Wednesday 16 May 2012

Communication

Hi Sarah, I find your blog to be very interesting, informative and well written. These videos are all very interesting and well chosen. I was particularly interested in the videos about Sarah Scott, and the vast improvement in her speech was remarkable. I was just wondering whether you know what kind of intervention techniques they use to improve Broca's aphasia?
 
Hi Aimee, thank you! yes Sarah has made great improvement! I'm not entirely sure on her specific interventions but an Occupational Therapist would work collaboratively with a Speech and Language Therapist to slowly improve her articulation, through word games and writing interventions.
Reply

Tutorial Six: The internet and online communities

In Fieldwork 1, being placed on the geriatric AT&R ward, I had a lot of experience dealing with the O.T practice area of stroke. There are many online communities that offer support and guidance for those people suffering from strokes and their family and friends.

Stroke foundation of New Zealand: http://www.stroke.org.nz/home
The Stroke Foundation of New Zealand website accompanies the Stroke Foundation of New Zealand and is a means of providing people with an easily accessible link to this support system. The website includes sections regarding how to contact the stroke foundation, how to donate to the foundation, stroke information, resources, information on campaigns, news, and links to other services. This particular site is not the most interactive that I have, although it is well set out, with drop-down headings, plenty of images and a search box - there is no particular area in which visitors to the site can directly contribute, or comment on the content. However, some areas of the site do require a log in and account, so for people who regularly use the website, making a registration may allow them to contribute and access more interactive sections of the site. 

The ehealth Forum is an online forum that aims to provide support through allowing people to share their thoughts and experiences with others. It defines itself as a "health community featuring member and doctor discussions ranging from a specific symptom to related conditions, treatment options, medications, side effects, diet, and emotional issues surrounding medical conditions". The site is very interactive - as well as easy to use. Once you are registered you have the ability to post under a wide range of topic areas. Many people ask questions which are then discussed and considered by other stroke sufferers and doctors to try and provide the original poster with a comprehensive answer. 

Facebook page - Strokes Suck - http://www.facebook.com/Strokessuck
Strokes Suck is a Facebook page that provides Facebook users with a network that they can connect to share stories, images, videos, easily organise events and chat to others who are experiencing similar things to them; therefore providing support and a sense of community. There is also a newsletter associated to the site that people can sign up to and receive. The page is extremely easy to use and interactive, and would be a familiar format for those individuals who regularly use Facebook. People can contribute through 'liking' the page - they then have complete accessibility to viewing content, and can communicate with others, post inspirational photographs and videos, and link other helpful information or pages that they feel may be valuable to members of the community. They will also be notified through email and Facebook's notification system if new information or interactions occur on the page (e.g somebody comments on a photo that they posted), enabling them to be continuously engaged with the site and feel up to date and informed.

I believe that the users of these online communities choose to engage in and contribute to them because they are a convenient, accessible and valuable means of support that can help them enormously in coping with their experience of a stroke. People who use such communities are seeking information regarding their condition from experts, but most importantly, they are seeking guidance, support and understanding. Because online communities, such as these regarding stroke often have contributors who have had similar experiences or share similar knowledge, it allows people to feel that they are talking to others who truly understand what they have been going through, and therefore creates a strong sense of support and friendship amongst users, which is what I believe is one of the key benefits of these sites. The information that is shared on these sites comes from a variety of sources; sites such as the Stroke Foundation of New Zealand provides a lot of government/ ministry of health audited information, while forums and Facebook pages contain a lot more reciprocal knowledge shared by stroke suffers, families, friends and medical professionals. 

Stroke has huge impact upon peoples occupational lives. People who experience stroke also often experience occupational disruption, which is defined by Christiansen & Townsend (2010) as being "a transient or temporary condition of being restricted from participation in necessary or meaningful occupations, such as that caused by illness, temporary relocation, or temporary unemployment". Stroke often happens suddenly, with no prior warning, and therefore people are unprepared for the  huge and sudden impact that the cognitive and physical effects of a stroke will have upon their occupational life, and their ability to perform the occupations that they once could with ease. This occupational disruption can be extremely hard to cope with for individuals and their families, and therefore the use of an online community can assist the person in creating a stronger support system and gaining advice on how best to deal with occupational disruption. Stroke sufferers may also experience an occupational transition - which is when "circumstances creating change in the nature or type of occupational engagement pursued by or available to an individual. Such changes may be the result of choice, changes in physical or mental status, life transitions, geographical change, geopolitical strife, or other factors" (Christiansen & Townsend, 2010). Stroke sufferers are almost certain to go through an occupational transition, as the occupations that they once used to participate in may no longer be possible, but new ones may arise through their involvement in a new community. For example, a stroke patient who once used to spend his time playing golf, may access an online stroke community, become involved in fundraising and awareness events and therefore experience an occupational transition. 

Although online communities have a number of benefits, there may also be ethical considerations that arise when using them. For websites such as the ehealth Forum, although one must make an account to contribute, there is a large degree of anonymity - with no real names or personal information supplied. This is essential in ensuring users safety, but because of the anonymous nature of contribution, there is often ethical issues around individuals who may chose to abuse the system - who post inappropriate and irrelevant information that may be considered offensive to others, and think that they can get away with it because nobody knows who they are. To address this ethical issue, many online communities have methods of moderating such users, where other members can report abuse or block them, and their membership privileges can be taken away.

Online communities such as those investigated above have plenty of benefits, but also have limitations when comparing them to traditional geographical communities, such as support group meetings. They can provide large amounts of relevant information, can provide connections over large geographical distances, are fast and less costly to run, and give people a more equal voice and a feeling of unity and understanding. But it is important to be wary of the negatives too when utilitising these systems- some of the information shared can be invalid and untrustworthy, having reliable access sources to the technology can sometimes prove an issue, and sometimes, overuse and misuse can immerse the person too deep into the virtual world and result in the individual developing a delusional reliance upon the community, isolating themselves from real life social interactions.

References

Christiansen, C. H., & Townsend, E. A. (2010). An introduction to occupation: The art and
               science of living (2nd ed.). United States of America: Pearson Education Inc.

Friday 27 April 2012

Tutorial Five: Video Production (Part Two)

My first fieldwork placement was set in an assessment, treatment and rehabilitation ward that specialised in rehabilitation in over 65's. Consequently the majority of patients that I worked with during the four weeks were elderly, and facing problems that many do in the later stages of their lives. Being exposed to not only the medical issues, but also the occupational issues that elderly commonly face has led me to investigate videos that concern elderly health, and the activities that older adults can engage in in order to facilitate the maintenance of their ever-developing occupational identity and be satisfied and engaged in their lives.

All this talk of technology, now here is proof that even the elderly are making use of I.T to keep their minds active and engage in meaningful occupation through electronic devices. This 100 year old women swears by her Nintendo DS, which plays on everyday and says keeps her mind active and her feeling young. The use of technology amongst the elderly is certainly becoming more common; even if it takes them a little while to get used to, many older people are recognising its benefits, such as using cellphones to keep in touch with family and friends easily.


There are many organisations for older people, such as Probus: an association of semi-retired and retired people who meet together in clubs to "keep their minds active, expand their interests and enjoy the fellowship of new friends" (YouTube, 2008). The video below from Probus includes interviews from members explaining how Probus is beneficial to their occupational lives.


Just because you get older, does not mean that you have to give up the occupations that have always loved, as this 91 year old water-skier displays. A skier for 50 years, Edith McAllister hoons away behind a jet boat no trouble at all. Of course, not all elderly remain in adequate fitness to participate in such physically demanding activities, but this lady is a great inspiration and goes to show that old age should not limit your occupational engagement, whether it be knitting, reading, or water-skiing!


Art as a meaningful occupation is used as the principle of Art Therapy, which is thought by many researchers and health professionals as an activity that can be used to improve the quality of life for older adults, even those who have dementia or Alzheimer's disease.


Here are two videos of the Tuesdays@4 performance troupe, a group of senior citizens using the  occupation of dance to socialise, have fun, express themselves, and show the world that even though they may be old, they still have moves!



References:

YouTube. (2012). 100 year old keeps sharp playing Nintendo DS. Retrieved on 27th April 2012
              from: http://www.youtube.com/watch?v=nawe7F8cZ_U

YouTube. (2009). Amazing 91 year old who slalom water skies daily 1. Retrieved on 27th April
              2012 from: http://www.youtube.com/watch?v=M8tQAdopfTo

YouTube. (2010). Beyond bingo: Art therapy for the elderly. Retrieved on 27th April 2012 from:
               http://www.youtube.com/watch?v=inTDrDax9pQ

YouTube. (2008). Probus. Retrieved on 27th April 2012 from: http://www.youtube.com/watch? 
               v=K3zcEF3p8Fo

YouTube. (2011). Senior Citizen Flash Mob! Tuesdays@4. Retrieved on 28th April 2012 from: 
              http://www.youtube.com/watch?v=Wuptqo31KiQ

YouTube. (2011). Tuesdays@4 Performance Troupe. Retrieved on 28th April 2012 from:
              http://www.youtube.com/watch?v=w8AtW3qLcKY

Tuesday 24 April 2012

Tutorial Eight: Assistive Technology

Assistive Technology is an umbrella term that is proposed in the Assistive Technology Act of 1998 as referring to "products, devices or equipment, whether acquired commercially, modified or customized, that are used to maintain increase or improve the functional capabilities of individuals with disabilities" (Gerard, 2001). As these functional outcomes are the real measure of the success of assistive technology devices, the primary aim of all assistive technology is to provide an increase in functional capacity for the individual (Cook & Hussey, 2000). It is very important as an Occupational Therapist, or any service or organisation that directly assists the individual with a disability to select, acquire and use assistive technology devices, to acknowledge that every circumstance and individual is unique and therefore each application of assistive technology needs to be carefully tailored to the persons needs, skills, activities and context. As I.T and technological devices become more and more advanced, it is inevitable that so to will assistive technology, and therefore individuals with disabilities will continue to gain greater increases in their functional abilities.


One of the pieces of technology that we were introduced to in the assistive technology tutorial was the iPad; a portable tablet computer designed and marketed by Apple Inc., first released in 2010. The newest version of the iPad is sleek and light, at a height of 241.2mm, a width of 185.7mm a depth of 9.4mm and a weight of just 652g, a far cry from the first ever computer which measured 2.4 meters, by 0.9 meters by 30 meters and weighed 30 tonnes - you couldn't fit that in your backpack! At its cheapest, the iPad costs around $729.00 for a 16GB version, and $1029.00 for more storage in the 64GB version. The iPad is host to a huge range of functions, such as a 2048-by-1536 pixel retina display, multi-touch screen, a 5MP inbuilt camera with 1030p video recording capabilities of 60 frames per second, wireless internet capabilities and bluetooth connectivity - to name only a few. It also has a number of built in applications such a mail, music, maps and many more, with the ability to buy and download thousands more via the Apple app store.

The iPad is a fantastic piece of assistive technology that can increase the occupational engagement for the user in a number of different ways through use of its many features and functions. In the tutorial session, when I was having a go with all of the adaptive equipment, I found the iPad to be and extremely engaging and interesting piece of equipment and one that could certainly be utilised by occupational therapist in order to increase the fuctional abilities of a person with a disability. Because the iPads functions are ever expandable through the use of downloadable applications, it is a tool that could be used for a variety of different purposes and therefore cater for the wide range of unique users that it may have. Non-verbal clients can use the iPad and its simple touch screen interface to communicate their needs and wants. For example, in the tutorial, we were able to use an iPad app as a communication tool to communicate and give directions to others while making a smoothie, without actually having to verbalise. There are also numerous apps that help clients with learning, scheduling, and many other areas.

The below link is a website called O.T's with Apps, and is a helpful resource that gives tips and tricks on using the applications, as well as reviewing their use and recommending them for O.T practice.

http://otswithapps.wordpress.com/

Here is the Apple store list of applications that are useful for people with Autism, Down Syndrome and other special needs.

http://itunes.apple.com/nz/app/autism-apps/id441600681?mt=8





The above videos demonstrate how the use of an iPad and apps can make changes in the lives of those living with disabilities. In the first video, the little boy who can not verbally communicate is using the iPad to communicate which occupations that he wants to participate in, allowing him to be engaged in occupation that is meaningful to him, and therefore avoiding an state of occupational deprivation, where he is unable to do things that he wants to do due to a lack of ability to tell others. In the second video, the iPad is used as a tool that can increase the potential of people with autism, helping them to improve their occupational function and engagement in many areas. The use of assistive technology relates directly to the concept of occupational justice; that all members of society have a right to equally participate in their occupations, as it is often through the use of such technology that this humanistic principle can be fulfilled for individuals with disabilities.

References: 


Cook, A. M., & Hussey, S. M. (2000). Assistive technologies: principles and practice. St Louis: Mosby.


Gerard, D. (2001). What is assistive technology?. Retrieved from:  
                http://www.rehabtool.com/forum/discussions/1.html


YouTube. (2011). 2010 year of the iPad - focus on Austism. Retrieved 25th April 2012 from 
                http://www.youtube.com/watch?v=31yEs9itueE

YouTube. (2010). Child with special needs uses iPad to answer questions. Retrieved 25th April 2012
               from http://www.youtube.com/watch?v=0EulS1MTqDo

Monday 16 April 2012

Tutorial Four: Video Production Sessions


Occupational Deprivation at Otago Polytechnic

In class we were put into groups and were required to make a short film relating to one of four concepts : occupational justice, occupational disruption, occupational transition, or occupational deprivation. My group chose occupational deprivation, which relates to the prevention of the person from performing their daily activities due to circumstances that are out of their control. We decided that focussing on access around the Polytechnic for people with disabilities would be relevant to the topic as well as achievable in relation to the resources and time that we had available. 

As a group we discussed and storyboarded the film, deciding on the use of an electric wheelchair, and several short scenes that emphasised occupational deprivation through lack of physical access around the Polytechnic, such as getting into the toilet cubicles, reaching for books in the library, and getting out of a building in the case of a fire. We also decided to shoot and edit the film in the style of a silent film, to make it more visually interesting for the viewer, and therefore be more effective in portraying our concept.

Tutorial Two: Occupational Engagement, Doing, Being, Becoming and Belonging.

Dance allows one to do, be, become and belong.

Dancing is a universal human occupation; it is an art form almost as old as humanity using movement of the body to express oneself. I have always loved to dance, however uncoordinated I may be; whether it is at a school disco or attempting to learn ballroom. I appreciate dance as a beautiful, intricate and skillful art form and wonder at the talents of professionals. During Fieldwork 2 I had the opportunity to participate in a weekly dance group with individuals with disabilities. Their incredible enthusiasm during these sessions emphasised just how important dance can be as a meaningful occupation and I therefore chose to investigate it further.

The concepts of doing, being, becoming and belonging are all integral to the philosophy of occupational therapy, because “together, they epitomise occupation” (Wilcock, 1998b). According to Hammel (2004), the notion of doing involves involvement in purposeful, goal-orientated activities. The ability to ‘do’ provides “structure, an affirmation of competence and enhanced feelings of self-worth through a sense of being valuable and capable” (Hammel, 2004, p. 301). Image 10 & 11 (Dancers in wheelchairs) shows that the ability to ‘do’ does not have to be compromised because of disability: adapted occupations still provide the same benefits and feelings of involvement. ‘Being’ is a more philosophical concept that is centrally concerned with the nature of existence. It is the time taken to reflect and introspective or meditative, rediscover the self, savour the moment, appreciate and contemplate art and music and enjoy being with special people (Hammel, 1998a, as cited in Hammel, 2004).  Image 4 (Royal ballet, swan lake) displays the occupation of dance as an art form that allows for humans to reflect upon and appreciate the beauty that can arise from occupation. ‘Becoming’ looks as life as a process, with our history and present contributing towards our ‘becoming’, and providing us with the ability to envisage our futures and explore opportunities in order to get us to where we wish to be. Image 8 (Billy Elliot) represents this concept: the visualisation of a future in the occupation of dance, and the necessary steps that will ultimately result in that achievement. ‘Belonging’ relates more specifically to social relationships, and emphasises the importance of social interaction, friendship, support and inclusion and feeling that ones life has value not only for oneself but for others also (Duggan & Dijkers, 1999, as cited in Hammel, 2004). Image 12 (Flash mob) epitomises the sense of unity, inclusiveness and friendship that dancing can provide.

Ethical considerations that I have made in relation to the images that I have chosen: ensuring that each image that I have sourced from online are appropriately referenced in full (on each slide), so that the original author of the material has credit and readers can easily access the original image. I took care in ensuring the online sources that I used were authentic and reliable and not using copyrighted material without permission. In my accompanying material I referred to my fieldwork placement, as it influenced my choice of occupation, but I made sure not to state names of people or places to ensure privacy.

References:

Hammell, K.W. (2004). Dimensions of meaning in the occupations of daily life.  Canadian Journal of Occupational Therapy, 71 (5).

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

View more PowerPoint from Aimee McKay

Thursday 8 March 2012

Tutorial One: Information Technology and Ethical Issues

We live in the “Information Age”. Technology influences almost everything we do; a curse or a blessing depending on who you are, and which way you look at it. Either way, its almost a certainty that the wondorous world of computers is not about to fade away any time soon. The first posting on this Participation in Occupation One blog focuses upon what Information Technology is and how it is used in society, in our daily lives, and in occupational therapy practice, and also how ethical issues can arise when using such technology.

Information Technology, or IT as it is more commonly known, refers to “anything related to computing technology” (Techterms.com, 2012). When one thinks of the seemingly infinite amounts of ‘computing technology’ that we are bombarded with on a daily basis, the above definition appears impossibly broad. It can be thought of as the umbrella term under which to cover almost anything that is relevant or related to computer technology (and that’s a lot!), for example, networking, hardware, software, the Internet, or even the people that work with these technologies. 

Looking around my room, I can count numerous ways in which IT is contributing to my life right at this very moment. Of course, I am typing up this blog post on the king of all IT devices, the Macbook Pro (Debates welcome, Mac vs PC... Go!): but there is also my cellphone at the ready in case of external contact, my iPod processing & playing the mp3 sound files necessary to maintain my study sanity, and that's not even mentioning the items that have been indirectly created in some way through IT. My textbooks were typed and printed with computers, that chair was probably designed with a computer, the photos on my wall were all taken with digital technology. The influence of IT is everywhere. Its use in human society and our daily lives has grown exponentially throughout the last few centuries, creating a technological world that is almost unrecognisable to that in which we lived not so long ago. At the young age of 18, even I can say, “I remember back in my day”, when my family received a hand-me-down computer the size of a microwave and the wonder, mystery and hours of fun this wonderful machine provided. If I ever got the chance to boot that old thing up again and attempt to write one of my assignments, or check Facebook, I am certain I would probably throw it out the window within minutes in frustration. Technology has advanced since then, and has become so commonplace that we don't only expect to own the latest techno-craze but we expect it to work efficiently as well. 


The above video gives you an idea on the growth of technology in our "Ever Changing World". If we have come this far, so quickly, just imagine what the future of technology can hold. Extremely human like robots are not so far off as seen in the clip below. Is this taking it too far? Are we setting ourselves up for a robot uprising? Perhaps we will be working alongside these new humanoid creations in the not so distant future?



Slightly creepy?

I believe that a number of different factors have contributed to my interest in IT and my comfort in using a number of different technologies throughout my life. It is a widely accepted notion that younger people are overall more competent and comfortable using IT than older people (teaching your parents how to use a computer/cellphone etc. anyone?) Having grown up in a time where technology was making rapid advances and becoming more and more commonplace in daily life, my generation was naturally expected to use IT, and therefore it has been, and remains an integral part of our lives. I also have a very positive view upon technology and its future, I would certainly put myself on the technogeek end of the technogeek-technophobe spectrum. New, exciting and useful IT devices and systems are arriving at rapid speeds, and as part of the technological generation, I want to utilise them and use them to my advantage for work & enjoyment. I am constantly using IT to engage in purposeful occupation: using it to work towards my future degree and career, using it to communicate and stay in touch with my friends and family, and using it for leisure activities and enjoyment - editing photographs, browsing the depths of the internet, listening to music. I.T opens up a world of connectivity and opportunity. The magical marketing & constant updating of the lastest cool gadgets doesn't really help. How can I resist that new, shiny, iPhone 4s, with dual-core A5 chip, all-new 8MP iSight camera and optics, iOS 5 and iCloud - "The most amazing iPhone yet.", from only NZ $1,049.00. Well, actually that price could be a slight issue...

The always expanding field of I.T is now firmly engrained into our professional work lives; it has revolutionised as well as created many career paths. Looking back to my first year days, when I was sent off to the depths of the South Island for my first four week placement, it is interesting to note that during my fieldwork experience, I was exposed to the least amount of I.T that I had been in goodness knows how many years. Although I was working in a full-fledged, government funded public hospital, all of the health professionals notes were hand-written and hand-filed, and the in the geriatric rehabilitation ward where I was, the use of assistive technology in intervention was not commonplace. I was thoroughly surprised as I had previously not envisaged, what seemed to me, to be such an 'old - fashioned' system still being employed. Don't get me wrong, it worked perfectly fine, and none of the patients were any worse off for it; but even my supervisor asserted that having a bit of an upgrade would not be unwelcome, and might make things speedier and easier for everyone. I believe that my situation was rather unique, as more and more occupational therapists are adopting IT systems and tools and incorporating them into their practice, and taking advantage of the full benefits that they can offer for both practitioner and client. I.T can be used at the basic level of word processing and digitally storing client notes and records as well as emailing and communicating with other professionals and services. But an understanding and use of I.T can also be taken further, to create amazing technologies that allow people to participate in meaningful occupation and activity that they may have previously been deprived of due to injury or illness. Below is a video of an example of the use of technology in occupational therapy.



The evolution of I.T devices, and the ability to capture, share and transfer information with the click of a button has unfortunately resulted in ethical implications galore. One of the main concerns in I.T today is regarding copyright and ownership. Even with copyright laws and measures in place and crackdowns on internet downloading and piracy, using I.T to illegally share and possess copyrighted data is extremely common and easy. Students needing their weekly fix of their favourite television show can do a quick Google and voila: its right there on their screen. And the excitement is only intensified by the prospect of outsmarting the copyright police and escaping a gigantic fine... right....? Another ethical issue that is common is privacy issues. Having your personal information splashed around the internet for any stalker to access is not ideal, but these days its becoming more and more common - especially with the use of social networking sites such as Facebook. Once you have uploaded content to the internet, it is important to realise that it is no longer exclusively under your control .Those disgraceful drunken pictures can be copied, pasted and sent to your grandma or boss as quickly as you can say reputation. 

References:

Techterms.com. (2012). IT. Retrieved from http://www.techterms.com/definition/it


YouTube. (2009). An Ever Changing World. Retrieved from http://www.youtube.com/watch?    
                v=yuKu6PZXCIY&feature=player_embedded           


YouTube. (2011). A very human like robot invented by Japanese engineers. Retrieved from  
                http://www.youtube.com/watch?v=MaTfzYDZG8c&feature=player_embedded


YouTube. (2009). Technology and Occupational Therapy. Retrieved from 
                http://www.youtube.com/watch?v=A4Bf9Sv8JdE&feature=player_embedded