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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Wednesday, 15 February 2012

Therapeutic use of a 99 Cent store

Happy Valentine's Day!

I have been able to spend a couple of sessions at Rancho Los Amigos National Rehabilitation Center in Los Angeles. Rancho is not part of the University of Southern California (USC), but it's OT services have close links with the teaching and research programmes here.

On my first visit to Rancho last week, I joined some of the OTs, Alison, Yustina and Annelise and student Mary with a Lifestyle Redesign group for people who have had a stroke and want to make lifestyle changes to reduce the chance of a further stroke event.

Alison with the Manual for the programme

The programme was initally designed by Alison Chu as part of her dissertation for her OT Doctorate. At that point it was for women but has since been continued and extended to men and women. This group meet weekly at the OT Department Wellness Center at Rancho and cover a range of topics relevant to reducing the chances of secondary strokes. The approach used follows the Lifestyle Redesign model with a focus on each individual's occupations and daily routines that can be used to promote health and well being, in this instance with a very specific area of health at the forefront. There is an emphasis on provision of correct information, developing awareness and self efficacy so that changes made can be embedded in an individual's occupational routines in a meaningful way and will therefore be sustainable.

Yustina at the 99 Cent store

The group had been talking about healthy eating the previous week and I joined them the day they were going out to look at food labels and menu planning in a real life situation. As most group participants are on low incomes, the local 99 Cent store was chosen for the visit. It is similar to a pound shop in the UK, but sells a greater range of groceries including fruit and veg.

We had about an hour at the store during which the group's aim was to investigate food labels for items they often use and possible alternatives. Also to plan and buy for a healthy meal to cook together next week (fresh ingredients were to be selected this week and bought by Alison on the day of the meal). All within a strict budget.

This session could be carried out sitting round a table, but the OTs were keen to use a real life situation as much as possible. The advantages of this became clear as issues and questions arose that might not have done without the prompts provided by being surrounded by food choices and the marketing that often pushes the less healthy choices. In a very natural way, people were prompted to enter into 'story telling', such an important part of this model of OT intervention. These openings were captured by the OTs who then facilitated individuals to explore their usual choices and to learn form each other as nest week's menu was discussed.

On this occasion, not all group members were able to attend which meant that those who were present got extra individual attention. It was quite a rush to get everyone in and out of the two cars that were used and round the store in the 2 hours allocated for the group, but it was achieved, everyone had enjoyed it and set their goals for the week on the way back to Rancho.

Mary- decisions decisions...

For me the outing was a small snap shot into another example of how Lifestyle Redesign is being used in such varied patient populations. Each group I have observed or learned about is very different, but the common threads of the model of intervention are apparent. This particular session showed the advantages of making use of real life situations in a therapeutic way- exactly what the skills of OTs are designed for.

There is much more to say about my visits to Rancho and I will come back to this in another post.

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