Posts filed under ‘Occupational Therapy’

Laama ja alpakka toimintaterapioissa

Entinen opettajani Joyce Collin-Kajaala käyttää laamoja ja alpakoita terapiaeläiminä toimintaterapioissaan. Eläinten kasvattajat, Joyce sekä alpakka Fuchsie ja laama Ulla olivat aamuteeveessä.

October 13, 2011 at 04:50 Leave a comment

Headstand to help shoulder pain?

I was reading International Herald Tribune on our flight back from France on the 3rd of August this year when something interesting caught my eye. Jane E. Brody was writing about treatments that “don’t cost an arm and a leg” in which she describes physiatrist Loren Fishman and his innovative methods.

What in particular was fascinating was a treatment developed for people with shoulder pain by Dr Fishman’s. Since yoga exercises form nowadays a centerpiece for his practice, this one was also a modified yoga pose: a headstand without actually requiring standing on your head. Done only for 30 seconds (sometimes combined with a little physiotherapy) for five different sessions this maneuver should ease the pain caused by a rotator cuff syndrome. The benefits matched and sometimes exceeded those following physical therapy alone or surgery and rehabilitation. ON a follow up yoga treated patients maintained the initial relief for as long as they were studied, up to eight years.

The mechanism behind this method is that the modified headstand trains subscapularis , the muscle below the shoulder blade, to take over the job of the injured muscle, supraspinatus. When normally it’s supraspinatus that raises the arm from below chest height to above the shoulder, after the headstand subscapularis will take that job.

According to Dr. Fishman, this doesn’t work for everybody, like for string musicians whose shoulder muscles are overtrained, but it has helped approximately 90% of his 700 patients. Not bad for a yoga pose!

September 5, 2011 at 16:50 Leave a comment

Check Your Happiness Ratio

As I write this on Sunday the 17th of April the results of the Finland’s on-going parliamentary election are being counted. After the preliminary votes have been counted the situation doesn’t really enhance happiness. Still, with the zen quality of mind, reminiscing Tolle’s teachings I’m determined to post about happiness. So here’s to a brighter future!

Barbara L. Fredrickson, Ph.D. and the director of Positive emotions and Psychophysiology Laboraty, published a book called Positivity in 2009. In her book she describes ten different emotional states that reflect happiness. I haven’t yet read the book but I found these emotions interesting and useful as means to mindfully learn to facilitate feelings of happiness. I encourage you too to apply these into your life. It’s a possibility to affect the 50 000 to 60 000 thoughts that go trough your head every day.  Our thoughts are mostly repetitive so a minor change for the better might result in a noticeable improvement in experienced happiness.

There’s also a test on Barbara’s site (Positivity Ratio) that you can make to score your happiness ratio for today. I suggest doing it to gain a little insight for your emotional status. As for me, the ratio left room for improvement even though I consider myself being quite on the happy side.

10 EMOTIONAL STATES THAT REFLECT HAPPINESS

  1. Joy  – I get joy out of flow experiences such as a good workout or an inspiring conversation. Today I was overjoyed for getting to swim in the sea!
  2. Gratitude – I’m grateful for having been born in such a privileged position. Today I was grateful for having all my limbs after watching a video of Nick Vojicic.
  3. Serenity – Working on this one through meditation, currently Tolle as my guide. Today I did a 6 minute meditation in the morning and went for a walk in the evening to calm my election aroused mind.
  4. Intrest – I’m hopelessly interested in plentiful things in life! Today I was interested in the politics and the feelings the elections generated in people.
  5. Hopefulness – As a person and as an occupational therapist I’ve always seen more possibilities than boundaries. Today I tried to keep up hope despite of the political shift to the right in Finland.
  6. Pride – I’m proud of our profession’s ability to see the speciality in every client. Today I was proud of myself entering the coldish sea water.
  7. Amusement – I get easily amused; it could be a funny dog (or MY dog 😉), myself screwing things up or some real life comedy such as a person’s “agenda” in a social situation going wrong. Today I was amused by a Spiderman band in the park consisting of elderly spidermen…
  8. Inspiration – I’m often inspired by extraordinary people or strikingly beautiful nature or a good book. Today I was inspired by the amazing Nick Vojicic mentioned above.
  9. Respect – I (try to) respect all living creatures. Today I really admired Nick Vojicic’s courage and life force. I also bought organic meat in respect of animals being treated well.
  10. Love – I’m lucky to have a tight knit group of my loved ones. Today I was happy to chat with my mom when I felt a bit lonely.
In occupational therapy we usually look at a person’s life in three areas: self-care (washing, dressing, eating, sleeping etc.), work (employment, voluntary work, studying etc.) and leisure (hobbies, recreation, socializing etc.). The emotional states mentioned above should be covered within those three areas. To ensure a good quality of life these areas should be in balance; the possibly neglected area or the area that’s been most affected by changes in the person’s state of health is usually the one that shall be paid the most attention in occupational therapy. This type of emotional analysis might help to work with a client on some specific areas and it most certainly will benefit all social relationships.

So, are you having any problems regards to these emotions and their manifestation in everyday life?

April 18, 2011 at 18:27 Leave a comment

11 – Poetic Therapy

I want to share a method of guiding someone – almost anyone – to write a poem. I learned this while studying occupational therapy on an intensive course in Dworp, Belgium in 2006. I’ve used this method for several years with a lot of different kind of people: it works for people with mental handicap, it works for the elderly, it works for people with memory deficits, it works for children, it works for you and it works for me.

You better start out some easier subjects such as animals, colors or seasons. You may then proceed in writing poems about places, people, emotions and finally of yourself. The method is very versatile and pretty quick. You may also use it to create a poem with a group. The guiding questions make it simple to get words out of people. Some of the most epic ones have been made by people with autistic features being composed solely of sounds, not words. Extremely impressive and poetic. Hopefully also empowering.

Today I used this method with a client of mine and I asked whether I could publish her first poem in my blog. I got the idea when she told her favourite subject at school was writing. Here it is in English, originally this was made in Finnish. She said this would be a good way to describe the Finnish autumn for a foreigner from the opposite side of the world.  After writing this she analyzed it and read it aloud for her roommate. The roommate thought it was fabulous. The writer was very happy about her poem and in getting something back which she thought was already lost.

Autumn

Colourful, dark.

Allows reading relaxed

It snows early, unexpectedly

Creative.

—-

So here’s the method called Eleven:

1. One word – choose a topic – for example pick an animal

2. Two words – describe the animal

3. Three words – what does the animal do – include a verb

4. Four words – what happens then? Something unexpected or surprising, maybe a twist in the story

5. One word – one, final strong word – how does this thing make you feel? Which word sums it all up?

Like this:

A Poem.

Delirius, succint.

Captures a moment

Thinks highly of itself.

The fool.

I sincerely hope you write your own poem and send it in the comments.

November 11, 2010 at 21:02 4 comments

From treating the patient into participating the client’s life

Today we had a lecture by Mika Raulas regarding client and customer managing as a part of my JET (johtamisen erikoisammattitutkinto, a degree in leadership and management) education. Here are some quotes and things that came up, also some of my thoughts during the day.

Peter Drucker: The practice of management is to create a customer (marketing+innovativeness).

Customer satisfaction index = happy customers – (passive+negative customers).

In-bound marketing = while the customer contact is happening.

My first enlightment: instead of asking How does the client participate the occupational therapy service we should be asking How are WE participating the client’s life as therapists?

My second enlightment: the services shouldn’t be built diagnose or segment based. Instead, we should offer services based on the different needs the clients (or citizens) have. For example the care homes for elderly and the supported houses for mentally/cognitively handicapped people should be profiled by the level of functionality: what are the client’s special needs? It’s not about someone being “mentally handicapped” or plain “old“. It’s about the things that restrict normal, independent life that people need some adjustments or help to. Not their age or diagnose.

Applies also to my long term goal: to finally combine the somatic and the psychiatric health care. Only then we can treat the person as a whole. It’s impossible to try help a person when you only see the half of him/her medical history. It’s like seeing only half of the person. Since now some of you may be horrified that I’m suggesting putting loonies (in its most loving meaning) together with frail, fragile elderly people: no, I believe there are other possibilities. The idea needs careful researching and planning but I’m convinced, it can be done. In a way that benefits both the people and the system. We just need to start looking the thing from a new perspective and as a possibility instead of a threat.

Jeff Bezoz: it’s not important to focus on what your competitors do but to what’s happening in your clients’ lives.

Mika Raulas also gave us some homework: to figure out, what does the value of our service consist of. In my case this translates to: which are the elements of occupational therapy service at the city of Helsinki that create value to our clients? Well, I didn’t do my homework yet but I shall reveal my thoughts once they are thought. You are welcome to share yours!

For now, good night! It’s been a long day.

October 12, 2010 at 19:07 Leave a comment

It’s a Shame (that stresses sick people)

Sickness, illness or health problems in general wouldn’t be described as something to be ashamed of. When one’s ill, she/he gets comforting, help and sometimes even pity. But shame? It has been common not to blame people on their conditions (at least if it’s not hangover). I say has been because the tendency has grown quite a bit in the direction of emphasizing one’s own responsibility in taking care of themselves by “living right” (also known as giving up your afternoon coffee cake, walking the stairs, passing the Friday night beer and so forth). But as the information gathers we are now more and more aware of the complicated system a body is. For example, calorie theory has been crushed (Don’t buy that? Read Gary Taubes: Good Calories, Bad Calories). Therefore it’s not as simple as 1-2-3 to go tell someone to stop eating fat/carbs to lose the extra pounds and the diabetes or to blame the years of cigarette smoking on someone’s COPD.

Anyway, I got a bit on the sidetrack. The point is that as I just returned home from the office, I feel ashamed. I feel ashamed because I discovered in the morning that I’d lost my voice totally during the night. I feel ashamed because even if I did go to work it wouldn’t work: it’s impossible not to speak as a therapist. And furthermost I’m ashamed because my work pair (a physiotherapist) commented that “you always have something going on“. No I don’t! I wanted to scream. I’m never ill! I haven’t had a flu in years and I’m vibrant and strong and balanced and… Versatile.

So you see, I would SO like to cherish my image of myself as the invincible human being that continues to work while others fall in the depths of a seasonal cold (or when they sneeze and cough for weeks). It hurts to feel like your body has let you down and it stresses to have all these thoughts going around your head about what people are going to think of me, getting a laryngitis right after my summer vacation. And it’s not that they would or that they will. And it’s not that it WOULD be my own fault that I lost my voice. But still: can’t help but being ashamed.

Which brings me to the key point of this post. For a therapist it’s priceless to be able to go under the client’s skin to better understand the phase and process she/he is going through whether it’s a long term disease or a minor illness. It’s not easy to go see a doctor. It’s not nice to be taken on the ward. It’s HORRIBLE to be dependent on the hospital staff in taking a leak or changing your position in bed. Illness steals away the sense of control one has to her/his life. On the top of that it makes you feel shamed for being weak while seeing others strive.

Sigh. Oh well. Maybe I overreacted. I just wanted to say that trying to relate to your clients’ situation really pays of. It helps to become a better (occupational) therapist regarding client centered approach, minding the psycho-social aspects of the therapy and empowering people to gain back their sense of control. And, first and foremost, their dignity.

Ugh, I have spoken. I shall withdraw to breath some steam and then to lay on the sofa working on some studies. Wish me well!

September 14, 2010 at 10:15 Leave a comment

Green is the Color of an OT

…so it’s only natural to try going green in all our actions. How? For example like this:

The Campaign for Greener Healthcare – 10 ways to cut down CO2 in OT department

Doggy dogg

Our dog goes green working her backpack!

At my office in the Helsinki City hospital we don’t have cars and mainly use the public transportation and bicycles to get around. That’s green! …even though the home visits from the ward are made using the city’s own transportation service. But that’s inevitable due to the security regulations.

Also we recycle in our kitchen all the following, whether it’s us making the lunch or our client practising cooking:

  • glass
  • metal
  • paper
  • cardboard
  • biodegradable

The metal we still have to take care of ourselves, which is a shame that the city doesn’t do that, and there’s no way to recycle energy waste.

We also try not to waste any food whether it being cooked by ourselves or the client. Sometimes the hygiene of the product may come in question but if not, we’re happy to eat, say, the remains of a fruit salad prepared in an OT group. We also purchase only as much groceries as we need.

Number 7 is a funny one in the list: sustainabili-tea. I think there’s no point in focusing on the tea drinkers in Finland, at least in my unit there are 5 coffee drinkers against one tea drinker! Of course, the rules apply for coffee drinkers as well, tho the coffee maker takes the time it takes. And I’ve tried this filter that can be used multiple times but THAT DOESN’T work. If you know a solid one, please let me know.

And like they say in the list, preventative healthcare is probably the most effective way to stay green: that way people are better able to take care of their own carbon footprint.

If you come up with some new ideas on how to save environment in OT, please share in the comments!

Thanks to Occupational Therapist Jouyin Teoh from Kuala Lumpur, Malaysia, from the link! Check out Jouyin’s page about The Kawa Model.

September 13, 2010 at 17:05 Leave a comment

R.I.P. Gary K.

Gary Kielhofner

Photo from MOHO Clearinghouse

Gary Kielhofner, the man behind The Model of Human Occupation, has unexpectedly passed away at the young age of 61 after a short illness on the 2nd of September, 2010. My condolences to Gary’s family and friends. Gary was a great inspiration for the whole OT community around the world.

Condolences also to the theoretic world of occupational therapy (ot). Gary has without a doubt had a huge impact in the development of ot. Even though I do think that in the ot education program in Helsinki, Finland (Metropolia, university of applied sciences), the teachers have gone a little too wild on the Model of Human Occupation (MOHO) as a result neglecting some other theoretic models, I still find MOHO and Gary’s work invaluable.

Model of Human Occuopation

Photo from Chips Books

But I’m convinced that there will be a phoenix bird rising from the ashes and new theories, models and work environments yet to be in discovered for occupational therapists.

What do you think is the most useful MOHO instrument? Or what do you think is good in MOHO? What would you criticize?

September 10, 2010 at 06:39 Leave a comment

COTECs new President from Finland

COTEC, The Council of Occupational Therapists for the European Countries, has elected a new President and as it happens, she is Finnish. Congratulations to Anu Söderström, who will start the work with the executive team in Portugal on the 30th of June.

June 2, 2010 at 04:37 Leave a comment

What’s valuable?

In my leadership education program we had a workshop about values. Values are the underlying base for all our actions and choices. At least in an ideal world. When work life is more and more hectic and companies are aiming for bigger savings and productivity, for example nurses may have to settle for something less in their quality of work than they would hope for based on their values. It’s that conflict that makes people burn out.

Anyway, we had a quite useful exercise in finding out for our own values, a long list of questions. The idea is that first you describe some of your action by answering a question (What do you spend a lot of time doing?). Then you try figuring out WHY is that important to you. You continue to ask yourself until you get to the bottom of your reasons of you’re doings or likings.

Like this:

What do you spend a lot of time doing? -working out. Why? -I enjoy working out, it makes me feel good and whole. Also I feel more confident and healthier. Underlying values might then be: pleasure and health.

What are you afraid of losing? -my sanity. Why? It would be horrible not to be able to think clearly and make good choices for myself. The underlying value might be: sense of control.

What would you do if you had the time? -I would read more. Why? -I love reading, it makes me relaxed, offers new perspectives on life and is sort of a get away from my everyday life. I also enjoy and admire talented writers and I think language creates the reality. The underlying values might be: wellness, beauty and learning.

After we answered some ten or twenty questions we had to put down five of the most important values. I put down acceptance, health, kindness, sharing and making a difference. The exercise would have continued by having to find out with each two values which is more important and by that way ending up with just one, THEE most important value. I didn’t have the time to do that but I think my number one would be acceptance. As who you are. Whoever that is. 🙂 I think the world would be a better place if it was easier for us to take people as they are and let them be themselves.

I hope my top five values guide my own leadership in my everyday work.

Here’s a list of questions if you want to try this out:

  1. What do you spend a lot of time doing?
  2. In what do you spend a lot of your money? (food!)
  3. What are you afraid of losing?
  4. What would you do if you had the time?
  5. What kind of issues agitate you?
  6. What would you pay a hefty amount of money? (if I had the hefty amount I’d pay my mortgage)
  7. Try to remember a situation where it’s been hard to make a choice. How did you choose?
  8. For what would you be willing to make a sacrifice? (for my own or my closest ones’ health)
  9. Think of a good childhood memory. What was precious about it?
  10. Picture one of your dreams?
  11. Who do you respect? Why? (my mom)
  12. What did you appreciate in your upbringing? (being trusted in)
  13. What the most important in upbringing in general?
  14. What kind of features do you value in a leader? (seeing people’s potential)
  15. What do you value in a friendship?
  16. What would you say is a good workplace?
  17. What should be valued in work?
  18. What kind of issues are bugging you right now?
  19. What does success mean to you? (being accepted)
  20. In what are you ready to commit yourself?
  21. Based on what would you choose a co-worker?
  22. After doing what kind of thing you might say: “I did the right thing.”?
  23. What do you believe in? (people)
  24. Which is more important: justice or love?
  25. Think about a crisis or a change you’ve been trough. What did you learn from it?
  26. Which traditions do you value and want to cherish? (such that encourage my important people get together)
  27. What do you expect from people you’re dealing with? (good will?)
  28. What obligations do you have?
  29. What rights do you have?
  30. What makes you feel safe? (lying in the sunshine on a warm cliff in an island)
  31. What kind of behaviour do you appreciate? What kind of behaviour you don’t approve?
  32. Think about your current life. Without what could you live?
  33. When are you happy and balanced?
  34. What do you enjoy doing while feeling a bit guilty about it? (using the elevator instead of the stairs!)

May 16, 2010 at 07:29 2 comments

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