Posts tagged ‘rehabilitation’
Vammaispalvelujen käsikirja ja Innokylä
Pari linkkiä, itselle muistiin ja tiedoksi kiinnostuneille.
Vammaispalvelujen käsikirja on tarkoitettu alan ammattilaisille sekä käyttäjille asiakastyön ja päätöksenteon tueksi. Käsikirjan tavoitteena on lisätä valtakunnallista yhdenvertaisuutta(!), parantaa palveluiden laatua ja “edistää uutta vammaispoliittista ajattelua, jolla halutaan vahvistaa vammaisten kansalaisten itsemääräämisoikeutta ja osallistumisen mahdollisuuksia”.
Toimintaterapeutteja kiinnostanee esimerkiksi artikkeli siitä, kuinka vaikeavammaisuus määritellään (tästä keskustelemme usein kollegoiden kanssa). Kuten sivulla sanotaan, “Arvioinnin tulee painottua toiminnallisten rajoitusten selvittämiseen ja kuvaamiseen (puhdasta toimintaterapiaa!) sekä toisaalta vammaispalvelulain edellyttämään pysyvyyden arviointiin.”
Uudenlaisesta vammaispoliittisesta ajattelusta on esimerkkinä periaatepäätös, jonka seurauksena tuetaan ihmisiä joilla on kehitysvamma muuttamaan pois laitoksista tuetun asumisen piiriin. Kyse on ihmisen oikeudesta valita asuinpaikkansa sekä toimijuuden tukemisesta. Muutos edellyttää luonnollisesti uudenlaisia ja riittäviä sekä yksilöllisiä tukimuotoja avopuolen palveluihin.
Näitä tukimuotoja voi kehitellä esimerkiksi Innokylässä, joka on terveys- ja hyvinvointialan innovaatioympäristö. Innokylän anti esimerkiksi työnantajalle selviää hyvin Innokylän systeemisestä innovaatiomallista (sivun alalaidassa linkki pdf-tiedostoon). Innokylän sivuilta löytyy aika hienosti muutakin materiaalia, mm. diasarjoja jne. esityksiä eri tapahtumista, joissa Innokylä on ollut mukana. Täällä läjäpäin esityksiä.
Innovoinnista tuli mieleeni, että huolimatta siitä, että kaupunki työnantajana ja palveluidentarjoajana saatetaan välillä nähdä jäykkänä, byrokraattisena tai kuivakkana, Helsinki näyttäytyy työntekijälleen (minulle) jopa hämmästyttävän monipuolisena, uudistumiskykyisenä, innovoimaan kannustavana, kehittävänä ja kouluttavana työpaikkana. Upeinta kaupungin työntekijänä olemisessa on se, että työtään tekee aina kaupunkilaisen hyväksi. Kun oma panos koituu helsinkiläisten hyväksi eikä esimerkiksi yrityksen omistajan, johtoportaan tai sijoittajien rahalliseksi eduksi, mielekkyys on taattu. Kaupungilla on runsaasti mahdollisuuksia vaikuttaa omaan työhönsä ja Helsingin hyvinvointiin.
Zen-seikkailu: 7. tehtävä
Jos normaalit liikemallit jostain syystä estyvät ja ihminen toimii uudella tavalla, aivoissa tapahtuu merkittäviä muutoksia vain 16 päivässä havaittiin Zürichin yliopistossa tehdyssä tutkimuksessa. Vaikka toista kättään ei ole järkevää kipsata toisen käden opettamiseksi, asioiden tekeminen toisin kuin tavallisesti on erinomaista aivojumppaa. Totutusta poikkeaminen edesauttaa helposti hetkessä elämistä ja siis ns. mindfulnessia eli tietoista läsnäoloa.
Oikea ja vasen aivopuolisko ovat myös erikoistuneet eri asioihin. Vasen on looginen, järkevä, analyyttinen realisti. Oikea on luova, taiteellinen, tunteva ja kokeva. Karkeasti yleistäen oikeaa kättä käytettäessä ihminen hyödyntää vasenta aivopuoliskoaan ja toisinpäin.
Tehtävä 7.
Kirjoita dominantilla kädelläsi (useimmilla oikea), miltä sinusta tuntuu juuri nyt. Vaihda sitten kynä toiseen käteen ja toista tehtävä. Kun olet kirjoittanut, vertaa tekstien sisältöä keskenään.
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.
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!
Rehabilitation Seminar, Day II (notes)
On the second day at the seminar I participated a workshop with a big name: Physical Functioning, Activity and Participation: research and education for health professionals in rehabilitation. Focus on physiotherapy and occupational therapy. So I started listening very eagerly. Esko Mälkiä, PhD. PT from The University of Jyväskylä, hosted the workshop and did it quite humorously and excellently. Nevertheless, I was a tad disappointed: the focus was clearly on physiotherapy and in my opinion it didn’t quite fill all the expectations regarding participating.
A couple of excellent speeches though. PhD, PT Birgit Steffensen from The National Rehabilitation Centre for Neuromucular Diseases in Denmark told how remarkably they’d managed to put together a continuous, guaranteed rehabilitation pattern for children (and adults) with the disease in question. Some unique team effort had been put together by the rehabilitation professionals and the Centre (being an NGO) to both develop the actual rehabilitation and to also put on the political pressure to guarantee the needed services. Quite impossible to imagine that happening in Finland. I think the political climate and willingness is far from Denmark’s historically flexible, human and empowering politics. Feel free to argue, please do that in the comments! 🙂
The maybe most interesting speech was the one by Reg Urbanovski, EdD, OT from Canada, who talked about rehabilitation and labour market. He stated that the on-going practices are not flexible enough and actually let the most vulnerable ones always fall first. There’s not even a beginning of a change for displaced people with non-adequate workplace constitutional skills. Regarding employment of the least likely Urbanovski stated it’s critical to ask: how to improve the quality of life of an entrepreneur (as to make it profitable to hire these outcasts)? Considering the problem from the employee’s point of view makes it possible to create long-term and hopefully human solutions for the labour marker. Win-win.
Urbanovski presented that in a modern world all the citizens need the skills for life-long learning. The emphasis has shifted from having the routine manual skills into having the routine cognitive skills which are the ones usually lacking within marginalized groups of people. And this is so true as I can tell from experience: my own dear big sister has MBD (current ADHD) and a mental handicap and yet she is a hard working, loyal, precise and priceless employee. Until sudden changes take place. Changes require flexibility, flexibility requires adequate cognitive skills and quick, abstract thinking to be able to organize your work again. Fast learning skills are a key skill at any work place. That’s when she’s in trouble, unfairly.
I know these marginalized (usually part-time working or long-time unemployed) groups of people are mostly not like my sister. I still believe that making it happen for different kinds of people, not just the surviving types, would make the world a more gentle place also for people like my sister. And as a result, for everybody. So for me making the entrepreneur want to employ and cherish the well-being of the employee makes a great starting point for better labour marker. And a human one. Now only if I worked in the employment office… 😉
Rehabilitation Seminar, Day I (notes to self)
Today was the first day of the two day National Rehabilitation Seminar here in Helsinki. The event is hosted by The Rehabilitation Foundation. The theme for this year’s seminar is rehabilitation partnership and participation. Here are some notes and thoughts that caught my attention today.
- the early retirement (mostly due to illnesses and/or disabilities) costs 24 000 000 000 euros per year
- from these a growing number is under 34 years old raising their share from 4,8 billion to 6,6 billion within the last six years
- early retirement caused by clinical depression has risen from 4,4 billion to 6,6 billion
—-
The outcome of a work community = The Will x The Ability x The Conditions. If either one of these is zero, the outcome is zero. Will includes attitude and motivation, ability includes competence, experience and tendencies, conditions includes leadership, leading, team-work, culture, structure, systems and the functional processes.
Productivity, innovation and the quality of work-life create outcome. The economical, human, social and ecological sustainability must be considered.
—
Money is a secondary motivation for working: meaningful activity, work mates and reputation and respect mean more. The lack of motivation to work isn’t the problem with unemployed people. According to Marie Jahoda The psychosocial or latent function of employment include:
- time structure
- social context
- participation in collective purposes
- regular activity
- provided status and identity
—
Juho Saari talked about perceived welfare and the politics of social possibilities. This approach would in a research look for the reasons why some group of people is succeeding instead of looking at the problems they’re facing to gather knowledge how to able other people from the same group to participate in the society.
He also talked about happiness and how the institutionalized structures define happiness (according to surveys Finns are among the happiest people in the world). Perceived welfare is relative: you might be perfectly happy until you see someone else is doing better. The single most significant factor contributing happiness is the perceived sense of inequality. Also the research (World Value Survey 1981-2000) shows that people who participate in volunteer work are the happiest! (I do.) Other factors are balanced time management (not too much activity, not too little), positive expectations for future and trust.
To increase happiness we should:
- increase (perceived) equality
- enable more volunteer work and to support associations
- organize better daycare and free time for family carers (omaishoitajat)
- cherish the trust in the government
- create positive expectations for future, to keep up hope
Is increasing happiness as a goal for politics conflicting with the financial goals?
—
Liisa Björklund from Diakonissalaitos presented the capability approach (by Nussbaum and Sen) in her philosophical and passionate introduction to human conditions for functioning. She stated that the paradigm is shifting from Rawls’ “veil of ignorance” to a more dynamic view on participation. She had some excellent quotes such as this:
Human rights are the moral state in which the person is able to act in a community and to take care of her duties. (Jaana Hallamaa) Human rights are being fullfilled when in use, not given. Already Aristoteles has said that a person wants to participate in the life of her community within her own abilities and skills.
—
Erkki Kemppainen from THL (The National Institute for Health and Welfare) defined rehabilitation as enabling and encouraging participation in unrestrained environment. Janne Jalava stated that the survival or well-being of a person in rehabilitation should not be evaluated based on discrimination rhetoric.
Meri Pekkanen: Occupational therapy, nutrition and other hot health stuff 
Comments