Mock Interview

     On September 09, 2020 I had the chance to do a mock interview with my school. I interviewed for a full time OTR position at a nursing and rehab center. Below is my reflection on how I thought the interview went.

 How do you feel the interview went overall? 

    I personally feel like it went well. I was a little nervous before beginning, but once I got in there my nerves went away. I tend to make myself nervous, but once I start I am reassured that I will do great if I just be myself. I think considered it was my first zoom interview it went well. 

How did you prepare for the interview?

    Honestly, I thought about a few questions I may ask the interviewer, but other than that I did not really prepare. I have had a job interview in the past and knew that some of the questions would involve asking about my strengths, weaknesses, and some personal experiences. I had in my mind what I wanted to say, but I do best when I think on the spot. 

What, if anything, went differently than you expected

I was not prepared for the question related to FW. I think it made me stop and think for a little because both of my most recent ones were online. I just had to stop gather my thoughts and answer the question to the best of my ability. I feel like I adapted well and answered the question honestly. This was a good question to ask though to prepare me.

What's something you would change if you could go through this process again (or something you'll do differently when you're in a real-life interview situation)?

     If I do this again, I will be more prepared when it comes to answering questions about FW. Another thing I may change would be when asked to tell a little about myself I was very short, and I think I could have done a little more explaining to let the person know more about me than what was on the paper. 

What's something you learned during this process that may be helpful to you as you prepare to enter the workforce as an OT practitioner?

    That smiling and making a mistake is normal we are all humans. That being open to criticism and letting people know that I have good personal skills and can use humor in a situation to lighten the mood could make my transition into a new facility easier. I need to prepare questions and again just be myself. If they hire someone, they thought was someone else it could make transitioning into work more difficult with other co-workers. Be open and always be ready to think on your toes. 

A Glyph on Leadership

January 2019

July 2020

The image to the left is when I first started OT school. And the image below is a current image. As you can tell the shape of the head changed from a square to a triangle. Which indicates that since starting school I have determined that leadership is most likely an inborn trait instead of stemming from nature. Also, the shape of the eyes have changed from circles to squares indicating that there is an equal mixtures of leaders versus non-leaders. I feel like this has changed for me because I had the opportunity to work with many different individuals in groups and see those who were leaders. The nose though remained the same resembling that someone can be a leader without seeing themself as a leader. As you can tell I placed freckles on the second image showing that through school self awareness is important to be an effective leader. If you are not self aware this can hinder the abilities to be an effective leader. As you can tell from the mouth I have and still have many leaders in my life whom left a positive impact on me. The ears in the second picture show that technology is not what is important to becoming an effective leader. A good leader is one who can use any resources and their own knowledge and advice to make an impact.  The hair remained the same as well demonstrating that a good leader is someone who can be both organized and creative to be a good leader. The length also demonstrates that even though an individual can be an introvert they can also be an effective leader if the initiative is taken. I still placed glasses and earring on both pictures which demonstrates that I see myself as a leader and have had many leadership roles. Lastly my name was signed different, the cursive symbolizes my goal to serve a leadership role in the future, especially when I become a practitioner. I think I have grown even more into a  leader since school and gained all the resources necessary to be an effective leader.  

Locus of Control

There are two different types of locus of controls, internal or external. Internal locus of control is when one believes they are responsible for their future.  External factors may occur, but they can make a decision on how to handle/respond to the event. When someone has an external locus of control, they believe things will happen to them and there is no preventing those events from occurring. 

After taking Rotters Locus of Control Scale I scored a total of 10, which represents an internal locus of control. I personally think this fits me so well. I normally am someone who follows by the rules and do not get influenced based on other opinions or decisions. I have always worked hard for what I have and still continue to work for great grades all throughout my current master’s degree. I take responsibility for my actions and even sometimes the actions of others which can be a downfall. I feel like I have always been able to handle whatever comes my way especially since I have learned to use humor to make the most of any situation. 

I can say that sometimes I do feel as if I have an external locus of control, because some things just cannot be in my control. I try to be as optimistic as possible and know that whatever actions/ efforts I put forth will impact the outcome. I have a strong sense of self-efficacy and like to take leadership roles. I am not the type to sit back and let others lead the way. I am determined to try to figure things out on my own and doing so has helped increase my independence in life.

This test has reassured me that I am in control of myself and my actions. I know I have the capabilities to be successful not only in school but as a future practitioner.  

Peds Sim Lab

Overall, I felt as if my sim lab went well. I think I had more positive things occur than negative. One thing that I found very comforting was the mother loved my sensory ideas on the schedule and gave me the reassurance I needed. When I explained what a sensory processing disorder was and asked her if she understood, she had no questions. So I feel like my job of explaining something that could be so complex to someone who was unfamiliar with it was accomplished. I really enjoyed this SIM lab encounter. I think having the materials before also really helped me think about how I wanted to present this information in the best, most understanding way as possible to the parent. I also have never really had the experience to talk to a "parent" so being able to put myself in their shoes was beneficial to my learning experience. 

If I could do anything different in this SIM I would have tried to not bounce around when talking to the mother. There were many times when I felt like I hadn't explained things to her. I was so focused on hitting the points I was supposed to cover, I would tell her things and then bounce back to something else. I wish I was more aware of the sequencing that I had during my conversation with the mother. I may also try not to pull emotion out of the mother. There are times when parents may not want to open up and I have learned that it is best to not pull for answers. 

There are many ways to show that you care to a client. The most important to me is by being empathetic and showing that you do care about them and their concerns. A client can also tell if you care by the way you present yourself. If you keep eye contact, listen to what they say, and respond by repeating back to them what you heard them say shows you care. When you are able to put yourself in that client/caregivers shoes they will know that you are trying to relate to what they are experiencing and that you do care and are there to help them.  

When I have the opportunity to experience something like this in the real world, I will be more prepared for what is to come. As humans we all react differently, so no scenario will be the same. This lab has helped prepare me to interact with a child's parents and know that not all parents will show the same emotions. Therefore, if they are not willing to open up to me, I do not need to keep pushing them to open up. I also will have more experience talking to and relating to the parents or even other clients when giving them new information. I think I also will be able to communicate the material in a more organized way and not bounce from topic to topic.The more labs I get to participate in, the more I am becoming aware of my communication skills and my own self awareness and the adjustments I need to make. These labs are teaching me so much to prepare myself for a real clinical setting.  

Memory Box Media Project

            I recently completed a media project for my class. It was a case report relating to a client named Susan, who was diagnosed with Amyotrophic Lateral Sclerosis (ALS).  Most individuals have a life expectancy of 2-5 years after diagnosis. Susan loves to scrapbook and wants to leave behind something for her two children after she passes. I was instructed to use an everyday household item and turn it into an intervention for Susan. My item was a margarine tub. We decided to turn it into a memory box that she could place pictures, quotes, cards, and even voice recordings inside of. She would have the opportunity to maintain the muscle function she has in her hand, while continuing to do what she loves to do. 

            After completing this project, the most rewarding thing I learned was that anything you have at home can be turned into a meaningful activity. Always make the best of any situation, and you can find something to meet the needs and values of the client. I knew that the values, beliefs, and needs of the client came first in any situation, but when I was challenged to use an object that wasn't the most common in intervention it was very challenging. After completing this I learned that if I think hard about what is most important to the client, I can turn any type of material or product into something that the client finds meaningful. Being challenged with what materials are available as an occupational therapist may be difficult at times, but knowing that I can make an intervention with any type of material as long as I put the client first is possible. I feel like now I can be more creative than I imagined and turn a simple intervention into something that is fun while maintaining, promoting, or even preventing health issues. 

            My hopes after completing this project is that the skills I learned will be carried over. I hope to use my creativity in clinical settings so the client can do something beneficial without it being the same boring intervention. I want them to do something they love that is rewarding or can challenge them while increasing their occupational performance. In other settings I hope it allows me to think about how to be a better therapist so each client can have a different intervention no matter the materials available. Not everyone is the same so their interventions should be tailored to them. The client is always first, and I will strive to create an innovative task to meet their needs while within their functional abilities. This media project has taught me so much about being creative and using what I have available and not using  normal intervention items. 

            

Can She Change Your Mindset?

In the Ted Talk, How My Dad’s Dementia Changed My Idea of Death Beth Malone talks about her father’s dementia. Malone’s father had frontotemporal lobe dementia which could change soemones personality, make them paranoid, or even violent at times. Her father was diagnosed with dementia over 10 years ago, but it was only three years ago when his symptoms began to worsen. His family decided to place him into a nursing home, which wasn’t the best option for him. One day he threatened everyone at the facility he was going to cut them, while also yanking curtains off the wall, and becoming very aggressive to others. 

Malone’s family found a facility for people with dementia so her dad could be in a more suitable place. She went to visit him one day and he had fallen over and was trying to take off the clothes they had placed on him. This upset her so much that she couldn’t even visit him that day and she left. She started to question, “Why should my dad have to live this life.” After visiting with therapists, psychics and support groups she knew she had to let him know she was alright and that she didn’t have to worry about him. When she went to see her dad to tell him she’d be alright without him, she had a change of heart. 

Her father was himself again. He was laughing and told her that he missed her when she told him she missed him. She knew that day that he was somewhat himself again. She knew when she held his hands he was still there. She then knew that she couldn't change death and the story of someone’s life.

As I reflect back on this story it shows the roles that each individual can have in someone’s life. All you need to do is be there to provide support when the day may either be good or bad. I have seen this personally when my grandmother was diagnosed with dementia. Some days she was herself and other it was like you were looking into an empty tunnel. Every day was different, but as we continued our roles in her life, she was at peace and when the time came, she went home with the Lord. 

As therapist we need to remember we are there to help no matter how good or bad. Some days we may feel like we have climbed a hill trying to find the soul inside the person without reaching the top and others we feel like we are at the top. We cannot change what has happened, but we can change what will happen in the future. 

Beth Malone’s touching, heartfelt story is one to listen to for sure. We need to remember who we are, and what roles we have in someone else’s life. Support the ones we love and even though they may not be the person you remember deep down a piece of them is still there. Dementia may take their memory or cause them to act in ways that are uncommon for them, but deep down there is a piece of them still there. We just have to be patient and wait for the day to see it again, wither it be a day, weeks, or months, or even in the afterlife. 

I highly encourage everyone to watch this Ted talk, to hopefully change your idea of what perceptions you previously had no matter the situation. It will make you have a different outlook on your decision. Click on the link below to watch the Ted Talk. 

https://www.ted.com/talks/beth_malone_how_my_dad_s_dementia_changed_my_idea_of_death_and_life

 Reference: 

Malone, B. (n.d.). How my dad's dementia changed my idea of death (and life). Retrieved August 22, 2019, from https://www.ted.com/talks/beth_malone_how_my_dad_s_dementia_changed_my_idea_of_death_and_life

How Would You Respond?

What do you do when a challenge is thrown at you, or when something doesn’t go the way you planned? Do you let it bring you down or do you turn it around and make the best out of the worst situation? We have recently learned about MS and how so many individuals have this diagnosis. I wanted to hear how it had affected a driven graduate student who was successful in her life. 

            In a recent Ted Talk, Thriving in the Face of Adversity, by Stephanie Buxhoevedem she talked about how she dealt with life when a challenge came her way. She was a graduate student who loved neurology and was pursuing a career as an anesthetist. She also loved to work out but one day while she was working out her leg had become numb. She didn’t think anything about it, maybe it was just a pinched nerve. She kept preserving and the day had finally come that she had been dreaming of, after all the hard work in the classroom it was finally time to be in the surgery room to give her first anesthesia. Before she knew it, her legs were completely numb, her arm was losing sensation and her vision became blurry. She knew something was wrong, it wasn’t just nerves. She then went to the hospital where she was admitted for numerous amounts of test. After days of being in the hospital she was given the news that no one wants to hear, she was diagnosed with relapsing-remitting multiple sclerosis. 

            She had to make a decision to keep pursuing what she wanted or let her MS determine her life. She was reading through some of her paperwork from the hospital, when she read that the doctor said, “she had a poor prognosis”. This led her to the decision of pursuing something new in life. She decided to become a multiple sclerosis nurse to help others with her clinical and own personal advice. She was able to help others with their diagnosis. She also started a website to help those with unanswered questions be aware of the diagnosis. 

            This Ted Talk shows that we never know the future and especially what our unknown is. Stephanie was faced with the most difficult, devasting news, but she had the choice to either deny, cope or thrive. She chose to thrive, and she said that this diagnosis has pushed her and gave her a purpose in life. As future practitioners we can take our own knowledge and help others and who knows we may even be able to give advice of our own. This story is touching because most people will want to deny and cope with their diagnosis, but as practitioners we want individuals to push through their challenges and be able to get the most out of their lives. 

            No matter the situation life will throw a challenge at you and it is up to you how that challenge is handled. The determination and support of others will have a great impact on how individuals can overcome challenges. There is no specific answer to the future, so making the best of the outcome can have a larger impact on your life and on others’ lives more than you think. So as future therapist we need to be holistic in all approaches. We need to let our patients know that we will support them and help them when they need it most. 

 Reference:

Talks, T. (2015, April 03). Thriving in the Face of Adversity | Stephanie Buxhoeveden | TEDxHerndon. Retrieved July 30, 2019, from https://www.youtube.com/watch?v=zuLOT6GsAxw

Sheryl's Perspective

            I was not for sure what Myasthenia Gravis was until hearing Sheryl’s touching story. She was a young girl, only 16, when diagnosed with MG. She was going about her childhood when she started noticing symptoms. She was very active in softball and had many friends. She started to experience extreme fatigue in her arms legs and hands. Then she started to notice a droop in her eye that kept getting worse. She was also having difficulty chewing foods and keeping her mouth closed when eating. She went to the doctor where they couldn’t really diagnosis her because they didn’t know for certain what was going on. She went to an eye doctor because her eyes continued to get worse. The doctor knew something was not right and wanted to do an ice test in the office to test for myasthenia gravis, it was then that he was for sure that was her diagnosis. They later sent her to the hospital to confirm her myasthenia gravis diagnosis. 

            She had to learn how to adapt to some things she was so used to doing. She had to give up playing softball because it was too much exertion on her muscles. She was not able to attend school for a few months because her body was so weak. She was so excited to finally be attending school again, it gave her a routine. She liked to stay busy and to be involved, it made her feel like a normal teenager again. Even when she had to go to the hospital for treatments, she stayed in touch with her friends to keep them updated and they gave words of encouragement. She also talked about how she still likes to go fishing, ride four-wheelers, and even take her sister for short walks because the long ones make her tired. She also has a bunny that she loves to take care of because it keeps her from thinking about her disease.

            She gave a great insight on what the disease meant to her and how to explain it to others in terms that could be understood. She talked about how her symptoms were being shown and how they would differ each day. She also talked about the different treatment plans and how one worked better for her than the other. 

Just because she was a teenager didn’t mean that she didn’t have a voice. Each story is unique in its own way and as therapist we need to observe the person as a whole, not just by their diagnosis. Each client will be involved in many occupations and all have different ways to handle things. Each client will also have different symptoms and different limitations. Listening to the whole story and giving them a sense of independence along with meeting their needs could be the most important thing in their life. 

Just like Sheryl, she knew some days were going to be better than others, but all she cared about was being able to have a meaning in life and enjoy a life like her friends. I truly encourage others to watch this video. This video explained Sheryl’s outlook on Myasthenia Gravis, and it helped to understand that each client has a story and different symptoms. Therefore, understand the person and their story and not just their disease.

Reference

Carter, B. (2014, October 23). Sheryl and Myasthenia Gravis: How I Cope! Retrieved July 31, 2019, from https://www.youtube.com/watch?v=UZU2nTf6_cc

Would You Change Your Outlook?

As a student I was interested in learning about Huntington’s disease, but I got way more than that after watching “The InnerKid Philosophy: Kristen Powers” on TedxTeen. I chose this topic because my aunt was recently diagnosed with Huntington’s disease within the last 5 years and I know the affect it has had on my family. Kristen shared her story of losing her mother to Huntington’s disease. Huntington’s is genetic, and it affects movements, speech, and even thinking. It was stated in the video that if you combine Parkinson’s, Alzheimer’s, Dementia, bipolar disorder, and ALS you will get a different type of Huntington’s disease each time. Kristen’s mother became diagnosed in 2003. She was old enough to witness the changes it caused on her mother’s health, both physically and emotionally. She watched her fall and get scrapes on her knees. She even watched her behavior change so much that it sent her to a mental hospital. Thereafter, she was sent to a nursing home since she wasn’t going to get any better. Her mother finally did not have to suffer anymore and passed away in 2011. After going through such a difficult time, it made her think about her future. And honestly who wouldn’t? Is it best to know what your future holds? Would you want to know if you only had months to years to live? When events like this happen in our life’s we can either chose to pick a path that can not only benefit us but others as well. We could take the wrong path and even turn to unhealthy behaviors. Kristen started a campaign that made people see that childhood doesn’t have to be the best time of your life. She wanted to spread the fun out and enjoy life every day and not just during her youth. After watching her mother decline, she knew that it’s not known how much time you have and being able to enjoy things throughout your life is very important. She recently turned 18 and has decided to get tested and find out if she has the disease. Through the InnerKid program she started she’s going to document her journey. Even though she didn’t want to know back then she does now, because it pushed her to enjoy life every day. Not only that, but it could help other individuals learn and even change their outlook on life and enjoy every second of everyday. The wisdom of not knowing pushes us to challenge ourselves and go for what we want in life. Kristen may or may not have the disease, but it was through the story of her mother that inspired her to try her hardest and chase her wildest dreams.

I can say with my whole heart that after losing loved ones to diseases or any other event that their story and lives have a major impact on the unknown. I would have never heard or even thought about wanting to become an occupational therapist. I would have never gone out of my way to start dating a guy that lived 1,400 miles away from me, but I did because he brought joy back to my life. I would have never left home and wanted to better myself for the future. I wouldn’t have the opportunity to grow and give encouragement to individuals that need a little extra encouraging in their life. No, we do not know the future, but we do know that each day is truly a blessing and if we can do anything to help others or even watch ourselves grow, we are living our life to the fullest.   

As future therapist I think we can help our patients apply this to their lives. That each day is full of different possibilities. Some can be good and some bad, but that it is best to take it day by day and live it to the fullest. While providing our services we can provide positivity throughout what might be the most difficult time, or even encourage them to live out their lives with the independence they have regained. So, what do you want to accomplish in your life? Would you change your outlook if you only had months to live? 

Checkout this TedTalk and see if you change your outlook on life.
https://www.youtube.com/watch?v=l6JiBiMqiI4  

Reference

Talks, T. (2012, April 13). The InnerKid Philosophy: Kristen Powers at TEDxTeen. Retrieved July 21, 2019, from https://www.youtube.com/watch?v=l6JiBiMqiI4 

Confidence and Mobility

Mobility is the constant state of instability. Therefore restoring confidence in mobility to perform occupations is an important factor in life. For an individual to be moved safely and with confidence, involves being comfortable with a small base of support, the line of gravity is outside of the base of support near the limit of stability, and the center of gravity is moving. The hierarchy of mobility skills is a great way to restore a clients confidence, no matter the level of independence they have. Based on this hierarchy the client can start at a level of functioning that is best for them, then as a therapist we can help that client build up from there to reach a state of stability and independence. The hierarchy of mobility starts with bed mobility and increases with --> mat transfers--> wheelchair transfers--> bed transfers--> functional ambulation for ADLs-->  toilet and tub transfers--> car transfer--> functional ambulation for community mobility--> community mobility and driving.

I agree with this hierarchy of mobility. My previous job in an inpatient rehab allowed me this opportunity. I have seen this hierarchy applied to many different clients, not only in occupational therapy, but physical therapy too. This approach to mobility is great for increasing trunk control as their stability becomes more unstable. It is also a great approach for a client that may have problems with orthostatic blood pressure and increase their ability to regulate BP as they increase in mobility. This hierarchy is not only helpful for the client, but also the therapist. It helps reduce fall risk, injury, and help to build confidence. 

I think this approach is very helpful because after SIM labs, it showed that transferring from the bed to the wheelchair vice versa can be very tiring and if the client is not strong enough they may need more help to transfer. Bed mobility allows them the chance to control how they move and increase strength. Even moving from the bed the a mat will allow them the ability to still build strength and confidence that they can transfer safely. Each level will get more challenging, and at each level you can strengthen the client to prepare for transfers. Even if they are not completely independent they can be safe and feel confident in whichever transfer they are performing. 

I personally never knew there was a hierarchy explaining this, I thought it was just what the therapist thought was best. I really love the fact that there is a specific chart to increase a clients stability and strength to reach a state of independence with mobility. 

The Just Right Fit

It is very important that each client be fitted to their assistive devices. An assistive device can be something like a walker, cane, or even crutches. Each client will have different heights, cognition, endurance and stability levels which will determine the effectiveness of each assistive device. If the client does not have very good upper body strength or wrist restrictions  you do not want to fit them with a device that is going to require the majority of upper body strength and make them push weight through their wrist. Another factor that is important when finding the just right fit for assistive devices is the stability and endurance of the client. You want to allow that individual to feel safe at all times and also have a device that correctly matches their endurance levels. An individual that may have really good stability, but tires easily may need a rollator. An individual that has good endurance, but weak stability may need a standard or front wheeled walker. 

To fit a client to a rolling walker the hand grips should either be at the level of the ulnar styloid or wrist crease. The handgrips can also be placed at the same level as the greater trochanter. Make sure that the client also has relaxed shoulders and the elbows flexed about 20-30 degrees.  

For a platform walker the platform should be adjusted so that weightbearing is allow through the forearm when the elbow is flexed at 90 degrees with the scapula relaxed. the proximal surface of the ulna should be positioned 1-2 inches off of the platform to prevent compression of the nerves. The grip on the platform should be slight medial so  there is a comfortable grip when arm is supported on the platform. 

To fit a client for a cane you want to make sure the client is standing straight forward, making sure they are steady and not going to fall. Along with the walker the cane handle should also be at level with the wrist crease, ulnar styloid, or greater trochanter. The cane can be adjusted with the locking mechanism allowing the client to have 20-30 degrees of elbow flexion. If the client needs a quadcane the same rules apply, just remember that the wider legs face away from the patient. If the legs are not facing away you can adjust them. 

When fitting a client for axillary crutches the height should be based on the appropriate  height of the patient. The hand grips should be placed at the level of the greater trochanter, ulnar styloid, or the wrist crease. The axillary rest should be about 5cm below the floor of the axilla with the shoulders relaxed. This is about 2.5 inches or a palm's length distance to fit under the arm. 

To fit a client with lofstrand crutches the arm band should be placed 2/3 of the way up the forearm. An important tip to remember is that the hand grips should always face forward to promote a proper gait.

There are many different types of assistive devices that accommodate for weightbearing status, endurance, stability, and decreasing fall risk of the client. Consider the needs/goals of the client when finding the right fit in assistive devices, and ALWAYS remember to use the gait belt when transferring or walking with a client. 

Body Mechanics

Why is proper body mechanics and posture an important factor? Body mechanics and posture work together to prevent injury and illness. Having poor body mechanics when lifting/moving things increases the risk of back pain. A benefit of having proper posture and body mechanics requires less energy to maintain a state of balance. Proper posture includes keeping your body centered over the base of support in regards to line of gravity when this is disturbed the individual increases risk of falling or injuring ones self. Proper posture and movement helps the body reduce stress applied to the spine and does not strain the body's muscles and ligaments. Posture is also involved in joint function and when the alignment is off it causes stress and the degeneration of different joints. Another factor associated to poor posture is a more difficult time breathing, if the body has proper posture the chest is able to expand. It is important to teach good body mechanics and posture to individuals because they are reducing their risk of injury, illnesses, and joint and muscle damage while increasing the spines stability. 

During an intervention of teaching a client body mechanics and posture the first thing I would do would be to have the client stand against the wall if possible to explain correct body posture. While against the wall the client needs to have their heels to the back of the wall, the shoulders against the wall, with the chin tucked and head down while against the wall as well to demonstrate proper posture. I could even have the client show me what they think correct posture is to them and correct where necessary. Next to assess body mechanics I will get the client to make sure they have their feet placed shoulder width apart or large enough to have a good base of support. Reminding the client that when lowering down to grab something and lift back up to bend at the hips and knees and not at the waist which stresses the back. They also may need to be reminded that when using proper body mechanics the neck pelvis and back should all be aligned remembering not to twist at the waist, which will cause back pain and or injury. Lift with the legs and arm muscles not your back and keep the object close to was it level. The client can practice this while using a stick placed on their back to make sure their alignment is correct or they can perform an activity while the therapist observes and corrects their posture. 

Man From The South

In the story, Man From The South by Roald Dah the soldier made a bet and if he lost this bet he would lose his pinky finger. If the soldier would have lost the bet, his ability to have a strong grip strength in his pinky would not as strong as needed. Upon losing the bet the wife might have to help with taking care of the man. One way that her life may be impacted along with his is going to the restroom. After using the restroom one must be able to wipe and if the grip strength is not present it would be difficult for him to clean himself so his wife may have to help it. They could work on exercises to increase grip strength of the other digits or make adaptions to going to the restroom.  They could also use a type of assistive device to help the man go to the restroom independently. Using a long handle bottom wiper that has a grip that includes only the three jaw-chuck grasp or even the lateral grip could make cleaning the bottom easier. Another way would be to have a device installed on the toilet to clean the soldiers bottom. This type of technology may have been more difficult to come by so using therapeutic exercise along with an assistive device to clean himself may promote more independence  for both the soldier and his spouse. 

Health and Occupational Therapy

Health promotion is the use of discipline specific techniques to assist people in achieving their health related goals. As an occupational therapist it is their job to have a holistic approach to health promotion while giving that client, or population their maximum health and quality of life. There are many different approaches that can have a negative impact on an individuals health like not being able to engage in occupations that can cause health issues known as occupation deprivation along with not being able to participate in occupations due to socioeconomic status, gender etc referred to as occupational apartheid. Therefore helping clients to engage and participate in these activities will increase or hopefully create a healthier lifestyle for them. As healthcare providers its best to think of healthy people 2020 and 2030 which is aimed to helping achieve a long healthy life. Healthy lifestyles are hard to understand to some individuals because they have limited health literacy. This is due to the fact that some individuals reading levels and understanding of healthcare is very low. Therefore its best to simplify health terminology, along with clear explanations, while asking questions to make sure the client understands the best approaches and techniques to live a full, healthy life.
As occupational therapist engage in helping a client live a healthy lifestyle they have the possibility to improve patient satisfaction and quality of care because they are client centered. While helping keep the cost per capita down, OT's are innovative and they think creatively to adapt to clients needs on the spot. Along with adapting they promote advice and the correct referrals so the client can live as independently as possible without returning to the hospital because they were taught and understood health literacy. Overall, it is best to understand that an occupational therapists' role in health promotion is important to not only prevent an injury or disease before it happens but also to limit the struggles of a disease already present. Health promotion not only is beneficial to clients, but also other healthcare providers and even family members.

It's All About The Rhythm

For the shoulder to have the greatest ROM the scapulohumeral rhythm is very important. Scapulohumeral rhythm is the muscle interactions within the scapula and humerus.  For every 3 degrees of shoulder movement, there is 1 degree of scapular movement and 2 degrees of humeral movement. This rhythm and its ratio is very important in the synchronization of the scapula and humerus movements.  The rhythm also helps maintain the subacromial space within the glenohumeral joint. This rhythm also allows for good length tension relationships to prevent active insufficiency. The two joints congruency results in decreased shear forces of the humerus in the glenoid fossa.  When the motion is distributed between the humerus and glenoid fossa it allows for stability, if the ROM is large there is a chance for instability. The scapulohumeral rhythm is important for therapist when looking at the overall muscle and shoulder joint functions. A poor rhythm could also cause shoulder impingements in the rotator cuff like bone spurs, humeral and scapular movement dysfunction, and changes in the acromion shape.

Modifications & Living Life

Many individuals do not think something as simple as an Alexa can help an older person who lives alone. One example in the podcast was that an elderly person had fallen and called 911 with the help of her assistive device, known as an Alexa. Many older individuals want to grow old in their homes or even remain as independent as possible in their homes or assisted living facilities. As occupational therapist strive to make aging in place safer this can be done with the use of assistive devices. An interdisciplinary team works together to make the best recommendations to home modifications and adaptive equipment. Some of the top modifications were putting grab bars into homes, elevated toilets, and even making a shower easier to get in and out of. 

Occupational therapist are not inventors and sometimes clients want something to work for them and no one else, so they have to reach out to other individuals to hopefully find the best product for that client. As a therapist it is their goal to make adaptive equipment as client centered as possible. Assistive devices can be incorporated into an individuals life not only by a therapist, but someone as simple as an employee at a home store. As stated in the Ted talk there needs to be a universal design. Different individuals need different requirements and we as by standers need to think of others needs to make it an easier world for us to all live in. Not only when someone has a disability in a public restaurant and needs help reading the menu but is blind, but also for older adults to grow older in their homes and to be as safe as possible. All individuals deserve to live life to the fullest and adaptive technology is an important part of life now of days. 

Test Positioning

It is important to use bony landmarks and proper positioning when measuring range of motion so the reliability between one therapist taking measurements and numerous therapist taking the same measurements is reliable. If the goniometer isn’t placed properly on the structure you are measuring this could decrease the validity.  Following the landmarks and correct positioning allows for more accurate repeatable results. The test position for MMT is important in the fact that you do not want to measure the start or the end of the motion. You want to measure the mid-line of a motion because this is the most optimal muscle contraction where the actin and myosin filaments overlap to form the best contraction. MMT is measured either with gravity applied or gravity eliminated.  If an individual struggle lifting their desired limb because gravity makes it hard difficult it may be best to use gravity eliminated movements. Gravity eliminated movements are possible by keeping the moving structure parallel to the ground, the client is not the one that needs to be parallel to the ground just the structure moving. When measuring knee flexion and extension with gravity eliminated the client needs to lie on their sideline with the moving structure on top, not in contact with the mat. Scores of 5-3 normally involves movements against gravity. If the individual struggles with barely moving a limb they are either on a scale of 2-0. Any score less than 3 should use gravity eliminated so you can get a true idea of muscle strength without over exerting or harming the patient.    

Analysis Of A Motion During A Daily Activity

Everyday I go to the restroom, it’s part of everyone’s daily life. I start in a standing position in front of the toilet; I squat down to place myself on to the toilet. This squat position going down involves the hips and knees going into flexion and the ankles in dorsiflexion. In osteokinematics, flexion of the knee occurs within the sagittal plane and frontal axis having a fixed distal segment which is a closed kinematic chain. The arthrokinematics movement in the knee involves the convex femur gliding posteriorly on the concave tibia. The primary movers when going down involve the quadriceps (rectus femoris, vastus intermedius, vastus lateralis, vastus medialis muscles.) The action of performing a squat is considered an eccentric contraction, because it is decelerating against the force of gravity. 

What Characteristics Are Important In OT?

Empathy is a term I had struggled with for a very long time. After my sister passed away I knew what it felt like to have people sincerely care versus just saying that they cared and knew how I felt. As an occupational therapist the main characteristic to include in therapy would be your own empathy. When individuals are at their low they need someone to pick them up and know that they sincerely care. Another important factor is by putting the client first and listening to all their needs. As an occupational therapist the main goal is to be client centered and that is only possible by focusing on them and what they want. Although having empathy and actively listening is important, we also need to advocate for OT and show them that we can help. Therapy is not possible without building a bond showing that you care about that client and their goals. Therapeutic use of self is the best way to connect with someone and try to put yourself in their shoes. Being able to care for others, listen to their concerns and promote a healthy holistic approach to life is why I chose to be an occupational therapist. 

Describe The Person Not The Disability

Disabilities, how do you describe this word? Hopefully you put the person first and not their disability, because you should know a person for who they and not the disability they have. After Dr. Keisling's lecture it proved to me that individuals were treated horribly in the past and even after the years there is still a stigma to treat those individuals unfairly. I have chosen to put the person first because a disability is a word, it doesn't describe the pain, love, communication, and enjoyment they get out of life.
Dr. Keisling's  lecture included that through legislation individuals with disabilities started getting treated more equally. As time went on the world started to see how people with disabilities were treated without care and were not given proper socialization skills. People also had been discriminated in a way that doesn't explain who they are as a person, just because an individual has a disability that doesn't mean that they are likely to cause a crime. After individuals with disabilities started to leave institutions they showed more positive vibes, efficacy, and they can acquire adaptive skills. After Kennedy's passing individuals with disabilities were offered protection and services to not be discriminated and treated equally with the Americans with Disabilities Act. 
After this lecture it made it even more obvious that I chose the correct profession. As a practitioner I will strive to treat all individuals the same even if that individual has a disability. An individual with a disability has feelings, they want to accomplish goals, and be included like any other person would. As an occupational therapist I will aim to advocate that words hurt and people should not exclude individuals with disabilities because they are important just like any other individual. I hope to make an individuals experience life changing because we all deserve the very best no matter an individuals situation. As Dr. Keisling's said, disability is part of a natural human experience. We need to love one another and as an occupational therapist I want to break hateful words and treat everyone fairly.