The view out the window

A few years ago I was working with a lady and her caregiver in a lovely home at the end of a tree-lined cul-de-sac.  The picture window in the great room at the back of her home looked out onto a park-like setting with a collection of bird feeders and baths at varying heights.  Feathers fluttered, birdseed scattered about, and splashes sparkled in the sun as those birds had a blast out there!  And the delight for my client was clear . . .

bird bath, 3 birds, splash, garden, summer, spring

She got it right.  I felt honored to be her occupational therapist in home health care to assist in problem-solving some transfer techniques as her condition continued to deteriorate.  I’ll call my patient “Sandy.”  She once worked as a Vice President of a large local car dealership.  Knowing her neurological condition was progressive, Sandy and her husband designed and built a completely accessible home long before the term age-in-place became mainstream.  I recall zero thresholds to enter the front door, wide doorways and hallways, an elevator for accessing the second floor, and more.  One key element was missing, however:  a mechanical lift to assist her petite caregiver in transferring Sandy from her recliner chair to her modified wheelchair.  Sandy didn’t want one however, which posed a grave risk for injury to her and her caregiver.  They decided to have Sandy’s husband continue to complete the transfer with maximum assistance.

I quickly learned that the focus of Sandy’s treatment would need to be on the tasks that mattered most to her.  Our treatment plan included training her caregiver in safe methods to provide Sandy passive and active-assist range of motion exercises, beginning when the patient was still in bed.  This positioning protected Sandy’s shoulder girdle and allowed for better body mechanics for her caregiver providing them.  When Sandy was out of bed, her focus changed to sensory delights for her abilities that remained intact:  a large T.V. screen cable-connected to her laptop and the outside world, hard candies, and her feathered friends just outside her window.  The last one was my favorite and the one that came to mind as I looked out my own sliding glass door this afternoon.

Splish-splash, they were taking a bath!  First one then two then one chasing away a third with the flaps of her dripping wings, oh my!  I was resting after a long morning of gardening at our local extension office when this simple pleasure caught my eye and my heart.  I wondered how Sandy was doing on this very pretty Fall day?  Oh how I wish she knew how much she taught me about savoring moments like these.  I am so grateful for the opportunity to share this insight with you as well.  Please take a moment to enjoy something like this today too, k?

Take care,

Julie, O.T.

Video on Fall Prevention Strategies

Thank you to the American Occupational Therapy Association for this video on simple strategies for preventing falls around the home.  Falls are not a part of normal aging nor dealing with chronic illness.   Many simple strategies can help to prevent falls when they are caused by hazards in the living environment.

http://www.aota.org/About-Occupational-Therapy/Patients-Clients/Adults/Falls/prevent-falls-in-home-tips.aspx

User Safety

Sometimes we find ourselves in a situation where we don’t have exactly what we need to get a job done.  When the “job” is taking care of ourselves, we might easily substitute say, a household item, for a proper piece of durable medical equipment.  I understand this.

However when the “job” is taking care of a loved one, we need to be really careful.  Often when first posed with an accessibility or care need does the loved one want to inconvenience us or cost us extra time or money.  In doing so our loved one may overestimate his or her ability to help (e.g. reach something from the floor or take a shower after a medical procedure) posing a risk for injury to both of you!  Here are some examples.  See if any sound familiar to you?

CASE #1:  An item falls to the floor near a door where a person with low vision has just entered on a rainy day.  Oh dear.  The floor is wet but it is hard to see and the keys are lying right next to the puddle!  Rather than asking for help or even gently nudging the keys to another place next to a chair (or counter to support body weight and balance), he or she reaches down and risks slipping on the wet floor.  The dog or cat strolls by providing a bit of distraction, further affecting the ability to make a good decision as well.

CASE #2:  Mom is recovering from surgery and anxious to get back to work.  She prides herself in her independence and keeping her home nice for guests.  Adding any bathroom equipment would bring a “hospital” feel to the rest room that is also used by family when they visit.  How embarrassing!  So she has her son retrieve a 2-step, step ladder from the garage and place it inside the tub/shower to use as a shower chair instead of purchasing a shower chair and tub rail.  Both of the latter could be removed for guests, placed in storage when no longer needed, and even be taken with her when travelling.  Oh well.  The step ladder has sharp edges from that project cleaning the gutters last Fall and ends up scratching her leg when using it as a shower chair.  Mom uses the towel rack as a “light hand hold” for about 2 weeks, eventually loosening the wall anchors and posing a grave risk for falls should it come loose sometime getting into or out of the tub/shower.

CASE #3:  Brother is quite independent during the daytime now, maneuvering his wheelchair and going to the bathroom independently since recovering from a serious stroke awhile back.  He likes to surf the internet when home alone but has no cell phone or land line available to him until evening when the family returns.  One morning he wakes up to the smell of natural gas and realizes he has no easy way to get out of the double-front door on his own or call for help.

As you can determine from these examples posed by everyday activities, there are simple solutions to these problems when we prepare ahead of time for them!  In my Living Safely Program presentations I would divide the topic into 3 areas:  Medical Conditions, Slips-and-Trips, and Behavior.  In Case #1, every effort must be made to dry ones footwear when entering the home in addition to minimizing glare from lighting or sunshine on smooth flooring surfaces.  The latter makes it nearly impossible to see water on the floor.  In Case #2, we need to provide the right equipment for the right task, check it often, and offer to help with the softer concerns (such as appearances) when necessary.  In both Cases #2 & 3, we need to problem-solve scenarios with our loved ones in advance and include them in coming up with the best solutions.  Emergency contact systems are now available that look more like a “Fitbit” for kids than a wrist-operated medical alert button; an emergency-only cell phone is quite inexpensive to own and operate these days.

fit-bit

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We could chat at length about other considerations in each of these situations.  Feel free to comment your suggestions and experiences below.  I would love to hear from you!

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Take care,

Julie, O.T.