This blog post is brought to you by Etown alumna, Arlynn Polsky Paris, MS, OTR/L, (’88).
I have been a therapist for almost 30 years. But I am still learning…. I learn from books, journals, other therapists, teachers and patients/students….. This is what happened to me earlier in December. It changed my heart.
Steven (not his real name) is a teenager. He has a developmental level which allows him to interact with his environment at the level of an infant. His motor control is severely limited with very little head control, slight shoulder movement and contractures in his hands and legs. He typically keeps his arms extended by his sides. He is fed via a PEG tube and is dependent on a wheelchair and someone to push him for mobility. Steven is able to communicate via smiling and crying. He loves to listen to Jazz music and likes to be “rough housed.” The music makes him calm and the rough housing makes him smile. When he cries, it is heart breaking and frustrating because it is hard to figure out why he is sad/mad/uncomfortable. So just like a content baby…. if he is happy people don’t “mess” with him. I was scheduled to do an OT evaluation on this student in his classroom to determine if he was still eligible for therapy services in school and at what level. Steven was “new” to me because he was evaluated previously by another therapist (I started this job a few months ago) and he did not have direct therapy services – consultation only.
When I did my evaluation I did not want to startle him and make him cry – so before moving him I began to interact by touching his arms…. he began to visibly relax and then when I stopped, he moved his arms back to me. It seemed very obvious that he wanted it to continue. As I talked to his aide we realized that no one really touches him except to move him or complete his “care”. So…. I spent the next 30 minutes playing with his arms, hands, legs and feet. During that time he didn’t cry at all (we turned his music off to see what would happen usually when the music stops, he cries) – but he smiled, made eye contact and held his arms in front of his body instead of hanging at his sides. This made ME smile and want to cry at the same time. How sad it must be to not know touch.
The lesson I learned …. touch seems like something that should be easy to give. But at times it is taken for granted and when we make the effort – it is a gift that is more valuable than you could ever imagine.
The benefits of touch have been researched and documented. It seems like we should ALL know about how important it is – maybe we do and have just forgotten…. for all of us who need a reminder –
Touch helps to:
- Feel connected to others. We are social beings – touch plays an important role in human communication.
- Reduce anxiety. Simply touching another person can make us/them feel more secure and less anxious.
- Bond with others. Touch is one of the ways romantic partners bond with each other and parents bond with their children. Caregivers connect and develop trust with their patients.
- Lower your blood pressure. Studies have shown that those who get regular touch often have lower blood pressure than those that don’t. Touch can also slow the heart rate and help speed recovery times from illness and surgery. Even having a pet can have beneficial effects!
- Give us the sensory input – craved by many, needed by all.
- Stimulate or soothe, depending on where and how it is provided.
Things to keep in mind:
- Senior Citizens receive the least touching of any age group. They are more likely to live alone and have less contact with family members.
- People with significant care needs may be touched less because so much attention goes into daily personal care that we forget to focus on touch as a personal care need.
- Infants who are touched gain weight faster and are noted with faster developmental progress.
As the song implies…. a kiss may just be a kiss, a sigh may just be a sigh, but a touch can change a life!
September is Suicide Prevention awareness month. Of course, this is important every day. The Substance Abuse and Mental Health Services Administration (SAMSHA) has various suicide prevention information and resources available for consumers and for professionals. Did you know that SAMSHA has identified risk and protective factors?
Risk factors* include:
- Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders and certain personality disorders
- Alcohol and other substance use disorders
- Impulsive and/or aggressive tendencies
- History of trauma or abuse
- Major physical illnesses
All of those risk factors above represent clients whom OTs may serve – in various practice settings, many of which are not considered mental health settings. Next, look at the protective factors* below:
- Effective clinical care for mental, physical and substance use disorders
- Strong connections to family and community support
- family may include a sense of duty to care for others or to care for pets
- Support through ongoing medical and mental health care relationships
- Skills in problem solving, conflict resolution and handling problems in a non-violent way
- Cultural and religious beliefs that discourage suicide and support self-preservation
Did you notice anything? Yes, many of the protective factors revolve around meaningful occupational activities and roles, e.g. family & social support, spiritual or faith-based values, caring relationships, and problem-solving or coping skills. OT can address these skills, roles, and factors in any setting. How do you address psychosocial health, coping, and engagement in meaningful occupations for your clients?
*Risk and protective factors are selected from the entire list at www.suicidepreventionlifeline.org. Risk and protective factors are predictive, not absolute.
by Carly Ensor, SOTA Publicity Chairperson
Several weeks ago our Student Occupational Therapy Association (SOTA) celebrated OT week on campus. OT week is held annually to promote OT around the college community. OT week included a banquet on March 31st, where OT students and faculty gathered together to celebrate achievements and memories from the previous year. Scholarship recipients and students who have volunteered at OT department open houses were recognized, and the evening concluded with a video presentation of photographs from the past year – both inside and outside of the classroom.
SOTA’s executive board works very hard to bring in a guest speaker annually whose life has been impacted by our profession. This year, our students and faculty alike were inspired by Miss AnnaRose Rubright, a very successful young woman who just happens to have trisomy 21. AnnaRose shared about her many successes in life including graduating high school with a very high GPA, being a member of the national honors society at her school, and now attending a local college. She highlighted the importance of person-first language, and how using it allows for a better relationship between medical professionals and their clients. AnnaRose explained that receiving O.T. early intervention services allowed her to achieve success in all aspects of her life. She is very thankful that her therapy team allowed her to be very independent and truly live life to the fullest.
AnnaRose and her parents started The Anna Foundation for Inclusive Education, which is dedicated to the enhancement of the educational experience of students with developmental delays and their participation in inclusive education. Because the Anna Foundation’s values align with our profession, SOTA chose to present AnnaRose with a $250 charitable donation so that they could continue their efforts. In addition, SOTA presented AnnaRose with a birthday cake and led everyone in singing, “Happy Birthday” to celebrate her 19th birthday, which was the same day as the banquet. Happy Birthday, AnnaRose!
Students, faculty, and other guests were inspired by the wonderful, hard-working, and successful Miss AnnaRose Rubright. This year’s SOTA banquet was a successful gathering to celebrate the club and very exciting profession of occupational therapy.
What did you do to celebrate OT Month?
At the POTA conference last fall, the keynote speaker focused on the distinct value of occupational therapy and how our profession needs to continue to communicate our worth and significance to others – clients, families, policy makers, insurers, and more. Wow- that’s a huge responsibility for one person. Can we do more if we work together? If you are already a member of your professional organization, good for you. If not, we encourage you to reconsider joining a professional organization. Maybe that professional association membership is more than just dues and newsletters.
Here are our top 10 reasons that the Etown OT Faculty belong to various professional associations (e.g. AOTA, state associations, other related organizations):
- Advocacy and policy issues – professional associations are a powerful collective voice. Who else has time and expertise to monitor ongoing legislative changes and legislative issues that impact OT?
- If not us, who will do this for us?
- My association speaks for me as an OT and represents me at the state and national levels.
- We need to be “at the table” when policies and plans are being formulated.
- Definitely strength in numbers – strong membership levels increase our profession’s credibility to policymakers and legislators.
- Professional identity – pride in and commitment to our profession, integrity as a professional
- Access to professional resources such as peer-reviewed journals and promotional materials
- Updates in practice trends and legal issues that affect practice
- Networking – opportunities to meet with other therapists from different regions in the state, country or world as well as with therapists who work in other practice areas/specialty areas.
- Networking also can lead to collaborative partnerships
- Hearing different perspectives and voices
- Opportunities for professional growth – e.g. continuing education, leadership, and service
- Professional responsibility
- Supporting the organizations’ mentoring and development opportunities for others, especially students and new graduates – our future.
- Professional association membership is job insurance for the future!
Occupational therapists and occupational therapy assistants who are licensed in Pennsylvania must comply with new education and training requirements under the Child Protective Services Law – Act 31, section 6311. Effective January 1, 2015, all licensed health care workers (and funeral directors), must complete DPW-approved (Department of Public Works) training in child abuse recognition and reporting requirements.
For new license applications: A minimum of 3 hours of training is required.
For license renewals: A minimum of 2 hours of training is required.
Further information about the law and links to approved training is available at the State Board of Occupational Therapy Education and License. The list of currently approved training will be updated on a regular basis.
Attention new grads who are pursuing licensure in Pennsylvania: You must have malpractice insurance within 30 days of obtaining your license. If you do not provide verification of it within 30 days, your license will be revoked – not a good way to start your OT career! You have a couple of choices to make this happen. You could go ahead and get the license and then apply for jobs; if you don’t have a job secured within 30 days you can apply for malpractice insurance on your own. There are many companies that provide timely affordable malpractice insurance for practicing occupational therapists (HPSO and Marsh are two that I know of). Some companies give new grads one year free!!! If you get a job that covers you with malpractice insurance, you can cancel your personal policy and then get most of your money back. It will be easier to get a job with a license already in hand …… and if you have the license you want to follow the rules.
From Jennifer Bush, BS, MOTS ’15
Jennifer Bush demonstrates how to wear and adjust a backpack to prevent strain and injury.
To highlight backpack awareness day (Sept. 17) and for my advocacy assignment in my O.T. Administration and Management course, I organized a backpack awareness event with the help of members of the Pennsylvania Occupational Therapy Association as well as Elizabethtown College students. To spread the word about our event and to raise awareness about backpack ergonomics, I created a flyer with the location date and time. The flyer was sent to local schools in the Lancaster County area; some schools posted the flyer on their website while others disseminated printed copies to students. Daniel Panchik, who teaches Kinesiology for the occupational therapy department, lent us posters that his students created about backpack awareness, and we displayed the posters on our information table.
We gathered at the Park City Mall on September 21st to teach school-aged children about backpack ergonomics. School-age children passing by were invited to our table to learn how to wear their backpacks safely.
- Each child was asked to take a backpack quiz, which included true and false statements and multiple choice questions about backpack ergonomic strategies and backpack injury statistics. We reviewed the correct answers with each student and gave explanations for the answers.
- After the quiz, the children were asked to step on a scale to determine their weight so they could calculate how much their backpack should weigh. We showed them how to use a calculator to figure out 10% and helped them to calculate the safest weight for their backpacks.
- The child then had an opportunity to fill a backpack full of books to try to get it to weigh exactly 10% of their weight. As each child filled the backpack, my helpers and I reminded them of tips and strategies for the best way for them to pack their bag and the best way to adjust the backpack to their bodies. When each child got their backpack to weigh exactly 10% of their weight, we asked them to remember what this bag feels like on their back and to never pack a backpack heavier than that.
- We also handed the bags to parents to feel and asked them to remind their children to weigh their backpacks at home. Afterward, each participant was given handouts about backpack tips and injury statistics, as well as parent handouts about ergonomics for purses, suitcases, and briefcases.
Angela Meyers, junior OT student.
We received a great deal of positive feedback and appreciation from both parents and students for holding this event. Almost everyone was surprised at how light their backpack should be in order to be a safe weight. Parents also frequently told stories about having to help their children onto the bus because their bags were so heavy and many students also admitted to experiencing back pain due to heavy backpacks. All of the parents with whom we spoke thanked us for our efforts. Parents and students alike promised that from now on they would “pack it light and wear it right!”
Many of you have heard an anecdote about a patient who was in a hospital, and the patient’s family member was horrified and angry to overhear a doctor talking to the nurse about the “S.O.B.” in room XXX… only to discover that the doctor was using an abbreviation of the diagnosis, “shortness of breath.” More recently I have heard or seen people refer to autistic children, ADHD’ers, schizophrenics, the cancer guy…and more. Wait a minute – are our patients defined by their diagnoses? Do WE want to be defined by our own diagnoses?
Several years ago I received a compliment from a director of mental health services at a community agency where some graduate students were conducting research. She noticed that these Etown students used person-first language. The students consistently referred to the clients as “people with mental illness.” Yes, they truly “got it”- that we interact with people…and a diagnosis should not define anyone. A diagnosis may be part of who we are, but should it be the first thing that people think of?
On the flip side, some advocacy groups don’t want to appear as too sensitive and do not recommend using person-first language. Some groups of people are proud of who they are, the challenges they have overcome, and see their disability or condition as part of their normal lives or their culture.
So, how do we use language and other forms of communication to demonstrate respect and caring for those we may encounter as therapists? Do you use person-first language? Why or why not? What do you think about this?
ALL patients involved in healthcare have an emotional response to their diagnosis, treatment and other aspects of their care. If a patient is emotionally labile after a stroke, we address that emotional lability and help them learn to cope with their new normal. If a child with limited self regulation has a meltdown in therapy, we address their regulation and coping skills, preferably with the family so they can carryover these skills at home. If a family asks about the support they need to manage their loved one’s care after discharge, you may make referrals to support groups or to the team’s social worker or psychologist in addition to giving some practical skills for dealing with the change in demands on the family. Does this sound familiar to you?
Addressing psychosocial issues can be overt as in traditional mental health settings or it can be integrated into a treatment plan in a physical rehabilitation setting, school setting, and more. Recognizing these components helps our students learn these vital therapeutic skills. Maybe we all need to be more intentional in our thinking about this aspect of our daily therapy practice. If you are not in a “mental health” setting, think about the psychosocial aspects of your patients’ lives – how do you address these as an OT? How can you help fieldwork students integrate this aspect of care into therapy?