Mock Interview Reflection

Overall, I was pleased in the way my interview turned out.  I felt prepared for the questions that were asked, and I think I responded in a confident way.  To prepare, I perused the resources that were posted online by Dr. Lancaster.  The resources included questions to ask your interviewer, how to answer tough interview questions, and OT specific interview questions that are popular.  I typed out my responses to some common questions so the answers would be on the top of my mind during the interview.  I expected there to be more information/role play given by the interviewer, but we really just jumped right into the interview questions. The interview also went much quicker than I expected.

After watching my interview video, I realized I talk with my hands excessively and my posture was poor. If I could go through the process again, I would keep my hands in my lap unless hand gestures are necessary, and I would make sure to sit up straighter. There was so much I learned through this process that I can take with me in the future.  We asked my interviewer her opinion on the best time to bring up salary in an interview, and she instructed to follow the interviewer's lead.  If they bring up salary on the first interview, you can ask questions about it. She said that often times, an interview is a process and there will be multiple times you will be in communication with them; you don't want to bring up salary first. I thought that was really great advice that I can take with me in the future! I really appreciated this opportunity, and I gained skills and knowledge that will hopefully benefit me at the start of my OT school career.

Sexuality in OT Reflection

Key Takeaways

Sexuality is an aspect of occupational therapy that is sometime uncomfortable to talk about, but it's absolutely in our scope of practice. Sex is an occupation, and it has a direct impact on older adult patients. Often, it is overlooked because of the myth that older adults are asexual. This is not the case because so many older adults admit their sex life over 50 years old is better than in their 20s. The aspect of sex most impacted by age is arousal. Sexual response definitely changes with age, and it's important to emphasize the importance of being less perfectionist, continue to engage in sexual intercourse, and be open to a new sexual repertoire.

As a provider, it's important to keep a few things in mind when addressing sex with patients:

1. Everyone has had different experiences with sex, and discussing it can bring up feelings of sadness, resentment, anger, and shame. Others have always had a healthy sex life, so this recent change in functioning could be very painful to them.
2. Sex should always be discussed in a private setting.
3. Sexual orientation and gender identity should be addressed upon evaluation because they impact treatment and outcomes.
4. A PLISSIT or DOUPE model should be used when addressing sexual health.
1. DOUPE (Description of problem --> Onset --> Understanding the cause --> Past attempts at solutions or treatment --> Expectations for treatment)
2. PLISSIT (Permission --> Limited Information --> Specific Suggestions --> Intensive Therapy)

Interventions:

Individual (1:1)

It's very necessary to become aware of the client's concerns and needs during the initial interview. A remediation approach may need to be taken following surgical procedures or other surgeries. Increasing range of motion, strength, and endurance may be necessary for sexual participation. In addition, addressing communication strategies and social participation are also necessary for quality sexual interaction. An intervention that could be used with an individual may be to practice communicating sexual needs aloud so that it can be carried over to the individual's sexual partner.

Group:

As mentioned above, sex should always be discussed in a private setting. I think a group session would be appropriate is if the group was made up of a client and his sexual partner. The OT could lead an education session with the group on modifications that to the environment or technique to improve the sexual experience. Any suggestion provided should be done using the PLISSIT or DOUPE model.In a group session, a therapist may suggest scaffolding in sexual activity a little at a time if the couple has been inactive for a long period of time. The therapist could also suggest being very open with communication and letting each other know their needs and wants. Different positions can be necessary for neurological conditions to reduce tremors or account for precautions after surgery or amputations.

MacRae, N. (2010). Sexuality and aging. In R. H. Robnett & W. C. Chop (Eds.), Gerontology for the Health Care Professional (pp. 235–258). Sudbury, MA: Jones and Bartlett.

Driving Rehabilitation Reflection

Key Takeaways

Driving rehabilitation is an area that occupational therapists are able to address. Some of the responsibilities of OTs in this field include to assess a client's performance skills and client factors that are needed to operate a vehicle, understand basic driving laws as it relates to driving with disabilities, and recommending and training on adaptations and adaptive equipment that can be useful in improving driving safety. As our role of OTs, we have to be dedicated to meeting the needs of our clients and help restore independence; driving evokes a sense of independence and could be necessary for someone's profession or day-to-day routine. Some common diagnoses that might be served include stroke, TBI, SCI, amputations, Alzheimer's, muscular dystrophy, cerebral palsy, visual impairments, and intellectual disabilities.

The assessment portion occurs in two steps: clinical setting and behind the wheel. The clinical session involves a visual acuity test, roadside recognition, visual perception, cognition, and active range of motion. Some common assessments completed include grip, Trail Making A and B, and a rules of the road test. The Behind the Wheel test assesses if an individual can shift attention from one task to another and sequence properly.

Occupational Therapy Interventions

Individual: An individual intervention to complete with a client would be behind the wheel training. The OTPF mentions the importance of using occupation as a means and an end. The best way to improve a specific task is to practice that specific task. An OT and a client could go out in a car and practice driving around a parking lot first and then progressing to roadways and intersections. This is a good way to practice reading road signs, identifying hazards, and basic driving skills necessary for safe commuting. 

Group: Another good intervention would be to hold a group session with the topic of driving. Some discussion points could be the importance of driving to each individual, experiences while driving, and concerns or fears that relate to driving. Come activities could be matching road signs with their meaning, discussing funny road laws, and identifying safe driving techniques.

Glyph Reflection

The two pictures you see above are called "glyphs." The one with green marker was completed over a year ago at the beginning of my occupational therapy school journey. The purpose of this was to explore what I thought a leader would look like. Different features were given based on certain characteristics. Some of the things stayed constant over the past year, for example: the square head that suggests leaderships stems from nurture rather than nature, the rounded nose suggesting that a someone can be a leader without thinking of him/herself as a leader, and a hat suggesting the way I think about leadership has changed since the beginning of OT school. There are several things that are different, as well. At the beginning of school, I did not have a written plan for leadership (print writing) and at this point, I do (cursive writing). At the beginning of OT school, I did not draw glasses on my person which meant I felt like I had not had as many leadership experiences as other people my age. After a year serving as president of Pi Theta Epsilon, I now do feel that my leadership skills are comparable to others of my age. Finally, I added a necklace to my most recent glyph, indicating that I now see myself as a leader. 

This was a great experience allowing me to reflect on how my view on leadership has changed in the past year. It's very interesting to see how I've grown in the past year of my OT journey.

Nutrition Reflection

Key Takeaways:
Nutrition as it relates to aging is an area that is often overlooked, but it is very necessary and relevant to the field of occupational therapy. There are ways, with proper nutrition, to slow down the aging process in older adults and maintain functionality, quality of life, and mental health. One of the biggest problems in hospitals is the lack of nutrition provided to patients. While in the hospital, the patient is normally in a hyper metabolic state where the metabolism is in overdrive due to the immune system working so hard to heal the body. This causes patients to require over double the amount of calories of what they would normally eat on a daily basis, which is almost never offered to patients in the hospital setting. This can cause malnourishment among patients at discharge, which can lead to decreased functional activity and increased risk of hospital readmission. Patients are rarely receiving the adequate nutrition education, an as OTs, we can play a role in promoting healthy eating habits and routines.

2 OT Nutrition Interventions:
-Many widows and widowers suffer from malnutrition. This could be due to many different factors: depression, isolation, low motivation, and not knowing how to properly prepare food. A good intervention for this population would be to hold a support group for those who have lost loved ones that educates proper nutrition habits and healthy meal preparation.

-Another intervention that could be useful for increasing one's knowledge of healthy meal preparation is to hold a session for education, safe kitchen mobility, and a cooking task where the client can ask questions and learn new habits and techniques.

Fieldwork Debrief

Here is the link to my debrief video!
https://youtu.be/4S8b1J3dX1Q

Neuro Note #4- My Beautiful Broken Brain

My Beautiful Broken Brain

    

Summary

My Beautiful Broken Brain is a Netflix documentary of a 34 year old woman who documents her struggles, setbacks, and breakthrough and she has a stroke. The night of Lotje's stroke, she had spent the evening watching fireworks with friends. She was awakened in the middle of the night by an excruciating pain, and she knew something wasn't right because she was fading in and out of consciousness. She tried to find someone to help, so she ran to a nearby hotel, but she couldn't speak. She was found hours later passed out in the hotel bathroom and was rushed to the emergency room. Lotje need speech language pathology because she was experiencing extreme Broca's aphasia, and she also was having hearing and visual problems as well. Lotje made the decision to live in an inpatient neurological facility. There she would see an occupational therapist, speech language therapist, psychologist, and a psychiatrist. Over time, Lotje made several breakthroughs. Her speech has improved drastically, and she was able to relearn to read and write. She went on the be the director of this documentary.

Why I Chose This

Since I began OT school, I've always had a special interest in stroke patients. I've worked with patients who have suffered from a stroke, but I've been curious about what exactly happens during a stroke and the recovery process from that. When I came across this documentary, I saw it as the perfect opportunity to further my learning in this area.

Reflection

I've learned about Broca's aphasia a lot during my neurological aspects class, but this documentary taught me about it much more in depth. Lotje struggled with finding the right words to say, and you could see how frustrated and discouraged it was making her. As an OT/S, one of the pillars that we value is client-centeredness. While Lotje was in the Neurological Inpatient Unit, she quoted "I'm having to get used to becoming a patient, and being reduced to being on the same level as everyone else." That quote is a perfect example of the medical model used by most healthcare practitioners. While that quote made me sad that she felt that way, I took pride to be part of a profession that values viewing the person first and their condition second. It was very uplifting to see how much Lotje improved after her stroke. It made me happy and excited to work with client's in the future who have suffered from strokes and help them return back to their meaningful occupations.

References:

Robinson, S. (Producer) & Sodderland, J. (Director). (2014). My beautiful broken brain [Film].

Link:

https://www.netflix.com/watch/80049951?trackId=13752289&tctx=0%2C0%2C0f6250ddafc9a32d895cdc00ed1c90e715d0e341%3A0c40cc2cecc710f94ba17481f02a8bc2a589edf3%2C%2C

Media Project - The Adaptive Zippering Board

           “The Adaptive Zippering Board”

            The media project was one of my favorite assignments of occupational therapy school to date. This project gave me the freedom to really use my developing OT brain to create an intervention for a client in need. One of the most significant things I learned from this assignment is that it is not always easy tailoring an intervention to someone with a specific diagnosis. Before I decided to create the Adaptive Zippering Board, I had several other ideas using zip ties that I thought would be great, but none of those were applicable to my client and the things that he found meaningful. One of the major pillars in occupational therapy is client-centeredness, so it is imperative as an OT to make sure that the interventions I assign to the client are functional and relative to the client’s wants and needs.

            Although my client is fictional, I feel like I really grasped and mastered the purpose of the “just-right challenge” through my innovation. The Adaptive Zippering Board and the adaptive clothing I have provided allows three different grades of the intervention that could be tailored to my client as he improves in therapy. For example, at his lowest level of functionality, my client should complete the adaptive zippering board using the zippers with the zip ties. As that task becomes easy for him to complete, he can move on to using the zippers on the Adaptive Zippering Board that do not have the zip ties. After this has been mastered, my client can put on the clothing with adaptive zip ties zippers and practice his dressing. Once this is done, the client can begin working on dressing independently with no adaptations. This project definitely challenged my creativity - both artistically in the way I designed my board and mentally as I thought of the perfect intervention for my client using the medium I was assigned.

            This assignment has impacted me by giving me incredible insight as to what my future as an OT will look like. I will be using my creativity to create and implement interventions that are meaningful to my client in order to help them get back to the activities they like to do in their everyday life. Projects like this make me fall more in love with the profession of occupational therapy and increase my confidence that OT  is the perfect fit for me.

Bonus Activity - Memphis Rolling Grizzlies

Memphis Rolling Grizzlies 

On May 30, 2018, my class and I attended a Memphis Rolling Grizzlies practice at the Glenview Community Center in Memphis, Tennessee. I have lived in Memphis basically my whole life, and I was totally unaware that there was a professional wheelchair basketball team in the city. Having the chance to watch these men practice a sport they loved was so inspiring and motivating. There were men of all different sizes, races, and levels of functionality. Some had suffered from spinal cord injury and were paralyzed from the waist down. Some had congenital conditions that prevented them from playing sports on a regular team. Some men were walking, and some couldn't even move their legs. Despite all these differences, these men come together weekly and transfer into their special basketball wheelchairs and do incredible things. I was utterly amazed by the strength and endurance these men possessed. I found it so inspiring that, although there were many debilitating injuries, these men were passionate about the sport and loved coming alongside their friends to play basketball. There were extreme examples of sportsmanship shown when someone would score a point, and everyone would rush to help if someone got knocked over in their chair. I truly felt welcomed into their practice and was given the opportunity to ask if I had any questions at all. After their practice ended, each player offered up their basketball wheelchair for me and my classmates to try it out. They really made it look easy! It was so hard to control the wheelchair, and I had extreme difficulty propelling myself fast and handling the basketball. The men of the Memphis Rolling Grizzlies are truly gifted in what they do.

My whole take-away from this experience is that I should not look down on someone who is disabled. I shouldn't belittle them or think that because they are disabled that they are unable to do anything. I shouldn't automatically think they are weak or fragile- some of the men on the team are stronger than I will ever be. As a future occupational therapist, it's important I help find things that those struggling with disabilities truly adore. I need to find the things that are meaningful to my client and bring them joy. I can help my clients adapt and do the things they want and love to do. It was important for me to see the Memphis Rolling Grizzlies because it changed my perspective on just how much someone who is in a wheelchair can accomplish if they are doing what they love. I hope one day to see the Memphis Rolling Grizzlies in action again! 

Neuro Note #3 - TransFatty Lives

http://www.acapela-group.com/wp-content/uploads/2015/04/transFatty-lives2.png

Description

TransFatty Lives is a documentary on Netflix about a man named Patrick and his battle with ALS. Patrick is an artist and filmmaker from Maryland. In Spring 2005, he was diagnosed with Amyotrophic Lateral Sclerosis and was given 2-5 years to live. ALS is a neurodegenerative condition that essentially unplugs your brain from the rest of your body. Physically, the muscles in your body lose their ability to work over time, but cognition is not affected. The first symptom of ALS Patrick experienced was his leg began trembling on a trip. Eventually, he began stumbling and falling, and his gait became affected. Being the filmmaker he is, he decided to film his life and the struggles of himself and his family as they dealt with ALS and the destructive path it took debilitating Patrick. He decided to make an art project from his struggles. A few years into his journey with ALS, Patrick met someone and they fell in love and had a child whom they named Sean. Sean became the spotlight in Patrick's life and the whole reason that Patrick fought as long as he did to live.

The documentary showed how serious ALS became once Patrick required a feeding tube and ventilator. He lived for a while in a nursing home, which was emotionally difficulty because of how young Patrick was. In this nursing home, Patrick hit an all time low, mentally and physically. His desire to live was decreasing and he was wanting to die. He received the opportunity to travel to a specialty home for those living with ALS, and once he moved there, it's like his life started all over again. He was able to travel and participate in activities and events. It was such as contrast from laying in the hospital bed all day everyday like he did in the nursing home.

Why I Chose This

Ever since I heard about ALS, I have become interested in learning what day-to-day life is like for patients and caregivers. TransFatty Lives gave me that inside look on what life is like with ALS. Being interested in the neuro aspect of occupational therapy, this was especially interesting to see what my future clients may be dealing with. I learned so much about ALS and some of the battles that are faced daily- emotionally and physically.

Refection

TransFatty Lives was the perfect mix of beautiful, inspiring, heart-wrenching, and weird. The documentary did a fantastic job in capturing Patrick's true personality, and the film's unique and artistic aspects was a reflection of him. It was incredibly hard to watch the deterioration of Patrick and the reactions from his family and caregivers. I could truly feel the love Patrick's family had for him as I watched them assist him with bathing, toileting, and feeding. Patrick's personality and outlook on life was incredibly inspiring. The bravery he had to film himself in his lowest, most vulnerable points of his life is something I  don't think I would ever be able to do. He had the absolute best attitude, and his use of humor probably made it easier for everyone around him to cope with the circumstances. One of the biggest take-aways from this film was a quote from Patrick himself that was translated on his communication board; it is as followed:

"When you can't help your circumstances, you might as well go with it and stay positive."

Handsome Cargo (Producer) & O'Brien, P. (Director). (2015). TransFatty Lives [Film].