26 Aug 2007

Medication Management for Geriatric Patients

A lot of older people take a TON of medication, and these meds might have to be on various schedules. In particular, I currently have a friend whose geriatric mother will be undergoing oral procedures soon and she will be on a very confusing assortment of drugs with different dosing times. Do any of you all have good ideas on how to allow the geriatric mother to take these pills independently without getting confused?

My original contributing idea was to take a short, wide piece of posterboard and do a timeline from left to right, taping the pill (in a tiny bag) beneath the date/time…so she'd just go to the chart and see the date/time and take the pill that was taped there. But the friend pointed out, rightfully, that this would probably be insulting to her mother, insinuating she cannot keep up with her medications. I think the current plan is to get several different pill boxes so that each medication has its own pill box, and then segment them by time. Or something. I don't know if I understood the plan correctly. The point is, it's very obvious my friend is not the first one to have to wonder about this – do any of you all have ideas, based on personal experience or OT knowledge,  to help manage lots of pills at different times without making it too confusing OR insulting intelligence?

Please comment if you do!

Thanks!

Karen
PS: Tomorrow is (at least for my blogging purposes), SENSORY INTEGRATION DAY! GET EXCITED!

Category: Occupational Therapy | Comments: 4

25 Aug 2007

Shout-outs to my new readers and to my newly arrogant self

Shout-outs to new readers who have de-lurked and made some comments or sent e-mails (THANK YOU!!! I love delurkers!!)

Bernard – a precious rare male looking into starting OT school. We’ve exchanged several e-mails and I think he’ll be great. I very much hope he starts that journey soon!

Mama Chill – she just started OT school and has young children, wish her luck. She said in a recent comment she managed to snag “The Healing Heart” by Ora Ruggles based one of my previous blog posts, and that she loved it. I was so happy to hear it, and also jealous she owns it. Her blog is linked on my sidebar. MamaChill – I will warn you that orientation can be overwhelming and that the first month or so may seem a little boring at times when the professors pound the definition and conceptual background of “occupation” into your head a thousand times. But keep your chin up, it gets way better once you get past that basic information. Also, don’t let gross anatomy get you down – use mnemonics, keep up, study hard, you’ll be fine.

Lady of Musotopia – she is in OT school in another country and sounds really fascinating. She mentioned she makes more “qualitative” observations now, which I thought was pretty neat. She also agrees your priorities shift a lot once you start OT school.

Ryn Tales – this is a blog linked on my sidebar and it is by a mom who has a daughter with CP. She is a wonderful writer and she gives GREAT insight into the world of CP, I highly recommend her blog to see the parental standpoint of therapy. She has written me some sweet and helpful e-mails recently about her thoughts on some of my posts, and I really appreciate it.

Burt – thanks for refreshing my stock of toilet paper. It truly was, as he pointed out, a story of “The Princess and TP”

Merrolee – also linked on sidebar- not a new reader but I consider her my OT blogging mentor and we’ve recently had some chats via Gmail that have been inspiring.

Everyone else who comments (Sarah, Suzy, Arnie, Scott, and many others): Thank you so much for your support and kindness! I really love it.

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My own shout-outs! I’m trying to become arrogant instead of self-deprecating…

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I submitted a Top 10 list to the Disability Blog Carnival hosted by David at http://www.growingupwithadisability.blogspot.com/. For my submission he posted: “Karen, an occupational therapy student and new blogger is stepping into a new world. She shares her love of her new career and learning through reading disability bloggers, “I realize, again via these blogs, that non-compliance has less to do with the client being stubborn and more to do with me not fully understanding their true needs.” Yes!! You are on your way.” (See, Anita, I did retain our lectures on the OPPM)

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Joshua, a recruiter over at CollegeCare, posted my tips for Newbie OT students (also linked on sidebar at way bottom) – that was so cool! See it at http://college.rehabcare.com/

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My stats are going up – this is really exciting to me. I’m also getting more comments and more e-mails. I’m happy because while I blog to get out my thoughts, I also very much want it to benefit others who are exploring the field of occupational therapy. E-mail or comment anytime, I promise I’ll love you forever.

Category: Occupational Therapy | Comments: 1

25 Aug 2007

Volunteer to hold babies :)

I know I said today is a shout-out post day, and it will be. I want to post about my day so far first and then I'll do my shout-out post! Because I'm allowed to post twice in a day! So there!

First thing I want to share is that as of today I have lost 12 pounds! I am really excited – with the exception of an occasional splurge, I have been working VERY VERY hard to lose weight so I am thrilled. Now of course this is just the loss of the weight I gained since starting OT school. AHAHAHAA – last semester involved a lot of milkshakes due to stress.

I'm trying to work out 5 hours a week (treadmill, elliptical, bike, swimming, yoga, pilates, Spinning, Weights, Core exercises, etc) – and stay between 1200-1500 calories a day. 1200 is actually pretty low though so I've gone up and I'm still losing weight just as quick, I think after a few weeks at 1200 your body gets angry and starts refusing to give up fat.
It's fun going to the gym at the university because it's filled with med students, physical therapy students, etc – lots of fit young people to motivate you.

Also, last week at Baskin-Robbins (getting a scoop of nonfat ice cream, thanks), I ran into a therapist from the local peds hospital. I couldn't remember if sh was speech, PT, or OT, since I was only there two weeks in March, but I knew her from the office. She was like Oh, are you a physician there? And I was like ummmmmm no, but thanks! She said Oh sorry, your glasses make you look so intelligent.
The funny thing is, I don't think she was being facetious? Or maybe she is just smart enough to always “guess up”….

Speaking of which, I'd like to go on a mini-rant here. When people say GUESS WHAT! and ask you to guess, always guess really low or really high depending on what they are excited to share. Like if they say guess what i got on a test and you say 100 and they actually got a 92, they feel bad. But if they say guess what I got on a test and you say 90? then they can excitedly tell you they got a 100. Work on that, people.

I also did my two hour volunteer session at the local peds hospital mentioned earlier. When I first walked in I went past their pictorial timeline of the last 40 years of hospital history. I normally ignore it, but today it got my attention. They had black and white photos from way back when, and the cribs looked so austere. The medical technology was so big and bulky and threatening, and even the wheelchairs were giant and wooden. The kids stared at you in these photos with a haunted face. I know it was meant to be inspiring, but it made me feel sick to my stomach. Thinking about the mortality rate of these children back, and how sterile and cold those environments used to be, made me so sad.

After that though, the volunteering was pretty good. I walked in and asked if they had anybody special they wanted me to go to. A nurse pointed me to a 5 month old baby who had been crying all day. I held him and he calmed down and fell asleep within about 5 minutes. He just desperately needed some human contact. I continued to hold him for about an hour as he slept because a lot of these babies need the stimulation so bad that it doesn't matter if they are asleep – they can still benefit from that touch. His IV went out though (not my fault) and he started to be in pain so I put him down so they could try to redo his IV. They tried multiple times and couldn't and had to get someone else in. Very traumatic for the poor baby. While they were doing that there was a little newborn squalling so all I did was stick his pacifier back in his mouth and press my hands against him a while, he immediately fell asleep too after staring at me a while. (I guess I'm THAT BORING! AHAHAHA) I stuck one of his beanie babies (he had the SNAIL beanie baby!) on his chest against the pacifier so he'd be less likely to have it drop out of his mouth. Then I went to the little girl I had held for 1.5 hours last time I was there. Unfortunately, I didn't realize one of her bigger tubes was actually pinned to the bed this time (normally you can at least lift them a little way and then start maneuvering the tubes), so I hurt her by trying to pull her up – it pulled on her stomach and she cried. I felt really bad. But the nurse came by and unpinned her and encouraged me to hold her because apparently she is just sensitive to the tube being moved by anyone period, and would calm down in a second. So I held her and sang to her for about 30 minutes until I needed to go and it was time for her bath. From now on I'll be more careful to make sure nothing is pinned down. Overall, with the exception of the tube issue, it was a good day. I wish they had more comfortable chairs though – it is really hard to hold babies for 2 hours in crappy chairs with nothing to put your feet on and IV poles and tubes to be navigating. One thing they have there that I really like is pacifiers sewn into the mouths of beanie babies – you can lay the beanie baby on their chest and stick the pacifier in their mouth and it gives them both firm pressure to the chest for calming as well as makes it less likely for them to lose their pacifiers, since most of them have a dysfunctional or poor sucking pattern.

One of the other things I thought was neat was that some of the babies had big notes tacked on their crib from OT/PT on them with advice like “Please try to play with this baby from her left side so she will move her neck more.” I tried to follow the advice because of my OT-osity, but really I just need to focus on holding the babies – if they are grumpy I am not going to irritate them further by forcing them to do things like turn to the left – my job as a volunteer is to calm babies, not piss them off. They burn more calories when angry due to the screaming etc, and none of them can afford to lose those calories – best to keep them calm. But I definitely would NOT be comfortable or have any idea what I was doing had it not been for my two weeks of occupational therapy observation there!

Okay this got long. Sorry. I'm really tired. I got home from the session and had lunch and decided to write a while. I also need to work out, study, and I am going to a friend's house for dinner, then studying some more. Not to mention dishes and cleaning the house. Etc. But now I am thinking that after I write the shout-out post I may just take a nap first. Don't y'all think that's a lovely idea.

Time for shout-outs.

Category: Occupational Therapy | Comments: none

24 Aug 2007

Random occupational therapy nuggets of joy


Above: My new flower vase with acrylic glass, PVC pipe, and Aquamend

Above: This is random but it is the multi-inch thick stack of papers I had to go through today, all that in a single day.

Above: Make a pencil grip for someone with no finger capability, using only a rubber band.

Stephanie scoring acrylic

Katie putting on zip ties according to people’s height.

Hi Everyone!

I’m ready to move on from the drama of the last few days regarding my Lolcats post and the surprising (eye-opening) controversy that ensued!

I wanted to post some random (cough long) tidbits, and then Saturday I’m going to give some shout-outs to new readers as well as some exciting shout-outs to my self (I’m going to go from self-deprecating to arrogant overnight), and then Sunday I have the BEST POST ON SENSORY INTEGRATION EVERRRRRRRRRRRRRRRRRR, so you better come back each day this weekend or I’ll cry.

A) I got an e-mail from a local church the other day that had the subject line “13 days after Pentecost” and I read it as “13 days after Percoset”. I’ve been in the medical field too long.

B) The other night I went to a fancy restaurant with some friends (I didn’t have to pay! Woot woot). They started discussing colonoscopies almost immediately. They commented “Oh, this probably isn’t good dinner material for Karen” and my immediate response was “It’s okay, I’m in the healthcare field.” And it was another one of those mini-defining moments in my life, like when I first got to put “OTS” (occupational therapy student) after my name or got my first professional AJOT (American Journal of OCcupational Therapy) in the mail. It just struck me that it is TRUE. I am no longer a generic student. For the first time in my life, I have a career label! That may seem obvious to some of y’all, but hey, I’m a little slow. Oh no, that was self-deprecating. Oops…

C) This is a really really really stupid question (Here I go again), but I am confused gramatically about the whole Master’s degree thing. A lot of girls in my class have the “MOT” written out in their e-mail headers, and they all do it differently. Should we be saying Master of Occupational Therapy? Master’s of Occupational Therapy? Masters of Occupational Therapy? And when we say we are getting this degree, do we say we are getting our Master’s in occupational therapy, or what? I’m so confused. Help me out, peeps.

D) I met with my Group professor to go over the Group I’ll be leading next Wednesday. I am nervous but also kind of excited. I have decided it is going to be called “The Cold Within”, which is the title of a poem that deals with six freezing people – if all six of them had contributed the stick of wood they had, they would have been able to start a fire and been warm. Instead they all clutched their sticks and did not share because they had biases against the others. Google it, it’s a great poem. So basically my group is going to be about the unconcious biases that could potentially affect our patient care, and how as therapists we can become more self-aware of these biases and thereby less likely to act on them.

E) WE HAD THE COOLEST LAB IN THE ENTIRE WORLD TODAY AND I WOULD POST A PICTURE IF I WASN’T SO LAZY BUT I WILL LATER SO CHECK BACK BUT ANYWAY OMG IT WAS SO NEAT!!! It was a lab on designing quick-fix, cheap/easy solutions – so it focused on things like duct tape, PVC pipe, Acrylic glass, Rubber bands, you name it. We learned how to make a hand grip with only a rubber band, how to cut/bend acrylic glass for various uses, how to use epoxy putty to make grips, how to use dysum (?) aka frictiony rubber drawer liner paper to help grip, how to use pipe insulation to build up grips or items or pad things, how to put wax paper between heavy things to ease friction, how to cut PVC pipe into different configurations, etc etc. I made myself a little flower vase using a piece of acrylic glass, Aquamend epoxy stuff, and PVC pipe. I also used a torch to bend a piece of acrylic glass to serve as a mini upright clipboard, and then I also used PVC pipe with right-angle crookies (I’m so technical) to make a square, and then made grips for it using pipe insulation. I’m going to give that to my friend Suzanne who needs to build up shoulder strength, since you can wrap ankle weights around the pipe and do overhead lifts, etc. OH and we learned about Quick-Grips (mini clamps) and Zip ties (apparently everyone in the world knew of this but me), and more. It was eye-opening and really, really excited me. I could have spent six hours playing with it. Too bad it was only an hour and a half. We also had a challenge of using a strip of duct tape, 15 pieces of dry spaghetti, and two rubber bands, and making as long a “rope” as possible going from the end of the table but not touching the ground. We followed the law but bended the rules. Or maybe I mean bent. Grammar angers me. We almost won by having the longest strip but it broke right as he was going to measure it. 🙁 It was so cool.

F) The same professor who taught the earlier class sat down with me over an hour today and helped me understand an SPSS statistics lab we had done. It really “clicked” and helped me a LOT. If it weren’t for hating statistics so much, I would have strongly considered a PhD program.

G) That’s probably enough nuggets of joy (that phrase makes me gag but it also makes me laugh), so I am going to stop for now. It also occurred to me I want to write a post about study tips, so um, yeah, maybe that will be Monday’s topic! Oh my goodness, I bet y’all are already on pins and needles waiting for that post. Oh wait, maybe that’s your paresthesias…

Update: Obviously, I added in the pictures.

Category: Occupational Therapy | Comments: 1

23 Aug 2007

Blog Comment Devastation- I need reader advice

Update: I received several e-mails and comments, which I am very grateful for. It gave me a lot of insight and it was a great learning experience. I’ve decided to keep the Lolcat post up, but put on a disclaimer. Several different perspectives were pointed out to me and it opened my eyes. The “debate” basically ended up that people who are not disabled didn’t find it offensive at all, and my friends especially felt quite strongly I was in the right. Which I did appreciate, since my intentions were good. But I also got some differing viewpoints from mothers with special needs children and a few other people with disabilities, and I understand why. I vow to be more careful from now on, and will repeat one more time that no offense was ever intended. Thank you all again so much for your insightful and helpful and sweet comments.


Yesterday, an anonymous person left a comment sharing their dismay at my post written a few days ago, “Occupational Therapy as Described by Lolcats”

Here is their comment:

“As a healthcare consumer, these feels condescending, arrogant, disrespectful – as thought clients and providers are 2 different species. I am guessing as you are a student that that was not at all your intent, but I tell you honestly that’s how it feels to me.
Wishing you success and wisdom in your chosen career. Keep in mind that the people that use your services are people too – people with their own careers, relationships, and lives.”

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When I read this comment, I almost cried. It reminded me that while having a blog is mostly fun, it also leaves me open to criticism. I pondered taking down that particular post. I couldn’t e-mail the person since there is no contact information. I talked with a friend (who had previously told me she loved the post), and she said I should open it up to the community. Did any of you find this post offensive and disrespectful toward clients? Is it wrong of me? Should I take it down?

My take on the manner is that it meant no harm. If you read my blog regularly, you know that every other entry is how we should be client-based, compassionate, open-minded, etc. But occupational therapy is not all fun and games. As an occupational therapist, I might deal with people who have severe depression, rage, or other serious issues, all day every day. This can lead to a lot of stress and burn-out, just like it does in any healthcare profession. I think it’s important to look at things from a humorous standpoint at times to try and prevent that potential burnout. I by no means meant to imply clients are a different species and that therapists are superior, and I hope the majority of people who read this post feel the way I do – that it was not disrespectful.

However, I am just an occupational therapy STUDENT, and I still have a lot to learn. I blog to chart my journey from student to clinician, and to share this journey with others who have or might want to follow this path as well. It is not a straight path to “perfection”, and I am bound to make mistakes or put things badly at times. My overall desire is to profess my LOVE for occupational therapy, and my JOY at getting to help clients improve their lives. If some of my posts don’t get that across, I apologize.

So please, readers, let me know what you think about the post on Lolcats, linked above. – Disrespectful? Wrong? Acceptable? I really, REALLY want to know what you all think.

Thanks!
Karen
PS: I didn’t really have the time to write this right now, but that comment has been floating in my head for two days and so I needed to write this out. Posts on sensory integration (SI) and new readers coming by this weekend!
PS2: Check out http://www.growingupwithadisability.blogspot.com/ for the blog carnival, posted today! My entry is on there! I can’t wait to read the entries!

Category: Occupational Therapy | Comments: 6

23 Aug 2007

air conditioner fixed

air conditioner fixed. lots to catch up on. No time. several blog posts in the work, especially regarding the comment about being disrespectful. Also want to give shout-outs to some new OT contacts. Check back late tonight!

Category: Occupational Therapy | Comments: none

23 Aug 2007

bad bad day

wow. bad day.

my group professor told me i had off-putting comments, someone emailed me anonymously and said my blog on lolcats was degrading and disrespectful, i almost got hit in the parking garage by someone not paying attention, and then i came home to a house that was 95 degrees because my air conditioner broke. i am spending night at a friend’s whose wireless previously worked on my computer and now does not. lovely. not fun. so uh, more tomorrow if my air conditioner is fixed…

Category: Occupational Therapy | Comments: 2

22 Aug 2007

Quote of the Day/Thought of the Day

Quote of the day:
Scene: In class, playing a “Price is Right” quiz show over the Person-Environment-Occupation (PEO) model and the Occupational Adaptation (OA) model.

Question asked: Name one thing the Canadian Occupational Performance Measure (COPM) is concerned with.

Answer provided: Canadians!

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Thought of the Day:
Scene: Shower

While Showering: Hmm, I need to remember to post to the blog about how I have right hemineglect because every time I get out of the shower I always have soap suds on my right shoulder/arm.

Post-shower, toweling off: Holy crap, I did it again!

Category: Occupational Therapy | Comments: 3

21 Aug 2007

"Top 10 reasons I love being an occupational therapy student that (gasps for air) also has access to eye-opening fantastic disability blog carnivals!"

10. In no other field can I get a Master’s that not only includes classes in ceramics, leather working, woodworking, and craft media, but also involves cutting into cadavers and neurobiology!

9. I get to practice wheelchair wheelies and fall on my professor’s knee when I tilt too far back, thus ensuring he will one day need a knee replacement and then I can be his OT and thereby complete the circle of OT life.

8. I get to play/learn how to use button hooks, dressing sticks, splints to hold utensils, plate guards, etc. And then I get to learn that most clients prefer not to use them.

7. I learn a little about a lot of different diagnoses and issues and really get to address the holistic, client-centered practice that makes up OCCUPATIONAL THERAPY!

6. I realize, through experience and by reading disability blog carnivals, that my future clients have a whole other life besides the few hours a week I may see them in occupational therapy.

5. I realize, again via these blogs, that non-compliance has less to do with the client being stubborn and more to do with me not fully understanding their true needs.

4. I realize via these blogs that no matter how stereotypical a client may sound or look on the outside, there is often a hilarious, intelligent, and wonderful personality inside! I just need to look harder!

3. I discover that there is often times a fine line between hope and reality, and my job as an occupational therapist is to nurture this hope while retaining reality.

2. I realize that the best way to help my clients is to help them help themselves – making leaders, not followers.

1. I realize that as a future occupational therapist, I have the potential to help so many lives if only I can stay open-minded and compassionate and AWARE of how others feel, through any means of communication possible!

0. I REALIZE DISABILITY BLOG CARNIVALS ARE AMAZING!!!!!!!!!!

*Note: This was written for a disability blog carnival with the theme of “Top Ten Lists” being hosted by David at http://www.growingupwithadisability.blogspot.com/ and being posted on Thursday, August 23rd

Category: Occupational Therapy | Comments: 3

20 Aug 2007

New RehabCare blog linked to me!

You better scroll down and read about my LOLcats, I am really proud of that 1am posting.
 
But I'm also excited to tell you I got an e-mail from a “campus relations manager”, Josh, with RehabCare. He told me he liked one of my posts and has posted it on their new blog and linked back to me! I am excited!
 
What is ironic is that I stumbled across this blog a few days ago and had meant to mention it/add it to my sidebar! I'll do that when I get home tonight. That is so cool!
 
We just had neuro on Gross Arm Control, now I am doing some e-mail/printing out stuff in the lab. Then we have a class from a guest lecturer (VA OT) on spinal cord injuries…then lots of studying then working out!
 
 
Category: Occupational Therapy | Comments: 1