Assistive Technology

Hi there! 

As technology advances, the tools or equipment occupational therapists can use to enable their clients to participate in meaningful and purposeful occupation increases.  The term used to refer to a broad range of products/devices, practices, strategies or services that have been developed to enable occupation participation and independence for the disabled and older people is, ‘Assistive Technology’ (Cook, & Hussey, 1995; Pain, & Pengelly, 2010).

One assistive device I was introduced to during one of my tutorials, and saw being used while on fieldwork placement last year, was a Communication Board.  It is also referred to as a Picture Symbol Communication Board.  These devices are used to communicate by children and adults with Autism, Cerebral Palsy, Down Syndrome, and other disabilities.  A Communication Board is essentially a card made of paper or cardboard that contains a set of symbols and letters which are adapted to suit the communication needs of the user.  They come in different sizes, but they are generally 25.4cm x 29.2cm.  The average cost for a basic Communication Board is $50 (NZ).

Communication Boards make communication easier for the user. During my fieldwork placement I saw firsthand how this device:

·         Minimised misunderstanding between the user and the individual they are trying to communicate with.

·         Improved efficiency of communication.  That is, the user had their needs or wants and questions answered more quickly.

·         Increased the user’s participation in activities and interactions with others.

A website that I found quite informative on alternative methods of communication, including Communication Boards, is  Augmentative and Alternative Communication

By enhancing a user’s ability to communicate, this device reduces the influence of occupational injustice as they have a greater ability to express their concerns and thoughts. Hence, their health, empowerment, and participation in daily life is not undermined (van Bruggen, 2010).

Here is a link to a video clip that discusses the use of Communication Boards in relation to children and learning. Children and Communication Boards 

References

Cook, A. M., & Hussey, S. M.  (1995).  Assistive technologies:  Principles and practice. 
          United States of America:  Mosby. 

Pain, H., & Pengelly, S.  (2010).  Assistive devices for enabling occupations.  In M. Curtin, M. Molineux, & J. Supyk-Mellson, (Eds.).  Occupational therapy and dysfunction:  Enabling occupation (6^th ed.) (pp. 453-468).  London:  Churchill Livingstone Elsevier. 

van Bruggen, H.  (2010).  Working towards inclusive communities.  In M. Curtin, M. Molineux, & J. Supyk-Mellson, (Eds.).  Occupational therapy and dysfunction:  Enabling occupation (6^th ed.) (pp. 297-312).  London:  Churchill Livingstone Elsevier.

The Internet and Online Communities

Hello everyone,

During one of my first year fieldwork experience placements I had the opportunity to work with older people and people experiencing mental illness.  In this posting I am going to explore three different websites, or communities, and discuss how these sites address or relate to the concepts of occupational justice and occupational deprivation.  First let me define these two terms.  According to van Bruggen (2010), the concept of “occupational justice expresses ethical, moral, and civic concerns that participation in daily life should contribute to rather than undermine health, empowerment, and life” (p.300).  Furthermore, that occupational injustices occur when participation in occupation is barred, confined, segregated, restricted, prohibited and undeveloped.  In regards to occupational deprivation, van Bruggen (2010), defines it as “... a state of prolonged preclusion of engagement in occupations of necessity and/or meaning due to factors outside the control of the individual” (p.300).  Some of the factors that can cause occupational deprivation can be social, cultural, economical, historical, environmental or political in nature (van Bruggen, 2010).

The three websites I will explore and discuss are Greypower, Age Concern New Zealand, and Like Minds, Like Mine.

Grey Power is a lobby organisation that promotes the welfare and well-being of people 50 years and over.  The organisation’s “... mission is to be the appropriate voice for all New Zealanders” (Greypower New Zealand, 2012).  The key aims and objectives of the organisation is: 

1.    “To advance, support and protect the welfare and well being of older people.

2.    To affirm and protect that statutory right of every New Zealand resident, to a sufficient New Zealand Superannuation entitlement.

3.    To strive for a provision of a quality Health Care to all New Zealand residents regardless of income and location.

4.    To oppose all discriminatory and disadvantageous legislation affecting rights, security and dignity.

5.    To be non-aligned with any political party, and to present a strong united lobby to all Parliamentary and statutory Bodies on matters affecting New Zealanders.

6.    To promote and establish links with kindred organisations.

7.    To promote recognition of the wide-ranging services provided by senior citizens of New Zealand.

8.    To gain recognition as an appropriate voice for all older New Zealanders” (Greypower New Zealand, 2012).

While the site has a very low interactive aspect to it, including a lack of opportunities for users or members to contribute directly to the site, it does provide a great deal of information on a range of relevant topics for older people.  It also provides a good list of related sites for visitors and members to utilise.

 Link to Greypower New Zealand website.  

Age Concern New Zealand is a charitable trust that “... works to serve the needs of older people by offering nationally contracted services, education, resources and national leadership”(Age Concern New Zealand, 2012).  The trust advocates on policy and issues relevant to older people at a national and international level.

The site provides visitors and members the opportunities to make comments and engage in conversation with like minded individuals through its facebook page.  The flow of information seemed to be more reciprocal at this site.  Visitors and members discuss current issues facing them such as the recent rise in prescription costs, give feedback on the positive gains the trust has made on issues surrounding health, finances, and housing.  The site provides plenty of relevant information for older people.  The site is easy to read and navigate, and text size can be increased for individuals with poor eyesight.

Link to Age Concern New Zealand website

Like Minds, Like Mine is a national programme that aims to reduce the stigma and discrimination associated with mental illness.  The website provides information and resources on the programme, and shows how people can contribute to creating a society that values and includes people with mental illness. 

According to the site, “... stigma and discrimination is one of the major barriers to a person's recovery.  But changing attitudes and behaviour in society is complex, so the Like Minds programme works on a variety of levels to try to achieve this” (Like Minds, Like Mine, 2012). It provides resources and information for the public.  The site is quite interactive, it invites people to post or share their stories of living with mental illness, and provides people with the opportunity to follow the current issues and news on Twitter.  

Link to Like Minds, Like Mine website. 

In general, people contribute to the websites to inform others about the issues they face, the services they can access, where they can get financial assistance, and support and advice.  People also contribute to educating the public on what it is like to have a mental illness or be an older person living in a modern society.

All three websites addressed factors relating to the concepts of occupational justice and deprivation.  For example, they:

·         discussed health, economic and social policies which impact on the website’s target population – occupational justice.

·         identified services that assist people to gain access to opportunities to participate in occupation, and the necessary resources that will enable participation in occupation – occupational justice.

·         discussed the importance of equal opportunities in employment, improving access in the workplace, increasing awareness of the social, cultural and political factors that cause occupational deprivation.

·         discussed rights and criteria for accessing government financial assistance, and the role government plays in decreasing the causes of occupational deprivation.

Of the three websites, only the Like Minds, Like Mine site has a strong identity and could be considered reliable.  This is because it is a government funded programme, unlike the other two organisations, which means it is accountable to the Ministry of Health.  As a result, the information and resources on the website would have been sourced from experts and reviewed more closely.  Thus, the information would be more reliable and up to date. 

Both websites and traditional face-to-face services have their benefits and limitations.  The table below presents some of the limitations and benefits of using websites and traditional face-to-face methods in delivering service/information.

Website		Traditional Face-to-Face
Limitations	Benefits	Limitations	Benefits
No face-to-face interaction	Information accessible 24/7	Information only accessible during the working week.	Face-to-face interaction occurs
Can’t ask questions and get immediate response, and get clarification on information	Information can be accessed from anywhere in the country or even overseas	Information cannot be accessed from anywhere in the country or even overseas	Can ask questions and get immediate response, and can get clarification on information
High resource costs to access information e.g. computer and internet access.	Can review information at own pace and in a familiar environment. Information can be viewed at a time convenient for the individual	Can’t review information at own pace. Have to collect information from an unfamiliar environment which might be anxiety provoking or stressful or inconvenient for the individual.	Low resource costs to access service are required, e.g. transport costs.
People may not like using computers.	Privacy is maintained	Privacy is compromised.
Information may not be reliable.	Physical barriers of accessing information are reduced.	Physical barriers impact on accessing information.
	Stigma, shame and/or embarrassment in accessing information is reduced.	Chances of experiencing stigma, shame and/or embarrassment in accessing information is high.

References:

Age Concern New Zealand.  (2012).  Retrieved from http://www.greypower.co.nz/activities/

Greypower New Zealand.  (2012).  Retrieved from http://www.greypower.co.nz/

Like Minds, Like Mine.  (2012).  Retrieved from http://www.likeminds.org.nz/page/5-home 

van Bruggen, H.  (2010).  Working towards inclusive communities.  In M. Curtin, M. Molineux, & J. Supyk-Mellson, (Eds.).  Occupational therapy and dysfunction:  Enabling occupation (6^th ed.) (pp. 297-312).  London:  Churchill Livingstone Elsevier.

Adaptive Equipment and The Gifts it Brings

Hello,

Occupational therapists use a range of methods or strategies to enable people to engage or re-engage in meaningful and health promoting occupations, as well as to improve people’s occupational performance, including reducing their risk of harm while engaging in the occupation.  During one of my fieldwork placements last year I got the opportunity to see how occupational therapists change people’s lives with a simple piece of equipment.  It was great to observe:  

·         the clients joy when they could perform activities of daily living (ADLs) more easily and with reduced discomfort;

·         the clients relief and happiness at being able to perform ADLs independently again. 

It was also great to hear clients say how they felt safer and more confident about engaging in occupations without assistance, as well as hearing family members say they feel less worried about their loved ones being home alone. 

To help explain and demonstrate the use and benefits of adaptive equipment in occupational therapy I have provided links to several on-line videos. I hope you find them as informative, interesting, and inspiring as I did.

The first link takes you to a youtube clip of a Quadriplegic typing on a computer using adaptive equipment. Quadriplegic Typing on Computer with Adaptive Equipment 

The second link takes you to a youtube clip of an occupational therapist demonstrating and providing information on how to move around the kitchen safely using adaptive equipment.  Using Adaptive Equipment to Move Around the Kitchen 

The third link takes you to a youtube clip which provides peoples personal experiences of living with a spinal injury. Aspire 

The fourth link takes you to a youtube clip of how a car can be adapted for wheelchair users. Ford Mobility Car and Adaptive Equipment Demonstration 

The fifth link takes you to a youtube clip which provides a mother and her disabled son’s personal experience of water skiing.  Mother and Son About Disabled Water Skiing

Karyn

Transition Through The Ages

Hi everyone, 

Today's post is on a topic I had to cover for the Participation in Occupation paper I am doing.  The task was to produce a video clip with several other classmates on a chosen topic.  However, because I found it difficult to link up with fellow classmates in the given timeframes, I produced a movie clip made up from a sequence of photos taken on my cell phone.  The topic I chose to cover was occupation transition.  More specifically, the occupational changes people experience as they transition from early adulthood to their 60s and older.  My movie clip shows a middle aged adult and a person in their 60s performing the everyday task of putting on shoes to go for a walk. 

To help plan and organise the sequence of events, and the best angles to shoot each frame/photo, I created a storyboard.  I found using the storyboard extremely helpful. It enabled me to: 

·         formulate my initial ideas more deeply and finalise decisions,  

·         decide the best way to shoot the frames to get the best photos given the resources I had at my disposal. 

·         decide what photos and how many I would need to tell the story of "Transition Through The Ages". 

·         identify and deal with issues prior to shooting the photos, which I believed reduced the amount of time spent during the shoot.

What is occupational transition?  Basically the term refers to how occupations like ADLs change due to some transition such as aging, illness, or disability a person may experience.  Due to New Zealand’s aging population I chose to explore the changes people experience as they transition from early adulthood to their 60s and older (Radomski, 2008).  According to Statistics New Zealand, the "... 65+ age group is projected to make up over one-quarter of New Zealand’s population from the late 2030s, compared with 12 percent in 2005 ... [and the] number of people aged 65+ is projected to increase from half a million in 2005 to 1.33 million in 2051.... [Also, Statistics New Zealand states] the largest increases in the 65+ age group will occur in the 2020s and 2030s,when the large birth cohorts of the 1950s and 1960s move into this age group" (p.1).  The main aspects occupational therapists need to keep in mind when dealing with people who are experiencing a shift in age are that their occupational function will change due to:  

·         declining physical abilities and capacities.  As people age their body functions slowly decline.  For example, body and bone mass reduces, and vision, hearing, vestibular function, and range of motion decline (Radomski, 2008). 

·         declining cognitive abilities and capacities.  As people age their cognitive abilities and capacities decline due to gradual brain shrinkage, for example, "decreasing memory capacity, decreasing abilities in areas of abstract reasoning and novel problem solving" (Radomski, 2008, p.290).  Despite brain shrinkage people still maintain their "... enriched perspectives based on lifelong learning and integrated experiences" (Radomski, 2008, p.290).  

·         shifts in coping strategies, values, priorities, goals, spirituality, behavioural patterns, and beliefs (Radomski, 2008). 

·         Personal context, which according to Radomski (2008), refers to the "... intrapersonal environment that shapes an individual's experience. These factors play a role in determining the client's unique response to the onset of illness or impairment and contribute to his or her ability to adapt" (p.289). 

·         Social context, which includes a person’s social resources, their roles and preferences, and what influences their occupational participation, satisfaction, and well-being (Radomski, 2008). 

·         cultural context, in which according to Radomski (2008), the "dominant culture influences the ease with which a person ... feels accepted and integrated into the community" (p.298).

References:

Statistics New Zealand (March 2006). Demographic Aspects of New Zealand's Ageing Population. Retreived from http://www.stats.govt.nz/browse_for_stats/people_and_communities/older_people/demographic-aspects-nz-ageing-population.aspx

Radomski, M. S. (2008). Assessing context: Personal, social, and cultural. In M. V. Radomski, & C. A. Trombly Latham (Eds.), Occupational therapy for dysfunction (6^th ed.) (pp. 284-309). Baltimore, United States: Lippincott Williams & Wilkins.

Occupational Engagement

Hi everyone,

Today I am exploring occupational engagement and what occupation means to people.  To explore occupational engagement I will reflect on a fieldwork experience I had in my first year of study, and talk about what occupation holds for people, particularly what people experience from engaging in occupation, namely doing belonging, becoming and being.

One of my first year fieldwork placements was in an Older Persons and Out-patients Rehabilitation Team (OPORT).  Through the placement I got to observe how occupational therapists assist patients in the community.  I saw the valuable work occupational therapists did in helping patients:

· re-establish life after experiencing surgery, illness or injury;

· maintain or improve their quality of life, including their independence within the home and participation in community.

It also gave me the opportunity to perform a number of functional assessments, install adaptive equipment, and assist patients to re-engage with normal Activities of Daily Living (ADLs), social, and recreational activities.  Engaging in this fieldwork placement enabled me to experience how occupational therapy can change people’s lives and what engaging in occupational therapy means to the patients.

My fieldwork experience with the local hospital OPORT helped cement the idea that occupation is more than just about doing something purposeful or productive.  I realised that occupation is a synthesis of:

· Doing, which is described as a purposeful performance of an action.  It refers to when people do activities to obtain knowledge and acquire expertise.  Doing provides a sense of entertainment and fulfilment, as well as affirming self-worth and competence (Collins English Dictionary, 2007; Crepeau, Cohn, & Schell, 2009; Curtin, 2010; Rowles, 1991; Wilcock, 1998).

· Belonging, which is described as a sense of feeling valued and included.  It is about experiencing relationships, and a sense of a connectedness with society (Collins English Dictionary, 2007; Crepeau, Cohn, & Schell, 2009; Curtin, 2010).

· Becoming, which is defined as a process of change over a period of time (Collins English Dictionary, 2007), or as a noun “... a coming to be” (Wilcock, 1998, p251). Becoming refers to exploring new ideas or opportunities, envisioning a future self or a new way of life, and thinking of how one can contribute to society and themselves. It is about making choices about which pathways to take (Crepeau, Cohn, & Schell, 2009; Curtin, 2010; Wilcock, 1998).

· Being, which is described as the “contemplation and enjoyment of inner life” (Wilcock, 1998, p250).  Being is about being reflective and introspective, as well as being true to oneself (nature, values and beliefs).  It is about contemplation, rediscover of self, and developing new appreciation for life (Collins English Dictionary, 2007; Curtin, 2010; Rowles, 1991; Wilcock, 1998).

Because occupation is a fusion of doing, belonging, becoming, and being, occupation holds different meanings for different people.  Consequently, in order to experience a sense of wellness or wholeness, occupational therapists believe people need a balance among occupations to ensure a balance between the four concepts.  To illustrate doing, belonging, becoming, and being, I have added a slideshow to this posting.  The slideshow presents images of adaptive equipment used to assist people to engage in different occupations (Crepeau, Cohn, & Schell, 2009; Curtin, 2010; Wilcock, 1998).

 

The Meaning of Occupation

In creating the slideshow, I had to consider several ethical issues surrounding the use of the images, namely copyright, privacy and informed consent.

· Copyright law:  Since I used photos I took of myself and photos I downloaded off the internet, which are classified as common material as they are located in the public domain, copyright was not an issue (Copyright council of New Zealand, 2012; Crepeau, Cohn, & Schell, 2009; Curtin, 2010).

· Privacy law:  In regards to the photos downloaded from the internet, privacy of the individuals in the photos was not an issue as they are deemed to be common material.  The photos of me were taken by me, and after careful consideration I chose to use them in this slideshow (Crepeau, Cohn, & Schell, 2009; Curtin, 2010; Privacy Commissioner, n.d.).

· Informed consent:  because the photos downloaded from the internet are classified as common material, no informed consent was required.  In regards to the photos I took, as they were taken in a family member’s home, I sought their informed consent to use the photos for the slideshow (Crepeau, Cohn, & Schell, 2009; Curtin, 2010; Privacy Commissioner, n.d.).

References

Collins English Dictionary.  (2007).  Glasgow, United Kingdom:  HarperCollins Publishers. 

Copyright council of New Zealand.  (2012).  Retrieved from
    http://www.copyright.org.nz/basics.php/

Crepeau, E., Cohn, E., & Schell, B. (2009).  Occupational therapy (11^th ed.).  Baltimore,
    United States:  Lippincott Williams & Wilkins.

Curtin, M. (2010).  Enabling skills and strategies.  In M. Curtin, M. Molineux, & J. Supyk-
    Mellson (Eds.), Occupational therapy and physical dysfunction:  Enabling occupation (6^th
    ed.), (pp.111-124).  London, Great Britain:  Elsevier Limited.

Privacy Commissioner.  (n.d.).  Retrieved from http://privacy.org.nz/

Rowles, G., D. (1991).  Beyond performance:  Being in place as a component of 
    occupational therapy.  The American Journal of Occupational Therapy, 45(3), 265-271.

Wilcock, A., A. (1998).  Reflections on doing, being, and becoming.  Canadian Journal
    of Occupational Therapy, 65(5), 248-256.