask a client to place the good picture on the empowerment board next to the description that would say something like “Take all medications. Talk to your doctor if you experience any problems.”

Overall, the groups went really well. At the in-patient mental health facility we faced the challenge of a very large group (17 clients) with all different levels of cognitive functioning. Even the staff OTs commented on how difficult a group like that is to run because you have so many different individuals on so many different levels. The main diagnoses in that group were schizophrenia and bi-polar and the dynamics were similar to what I experienced in my first time visiting there. There were few people who were very disorganized or actively hallucinating, but most were on topic and at least somewhat attentive. I felt the clients were somewhat reluctant to participate and would have done better in smaller groups.

At the nursing home, the residents were clearly eager to participate, but had a hard time doing so due to problems like hearing. This was also a pretty big group and the nursing staff had them on strict schedule, so we could only pick 3 of the 8 topics we planned to discuss. I think I gained a lot from this experience, and unfortunately a lot of what I learned is what NOT to do. We got to stay and observe the residents exercising, which most claimed to enjoy. In my opinion, it was just shy of horrific. Their “exercise” consisted random movement s with no functional goal or enjoyment purpose. “Touch the sky” “Tap your toes” “Roll your wrists” I certainly would have enjoyed touching the sky a bit more if we were playing a game of balloon volleyball or dancing to a song. The one time a ball was involved it was repeated thrown in the residents face with the instructions of them to bat it away. I literally saw a women who was refusing to participate because she did not feel well get hit in the face or head like 4 times before they stopped throwing the ball at her… horrific. I swear if I ever have a ball thrown in my face after I have declined participation…

I recognize that it is important to try and engage people in exercise or therapy even if they decline but there is a way to do it and it is NOT a degrading way like throwing a ball in their face and telling them they need to bat it because they have to exercise. This facility was also big on making clients do things as a group even if they did not want to. ( I really want to give a good example but I do not want to identify this facility so I will make up a less harsh example) For example, they all have to go into the dining room to eat at a certain time even if they do not want to eat and even if their cultural or other habits are to eat a different way at a different time of the day. Or, they all have to go outside and observe a Mardi Gras parade that passes by even if they hated Mardi Gras with a passion and think it is against their religion to watch people celebrate it. I understand there has to be structure, but the lack of choice here seemed to be significant. With that being said… this actually was not a bad facility all in all. I just think that some drastic improvements could be made to make activates more meaningful and create some social participation. Throughout everything it was like the residents were participating alongside each other and not with each other. How great would it be if they could do a small yoga group for exercise where they partnered up and helped one another? Or even a more simple idea like balloon volleyball where they either partnered up or had to hit it to the person next to them?

I have come to realize that I am very passionate about working with older adults so some of my zeal might come from that. I just think there needs to be a certain level of respect for people who have lived longer and experienced more than you have. I also think it is vital to remember, especially when dealing with clients with dementia, that these people are ADULTS not children and to treat them with dignity and respect. On that note I will leave you with the words of Mr. Shel Silverstein…

Said the little boy, "Sometimes I drop my spoon."
Said the old man, "I do that too."
The little boy whispered, "I wet my pants."
"I do that too," laughed the little old man.
Said the little boy, "I often cry."
The old man nodded, "So do I."
"But worst of all," said the boy, "it seems
Grown-ups don't pay attention to me."
And he felt the warmth of a wrinkled old hand.
"I know what you mean," said the little old man.

Thursday, February 9, 2012

Ortho Lab

Last week we had a really great ortho lab and my instructor sent us pics so I wanted to share them.

I've been pretty busy lately and have not had time to update, but there will be a blogging mini-marathon this weekend or early next week so just you wait!

OT Students B and ST practicing passive range of motion

Ot Students SE and SS using a pinch gauge

Several OT students practicing retrograde massage

Me and OT student K - she's testing my reflexes

OT students J and K apparently loving the contrast bath that I found to be rather painful

OT students E and A using the volumeter (measures edema aka swelling)

OT students D and A using the dynamometer to test grip strength

OT students P and A using the vibrator for scar massage

OT Students L and S with the volumeter

Brushing up on anatomy