OT? So What?

During the week I attended the College of Occupational Therapists Conference in Glasgow. The College of Occupational Therapists Specialist Section- Older People (COTSS-OP) conference ran simultaneously. It was really inspiring to hear many of the main keynote speakers, such as professor Michael Iwama, talking about preventative work and public health being important future arenas for OTs. The vital role OTs play in acute and emergency care settings was very much acknowledged, but the importance of linking well with community based services was very much at the forefront of the discussions.

I presented a facilitated poster discussion about my study visit to the University of Southern California. I outlined the background to the visit and then went on to the following:
 

'...Current hospital discharge practice can be frustrating for both OTs and older people themselves. It can be reductionist, grounded in a medical model and emphasise ‘safety’ at the expense of occupational engagement and enablement of valued daily activities. A paradigm shift on the part of policy makers, service managers and individual OTs is needed to change this. An understanding of the principles of the LRD model can provide a way forward.

I want to leave you with some points to ponder based on the opening plenary speech given by Professor Iwama and Jacqui Lunday Johnstone’s Keynote address to the COTSS-Older People’s conference. Professor Iwama challenged us to re-examine how and where we work and to look at the preventative and public health arenas as the future of Occupational Therapy. He asked us to consider the relevance of our services to the lives of the people and communities we serve. Jacqui Lunday Johnstone emphasised the need to demonstrate outcomes or the ‘added value’ that occupational therapists provide- what she termed the ‘So What?’. Both affirmed that the unique skills of OTs, if fully utilised can have real impact on the hospital to home interface. Using an approach inspired by Lifestyle Redesign® could help to make this a reality.

Imagine the older people who use your service being asked two questions:

1. Was the OT service you received relevant to your life?
2. If you received a service, So What? What was the added value it brought?

If the answers you think you would get are not what you would wish them to be, then it is time to begin looking at the reasons and to think about whether using aspects of Lifestyle Redesign® could be a way to change the answers in future.'

Occupational Therapy

 

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Occupational Therapy- what exactly is it?

The College of Occupational Therapists in the UK give the following definition:

‘Occupational therapy provides practical support to people with physical and mental illness, disability, long term condition, or those experiencing the effects of ageing, to do the things they need or want to do. It enables people of all ages to carry out practical and purposeful activities (often referred to as 'occupation'). This could be essential day to day tasks - such as dressing, cooking, going shopping, to the things that make us who we are - our job, interests, hobbies and relationships.

Occupational therapy considers all our needs - e.g. physical, psychological, social and environmental - and helps to increase people's independence and satisfaction in all aspects of life.’

Occupational Therapists (OTs) have traditionally worked in rehabilitation and recovery situations, but their training and focus on the whole person and on occupation or activity mean they are ideally suited to work in health promotion and preventative settings too. As health care increasingly moves towards a preventative approach, this is an area that more OTs may begin to focus on. OTs are ideally placed to help you Age Proof your life...

For information on how to find an OT follow this link to the College of Occupational Therapists website. Similar professional bodies exist in most countries.

Never too late...

"It's Never too late to go healthy. Anybody, young or old, can successfully redesign the way they live to be healthier. While we don't have a say in our own genetic makeup, greater than 50 percent of our mental and physical health status is related to lifestyle. You can even start small: ride public transportation, reconnect with a long-lost friend, join a ballroom dance class, or follow guidelines on how to safely move around the community. The point is, try something new and be willing to learn."

Dr Florence Clark, University of Southern California

I love this quote from Dr Clark, key developer of the Lifestyle Redesign approach in Occupational Therapy. It emphasises the way in which a variety of things, such as socialising with friends contribute to overall health and well-being, not only the obvious things like diet and exercise. It also shows how being open to new ideas and ways of doing things can help to Age Proof your life.

This 'tip' was published in the Atlantic magazine last year. For the full article and all 5 Tips, follow this link:

http://www.theatlantic.com/health/archive/2012/02/professional-help-5-tips-for-senior-citizens-on-simple-healthy-living/252556/http://www.theatlantic.com/health/archive/2012/02/professional-help-5-tips-for-senior-citizens-on-simple-healthy-living/252556/

Lifestyle..

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Lifestyle Redesign®

“..is a process of acquiring health promoting habits & routines in daily life” (Clark et al 1997)

“…is the process of incorporating health promoting habits & routines in your daily life. OTs look at how you ‘occupy’ your time and how the daily activities you engage in affect your overall health, wellness & life satisfaction” University of Southern California Faculty Practice

Four core beliefs of the Occupational Therapy profession informed the development of Lifestyle Redesign®:

• Occupation is life itself
• Occupation can create new visions of possible selves
• Occupation has a curative effect on physical and mental health and on a sense of life order and routine
• Occupation has a place in preventive care (Mandel et al 1997)

The concept is now widely recognised in occupational therapy and health literature (see report tab at top of page for more detailed information). The term ‘Lifestyle Redesign’ is trademark protected, but any OT can draw upon the methodology. I suggest reading the report as above as a starting point.

Choosy about Chairs...

 

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Are you sitting comfortably?

Getting in and out of chairs is something that often becomes more difficult as we age. One of the main reasons is that the large muscles of the legs tend to become weaker, but aches and pains from arthritis and various other complaints can also play a part. Luxurious deep, wide armchairs with squashy cushions make for a lovely soft landing when sitting down, but it can be an inelegant struggle to get back up again!

If you are in the market for a new chair, think ahead and aim to choose something that is not just stylish but practical as well as comfortable. The ideal is to aim to be seated comfortably, but not slouched in the chair, so a fairly straight, high back to the chair is an advantage. You want to have your knees level with your hips and your feet firmly on the floor. If the chair is too low your knees will be higher than your hips and more effort is needed to get up. If the chair is too high your feet will be dangling, this is not comfortable and can lead to swollen feet and ankles. The chair should be reasonably firm to provide support. Don’t forget to look at how wide the seat of the chair is, aim to feel supported in it without it being tight. Check the ‘depth’ of the chair- the distance from back to front- make sure the back supports you without needing lots of cushions behind you and that most of your upper leg is supported. Firm armrests are important as these give support to push up from. If at all possible try the chair in the showroom before you buy as mistakes can be costly. If you prefer lounging on the couch, remember that these offer less support when sitting and when getting up. You might want to think about a chair and use a footstool to put your feet up.

If you are unable to try out a chair, you may want to ask your Occupational Therapist for advice or help with measurements. Your OT can also help if you are not able to buy a new chair as there may be equipment that could be used to make the chair you have more suitable for you.

So, this is great, you know what to look for in a chair to make getting in and out of it easier. But, as always, prevention is better than cure and age proofing your life involves keeping strong, particularly in your leg muscles, for as long as possible. So don’t neglect the exercises or activities you enjoy that make you use your leg muscles, walking is one of the best and the sooner you begin the better!

Age Proof Your Life

 

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Age Proof Your Life

The population of the developed world is getting older.

• One in 4 babies born today will live to be 100
• The number of people aged over 65 is expected to rise by 50% in the next 20 years
• The number of over 85s is predicted to double in the next 20 years and treble in the next 30 years
• 3.8 million older people live alone, 70% of these are women
• These figures are based on the UK, but other comparable countries may be ‘ageing’ even faster!

My theme for this year’s A-Z Challenge is Age Proof Your Life.

As an Occupational Therapist (OT) with over 20 years experience, mainly in working with older people, I have had the privilege of witnessing at close hand the ways that many people cope with the challenges of growing older, whether in good health or poor, whether surrounded by family or alone and whether financially comfortable or not.

Last year I used the A-Z Challenge to reflect on a study visit I had just completed to the USA (I am UK based) to study Lifestyle Redesign®, an occupational therapy approach that enables people to make changes in their lives that are long lasting and health promoting. Research has shown that this approach has benefits for the health and wellbeing of older people that are sustainable and reduce the need to use health and social services. Lifestyle Redesign® is based in the theories of the OT profession and also those of Occupational Science. To read my report click the WCMT Study Visit report tab above.

I will draw on this experience as well as the theories and evidence that underpin the profession of Occupational Therapy. An OT can help you to live life your way. OTs believe that you are what you do and we look at ‘occupations’ as the meaningful activities in your everyday life. OTs look at the whole person and how occupation shapes your life. An OT can help find ways to incorporate health promoting activities and routines into daily life resulting in greater life satisfaction, health and wellbeing.

An OT can help you continue to have an active life as you get older by finding ways to make everyday tasks easier or by helping you to try something new to aid independence. An OT can offer solutions and alternative ways of doing things when everyday activities become difficult to help you to get the most from life.

When illness, injury, disability prevent you from doing the activities that are meaningful in your life, an OT can help restore health, independence and wellbeing.

OTs are experts in understanding and working with the complex interaction between an individual with all their preferences, abilities, limitations and aspirations, their home situation and lifestyle and their occupations.

So whether you are an older person, looking to the future, an OT yourself or just interested- I hope you will find my posts this month interesting and stimulating.

I will not be presenting lots of ‘heavy duty’ theory, but where relevant I will try to provide links or references for further reading for those who do want to read further.

Key References

Craig, C & Mountain G (2007) Lifestyle Matters. An Occupational Approach to Healthy Ageing. Speechmark. UK

Jackson, J. (1996). Living a meaningful existence in old age. In R. Zemke & F. Clark (Eds.), Occupational science: The evolving discipline (pp. 339-361). Philadelphia, PA: F.A. Davis Company.

Mandel, D. R., Jackson, J. M., Zemke, R., Nelson, L. & Clark, F. A. (1999). Lifestyle redesign®: Implementing the well elderly program. Bethesda, MD: The American Occupational Therapy Association.

World Congress on Active Ageing

 

Last month I attended one day of the WCAA in Glasgow to present a poster about my study visit to the University Of Southern California to investigate using a Lifestyle Redesign® based approach to improve the hospital to home interface for older people.

The congress was held at the armadillo (otherwise known as the Scottish Exhibition & Conference Centre- but it looks like an armadillo!). Delegates included academics, various health and social care workers and professionals and a lot of older people. In addition to the serious presentations there were lots of fun activities going on in the main hall. I met one older couple who had arrived on their bikes and I last saw as I left playing a highly competitive game of table tennis together!

The day that I attended, the focus was on falls and bone health. Many of the presentations were about exercise, it’s benefits for falls prevention and bone health and a lot of discussion about problems with uptake and adherence to exercise programmes. My main reason for attending was to present my poster, and I had many interesting conversations with delegates viewing the poster but the presentations I attended got me thinking about how a Lifestyle Redesign® based approach could help to deliver a more holistic and lifestyle management orientated approach to falls prevention for older people. OTs sometimes find that their role becomes one of advising about environmental hazards and recommending equipment, but these factors on their own have only a limited impact. Incorporating health-promoting changes into daily routines could have a more significant and longer lasting impact on falls prevention- and on health and well being.

I intend to look at this in more detail in a later blog post- so watch this space.

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 atlantic.com 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:

http://www.theatlantic.com/health/archive/2012/02/professional-help-5-tips-for-senior-citizens-on-simple-healthy-living/252556/