OT 537 Neuro Note #2: TED Talk on Parkinson's disease

I watched a TED Talk called "Simple hacks for life with Parkinson's" given by Mileha Soneji. I chose to watch this talk because of our recent lectures in class on Parkinson's disease. Mileha Soneji has an uncle who was diagnosed with Parkinson's disease. Before his diagnosis, she described him as being playful and always the center of attention. After his diagnosis, he began to hide from people because he didn't want to be noticed. She noticed how much her uncle struggled just to get around using a walker, and she decided she wanted to do something about it. She decided to target small, every day tasks instead of tackling one huge problem; this is something an OT would do. We look at every day tasks that our clients have problems with, and we help them overcome them. Soneji wanted to help her uncle with his tremors first because he didn't want to drink coffee or tea in public anymore because he felt embarrassed. She designed a no-spill cup that deflects the liquid back inside the cup when tremors occur. It looks like a cup any person could use, and she designed it that way so that the person could feel like they blend in. She interviewed her uncle to see what his challenges were. When she realized she was only getting superficial answers, she decided to gain perspective and observe her uncle as he performed his daily routine. One thing she wondered was how her uncle got up and down the staircase, so he showed her. She showed a video during her talk of her uncle walking up and down the stairs with ease. She explained because it was a continuous motion, so his symptoms hardly affected him. Soneji wanted to translate the feeling of walking on stairs to walking on flat land, so she designed a staircase illusion. She showed a video of her uncle walking on the staircase illusion on flat ground, and it was amazing to see how easily he could walk; however, when he got to the end of the staircase illusion he had freezing of gait. So she had the staircase illusion flowing through all the rooms of her uncle's house so he could get around easily. It was really interesting to see the ideas and simple solutions she came up with to help her uncle. We try to make finding solutions so complicated because of the many technological advances we have today. This talk really opened my eyes to see that most problems can be solved with a simple solution, and this idea is something I will carry with me in my career as an OT.

Soneji, Mileha. (2015, February). Simple hacks for life with Parkinson's [Video file]. Retrieved from
        https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s

OT 425: Emerging Areas

Community mobility and older drivers was identified as an emerging niche in productive aging by AOTA in 2011. The number of adults over the age of 65 is doubling by the year 2030. Because the older adult population is increasing, more emphasis is being put on driver safety. Older adults want to maintain their independence for as long as possible, and being able to drive is a big way they can feel independent, which is why they are so reluctant to give it up. Occupational therapists can ensure driver safety by addressing driving and community mobility through occupational analysis, occupational performance, and clinical reasoning. Driver safety for older adults can be done through rehabilitation, making car modifications, or looking at the community for alternate mobility options.

Community mobility and older drivers relates to AOTA's Vision 2025 because it maximizes the well-being and quality of life for the older adult population. If they are able to maintain the ability to safely drive, then we are helping them to continue doing something that brings meaning and value to their lives. Also, we are helping to ensure the safety of not only older adult drivers but other drivers on the road as well, by preventing someone who could be a danger on the road from causing any accidents.

OT 537 Case Study: Parkinson's Disease

Michael J. Fox is a 55 year old male who was diagnosed with Parkinson's disease in 1991. Before his diagnosis he was very active and healthy. His occupations and roles include actor, activist, author, father, and husband. When he was diagnosed, his doctor told him he would be immobile after 10 years, but he is still active and does not show many signs of Parkinson's disease when he is in public. In our discussion, we talked about how speech was his biggest problem. After his diagnosis, he founded the Michael J. Fox Foundation, which funds drug development for Parkinson's disease. He is very passionate about the foundation, but is very private about how the disease is affecting him personally. The role of OT for him would be to make sure he is participating in meaningful occupations such as be with his family, play with his dogs, and remain independent for as long as possible. An OT would also provide help for the caregiver and assist in home modifications.

OT 425 Ethics and Jurisprudence

Ethics is the study of how judgements are made in terms of right and wrong. Jurisprudence is the study of law, regulations, and related philosophy. It is important to have a Code of Ethics in the field of OT because it gives us consistency and a guide to lean on if we get in a tough situation. The standards of practice for OT overlaps with the Code of Ethics; this overlap, or gray area, is considered clinical reasoning where we have to use our judgment and experience to determine right and wrong. There are 7 principles in the AOTA's Code of Ethics. Beneficence is being aware of the client's well-being and looking at them holistically. Nonmaleficence is refraining from action that could cause harm to the client or others. Autonomy and confidentiality has to do with the client's freedom to choose and their right to privacy. Justice is the fair and appropriate treatment of others and complying with rules. Veracity is confidence of information to the client and strengthening the professional relationship. Fidelity is keeping commitments and promises made between the client and practitioner and staying with the client in time of need. The Ethics Commission ensures that these principles are being upheld and fairness to all individuals who may be parties in an ethics complaint.

OT 537 Case Study Take-Away

John Stoker was in a motorcycle accident in 1984 that caused internal bleeding and abdominal trauma. Complications during his surgery resulted in an incomplete spinal cord injury and blindness. He had no movement below the thoracic region and almost complete control over his right arm.  He had a trach and saliva bag and a G tube, but he still enjoyed eating some just to taste food. He passed away in 2003 from pneumonia. John was very active and healthy prior to his accident. He enjoyed riding motorcycles, fixing cars, and was a seaman in the Navy. John's aorta was clamped for too long during surgery, which lead to blood clots that caused the spinal cord injury and blindness. Prior to our discussion, I did not know that clamping the aorta for too long could cause spinal cord injury, and we talked about how blood clots could cause damage to the spinal cord and optic nerve. John saw an occupational therapist for about 3-4 months, and interventions were mainly focused on bowel and bladder control. He also wanted to gain more independence by being able to dress himself, being able to learn phone numbers to keep in touch with his family, and move around in his wheelchair without vocal cues for direction. John maintained a positive outlook after his accident and didn't let his injury stop him from doing the things he loved to do. Our discussion was really eye-opening to the causes and complications that can result in spinal cord injury.

OT 537 Neuro Note #1: Still Alice

I watched the movie Still Alice, which is based on the book Still Alice by Lisa Genova. This movie was incredibly eye-opening to the experiences a person has with early-onset Alzheimer’s disease. Alice, the main character, gave a glimpse of what it was like to be living with Alzheimer’s disease. She said it was like being able to see the words you want to say hanging right in front of you, but you just can’t reach them. Alice also said that she was mastering the art of losing, and that she wasn’t suffering, she was struggling. I feel that hearing and seeing Alice’s experiences will help me to better empathize with clients who have this disease. I was also able to see the challenges that not only Alice faced, but her family faced as well. As occupational therapists, it is important that we also include the family/care-givers in interventions to better educate and help them too. I chose to watch this movie because my grandfather was diagnosed with Alzheimer’s disease in his early 70’s, so I was interested in seeing how early-onset Alzheimer’s disease affected someone. In this movie, I saw how painful it was for Alice’s family to watch the disease progress, just as it was with my family. I watched my grandfather go through the stages of the disease like Alice did, except my grandfather’s progression was slower. Much like Alice, my grandfather was a brilliant man, and it was really hard for my family to see the intelligent man we knew revert back to an almost childlike state. Still Alice was a very insightful movie, and I feel that I learned some valuable things that will help me as an occupational therapist. I would highly recommend this movie to anyone who is looking to see Alzheimer’s disease from a patient/client’s perspective or just looking for a really good movie to watch!

Koffler, P., Lutzus, L. & James, B. (Producers) & Glatzer, R. & Westmoreland, W. (Directors).

            (2014). Still Alice [Motion picture]. United States: Sony Pictures.

OT 425 Professional Development

Acquiring skills, knowledge, and attitude going forward as an entry level practitioner is important for professional development. Being a lifelong learner is very important in occupational therapy. Lifelong learning to me means growth, gaining new perspectives, and is a choice that is very self-directed. It is very important to keep an open mind to new information, especially when it comes to technological advances and changes in health policy/regulations. Learning as an OT student is different from learning as an OT practitioner. As students, our curriculum is mapped out and our goal is more clear, which is to pass the NBCOT exam and become occupational therapists. As OT practitioners, our path is not as clear cut and it is important that we figure out how to obtain information. Finding a mentor or role model is important as OT practitioners because they can help facilitate our learning. Professional portfolios help document professional development and are important in proving and ensuring competency as OT practitioners. Professional portfolios can prove that we are continuing to learn by documenting professional development hours (PDUs), contact hours, and continuing education units (CEUs).