Looking ahead, looking back.

In class this week we did in activity that simply involved us closing our eyes and listening to our instructor guide our minds to visualize ourself infront of a mirror at 75. I had a hard time actually seeing myself, but instead I kept seeing my grandma, who is currently 82, and in early stages of Alzheimer's. At first my mind wondered to the more obvious outer appearance changes. Of course I didn't really like what I saw, but it was just that, outer apperance. It was when I looked on the inside that this activity became more emotional for me. I continued to think of my gma, as I was thinking of how I got ready and how hard simple things were for me to do that I once did without second thought. I pictured myself with several of these physical changes that I have seen in my gma, and thought of the emotional impact it would have on me. When did these "simple" tasks become so hard? Starring into the "mirror" my "old" self kept seeing me at my current age, 26, and wondering where in the world did the time go? Did I do what I wanted with my life? What could/should I have done differently? What would I do to see my son again splashing in the waves at the beach for hours on end. WOW, where did my life go?

Everyone is going to get older, it is a part of life we must accept. That doesn't make it easy though. After this assignment, I realized that each day I am here is special, and it is up to me to make the most of it; one day, I won't have a chance to go back and do it over.

I found an interesting blog on the perspective of aging, and wanted to share http://http://coachirisblogs.com/2010/11/21/thinking-learning-laughing-crying-aging-end-of-life-reflections/

I am going to take this week to tell you about a personal mission that I have set out on within my own family. We are not very far into this semester concentrating on geriatrics and it hasn't taken much reading in the textbook or many class discussions to confirm what I already knew - that my own parents are not where they need to be. My dad retired 4 years ago and my mom has not worked since my siblings and I were young. My dad is a social person and that need was met through his work. Since he retired, he and my mom have not made (in my opinion) a successful retirement transition and it makes extremely sad. They live in a very rural area and don't seek out any outside activities. They stay at home and take care of the basics of IADL's for the house and yard but the only outings are to the grocery store, bank, and doctor's office. They are only in their sixties but their mindsets and behaviors depict a much older age. I am very concerned about this situation because I know there is so much more for them to be experiencing in life and that is becoming even more apparent to me through my studies in OT. I make small comments here and there about them needing to "get out" more but they get very uncomfortable and change the subject quickly. After we made plans for our service learning project in one of my classes I could see clearly the steps I needed to take to help my parents get out of their "rut". I think just making general statements like "you guys need to get out more" is not effective. But if I could present actual actions to take, maybe they would be less overwhelmed by the whole thing. What I have done so far is contact resources in their area. I called Social Services and local nursing homes to see what volunteer opportunities might exist. I left my phone number so they could call me if they came across an elderly person in the community who needed a ride to the doctor or something of that nature. My parents are very kind, generous people and I feel if given a specific person in need, they might act. I also discovered there's a senior center nearby with loads of activities that might appeal to them such as horseshoes, crochet class, computer classes, etc. I am having a staff member mail me their newsletter and schedule for June. I don't know how effective my efforts will be as my mother and I have already gotten into one argument about it. I am going to really tone it down a bit in my conversations with them and try to be more stealthy in my attempts like mailing the newsletter to my mom so she doesn't feel as though she is being put on the spot. Perhaps some of you have had a similar position and may have some advice for me? Below are some links to the resources I tapped into in my parents' community. I know they are of no direct use to any of you but it maps out the course I've taken so far in case any of you ever need to take similar measures. http://www.northamptonnc.com/socialserv.asp Social Services
http://www.ncdhhs.gov/aging/services/scoper.htm Senior Center
http://www.northamptonnc.com/health.asp Health Department (Office on Aging, Meals on Wheels, etc.)
http://britthaven.com/index.jsp?sec=NC&city=Jackson,%20NC Nursing Home (contacted Activities Director)
http://www.linkingseniors.com/senior_center/sc_northcarolina.htm Listing of NC Senior Centers

Getting to Know a Stranger.

I started my fieldwork today and I have to say that I was very nervous. Although I have been to two other sites, I was more comfortable with those sites because I was some what familiar with working with children, and had been to the other site before. But, I had never worked with the elder population. The only elders I have been around before were my grandparents, and unfortunately I never got to know them well before they passed away. But, now I see that my mother & father are both retired and I will probably be the one providing care to them, unless they are in a retirement community. I have 4 siblings, and each one of us has our specialties, but we are all very connected and love our parents very much. And between all of us, I know we can really take care of our parents the way they deserve.

I saw that same love in my client's eyes today. She sat quietly with her granddaughter until I entered the room, and she could not wait to tell me about her children. Immediately, I was put at ease. I have commonalities with my client that I can be even more involved and see where she draws her strength. How and when I can push her to do her best, while at the same time teaching her that she has limits. I already have so many ideas in my head about what I will be able to do with this client, and I can not wait to go back.

During our meeting my fellow classmates and I were responsible for getting as much information from our clients as possible, in a short amount of time. Well, after realizing I was going to ask a ton of questions to a perfect stranger I looked to my trusty computer to come up with some other questions that I could ask to get more pointed information about who she really is, and how I can use that information. I found so many sites that had a list of questions, but I wanted something that she and I could both use to learn about each other and this is the site that I found. Getting to Know You. It needed to be short enough to do in the time available, but long enough for my client to feel like she is getting to know me. But, the funny thing is that I did not need any of them. I was able to think on my feet and came up with questions I did not even have any idea that I would ask. It was a great experience for me, but I know that others have a hard time thinking up a conversation topic when they meet new people. So, I hope the site I attached will help someone. And I wish you good luck in your endeavors to meet new people & strike up a conversation.

Ms. Peaches

I work for an elderly couple in the area. I care for Ms. Peaches who has Alzhiemer's, while her husband does errands, goes to excercise, or goes out to breakfast with friends. I have been working with Ms. Peaches for a year and when I started she was able to help do laundry and make her lunch. She's had periods of anxiety, aggression and days where she wanders the house opening and closing the blinds. But I have noticed in the last 2 weeks that she seems less cognitively aware of her surroundings and she doesn't say "hello" to me in the mornings any more.
That makes me sad.
The family wants to keep her at home. I understand wanting to keep their loved ones near. But I see Ms. Peaches just sitting in her chair watching TV, not being engaged. I have tried my best to engage her in conversation, we look through her new magazines and we made a memory book.
The daughter called the other day to "vent" about her dad. He's waking Ms.Peaches up at 6:30 every morning to get her ready for the day because that's what she did before she became ill. I'm sure the husband will broch this subject with me at some point. I've been mulling over in my mind how this conversation will go. What direction will this conversation take? Why does he feel that she needs to keep the same schedule? Does he feel that letting her sleep is giving in to the disease? I'm anxious about this conversation but I feel that I'm prepared to guide him through whatever decision he makes. Thanks to my "therapuetic use of self".

Should Mom Drive?

Until recently I have never thought of my mother as too old to drive. She worked out at the Y 5 days a week and went golfing with her brothers every Thursday. She was doing all the cooking and most of the cleaning for my sister and her husband who live with her (my sister never left home). She also cared for my father who needs help with ADLs and IADLs. She suffered a small stroke last week and though she has told me she is totally fine, and ready to get back to her routine, this has really made me realize she REALLY IS 80 YEARS OLD! Her MRI showed that she's had several mini-strokes in the past. She is itching to drive but she is waiting on clearance from her doctor who she will be seeing this Friday. It will be interesting to hear what he says. I remember her telling me she told her father he couldn't drive anymore when he was in his 60s. She had no reason other than she thought he was too old to be driving anymore. I'm worried this conversation is going to come up when I go to visit her at the end of this summer. It will be difficult if I think she is not safe to drive anymore. I know how important her activities outside the house are to her. She gets lots of her social contact at the Y and she is the "baby" of her church friends and is often the one who drives them around. My sister will not be happy since she will bear the brunt of the burden of being the chauffer and she will no doubt try to convince me our mother is safe to drive in town.

We talked in class about driving not having to be an all or nothing deal and I thought that made perfect sense but I came across a couple of articles stating that accidents are not just happening to elders in heavy traffic on unfamiliar routes but also close to home. They are just not as quick to react, have visual perceptual deficits, and have problems focusing. Also, knowing that my mom has been having small strokes makes me worry what if the next one happens while she's driving. What if she injures someone else? I know that would devastate her more than the effects from a stroke. At what point do the "what ifs" weigh heavily enough to take a parent's license away? It's so much more than just a license and the impact is felt not only by the person who is no longer able to drive but also everyone that person associates with as well. I can only hope it's the doctor who makes that call.

When is it time to put brakes on the elderly?

Older drivers, elderly driving, seniors at the wheel

How do we relate...

I was thinking this weekend after I heard the song "This Ain't Nothin'" by Craig Morgan. If you have not heard the song, it is all about how an older gentleman is faced with a natural disaster & a camera crew puts a camera in his face and wants to know how ever will he go on. But, what they did not realize is how much the man had already gone through in his life and that this does not even compare with the disasters that have happened to him all through his life.

So, I came to the realization a long time ago when I was working as a camp counselor that all of us relate in some way. Whether it is with how many siblings we have, whether our parents are divorced, or we live/work in a particular area. But, some times this thought is lost and we need to get it back so we can really relate to the people in our lives. They may only be in your life for a short time, but you never know what kind of impact they may make on your life. I know that I am a better person for knowing the young and older generations. I have worked a lot with the younger generation, and now am going in the opposite direction through schooling. And I am taking these thoughts in with me so I can get the most out of the experience, as I believe that everyone should.

If you would like to see the lyrics of this song, please click:Craig Morgan - This Ain't Nothin'

I hope you can listen to the song at some point and really appreciate how much our lives are changed and shaped by the events that occur, and how much another person can learn from another's experiences.

Working in Geriatrics

Many people have asked me what population I want to work with after I graduate, and my immediate response is peds, followed by, anything BUT geriatrics. Being how geriatrics is one of the biggest job markets out for the OT profession, I doubt that I will make it through my life without having some job in a geriatric setting. I have started to see this "population" in a different perspective through my FW 1 experience, and classes. I was surprised at the fact of how much I enjoyed meeting these people and hearing the stories they tell, even if I could only listen for a few minutes. I found myself feeling guilty that I have been "overlooking" this population as though it wasn't important or they didn't exist. It is easy to see an elderly person as just who they are on the outside; yet it so important that we not forget who they are on the inside, and they were once that young 20 year old that had nothing but time. Just because they are "old" doesn't mean that all those years of life and experiences has disappeared! They are just as much alive as I am! No wonder depression is so common in elderly; you have lived all these years, just to be considered another "old person in a rest home". No matter what population my career leads me to serve, I will be evermore grateful for the experience I have and will have in this area of practice.

I know there are many quotes out about aging, and I ran across one the other day that I love:
"How old would you be if you didn't know how old you are?" - Satchel Paige
(I thought that was a good question to think about, no matter your age!)

a new view

Several years ago I worked as a CNA (certified nurses aide) in an upscale retirement
community in the area. OOH, how I hated that job!! It was the hardest job I ever had, it required alot of physical strength which I do not possess. I loved my clients and loved listening to their stories. But it was really about getting 8 or 9 clients fed, bathed and into bed by 11:00. I felt as if I was missing something,I wanted a personal connection with my clients and couldn't get that as a CNA. Something great did come out of that job, I discovered my true calling in life, to be an OTA. (and not a nurse as previously planned)

I'm interested to see what my feelings/perpectives will be working in geriatics now that my job title has changed from CNA to OTAS. Will I have the feelings of fulfillment that I was lacking when working as a CNA? Will I be a better OTAS because of my experience in geriatrics? I said I would never go back to geriatric but now that I have some years behind as a CNA, I might really love. I'll keep you posted.

Better Understanding My Role

As I was reading Chpt. 3 in our book this week - "The Aging Process" - I had an "aha" moment. Up until now I've not been 100% clear on exactly how some of our therapeutic interventions help the geriatric patient. For instance, I have thought on more than one occasion, why would we have to teach an elderly lady how to make a sandwich or heat up a bowl of soup when she's been cooking her whole life? Just because she broke her hip doesn't mean she's forgotten every skill she ever had. I totally understood teaching hip precautions and use of AE like a reacher but was a little befuddled on how making a sandwich tied into their therapy. This chapter allowed me to realize that the geriatric patient is not only dealing with the injury/illness at-hand (ex. broken hip) but they are functioning within a body that is not the body they once had and does not perform the same way. Where a patient may remember exactly how to make a sandwich, she may be using hands that don't move the same or have the same sensation. She may have a heart and lungs that don't allow her to stand as long as she once could. And on top of that, her hip is broken! I always knew that aging meant "slowing down" but the way this chapter broke down all of the physical changes that take place in the aging body, it helped me to make some of the subtle connections that were lacking in my own understanding of my future role as an OTA in the lives of the elderly. I'm certain it's hard to face having to perform tasks that were once so simple in a new and modified way than the way you've done it your whole life. I think it's important for us to instill in our geriatric patients the mindset that regardless of how you do something, the fact that you can still get the job done is what matters most. Hopefully we can foster a sense of pride in maintained achievement where there would otherwise be a sadness for lost function.

What is Old Age?

I came across About.com Senior Living and read people's responses to "When do you think old age begins and why?" There were lots of the standard it's not the number but how you feel type of answers. The common thread I got from these people was that they were active and enjoying their lives and had connections to their community. The other comments were physical decline and loss of independence as signs of old age. One person summarized it nicely and said "you are old when you give up". It's not so much what you've lost in looks, physical abilities or independence but what you plan to do with what you have left.

Looking Back

Sometimes we get so caught up in the day to day "to-do's" that we forget to realize the good we have done in that day. I have found this true in my FW at LS. It seemed that everyweek, though I much enjoyed it, was just a matter of getting the activity done. I remember often leaving there thinking I didn't make much of an impact, and why was I even there. It wasn't until this final week during the party and looking back at all the things we have done there with the guys. I watched their faces light up when they saw their picture on the projector, and some of them remembered doing these activites. As I watched through the slideshow of pictures it hit me; we HAD done alot with them, and made an impact somehow in their lives. I remember thinking at the beginning of FW that something "huge" had to happen during a group for it to be called "successful". I have realized that this is far from the truth. For many people just being there and connecting to someone is a great deal.

I learned a lot about myself. I was able to work well with one client in particular who was so severely disabled, that when I met him from the first time I could hardly look at him without crying. Later that day, I spoke with my sister who gave me great words of wisdom. The next week, I was surprised at my ability to work with this client with ease. It soon was apparent that I had made a connection with him, and felt inspired to work with him every week. I don't know where this strength came from, but I am very blessed to have been a part of this experience. I find it hard to put into words exactly how I feel about working with him, but I know that it was a huge growing moment for myself.

I am so thankful for having the opportunity to get to know each person I worked with. I couldn't have asked for a better FW experience. I take away from there many things, but one for sure, my clients will have just as much (if not more) impact on my life as I did theirs, and I am evermore thankful to have been a part of each one of their lives.

I found this website which is a blog by someone with a TBI, and thought it was interesting to share. http://blog.brain-injury-online.com/

Final Goodbyes

Today was a great day at my field work site. I celebrated the last day of many days spent with some the most wonderful guys I ever met. Thinking about my experience with these guys and how far I have came just from working with them made it kind of hard to say goodbye. After talking to some of the guys and listening to how they felt about today being my last day gave me a feeling of acceptance. I really feel I made a positive impact on their lives, as well as they have on mine. Even with their disability they managed to stay positive and hopeful each day I spent with them. They can put a smile on anyone's face with a simple joke or just by smiling at you. With that being said, I can truly say I will miss them very much.

Storytelling

During my fieldwork experience with individuals with developmental disabilities, I discovered a new tool for my OTA toolbox - storytelling. I am still amazed at how small, everyday items and ideas can be transformed into therapeutic tools. During our weekly sessions at the facility, we have always started out with ~20min. of seated exercise. During a recent session, I realized that the group responded much more enthusiastically to moves that were descriptive, such as "climb a ladder" or "do the backstroke" vs. using exercise terminology or just modeling a move for them to mimic. The night before the next session, I sat down and briefly jotted down a story to use during the exercise session the next day. It was a journey to find a treasure chest and the moves included:

Run, a bear is chasing us
Climb up the tree
Paddle the boat
Do a celebration dance (when we found the treasure)
Punch the robber
Kick the bandit

The response from our group was incredible. The majority of the group was standing vs. their usual sitting during exercises, clients who had never participated were actively engaged, and it became very interactive with the participants helping tell the story. Storytelling is definitely a tool I will use in the future as an OTA. I think it's especially useful with children and individuals with developmental disabilities. This is an interesting website I found on storytelling: http://www.storyarts.org/classroom/index.html