Occupational therapy and client/ patient handouts

I have had some recent experience of knowing someone in hospital. From this experience I have some thoughts about handouts.

Many professions use handouts as a way of informing patients and their relatives about an issue, strategies or techniques that would be useful for the client and their family to know. The concept is a very good one. We know that clients and their families don’t always know what to ask or what will assist in the persons treatment, a handout can help answer questions and give them things to do. It gives them something to refer back to, gives them the time they  need time to absorb the information at their own rate and means that they can use the information to help them form questions.

So from my experience here are some things we should consider when giving out a handout (and I reiterate I do think handouts are very useful, if well thought out and I acknowledge that we don’t have time for them to all be individually done).

1. Handouts are often generic, so find a way to personalise it for that client. Put their name on it – and find a way of indicating which of the pieces of information/suggestions or techniques are best suited for that client. For example you could state at the beginning of the handout that the ideas suited for Tom or Sally have a tick beside them and the ones that aren’t relevant a cross (make the ticks big and bright).

2. Find a way of keeping the information together for the client – a bundle of loose pages gets lost, people don’t know if they are still relevant or even for that person, they don’t know if the information is out of date or still relevant. Perhaps they could be placed in a file (with a date on them) or perhaps they could be dated and put on the wall.

3. Indicate on the handout how you think the information should be used e.g. is it something that you are suggesting family/visitors do with the client (negotiate with the client that this is ok with them first though and have this on the handout) or do you expect the client to do it themselves?.

4. Make sure the handouts are up-to-date with the clients progress

5. When you do give a handout – don’t just hand it quickly over and walk away (after  all it is important) – explain and go though it with the client and/or family

5. Finally, all of the above is even more important if the client has a memory problem !!!!! (sounds obvious!)

So if you are a therapist how about thinking about your handouts. Could you improve them, and how you introduce them to your clients and their families.

I will look forward to seeing if any of you have other suggestions of the does and don’ts to add to this list.

Occupational Therapy and Literature

Middle Beach St Clair

Today I went to a lunch time seminar the speaker was Rosemary who had been a lecturer at our school of occupational therapy until her retirement last year. She is now finding time to do a PHD.  It was a really interesting talk on using popular literature to gain an understanding of Occupational Therapy – an understanding of occupation and an understanding of the human condition.

Two things I have taken from or thought about since the talk:

Occupational therapists recognise in all occupations the technical skill e.g. in baking a cake (the techniques such as creaming butter and sugar together, measuring ingredients, using the stove etc). But  when you read a popular literature story (or even a children’s story)  that involves baking a cake the reader realises as occupational therapists do when working with clients  that there is much more to baking a cake than the technical skills. Why is baking a cake important to that person?, why do you decide to bake a cake?, what do they gain from baking it?, how does doing it impact or affect who we are? As we work with our clients/patients as occupational therapists we believe that all of these things are implicit to why people choose to  engage in certain occupations.

So the occupation of baking a cake and most occupations are complex they are not just about the technical skill but also tell us about the human condition.  As we work with our clients/patients as occupational therapists we know that many things contribute to why people choose to  engage in certain occupations.

The other piece of food for thought as an educator is that occupational therapy students and occupational therapists need to know as much as they can about occupations and the human condition. How do we get this knowledge when we only have our own experiences. Rosemary suggests that ‘good’ popular literature is a way to come to a greater understanding.

The New Zealand Occupational Therapy Conference and the Australian Occupational Therapy Conference

Recently I had the opportunity to attend both of these conferences. The New Zealand Conference this year was in Palmerston North – not the easiest place to get to, but at the end of the day its being able to get together that matters. This was up there with the best of the New Zealand Conferences that I have attended. It seemed that people were all ready to do something about influencing the future of occupational therapy in New Zealand. There was a lot of celebrating  and showcasing the core values of our profession,  with an emphasis on occupation,  and an awareness that as a profession we bring a different perspective and approach to working with others.

You might argue that we did not have the well known names of the profession as key note speakers (we have had them in the past and value  their contributions) but there was something quite wonderful in having as key note speakers people who were researching but who were clearly still at the coal face engaging with clients or students, showing us that you can do both well.

The association continued its commitment to always have key note speaker who is a New Zealander. As a country of only 2,000 occupational therapists it has in the past been seen that conferences were a way to bring the experts from overseas in to tell us what they are doing. However in this decade we have seen the importance of not only learning and hearing from others, but celebrating what we are doing here, learning from each other and valuing this, alongside the insights from overseas.

So not only do we now always have a key note from a New Zealander but also no longer is our Frances Rutherford Award Lecture (for occupational therapists the New Zealand equivalent of the Eleanor Slagle Clark US or the Docker AUS) on the second or third day of the conference, but now on the first day of conference a true celebration of the contribution one of our own therapists has made to the New Zealand profession.

It was the first time that I have been to the Australian Occupational Therapy Conference and I have to say that this time round I think the New Zealand Conference was the better more focus, a greater pride and enthusiasm. So perhaps if you are an Australian occupational therapist or indeed from anywhere off shore next time the New Zealand Conference is on it might be worth thinking about coming across ‘the ditch’ (the pacific) and seeing what it is all about.

One of the highlights this year at the NZ Conference was Trish Egan’s call for us to develop our own model for occupational therapy practice. A suggestion that got everyone talking – so what is it that we do as occupational therapists here in NZ?, do we practice differently from elsewhere in the world?, are our  belief’s and values the same?

I do think we approach things differently, and work in a slightly different way than our colleagues elsewhere. Certainly because of New Zealand’s commitment to the Treaty of Waitangi, I think our understanding of identity, culture, cultural awareness, and cultural safety positions us a little differently to other countries. So watch out for a model in 2015 that gives an underpinning to NZ occupational therapy practice.

Freerice

Tonight I decided that it has been a while since I visited some of the Occupational Therapy Blogs that are out there. One of the first I found when I was first starting to blog was Hosmer School it always has an interesting range of postings. They don’t get a lot of comments but they certainly get a lot of visits. Tonight when I went on they had a link to Freerice. A site where you test your vocabulary and for every word you can define (through multichoice questions) you are donating 20 grains of rice to the United Nations world food programme to help end hunger. They state:

“FreeRice has two goals:

1. Provide English vocabulary to everyone for free.
2. Help end world hunger by providing rice to hungry people for free.

This is made possible by the sponsors who advertise on this site”.

They point out and again I quote from the site that:

“Learning new vocabulary has tremendous benefits. It can help you:

• Formulate your ideas better
• Write better papers, emails and business letters
• Speak more precisely and persuasively
• Comprehend more of what you read
• Read faster because you comprehend better
• Get better grades in high school, college and graduate school
• Score higher on tests like the SAT, GRE, LSAT and GMAT
• Perform better at job interviews and conferences
• Sell yourself, your services, and your products better
• Be more effective and successful at your job

After you have done FreeRice for a couple of days, you may notice an odd phenomenon. Words that you have never consciously used before will begin to pop into your head while you are speaking or writing. You will feel yourself using and knowing more words”

To find out more and to put your vocabularly to the test
visit Freerice

It certainly enhanced my vocab more than Gordon Ramsey was doing on the TV.

Trust yourself, explore, experience

Part of some homework I have for the permaculture course is to work out the microclimates on my plot of land, by moving around the land observing changes of temperature, wind, soil etc. I found myself thinking that it would be helpful to have a probe to tell me about my soil, a temperature and wind gauge etc. It made me realise just how technology and instrument driven we have become and yet our observation (what we feel and see) can tell us such a lot if we tune into it and trust what it tells us. It seems to me that it is easy to forget just how good our senses are and thus we could be in danger of not utilising these skills, not just when we are gardening but in everyday life. Perhaps this is one of the challenges for us as occupational therapists, the utilisation of a range of skills and abilities when we work with clients, taking care to focus in on what we observe. Perhaps we don’t need a test or assessment for everything? We already know evidence needs to be considered along side the clients context before we act. So my tip for today is build up and trust our skills in observation … however knowledge needs to grow alongside observations e.g if I knew the story the weeds in my garden were telling me my observations would be more meaningful e.g clover growing tells me there is nitrogen ? in the soil, but what do buttercups, thistles etc tell me.

There are holidays, there are distractions and there are … clinical workshops!

I can’t believe how long it is since my last entry. It’s been a pretty busy couple of months. I am a bit amazed that I even have to confess that I didn’t check my blog statistics for three weeks ( I was becoming a little addicted). I see Merrolee (Occupational Therapy Education) has a bit about checking the blog statistics and I have to agree they do give you a prompt to keep on posting – so all those lurkers who read but don’t post have something to think about (mind I would love it if they posted). I am interested that people are still visiting despite the weeks of silence.

Last week I attended the New Zealand Association of Occupational Therapy Clinical Workshops in Cromwell Central Otago ( so right here in our backyard) held in the off year to their conference. It was great to catch up with other occupational therapists and interesting to see what issues are occupying people’s mind about the profession.

There was quite a lot of conversation about how to position occupational therapy so that therapists are able to offer more in the primary health area, topics on strengthening communities – how to facilitate communities in their support and encouragement of each other, changes to ACC (New Zealand’s Accident Compensation Corporation) the International Classification of function (ICF). There was an interesting challenge about whether some people who clearly have significant challenges in going about their everyday occupations get the opportunity to receive occupational therapy. The example given was people who live with psoriasis (most often only seen by the doctor and treated through medication) . Perhaps maybe we need to open our and others eyes to think more about who could benefit from occupational therapy rather than staying with the traditional client base. Plus lots more.

I was fascinated to hear about how the building we were meeting in was built. A real story of a community knowing how to make something happen. I am not sure I have all the facts sorted but it goes something like this. The area needed a new church they decided that they would build a building that whilst a church could also be used as a conference centre and become a community asset . They had the plans drawn but were facing real issues in raising sufficient funds to build it. The community rallied and over a weekend the shell of the church come conference centre was built . Over 300 people donated their time and skills they saved themselves 1.5 million and were able then to get the funding to finish the building. It is a building that is now clearly used by the whole community and which has the potential to fund itself, by having people like us having their conferences and meetings there. A great story – one that makes you realise the power a community working together can have.

Well I hope this ends the blogging holiday – guess we will see.

Online Learning Communities

As can be seen in a previous blog ‘Communities of Interest’ I have recently been checking out the online information about how to develop and maintain effective learning communities. In looking at the online learning community I assumed I would find similar findings.

So in trawling through a number of readings what did I learn:

As with face to face communities the literature on online communities emphasizes that a sense of “community” is necessary for successful learning outcomes. There is recognition of a strong link between a positive social dynamic and cognitive learning.

And yet conversely the literature shows that online learning communities can have many members who act very much on an individualistic level. These people are usually successful and well motivated; they have other networks and supports. In effect they access the learning but they don’t appear to want or need the social aspect to assist with the learning – they get this elsewhere. To me the dilemma then appears to be one of recognizing quickly enough the member’s styles and needs. There appears to be a risk that people will fall through the gap between these two ends of a continuum that supports learning, ending up not being connected to the community and not getting the desired learning outcomes.

Interestingly when I looked at supervision of occupational therapists (see previous blog) – those therapists that built a range of networks and didn’t just rely on a supervisor to gain different perspectives appeared to gain more from supervision. So perhaps across many activities in today’s society an ability to develop and use networks is an important skill.

The cornerstones of developing a successful online community seem to be the development of; respect by members for each other and their perspectives, a common vision, shared perspectives, the ability of the facilitator (I may have to revisit these I’m not sure I have got the true cornerstones). Part of the facilitator’s role is seen as being about generating excitement, interest, relevance, purpose and value.

There is acknowledgement that the limited means of communication used in many online forums e.g. a strong emphasis on the written words, can affect the development of relationships. The face to face setting has the advantage of members being able to process, verbal, visual, non verbal information to assist us in developing our relationships with those in our communities.

I’ve been challenged by the concept that communities need artefacts “In highly literate communities like ours we need to find our own authentic artefacts around which we can express our unvoiced thoughts and which give meaning to the changes we aspire to”.(Friere) So what would be the artefacts of an online community be? –the reading suggested things like presentations, showcases, photo’s. I’m not sure…..

Well that’s it for tonight’s reflection. It’s past bed time.

Websites that contributed to this reflection:

http://halfanhour.blogspot.com/2007/08/distance-learning.html

http://elgg.jiscemerge.org.uk/george/weblog/680.html

http://pre2005.flexiblelearning.net.au/guides/facilitation.html

http://en.wikipedia.org/wiki/Intentional_community

http://en.wikipedia.org/wiki/Social_interaction

http://www.techlearning.com/blog/2007/08/the_art_of_building_virtual_co.php

http://www.westga.edu/~distance/ojdla/spring61/woods61.html

 

Occupational Therapy Communities of Interest

 

I have been doing a bit of reading about communities of interest and thinking about how belonging to such communities contributes to and enhances the experiences we have.

The literature describes communities of interest as being people with a collective perspective, a common; identity, purpose, and concerns. And importantly they are about sharing and social interaction between the people in them. How well the community works is seen to have an effect on the well being of the people.

Working in an occupational therapy school (you could probably substitute any type of school) the role we have to establish, maintain and grow the community of staff and students is a complex one. Ensuring everyone from the newest of students, to staff who have been within education for some time all feel apart of this same community.

The curriculum we have plays a large part in enabling students and staff to develop a collective perspective, an occupational therapy identity etc. But perhaps of equal importance is the other things that happen within the school e.g the events, the structures and of course the environment which contribute to ensuring we have a strong community of interest. A community that assists students and staff through the hard times, which celebrates the good times, and has a positive effect on everyone’s sense of well being.

My reading would indicate that communities work best when the people in the community feel that their; views are heard, where they are a part of the decision making, where they have a sense of belonging, unity, affinity and compatibility.

I see our challenge as one of ensuring we have not only the best curriculum we can, but ensuring the environment and the other activities within the school also work to develop a positive community of interest inclusive of both students and staff.

This isn’t rocket science and isn’t new, however sometimes it’s good to stop refocus, and reset priorities.

I believe the same thinking applies to teams of occupational therapists in practice.

These URL’s helped shape the thinking in this blog:

http://crawford.osu.edu/cd/cd/myweb2/concept_of_communities_of_interest.htm

http://www.dlg.nsw.gov.au/Files/CommissionsTribunals/bconcept.pdf

Occupational therapy is it boring??

Blog statistics are interesting things. I was intrigued to see someone had done a search on “occupational therapy boring” and some how they had got to my site !!. It made me stop and think is occupational therapy boring?, have I been bored being an occupational therapist?, are students bored?  What is boring about? is boredom internally or externally driven? 

When I look at the dictionary the following phrases are associated with bored, boring, or boredom: A dull and uninteresting activity, tedious, feeling weary and impatient because one is not well occupied.  

Occupational therapists should know about being well occupied, but do we apply our knowledge to ourselves? 

And the opposite of bored  = excitement.

Strong, R., Silver, H., Perini, M., & Tuculescu, G., (2003). Boredom and its opposite. Educational  Leadership, 61(1), 24-29. 

Have this to say about boredom in the classroom: “Adam Phillips (1993) describes boredom as both: 

A form of depression—a kind of anger turned inward;

and A longing for that which will transform the self, making life and learning meaningful. 

This double aspect of boredom—its negative brooding and its positive yearning—makes it difficult to deal with in the life of classrooms… Instead of [teachers] asking, Am I boring?, we can ask, when are students most likely to be interested enough to overcome the boredom that occasionally haunts almost any sustained act of learning? In other words, When and under what conditions do students care enough to work hard? This question shifts attention away from an obsession with boredom and toward a more productive fascination with ordinary human interest.”

And “student achievement is more highly correlated with student interests than with cognitive ability, then we should make curriculum design based on human interests a primary focus for professional development” 

for more you will find the article on http://www.ascd.org/authors/ed_lead/el200309_strong.html  

And so clearly there are ways to help students be less bored  but is occupational therapy boring? I look forward to hearing from others….

Blogging duldrums

I seem to have the Blogging duldrums. I have a few things that I could blog about but it seems like a bit of effort at the moment. And so a post that doesn’t require too much thought is in order….

I was doing a little procrastination at the end of the day yesterday when a survey on using technology for professional development popped up in my emails – and so it got my attention. It made me realise just how dependent I am now on the web and yet 10 years ago it was not a feature of my work life at all, I started to wonder how I coped without the instant information I now have at my finger tips.

Did it mean I relied more on my own analysis and interpretation?…. was it easier to be confident in my own abilities and reasoning i.e. no checking it out on the net …. does the web mean we individually now know less or more? …. does it help us articulate ideas more easily or less? …. what do we do better as a result of the web and what do we do less well?

I think this post is turning out to require more thinking power than is available tonight as I multitask watching TV (as I was going to have an evening blobbing out) blogging, and trying to fit the cat and the lap top on my lap at once. So if anyone else has any thoughts they would be appreciated.