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.