This blog began as a journal of a Winston Churchill Memorial Trust Travel Award visit to the USA to study how Lifestyle Redesign could be used in Occupational Therapy to improve the hospital/home interface for older people. It has continued to record developments and inspiration gained from that experience since returning from Los Angeles early in 2012.

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Thursday, 12 January 2012

Lifestyle Redesign and Well Elderly- learning more

This morning I joined the first class of a 16 week block on Lifestyle Redesign taught by Camille Dieterle at 'the Center' on the main UPC campus. There are about 20 students in the class, all 2nd Year Masters level who will graduate in the Spring.

We went through introductions:
Who are you?  Current practice interests?  Why did you attend?  What new occupation do you want to try in 2012? (Everything from learning to cook or sew, to kite flying, hot yoga and driving).
My new occupation was to learn to get around in LA on my own, either by public transport (which seems to be a bit of a challenge) or by car (which looks quite scary). Watch this space...

Some definitions of Lifestyle Redesign:
  • 'process of acquiring health promoting habits & routines in daily life' (Clark et al 1997)
  • 'process of implementing self directed, personally meaningful changes to one's lifestyle and daily routines that promote health and enhance quality of life'

We looked at:
  • Lifestyle Components e.g  time management, eating routines, physical activity etc.
  • Client Factors e.g. chronic conditions
  • Risk factors for chronic conditions, these may include poverty and violence
  • Occupational role overload
  • Occupational deprivation
The current emphasis on 'wellness' and preventative work, make Lifestyle Redesign very relevant to current healthcare concerns.
We looked briefly at some of the key research papers, we will be revisiting these in more detail as the course progresses. We also discussed some of the areas Lifestyle Redesign is being used in e.g. weight management, diabetes, pain management, chronic headache. Apparently there is a programme working on prevention of further strokes in women who have had one previous stroke- I will try to find out more about this.
We looked in more detail at the syllabus for this course, which covers experiential learning as well as theory. As well as textbooks, reading and assignments, we were put into pairs (I will be working with three other faculty members who are attending the class) to begin a didactic process using the Lifestyle Redesign methodology that will continue throughout the class and be recorded through journals.
This class will give me the opportunity to experience and learn along with others and to have some experience of the process myself.

One of the key articles about Lifestyle Redesign describes the first Well Elderly study.
Clark F et al (1997) Occupational Therapy for Independent-Living Older Adults. A Randomized Controlled Trial. Jnl of American Medical Association Oct 22/29 Vol 278

I re-read it this afternoon and wanted to share a few of the points made in the final comments section accounting for the succes of the OT interventions (in comparison with non-professionally led activity groups):
  • 'activities chosen based on principles from the OT field that pertain to the relationship of occupation to health', particularly in developing daily routines that are relevant to an individual's own context, meaningful & health promoting.
  • highly individualised, despite the group context.
  • specific instruction is included on how to overcome barriers in everyday life within often limited resources
Individuals learned to 'confront obstacles, take risks & experience self efficacy and personal control while participating in daily activity'.

This afternoon I also met with Jeanine Blanchard who is currently part of the Pressure Ulcer Prevention Study team, but has a lot of experience within the Well Elderly studies. She shared information and her experiences with me, which helped to give me a clearer understanding of how the studies worked at more of a 'nuts & bolts' level and to begin to clarify some of the differences between how systems work here in comparison with the UK.

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