"Help others achieve their dreams and you will achieve yours"
How do we as OTs help make our clients' dreams come true?
Or to make the statement more scientific....How do we as OTs take our clients and their goals into account?
As part of our course we learn all about client centered assessment and intervention. This basically means that we use our clients and their challenges and goals as a way to guide our assessment and intervention. Sometimes this can be rather difficult as goals can be unrealistic or not match with your therapeutic goals. How do we solve this problem? Well we can educate if goals are unrealistic and we can incorporate client goals into our intervention plan. How do we do his? As OTs, we are taught all about activity analysis, and by analyzing an activity, you are aware of all the components that make up an activity. If you're aware of all the components, you can change certain aspects to be able to get what you want out of a session while still fulfilling the clients' wishes.
I used this approach when treating my first client (SCI), as his goal is to be independent in all his ADL's so that he can go home and be able to help himself as much as possible. Therefore, we started working on bed mobility - the goal being that he is able to get himself out of bed and onto the wheelchair by himself. As this is part of his goal, he is more motivated to participate in the activity. I have found that using a client centered approach really helps to get the best out of your clients as they feel you are listening to them and are taking their opinions and goals into account, and this results in them being much more active in your sessions.
With my spinal cord injury client, there has been a lot of progress as he is able to roll onto his side without any assistance. He is able to sit on the edge of the bed with minimal assistance, as the only thing I have to do is throw his legs off the edge of the bed.... and by throw, I mean gently place... before anyone gets the wrong idea... This has lead to us exploring different ways of getting his legs off the side of the bed, which is somewhat challenging as he has poor lower trunk control.
He is doing very well in his therapy sessions and has made some amazing progress. His balance has improved slightly and his upper limb strength has improved considerably. His wheelchair mobility (wheeling himself around) is going much faster and inclines can possibly be introduced. His orientation to the wheelchair and it's parts have also improved. He is very appreciative of our therapy sessions, even though he says I exhaust him. He has also started to call me "tricks" rather than by my name as every time I upgrade an activity, he says I am playing tricks on him. I have to say that I quite like my new nickname :p
I received another client this week. He has had a CVA in the left side of his brain, which has resulted in right hemiplegia. this was caused by a thrombosis in the left middle cerebral artery. The middle cerebral artery (circled in first picture) supplies the frontal lobe, parts of the temporal and parietal lobes, primary, motor and sensory areas of the face, throat, hand, and arm. It also has a big impact on dominant areas for speech. As you can see in the second picture, it is quite a large area supplied by this artery. Therefore a blockage in the beginning of the main supplier will affect all the above mentioned areas.
He also has global aphasia - meaning he cannot express himself or understand others when they are speaking to him. I was very privileged to be able to observe a speech therapy session where his receptive(understanding) communication could be seen to be improving. The speech therapist instructed me on how best to communicate with my client and how to ensure that specific words and feelings are related to each other. Here is a visual representation of aphasia....
He also presents with ideational apraxia. This is when a person uses objects for activities they weren't meant to be used for. An example of this is when a person is given a toothbrush, and they start to brush their hair with the toothbrush.
I will admit, I found it quite daunting to have to deal with a client who can't understand me or talk to me. This means he will have difficulty following instructions, but mostly, I am worried he will not be able to communicate when he is experiencing pain. This could be a huge concern with a CVA client as subluxations (basically a dislocation) are very common, as well as contractures (where skin, tendons or bone become so stiff or fused that movement at certain joints is difficult and painful). I have decided to start with a wheelchair orientation programme as it involves physical demonstration, tactile sensation and improving wheelchair safety. I am also going to make use of a communication board, as per the Speech Therapists suggestion, to assist with communication.
On Monday, I am assisting in running my first physical group. Luckily I am starting off as co-therapist which means I am going to assist the main therapist. This involves helping with set up, gathering patients and ensuring everyone is getting equal amounts of attention during the group. The group I am running will be happening in the next 2 weeks, so this is wonderful preparation for that.
It's been a hectic week in terms of fieldwork, with the planning of intervention sessions, stressing about the new client, then stressing about ways of communication, stressing about group sessions, stressing about writing SOAP notes correctly, stressing during the actual session .... basically stress... lots and lots of it... but I found a quote this evening that made me think differently about my "stress" so I am going to share it with you and maybe I can change your mind too.
"Working hard for something we don't care about is called stress. Working hard for something we love is called passion."
And what greater thing to have a passion for than helping others achieve their dreams?
References:
Or to make the statement more scientific....How do we as OTs take our clients and their goals into account?
As part of our course we learn all about client centered assessment and intervention. This basically means that we use our clients and their challenges and goals as a way to guide our assessment and intervention. Sometimes this can be rather difficult as goals can be unrealistic or not match with your therapeutic goals. How do we solve this problem? Well we can educate if goals are unrealistic and we can incorporate client goals into our intervention plan. How do we do his? As OTs, we are taught all about activity analysis, and by analyzing an activity, you are aware of all the components that make up an activity. If you're aware of all the components, you can change certain aspects to be able to get what you want out of a session while still fulfilling the clients' wishes.
I used this approach when treating my first client (SCI), as his goal is to be independent in all his ADL's so that he can go home and be able to help himself as much as possible. Therefore, we started working on bed mobility - the goal being that he is able to get himself out of bed and onto the wheelchair by himself. As this is part of his goal, he is more motivated to participate in the activity. I have found that using a client centered approach really helps to get the best out of your clients as they feel you are listening to them and are taking their opinions and goals into account, and this results in them being much more active in your sessions.
With my spinal cord injury client, there has been a lot of progress as he is able to roll onto his side without any assistance. He is able to sit on the edge of the bed with minimal assistance, as the only thing I have to do is throw his legs off the edge of the bed.... and by throw, I mean gently place... before anyone gets the wrong idea... This has lead to us exploring different ways of getting his legs off the side of the bed, which is somewhat challenging as he has poor lower trunk control.
I received another client this week. He has had a CVA in the left side of his brain, which has resulted in right hemiplegia. this was caused by a thrombosis in the left middle cerebral artery. The middle cerebral artery (circled in first picture) supplies the frontal lobe, parts of the temporal and parietal lobes, primary, motor and sensory areas of the face, throat, hand, and arm. It also has a big impact on dominant areas for speech. As you can see in the second picture, it is quite a large area supplied by this artery. Therefore a blockage in the beginning of the main supplier will affect all the above mentioned areas.
He also has global aphasia - meaning he cannot express himself or understand others when they are speaking to him. I was very privileged to be able to observe a speech therapy session where his receptive(understanding) communication could be seen to be improving. The speech therapist instructed me on how best to communicate with my client and how to ensure that specific words and feelings are related to each other. Here is a visual representation of aphasia....
He also presents with ideational apraxia. This is when a person uses objects for activities they weren't meant to be used for. An example of this is when a person is given a toothbrush, and they start to brush their hair with the toothbrush.
I will admit, I found it quite daunting to have to deal with a client who can't understand me or talk to me. This means he will have difficulty following instructions, but mostly, I am worried he will not be able to communicate when he is experiencing pain. This could be a huge concern with a CVA client as subluxations (basically a dislocation) are very common, as well as contractures (where skin, tendons or bone become so stiff or fused that movement at certain joints is difficult and painful). I have decided to start with a wheelchair orientation programme as it involves physical demonstration, tactile sensation and improving wheelchair safety. I am also going to make use of a communication board, as per the Speech Therapists suggestion, to assist with communication.
On Monday, I am assisting in running my first physical group. Luckily I am starting off as co-therapist which means I am going to assist the main therapist. This involves helping with set up, gathering patients and ensuring everyone is getting equal amounts of attention during the group. The group I am running will be happening in the next 2 weeks, so this is wonderful preparation for that.
It's been a hectic week in terms of fieldwork, with the planning of intervention sessions, stressing about the new client, then stressing about ways of communication, stressing about group sessions, stressing about writing SOAP notes correctly, stressing during the actual session .... basically stress... lots and lots of it... but I found a quote this evening that made me think differently about my "stress" so I am going to share it with you and maybe I can change your mind too.
"Working hard for something we don't care about is called stress. Working hard for something we love is called passion."
And what greater thing to have a passion for than helping others achieve their dreams?
References:
- Help Others Quotes - BrainyQuote. (2019). Retrieved from https://www.brainyquote.com/topics/help_others
- Middle Cerebral Artery Anatomy, Function & Diagram | Body Maps. (2019). Retrieved from https://www.healthline.com/human-body-maps/middle-cerebral-artery#1
- Work Stress Quotes - The Web's Best Collection of Work Stress Quotes. (2019). Retrieved from http://www.work-stress-solutions.com/work-stress-quotes.html
- Aphasia GIFs - Find & Share on GIPHY. (2019). Retrieved from https://giphy.com/search/aphasia
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