Tues 30th Aug 2016 How OT’s Add Value to the Low Vision Team – with @LYBOT

This week Laura @LYBOT will host #OTALK

Introduction
About 285 million people in the world have a visual impairment: 39 million are blind and 246 million have low vision. Well over half of these individuals are over the age of 50. Approximately 90% of these individuals live in developing countries, where they may not have access to correction for refractive errors (e.g. glasses), eye health services, or OT. Leading causes of visual impairment are cataracts, refractive errors, glaucoma, and macular degeneration. (World Health Organization, 2014). Low vision can affect occupational performance in many areas, from community mobility, to physical exercise to chosen leisure activities (e.g. Schoessow, 2010; Rees, Saw, Lamoureux & Keeffe, 2007). Clearly this is a large community of people who could be served by OT’s, and who perhaps are already! During this week’s #OTalk we will dive into a conversation about how OT’s are contributing and can contribute to the team of people serving individuals who have a visual impairment. The following are some ideas to get us started. OT’s can help:
● Enhance occupational performance and support complex needs of individuals with multiple conditions
● Contribute to an assessment of visual function
● Assess cognition, motor skills, and positioning as they relate to device and compensatory strategy use (Schoessow, 2010; Kaldenberg, Markowitz, Markowitz & Markowitz 2006)
● Make environmental modifications (e.g. add contrast or improve lighting)
● Work with individuals to highlight and use their strengths
● Recommend and train individuals for the use of assistive devices with consideration of environmental, social and personal factors.
Terms
As OT’s concerned with the empowerment of individuals and communities, we feel it is important to address the terms we choose because words can make a big difference in shaping attitudes and shifting awareness. Person-first language is promoted within most North American organizations/communities, while terms such as ‘disabled person’, which emphasize the social model of disability (i.e. a person is disabled by the society) are favoured in other parts of the world. Many members of the blind community have chosen to favour ‘blind person’ as an identifier for individuals who have a range of visual impairments. I (Laura) personally prefer to refer to myself as a blind person, choosing this identity first language because it emphasizes that I consider blindness to be a valuable part of who I am. Some use impairment to describe the embodied experience and disability to describe the interactional experience wherein a person is in some way barred from participation; however, the terms impairment and disability have also been criticized for having overly negative connotations. Linguistic choices are important, controversial, ever evolving, and diverse. In our discussion we use the term ‘person with a visual impairment’ as a compromise between the social model (i.e. the disability is not within the person, as person ‘with’ a disability would suggest) and discourses regarding the importance of acknowledging the embodied experience of an impairment. During the discussion we may use other terms, as will individuals who join the conversation – you are encouraged to think about what terms you might choose and why.
● Following are few interesting links on the topic: a blog on Gotta Be OT, a blog by Cara Liebowitz, and a blog by Rachel Kassenbrock.
What is Happening
Following are profiles demonstrating how OT’s are contributing to the empowerment of people who have visual impairments – they are drawn from the Canadian Association of Occupational Therapists’ OT in Low Vision Rehabilitation Network.
A Clinical Example
Melissa de Wit OT Reg. (Ont.) is working in stroke and geriatric in-patient rehabilitation. She is part of a passionate interdisciplinary in-patient team and collaborates with an optometrist in functional assessment and treatment of visual impairments resulting from acquired brain injury, including visual midline shift, visual neglect, impaired visual memory, visual field cuts, diplopia, and cranial nerve palsies. She has participated in several international specialized courses associated with assessment and treatment for visual processing disorders, neuro-visual postural therapy and prism therapy. Melissa is certified in Neuro-Developmental Treatment and is an authorizer for mobility aids in Ontario, Canada. She also has a passion for therapeutic horseback riding and is certified with the American Hippotherapy Association. Other occupational pursuits Melissa enjoys include being a proud mother, playing soccer, horseback riding, reading and gardening.
A Research/Clinical Example
Dr. Tanya Packer is a professor of Occupational Therapy at Dalhousie University in Halifax, Nova Scotia, Canada. She has been heavily involved in low vision rehabilitation research around the world. In Australia, Tanya contributed to research on, among many other topics, the psychological and emotional aspects of vision loss. She was also involved in research on self-management programs for people with vision loss , which were associated with improvements in occupational participation and well-being. A notable self-management program that Tanya co-developed in Australia, called Living Safe, has, with her efforts, been implemented at CNIB in Halifax. Living Safe teaches self-defence skills to people with a visual impairment. It aims to increase confidence in home and community environments. A CNIB article showcasing positive reviews of the program can be found here. Currently, in addition to her research work, Tanya serves on the National Board for CNIB and works closely with Dalhousie students who complete fieldwork placements at CNIB.
Conclusion & Invitation
From promoting research and evidence-based practice, to using their holistic OT perspective to empower individuals in removing barriers to participation, OT’s have a strong role to play within vision rehab. We gave only a couple of examples of how OT’s are contributing, and invite you to share more when you join us on August 30th 2016 at 12 noon Pacific Daylight Time (click here for a time-zone conversion). We will discuss questions such as:
● How can OT uniquely contribute to the interdisciplinary team in vision rehab?
● How can we prove the value of OT in vision rehab?
● What experience of working with people with visual impairments have you had?

Note 1: As the OT in Low Vision Rehabilitation Network develops we are working on articles, workshops, and presentations to discuss the role of OT in this area. The transcript from this #OTalk may be used to contribute to a greater understanding of the global story. Any ideas or tweets used will be anonymous. If you do not wish to have any of your tweets or a particular tweet used, please let us know. The research ethics board at the University of British Columbia has been consulted and it was concluded that ethical approval for this was unnecessary.
Note 2: Thank you to Ellen Johnson, Kathleen Sullivan, and Minnie Teng for their assistance putting this blog together.
References
Kaldenberg, J., Markowitz, M., Markowitz, R. E., & Markowitz, S. N. (2011). The multi-disciplinary nature of low vision rehabilitation- A case report. Work, 39(1), 63-66.

Schoessow, K. (2010) Shifting from compensation to participation: a model for occupational therapy in low vision. British Journal of Occupational Therapy, 73(4), 160-169.

Rees, G., Saw, C. L., Lamoureux, E. L., & Keeffe, J. E. (2007). Self-management programs for adults with low vision: needs and challenges. Patient education and counseling, 69(1), 39-46.

World Health Organization. (2014). Visual impairment and blindness: Fact sheet N°282. Retrieved from http://www.who.int/mediacentre/factsheets/fs282/en/

#OTalk – 23rd August 2016 – The impact of dysfunctional sleeping patterns on inpatient mental health facilities

This week’s #OTalk will be hosted by Erin (@erinnnnn14). Join us tonight on Twitter using the #OTalk hashtag at 8pm GMT+1 (click the link to convert to your local time – opens in new window).

 

Sleep as an occupation is still a frequently contested concept in our profession. Literature suggests that it is because sleep is considered as ‘time wasted’, something that we are not directly engaging with or something we can influence or direct (Green, 2008). However, the lack of, or dysfunctional sleeping patterns, can affect the occupational performance of the activities that we engage in during the day. Sleep problems can have a detrimental affect on our physical and mental health. Frequently, inpatient mental health facilities offer ‘Sleep Hygiene’ groups to facilitate better understanding of the importance of ‘good sleep’ but is this enough to be able to support patient care and recovery?

 

I’m currently an MSc (pre-registration) student. I am just finishing a placement in a mental health rehabilitation hospital for males. The therapy programme is rich, varied and tailored towards the needs of the patients however sleep is something that continually affects patient engagement. I’m really interested in hearing your thoughts and experiences and how we should best proceed as professionals to better support the patients we work with.

 

Questions I would like to consider this evening with regards to this are as follows:

 

  1. (The big question!) Should we consider sleep as a meaningful occupation?
  2. What role does OT have with regards to sleep dysfunction?
  3. How can better sleep routines be incorporated into the clinical environment?
  4. If sleep is considered as a coping strategy for a patient then how can OT support them to access other means of managing?
  5. What strategies can be put in place by an MDT to better support functional sleep routines for patients?
  6. What are the advantages and challenges for the profession with regards to developing our understanding of the role of occupational therapy and sleep?
  7. What are your experiences, challenges and difficulties in your settings with regards to sleep?
  8. Final thoughts, ‘lightbulb’ moments and hopes for the future for the profession and sleep.

#OTalk 16th Aug 2016 – OT Show 2016 – Chat 1

“Much of the CPD provided by The Occupational Therapy Show has previously been clinically focussed so that delegates can take what they have learnt back to practice to provide a more enhanced service to their clients.

 

For 2016, while there will still be plenty of clinical focused seminars, there will also be seminars looking at research within Occupational Therapy. The College of Occupational Therapy states that “It is clear that occupational therapy research will take place within a number of overarching contexts, and prime consideration must be given to the following aspects when developing research questions:

 

Gaps in the existing knowledge base can only be identified for research from a thorough literature search and systematic review of existing evidence

Government priority areas are the main drivers for much supported research activity

Occupational therapists should focus individual research endeavours within larger programmes of research, maintaining awareness that funders prefer multi-professional research”.

 

With seminars hosted by Avril Drummond, Dr Claire Ballinger, Suzanne Martin, Dr Jo Fletcher-Smith and Lynn Legg, they will provide you with all the information you need to get into research, being able to translate research effectively, what research has done for Occupational Therapy and much more.

 

Questions to be discussed tonight , and explored in more depth at the show are:

Why should clinical OTs be interested in research?

How would you start doing your own research?

Do you find it difficult to understand current research papers?

How could you get involved in research without losing clinical skills?

What has research done for OT?

 

Make sure to attend The Occupational Therapy Show on 23rd and 24th November 2016 to find out more.”

 

Tonight’s hosts are:

@AvrilDrummond1 and @TheOTShow

 

Post Chat Updates

Online transcript from healthcare hashtags. 

PDF of transcript: #OTalk 16 August 2016

The Numbers

2,181,732 Impressions
619 Tweets
43 Participants

#OTalk Participants

#OTalk – 2nd August 2016 – The identity and role of an occupational therapist working in the charity sector.

On the 2nd August 2016, at 8pm (UK) for other time zones Michelle Gersh @mershy73 will be hosting #OTalk. Michelle would like to explore the roles and identity of other occupational therapist that work with in the charitable sector.

Michelle has suggested some questions to get you thinking about this topic:

It has become more and more common for occupational therapists to take up emerging roles within the charity sector. If you are one such occupational therapists, have your experiences been positive or negative?

If you are not working in the charity sector do you know other occupational therapists that do or have you considered it?

What are the unique rewards of working in the charity sector?

What are the unique challenges of working in the charity sector?

Are your skills as an occupational therapists recognised by your employer?

How do you maintain your identity as an occupational therapist?

How do you maintain your continuing professional development if working in a non occupational therapist role?

What are your experiences of supervision within the charity sector?

I hope this chat will connect like minded occupational therapists and create new ideas and opportunities for further development as well as pave the way for tomorrow’s occupational therapists who are still in training.

Post Chat Updates:

Online Transcript from HealthCare Hashtags. 

PDF of Transcript: #OTalk – 2nd August 2016

The Numbers

507,317 Impressions
176 Tweets
34 Participants

#OTalk Participants

26th July 2016 Medical Tourism and Occupational Therapy

This week @Sweet_Hiral will be hosting #Otalk

Medical Tourism is booming these days. People are willing to get medical services from best possible care facilities/organizations but lower prices. The definition suggests, “As the cost of healthcare began to rise in industrialized countries, particularly in the United States, the face of medical tourism began to change to include individuals seeking affordable and timely alternatives to surgery or treatment in their home countries” (Bennie, 2014) and such needs created the idea of the Medical Tourism. According to Kher (2006), “Medical services in India are particularly affordable, with prices as low as 10% of those in the United States” (as cited by Horowitz, Rosensweig, & Jones, 2007, p. 2).

As cited by Howard Bye, the reasons for changing health care trend for medical tourism is:

“(1) to receive specific medical treatments not found in their countries;
(2) to obtain more immediate surgery or other medical care;
(3) to receive lower-cost dental and medical services;
(4) to get treatment not covered by their health insurance;
(5) to purchase cheaper prescription drugs; and
(6) to shop for medical procedures not approved by regulatory bodies in their home countries, such as the Food and Drug Administration” (as cited by Bennie, 2014, p. 584).

I found an interesting article that suggested a few facts on why the medical tourism is being utilized more among people from developed countries like the United Kingdom and the United States.

Bennie (2014, p. 585) suggested following four groups of clients who prefer medical tourism for health care services.
• Some are from countries that ration health care, such as Canada and the United Kingdom, and are looking to avoid long waiting lists for treatment in their country of origin.
• Underinsured Americans, including U.S. retirees who do not yet qualify for Medicare
• A third group is composed of middle-class Americans seeking cosmetic surgery that is not covered by their insurance, or that is cheaper than their insurance deductibles
• The final group is the affluent upper-class of developing countries, which seeks medical care in the United States or other developed countries to receive a higher quality of attention than the patient-tourist would win at home.

I wanted to discuss the scope of medical tourism in the occupational therapy field. The occupational therapy service charges are also becoming expensive. In some countries people get treatments daily and in some countries the treatments are restricted to once or twice a week as per the medical insurance policy coverage. That means, services are pretty expensive and not everyone is willing to afford daily and consistent therapy. At such point, I believe, medical tourism is a great option for specific conditions for example, learning activities of daily living or getting trained on how to modify your home environment etc. The qualified occupational therapist would help client to gain recovery within budget even if they count tourism-flight fare and stays. For example, these days many developing countries are providing fascinating medical tourism packages that includes therapy charges with their long term stay.

There is always a thought when you think about getting treatment with minimal prices. But, I believe that is a myth. Today, health care education and organization standards have been raised to international qualification levels. So when developed countries are welcoming medical tourism, they do not risk those standards to get any legal or ethical negative aftereffects. The series would be of similar assessment scale standards, procedures, and equipments to get a name in the OT-tourism field. I believe, the OT tourism would serve the purpose of providing OT care services to the population that never thought could afford it in the same country.

Following questions in this OTalk session will be discussed:

1. What is the client-therapist ratio in your country of work? Are those equivalent to the necessary standards from the governing organization or it is less than what is needed? (For example, one therapist needed per 50 population).
2. Do you think Occupational therapists should know each other globally to develop medical aka OT-Tourism?
3. Have you ever sent any client to some other occupational therapist in another country?
4. Do you think the therapeutic service charges should be similar globally to avoid such tourism ? or you think that it is a great opportunity for clients to get therapy procedures in a budget friendly manner?
5. Have you thought about enhancing your OT-contacts globally for the medical tourism purpose for your client? Sometimes patients from another country visit your country, and at the time of ‘good-byes,’ such contact lists could help you become a global therapist if you could guide/refer them to continue similar therapy in their country.
6. Are there any threats you feel with OT-tourism?
7. Do you know any facility that runs OT-Tourism?
8. Share your Final thoughts

Reference

Bennie, R. (2014). Medical tourism: A look at how medical Outsourcing can reshape
health care. Retrieved from
http://www.tilj.org/content/journal/49/num3/Bennie583.pdf

Horowitz, M. D., Rosensweig, J. A., & Jones, C. A. (2007). Medical Tourism: Globalization
of the Healthcare Marketplace. Medscape General Medicine, 9(4), 33.

Post Chat Updates

The Numbers

1,145,441 Impressions
351 Tweets
25 Participants

#OTalk Participants

Online Transcript from HealthCare HashTags. 

PDF of Transcript: #OTalk – 26th July 2016

 

#OTalk 12th July 2016 – Our #OTMoments

My sister, also an OT, but not a Twitter faring one,came up with this topic. I thought it would be fun for us to share our OT journeys through recollection of some key #OTMoments, it might also be helpful for those looking to study the profession, and those newly graduating, and well, all of us as a little reflection.

Here are some of the questions that we will use to guide the chat tonight. Please do remember to follow guidelines re confidentiality.

  • When you were little what did you want to be ‘when you grew up’? (I wonder how many of us can say OT?)
  • When do you first remember hearing about OT?
  • When did you decide to study OT?
  • What was your route onto your OT course?
  • What university/college etc. did you attend?
  • What was your favourite part of studying to be an OT?
  • When was the moment when you knew OT was right for you?
  • When did you feel confident to call yourself an Occupational Therapist?
  • Have there been any occasions that have made you question being an OT?
  • When have you truly understood the power of occupation? In your own or others lives?
  • What are some other key #OTMoments in your career so far?
  • What #OTMoments are you working towards now?

Hope to see you tonight. @kirstyes

Post Chat Updates

The Numbers

2,619,929 Impressions
855 Tweets
94 Participants

Online Transcript from healthcare hashtags. 

PDF of Transcript. #OTalk 12 July 2016

#OTalk Participants