Monkey versus Robot & Caregiver Burden

We had a lecture on Caregiver Burden the other day, which I found fascinating. Again, this is all my own understanding – go google it or talk to a professional if you want more information.

We talked about the “Sandwich Generation” which is where the middle-aged are discovering they are taking care of both their own parents and their own children. Very difficult to do.

We talked about how stressful it can be to be a caregiver, and how caregivers need to understand taking care of him/herself is vital to being able to help the person he/she cares for. We discussed “compassion fatigue”, which I think a lot of people get, due to having to constantly deal with so much.

We talked about how OTs can help caregivers by giving them education about stress relief, respite care, home modifications, assistive devices, and more, to make his or her life easier. Also, OTs can work in advocacy, as well as in hospice, or doing consultation. Our professor used the example of IHOP – you see young waiters waiting on a lot of elderly people. These young waiters could probably benefit from some training on how to best interact with their elders, in terms of respect, understanding of low vision, hearing issues, patience, etc.

I really wish Dear Abby/Ann Landers/Advice Columnists would learn about OT and recommend it – I constantly read Dear Abby articles about people stressed out about their parents, and OTs can help a LOT with that. But of course she never mentions it. I also think an OT could be a great advice columnist for all sorts of issues. But that’s another post.

Finally, we had a discussion about “monkey versus robot”, which started up because we discussed how some older people just require a LITTLE bit of help – something that is necessary but would be silly to have someone come out just for those reasons (like putting on a shirt). We discussed how robots might be used one day to help with these tasks, but also that most elderly people would probably not be comfortable with that. One girl, Mary, pointed out her father would probably go at it with a bat. We then talked about how monkeys are sometimes used, but that the thought of monkeys going into the fridge for food and such is a little unappetizing. Some of us preferred the monkey, some the robot. It was interesting…somewhat jokey, but also good points.

Speech therapy and feeding…geriatrics…occupational therapy…

We recently had a speech therapist who works at a local rehab hospital come in to talk to us about speech therapy and geriatrics. She talked about (and all the following is just my own, possibly wrong, understanding) how there are three major domains – cognition, communication, and dysphagia.

Cognition – a lot of overlap with OT
Communication – verbal expression, comprehension, voice, etc
Dysphagia – swallowing issues

Some of the cool things we learned about:

• The Passy-Muir speaking valve is used on the ends of trache’s to help some people speak, and it’s just a little cap thing that costs a few hundred dollars. Insurance usually covers it.
• Dysarthria is slurred speech – slow, loud, overarticulate
• We/they should look at the person’s face for nonverbal cues and/or lipreading
• Amonia is trying to find the right word an it’s a type of aphasia (the whole Wernicke’s & Broca stuff)
• Receptive aphasia – trouble understanding
• Expressive aphasia – trouble sharing information (on one of my fieldworks, there was a young girl who had a stroke and had this – she couldn’t figure out how to speak except to say “Toaster Strudel”, which was her favorite food).
• People may have difficulty manipulating the bolus (the food) or forming the bolus, which is an oral issue, due to perhaps lip weakness or limited tongue movement
• People may show signs of aspiration such as coughing, which means food is going down the wrong tube, so to speak. Modified barium swallows can help find if this in fact happening
• People who do have problems with aspiration may need to be on thickened liquids – there is a powder you can use to thicken water, even. Gross!
• OTs/Speech can give tips like clearing out the throat, swallowing twice after each bite, and pointing out “pocketing” in the mouth where the person doesn’t realize they still have food in their mouth…perhaps due to a stroke, or because of Parkinson’s, etc.

I’ve also been in contact with an anonymous OTR/L who told me about her pet peeves with feeding. The following is a copy/paste from her e-mail, after I asked her about it.

I am glad you asked about the techniques with feeding. Next time you are at the nursing home if it’s close to a meal stay and observe. even for 5 minutes. OH OH where do I start…

.Before the meal some staff walk around and say here Mrs. Smith here is a bib and put it on, or worse; don’t say anything and just put it on. An OT would say Mrs Smith would you like me to help you put on an apron we are having spaghetti and sauce or some thing like that. We look at how they are positioned at the table, do we need a special chair, cushion, special table. We are big time into equipment, but keep it looking as close to “Normal”. that can be a challenge. Hygiene at meal time is so important, some staff go from patient to patient without changing gloves,or washing hands that drove me crazy. Karen there is so much more I will just say a little more and then see if you notice anything, good or bad. Some staff just scoop a big pile of food and put it in,from the side of the patient, the patient gets startled and nearly chokes. A good OT like you would say Mrs. Smith what would you like next, the salad, bread or meatball?

Random OT student day update…

Today was fun, but I’m tired. I decided I’m not doing anything tonight but catching up on blog posts and I can catch up on things tomorrow. In the morning I’ll be at a local peds hospital following an OT in what is basically a step-down ICU for babies. I’m excited. 🙂 I better finish my leadership paper tomorrow or ELSE!

BTW – I hate to do the blog blizzards because I know regular readers can get frustrated with all the new material – but A) content is how new readers get attracted, and B) I have tons of ideas go through my head that I try and write down…and there are way too many to pace it to one a day, so I try to catch up when I can/feel like it.

Even the video engineers love OT students…

I’ve talked before about our amazing superhero tech guy….he is so cool and we all love him. NEAL!!!!!!!!!!!!!!!
I asked him the other day to write up a blurb about us OT students (he helps with all our live Memphis-Chattanooga distance education connections). I took out the specific departments he spoke about though – I don’t want to get him in trouble.

“Ive done video-conferencing at UT for over twelve years with the
Colleges of X, Y ,and Z. What I’ve experienced in the first year of OT video-conferencing is that our OT’S adapted to this new form of instruction faster..way faster than any other College
before. It just goes to prove that OT’s are the most adaptable, socially
and technically.”

Celia – play therapy – my reason for being in OT school

This is Celia. I did (informal) play therapy with her for years, multiple times a week – she is why I am now in OT school. I love her so much. She moved away 1.5 years ago. She was probably 7 or 8ish in this video. She was talking to me about her “friend” (actually an adult) named LisaJo who she really has fun with, and how “she wished to the lord” she could play with her. I thought that was so cute and pulled out my camera – trying to prompt her to kind of repeat the story. She had a tendency to always try and run to the camera to see so I had to be careful. She has developmental delay, hypotonia, apraxia, etc. Notice her “high guard” – the way she holds her hands when moving. Also note the way she shakes her head, the way she holds her fingers, the way she interacts with me, how she is distracted, and how the phrases she speak seem to come from sources other than her own creation.

I ADORE her!!!!!!!!!!!!!!!!!!!!!!!!! She is one of my favorite people in the world and I really miss her.

She can be hard to understand for people who don’t know her so I transcribed her parts.

Celia: Lisa Jo is so nice…Lisa Jo is so nice and so pretty. I wish that Lisa Jo could take us out… On a date. ..to the ball….my ???? ……Lisa Jo is going to wear a kimono….

Occupational therapy treatment project by Kerri

Kerri’s occupational therapy treatment project from last semester, made for a young child with sensory defensiveness. She was the therapist and I was the young child. The cat is just a bonus.

Disability Blog Carnival catches my OT eye

I should be studying, but instead I’m reading this disability blog carnival over at ryntales.blogspot.com – its theme is “What Professionals Should Know” and most of the posts are by people with various disabilities and/or their caregivers. It looks fascinating!

http://ryntales.blogspot.com/2008/01/29th-disability-blog-carnival-what.html

Update: I just read the majority of the posts in full, and it kind of made me sad. Because the main theme, at least to me, was that most of the bloggers think that health-care providers (and other service providers) are just ignorant and mean people that need some basic etiquette lessons. I was appalled at the stories they all told. I’m not an expert and I’m just a student, but it seemed like all the things the readers thought “professionals should know” were primarily common sense things that apparently aren’t so common sense. Things like parking a person in a wheelchair by facing them to a brick wall, laughing at a person who asks for their food cut up, and a ton of other horrifying stories. It’s not that I think these bloggers are wrong – but it is sad to me that so many people have bad experiences. I’m not perfect by any stretch of the imagination, but I do my best to be thoughtful and compassionate to EVERYONE, disability or not. I do highly recommend people check out the carnival – pretty cool overall. Just wish there were more smart & nice people in the world. Occupational therapists, time to take over the world and make every thing better!

Rolling: Go watch it – perspective from people using wheelchairs

Go watch this documentary. Friends told me about it and it looks amazing. I'm going to try and watch it this weekend – it's viewable on the website listed below. The text is also taken directly from that website. It's based on three people mobilized by wheelchairs who video their life.

http://www.thirteen.org/rolling/experience/thefilm

Rolling

ROLLING was named best documentary at the Independent Film Project conference for works in progress, held in New York City. The film was also one of 14 new American films chosen by the Independent Film Project for screening at the European Film Market, which was held in conjunction with the Berlin Film Festival.

While Berland and her cinematographer both shot footage for ROLLING, the documentary is primarily filmed by the three participants via video cameras mounted on their chairs: Buckwalter, a clinical psychologist paralyzed at 17; Wallengren, a TV writer with five children who suffered from ALS (Lou Gehrig's disease), which stole his mobility and, finally, his ability to speak and breathe; and Elman, who was the business manager for a department at the UCLA School of Medicine until multiple sclerosis put her in a chair.

In the film, Buckwalter calls himself a “proud gimp” and says, “My blessings don't stop it from hurting.” Each participant captures the joy of living as well as the pain. Buckwalter films himself practicing with his band, Siggy, camping with his wife and friends, stressing aching shoulders by repeatedly lifting himself in and out of his car, and during a frustrating doctor's visit.

Elman, the divorced mother of a daughter in medical school, is seen advocating for Californians for Disability Rights and a bill called the “V. Elman Community Living Act,” which would make it easier for the disabled to live at home.

Wallengren is seen deftly coaching his sons' basketball team, dealing with awkward comments from well-meaning people at a birthday party, and using dry humor to deflect difficult situations.

“Even though the film started out as a way of understanding the experience of being in a wheelchair, in the end, it's really about life,” says Berland. “It's not about feeling sorry for someone with a disability.”

Karen and Brooke are soooo excited about OT student life

Karen and Brooke were fascinated by occupational therapy, and they loved being OT students. The day they learned their applications had been accepted to be candidates in the Assembly of Student Delegates Steering Committee was such a wonderful day, as evidenced by this picture. No aliens or artists in this almost true story! AOTA student members need to go vote at www.aota.org in the AOTA elections link. 🙂

MOT Class of 2010

The MOT Class of 2010 is getting into the swing of things…tons of anatomy, learning about Slagle lecturers, basic conditions such as cerebral palsy, and ten thousand definitions and explanations of the meaning of “occupation” (aka a purposeful, meaningful activity).

They all seem very sweet and I really like them!