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.

3 Reasons to follow this blog...

Be Inspired-
WCMT travel awards are open to all British citizens

Be Involved- learn about Lifestyle Redesign programs and contribute to the discussion about the potential of this approach.

Be Information Technology savvy- just learning how blogs work is a new skill for many of us!

Monday, 30 April 2012

Z is for zeitgeber.......

Zeitgeber- literally ‘time giver’.

Our daily rhythms and routines are governed and influenced by a number of factors. Internal factors set by hormonal levels and circadian rhythms such as sleep/wake cycles may operate at a cellular level and remain roughly consistent but not exactly in synch with a 24 hour clock. Zeitgebers exert influences on our internal ‘body clocks’.

Examples of physical zeitgebers are noise or daylight, social zeitgebers could be meal times or bed time rituals. Zeitgebers are very important to maintain synchronicity between an individual and their environment e.g. helping to conform to the 24 hour cycle that governs most people’s lives as work and other activities are arranged to start and finish at set times daily.

We can experience the disruption of this relationship when we travel across time zones and have ‘jet-lag’. Any disruption in zeitgebers, such as a traumatic life event, can lead to a period of instability as usual routines are disrupted, literally enough to disrupt internal rhythms as the expected prompts no longer occur- perhaps this is why family holidays are said to be one of the most stressful occasions!

Zeitgebers can be used to help ‘train’ into a desired pattern of daily life or to reinforce and maintain stability. In order to perform at our best we need to be in balance with our internal rhythms. Occupational therapists may find that considering the implications of this can be helpful when working with individuals, especially those who are in a disrupted situation, such as an acute admission to hospital.

Saturday, 28 April 2012

Y is for Yerkes-Dodson....

Yerkes & Dodson were the psychologists who defined the Yerkes-Dodson Law in the early 20th Century.
This theory shows that human performance and learning of new skills varies with ‘arousal’ level. Arousal means interest, excitement or stress- a certain amount is good and increases ability to learn, but too much and performance begins to deteriorate. There are some classic graphs that demonstrate this- here is a link to a website that explains it in simple terms and gives the original reference too.

I chose this subject for my Y post as I thought it links quite closely with the concept of ‘flow’ (see F) used in occupational therapy. Flow occurs when someone is fully engaged in an activity, the activity needs to have the right balance of challenge and skill, so a certain amount of stress is involved- flow will not occur of the task is boring, but too much stress i.e. the task is too difficult, and flow will not occur either.

Whether we think of it as the Yerkes-Dodson Law or as the concept of ‘flow’, these are both ways of helping us understand the importance of pitching activities at the right level if they are to be effective, and that level will be different for every individual.

Friday, 27 April 2012

X is in neXt....

As in what’s next for this blog- OK cheating a bit I know, but X is difficult!
This blog began as a diary of the study visit I carried out earlier this year. I will continue to use it beyond the end of the A-Z challenge to record the experiences I have of putting my learning into action and sharing what I have learned. This will be an evolving process over time, so I will have plenty to write about.

The other day I did an informal presentation to the Occupational Therapy Support Workers group where I work, we had some really interesting discussions about the experiences I had and the similarities and differences between our workplace and those I visited. I was really inspired by their enthusiasm, interest and openness to new ideas.

I hope some of you who have become followers of this blog during the A-Z challenge will continue to follow and find this blog interesting and informative. I’ll try to keep it that way!

Thursday, 26 April 2012

W is for Winston Churchill Memorial Trust...


W is for Winston Churchill Memorial Trust…


Winston Churchill is an iconic figure in British history, best known for having been Prime Minister during the Second World War. On his death in 1965, a memorial fund was set up and the decision was made that instead of a building or statue, a ‘living memorial’ would be created. The Winston Churchill Memorial Trust (WCMT) funds travel awards for British citizens to travel abroad to learn and share knowledge and skills for the benefit of themselves, for Britain and for the countries they visit. WCMT’s slogan is ‘travel to make a difference’.

The study visit to Los Angeles that I undertook earlier this year has been the subject and inspiration for this blog. I owe a great debt of thanks to the WCMT for funding my visit and for their support throughout the whole process.

Last weekend I attended the Scottish Winston Churchill Fellows AGM. Three recent fellows gave presentations that demonstrated the wide range of subjects that are included. One was about hydro-electric schemes in Africa, one about early years parenting skills in Italy and the Netherlands and one about reducing losses in fishing vessels in North America. They were all fascinating and it was clear why the speakers had chosen their topic and how they planned to make use of their learning.

WCMT is developing the ways that it supports fellows once they return from their studies and is working to develop links and mentorship for key areas of study.

The whole experience has been a real once in a lifetime opportunity, and in many ways, the visit is only a beginning. I would very much encourage you to follow this link to the WCMTwebsite for more information.

Wednesday, 25 April 2012

V is for Value....

‘Valuing the ordinary’ is a concept used in the development and use of the Lifestyle Redesign® approach in Occupational Therapy (OT). It can be incorporated into any OT intervention.

Valuing the ordinary simply means taking note of and seeing as important, the everyday ‘trivia’ of someone’s life. Our lives are all made up of a patchwork of everyday small tasks and concerns that create a whole.

Allowing some time to focus on small and seemingly unimportant matters, can have positive effects in that it allows the person, rather than the illness or problem to be the focus. Exploring the ordinary may give the starting point that allows someone to begin to envision a new possible self as the OT uses the opportunity to be positive about progress and to help someone see new possibilities for the future.

Reading about this, I was reminded of the quote from one of the OTs working in the Pressure Ulcer Prevention Study at the University of Southern California during my recent study visit there: “If it’s valuable to you, it’s valuable to me”.

Tuesday, 24 April 2012

U is for University of Southern California...

The University of Southern California (USC) is a privately funded university located across 2 campuses in central Los Angeles. Occupational Therapists (OTs) have been educated here since 1942 and many of the profession’s famous names are alumni e.g.Mary Reilly and Gary Kielhofner.

Mission and Vision

‘The mission of the USC Division of Occupational Science and Occupational Therapy is to maximize the potential of people to construct healthy, satisfying and productive lives by generating knowledge of value to society, advancing the profession and educating generations of practitioners, researchers and leaders.

Our Vision
We envision the Division of Occupational Science and Occupational Therapy as a hub of innovation and leadership where we study participation in daily activities defined in the discipline as “occupation” and its relationship to healthy living over the lifespan. We aim to establish occupation as an essential component in health and well-being. We promote this perspective by educating a global community of researchers and practitioners and advancing practice models about occupation that are science-driven and address health and societal needs.’
(Division website at

In addition to the two University owned hospitals, close links are maintained with clinical partners at Rancho Los Amigos National Rehabilitation Centre, Children’s Hospital and others. A global network of contacts including Ghana, Hong Kong & Romania is well established.

There are 3 main ‘arms’ of the Division’s work:

·      Research- the Division is currently operating with a research ‘portfolio’ of over $8 million. The studies in progress have potentially powerful implications for OT practice and range from community based lifestyle interventions to neuro-imaging following stroke to improve rehabilitation methods. Numerous peer reviewed publications have contributed to the aim of generating ‘rigorous science with clinical relevance’
·      Clinical Practice/Care Services- clinical OT staff work within the USC Occupational Therapy Faculty Practice and Keck Medical Center at USC Hospital. Lifestyle Redesign® forms the basis for the Faculty Practice programmes. In addition to meeting patient needs, the clinical practitioners are closely involved with the teaching and research ‘arms’.
·      Training/Education- the entry-level Masters programme has recently been remodeled and includes foundations and essential core studies, practice ‘immersions’ (Paediatrics, Mental Health & Adult Physical Rehabilitation/Geriatrics), academic fieldwork, leadership development and specialty focused elective placements.

 During my visit I had the opportunity for involvement in all three areas and was able to gain an appreciation of how closely interwoven they are and how Lifestyle Redesign® is applied in many different situations.

The opportunity to have this in depth experience was made possible by a Winston Churchill Memorial Trust travel award (more about this when we reach W). The purpose of my visit was to investigate how Lifestyle Redesign® could be used to improve the hospital/home interface for older people. This blog began as a record of my experiences during the visit and now continues as a reflection and record of progress since my return to the UK.

Monday, 23 April 2012

T is for Tips...

5 Tips for Senior Citizens on Simple, Healthy Living from Dr Florence Clark, Professor at the Division of Occupational Science & Occupational Therapy, University of Southern California (USC).
This easy-read article was published on The Atlantic web based news page the during my study visit to USC earlier this year.
Image: Monkey Business Images/Shutterstock.
Great to see an OT advising on healthy living and wellbeing. And great to see activity or occupation being championed as a way to keep healthy and happy.
The 5 Tips are based on the results of the Well Elderly 2 study (see my post for E on 5th April)

Follow this link for the 5 Tips: