When parents die

My mother died in Nov '10 & my father died in Dec '11. Their deaths were very different.

My mother had a major surgery in '09 & had complications that resulted in kidney failure. The last year of her life she was on dialysis every Mon, Wed & Fri. My mother did not take care of herself.... she was a smoker, which resulted in COPD. She even had to start using oxygen while at home, but she continued to smoke (she just made sure the O2 was off while smoking). She also did not eat very well... hot dogs, french fries, chips, etc. We tried to get her to eat healthier, but she wouldn't. My mother developed a terrible blood infection & had to go to the hospital. She was there for about 2 wks when we finally thought she was out of the woods. The last time I visited my mother at the hospital she was alert, joking, eating & seemed to be feeling a lot better. My oldest brother & sister talked to her on the phone that day & my other brother went to visit her after he got off of work..... that same night my mother passed away without any warning. Her body was worn out from fighting the infection.

Before my mother died, my father began having pain in his back/buttocks areas. He & his dr thought it was due to a pulled muscle, so the dr gave him pain pills. 9 months later in August the pain had gotten worse, so the dr took x-rays, and saw something on my father's lungs. My father was a smoker too (since the age of 11, when he would take tobacco pieces off the floor of the tobacco barn & roll them into a cigarette). A CAT scan revealed cancer that had metastasized to other parts of his body. From that day forward, my brother, sister or I stayed with him, cooking, cleaning & making sure he ate & took his medications. My father agreed to have radiology treatments for a spot on his spine... the spot that had been giving him such pain. The treatments helped for a short time. He began to lose weight, he didn't want to eat, had terrible constipation from his meds, had to have a foley, and could barely walk anymore. Home health care came in weekly to check on him, & helped in with bathing & shaving. But there finally came a point when he just could not take the pain anymore, & we were not able to help him. In November my father had to go to a hospice facility.

At first my family did not want to use hospice. We wanted to do it ourselves & thought our dad would be happier at home. But we were wrong. It was a wonderful place for my father. They were able to relieve the pain my father was having. The staff were all so caring & attentive. They answered all of our questions... even if we asked them over & over again. They made sure my father did not suffer while he was there. He even joked with the nurses & CNAs. My father was at the hospice facility for about 3 wks when his body finally gave out. Even though my father would have wanted to die on the same land that he was born, he knew that his family could no longer take care of him, & he was able to die peacefully. I would highly recommend to anyone sending a love one to hospice facility.

In the last 2 years I have had to go through 2 different types of deaths - one sudden & one drawn out for a few months. When it's time for me to die, I'm not sure which way I'd like to go. I think they both have advantages & disadvantages.... I guess I just need to be ready just in case it does happen.

Now that I've experienced death with my parents, hopefully I will have more compassion & understanding when I have to deal with it as a COTA.

Death and family

This week's blog is about death and I have my fair share of it these past weeks; my stepdaughter losing her infant daughter and I losing my uncle, a very close relative. Death unfortunately is apart of life and at some point in time one has to deal with it. Were they "good" deaths? I am not sure, maybe they were. One developed an infection after being born prematurely, and the other was sick but in treatment and optimistic. What constitutes a "good death"? Is it one without suffering, one that happpens before realizing any disabilities are present, or one that happens when there has been enough suffering and pain? Whether there is a good death or not, the one thing I want is to be remember for having a good life.

My uncle's death might have been considered good because he did not get any sicker or suffer lots of pain but the one thing that stands out for me this past week was the good life that he had. My uncle had found his soulmate, had three sons and was devoted to his friends and community. My uncle never met a stranger and if you ever met him you would not forget him. He had the most unbelievable way of being positive and encouraging that you wanted to be the best that he knew you could be. He touch so many lives and it was reflected by the standing room only at the two services held in his honor.

As I pause and cry alittle, I realize that I might be off topic but death to me right now is from the family's perspective and how I can use this experience to be of help to families of my patients.

A Good Death..Is There Such a Thing?

The one time our instructor gives us a topic to blog about it is about death...thanks Ms. G!! I really do not think about death much because it kind of makes me uncomfortable. I will say that I am more comfortable now with the topic than I use to be, but it still is not an easy topic to deal with for me. I have been fortunate to not have many people to pass away in my family. I still have my mother and all my grandparents. My great-grandmother passed away when I was in the 8th grade so I was very young (and like another blogger posted "self absorbed") and really did not grasp what was going on. I had a good relationship with my great grandma, but I know if she would have passed now as opposed to then it would affect me differently. Almost 2 yrs ago my grandfather's physician gave him 24 hrs to live...when I heard that I thought I was going to die with him! I literally fell out of my chair and just started crying uncontrollably. I am usually the one that "keeps it together" in the family and my mother is the cry baby (she knows I have given her this title), but I could not hold back all the emotions I was feeling. I was sad, mad, scared, anxious and confused all at one time and all in the matter of minutes!! So my incident with him is the only thing I have to go on regarding death. I like to image that my grandfather wishes he did some things different in his life; I know even at my age now I wish I would have done some things different. The main thing I think about now regarding myself and dying is my son. If something were to happen to me now I hope that my mother is around long enough to look after him until he matures (that might be well after he is 21 yrs old!!) and if something happens to me later in life I hope that I go in peace and all that I leave behind will be ok.

No Regrets

This week we have been given a topic to blog about. Death. I can't say that I am totally excited about this topic because it brings up some feelings that make me feel uncomfortable. I guess what I can say without doubt, is that I have some personal life experience to add to the discussion. I watched my father in the dying process for about 4 months. I was in my mid 20's and to say the least, self absorbed. I avoided the situation as best I could and did not invest emotionally. The problem with this is that these feelings of regret and unfinished business follow me. I would urge anyone facing a love ones death to deal with any positive or negative feeling they have with the person. Say everything you have to say to them or want to share with them in the time you have together, even if you think it will upset them. Having regrets after one passes is difficult and it makes the grieving process longer and harder. I believe this is true with our future clients as well. We all dye and it is more than probable that in our careers as OTA's we will experience death with some of our clients. I hope to help the families as well as the person going through the experience. In researching for this blog, I found a great resource for family members. Some people may not know the signs of death and understanding and recognizing them may help in the process. The article talks about symptoms of the final stage of life including; coolness, sleeping, disorientation, incontinence, restlessness, urine decrease and food and fluid decrease. The article also mentions some emotional and spiritual signs and responses including withdrawal, vision-like experiences, restlessness, and unusual communications. I saw some of these for myself first hand. My father was in the hospital the last few days of his life. I was not there the whole time, but the time I was there he was sleeping and seemed to have conversations in his sleep. Similar to a dream, but there was something different about them. It seemed as if he was preparing himself to walk over to the other side. He was in conflict for a day or two and then seemed to let go. I often wonder if I had given him permission to let go, would he have let go sooner? Now that I am older and somewhat wiser I hope I can be of support to my clients and family members when faced in this situation. Death can be a sad time, but it can also be a time to finish what we have started here on earth and know that our loved ones will be waiting or us, because there will come a time for us to finish here on earth as well. Saying thank-you and I love you is not always easy, even in death. Giving family members support to do this can be very valuable as therapist. Being the one to tell a client thank-you or I love you might be the only thing we can do for them because there may not be anyone else. I am ready for that challenge and just wish I didn't have the regrets with my own father's passing.

Role as a Nurse

My mom recently took a PRN position with Alamance County Hospice Home. She currently works in critical care as a nurse in the hospital and is met with challenging patients who die everyday. When I asked her how could she work at hospice with all of the people there, knowing that they are going to die she responded that at work the people die and there is nothing that they can do. At hospice you go in knowing that they are going to die and your job is to keep them as comfortable as possible. Everyone dies. I guess it is better off knowing than not knowing.

This led me into the conversation about how she talks to patients about dying and how she talks to them about hospice. She told me that when she talks to someone about dying in the hospital that she doesn't dance around the subject and give them false hope. She asks them if they understand that they have exhausted all medical procedures and medicines and that there is nothing left that they can do for them. Sometimes she has to "pull the cord" on breathing machines if the patients want it . She tells them that they will quit breathing but that they have medicine so that they will not be gasping for air, just be comfortable and go without suffering. This is something that I would find extremely hard to do. It's kind of like killing someone. But not, just letting them go and not have them suffer.

When she talks to someone about going to hospice, she talks about dying again and that there is nothing left to be done, and then talks about the services that hospice offers. She tells them that without treatment they will die soon and hospice can make them comfortable, they have round the clock nurses that can take care of them and it can relieve their family from having to take care of them.

She told me that the most problems she sees in someone who is getting ready to die is that they are worried about their families and if they will be ok, financially and emotionally. Most of the patients need to hear their family say that it's ok to go and that they will be ok before they pass on. I can see this being a problem - not knowing if your kids or grand kids will be ok or if your wife will have enough money without you- major stress.

These are all issues that I will struggle with talking to patients about. I guess it takes experience, but I don't know if I'll ever get used to talking to someone about dying or their life ending. Hopefully I can gain knowledge on how to do this and get my frame of mind in a place were I can deal with death more easily.

I have attached an article on how to deal with death, something I find useful.

Hospice+grief+letting go

This week I am supposed to blog about "a good death." As I'm told this, I'm thinking, "seriously? Could there be a more depressing topic? *sarcasm*"So what does a good death mean to me? I think that a good death is when you have come to terms about what you've done or haven't done, about the life you lived and what may or may not await you. Ideally when it is my time I would like to have forgiven those who I still hold grudges against and forgive myself for choices that I've made. I want to feel ready. I want B to be all grown up and not need me anymore. I want to know that she'll be ok when I'm gone.

I didn't really know what hospice was before this assignment. We talked about myths of hospice care last week in class. I thought a lot of those "myths" were true. After our discussion I decided to look a little deaper. Hospicenet.org has a wealth of information for patients, children and caregivers. It has information on how to handle grief and how to talk to children about death. Here is a portion of the hospice concept that really stuck out to me,

"Hospice affirms life and regards dying as a normal process. Hospice neither hastens nor postpones death. Hospice provides personalized services and a caring community so that patients and families can attain the necessary preparation for a death that is satisfactory to them.

Those involved in the process of dying have a variety of physical, spiritual, emotional and social needs. The nature of dying is so unique that the goal of the hospice team is to be sensitive and responsive to the special requirements of each individual and family."

Hospice is so much more than I thought that it was. I think that someone choose hospice either b/c they know that their is no treatment left or that they don't want to fight the disease at all or anymore. I think people who choose hospice are at peace with death.

I think that the best activity for someone who is dying is to make a scrapbook of their achievements or what they want their legacy to be. What do they want people to remember about them? Or maybe even a video of them telling their life story or showing off their talents. Something concrete that can be left behind, something more than memories.

Someone once told me that you never get over the grief of losing someone, you learn to deal with it. About 5-years-ago my mom's friend died. Her daughter was in 5th grade and her son was in 2nd grade. About the time she was given a year to live she began to write letters. She wrote them a letter everyday addressing any possible issue that may come up. She talked to her daughter about getting her period and how to buy a bra and how to apply make-up. She wrote to both of them about how it was ok for their dad to find someone new and it was ok for them to like her. She told them that it was ok for them to be mad at her for dieing. I think that this is a great way to handle grief on both ends.

When do you push someone to do more and when do you "let go?" I was thinking about this out on FW last week. My pt. is almost 94-years-old. He has been refusing to transfer and would rather sleep than do anything else. I understand the justification for services but at the same time, he is really old. Can someone at his age still be independent? Certainly. Could he still live another 5 years? Sure. My thoughts are just that if he doesn't want therapy, then who am I to make him? Also, there was a pt. that I saw out on FW who was a member of one of my peer's churches. She was a tough pt. What I heard from the OT and the CNA was that she refused to eat, threw her food at people, pulled hair, swatted her hands around and bit. The CNAs would give her meds. to calm her which ended up knocking her out so when I saw her she was pretty much asleep for the whole session. Well, I saw her on a Tuesday, she died a few days later. I hate that she spent her last days in a place that she hated with people trying to get her to do things that she didn't want to do. I think that is another reason why I struggle in this FW. It seems to me like it is time to "let go" when the pt. decides that it is time to let go.

Cheesecake on the Way Out!

It was a normal day at the senior center for 87 year old L, she attended her normal Pump and Tone exercise class, relaxed in the library while finishing her daily newspaper crossword puzzle, played bingo, and even ate a delicious lunch with cheesecake as dessert at the Meals on Wheels nutrition site. With in 10 minutes of her last bite of cheesecake she had a pulmonary embolism and passed away on the way in the ambulance on the way to the hospital. Now that is how I want to go out! Pumpin iron with friends and eating cheesecake. She definitely left this earth with her boots strapped on.

This was my first experience of the death of an elder who I called a friend. Interestingly enough, I saw death differently when it wasn’t a family member. I was really present with my emotions and I remember it spurring on so many thoughts about death…How I want to die, how I don’t want to die, she was here one minute…and gone the other, transition from life to death (kinda peaceful, yet creepy), funerals, wills, grieving loved ones. This was 3 years ago and I still don’t have my mind wrapped around it all (and probably won’t ever fully understand until I go through it myself). But all these thoughts and ponderings will hopefully help with understanding some of our patients who happen to be at the end stage of life.

Each patient we come across as OTAs will have different needs at the end stage of life. The challenge is to figure out where they stand with death and help them make their short days meaningful and full of life. As OTA’s we will face a lot of patients either grieving a loved ones lost life, or grieving their own life that is coming to and end. We are to be resources of knowledge, compassion, empathy, and another person they can count on to make their wishes become reality. Sometimes family and friends are reluctant to face up to the fact that the person is dying and it might be beneficial for them to seek outside support.

We might watch our patients withdrawal from life, but I don’t necessarily think this is a bad thing. Sometimes people need to take time to reminisce in the quiet, ponder their accomplishments, their shortcomings, their relationships, their faith…etc. I think it is healthy to bunker down for a while and realize the feelings that might be deeper down inside.

I am halfway through the book Tuesday with Morrie and what a good book! He really has a grab the bull by the horns attitude on dying. He refuses to wallow away until his final inevitable breath. I want to share a beautiful part of the book that we can all take a mental note of…

I asked Morrie if he felt sorry for himself. “Sometimes, in the morning,” he said. “That’s when I mourn. I feel my around my body, I move my fingers and my hands—whatever I can still move—and I mourn what I’ve lost. I mourn the slow, insidious way in which I’m dying. But then I stop mourning.” … “I give myself a good cry if I need it. But then I concentrate on all the good things still in my life…I don’t allow myself any more self-pity than that. A little each morning, a few tears, and that’s all.” How useful would it be to put a daily limit on self-pity. Just a few tears, then on with the day. pp 56-57

I know Morrie is an exceptional case and not everyone will be able to reach this point of peach and clarity before they pass on…but I think as OTAs, we can play a part in helping someone get to that point. We have an important role in their comfort and support. And hopefully we can see some of the leave this earth sweatin to the oldies and eating cheesecake!

A Good Death

The theme for this week is "A Good Death". There are so many things running through my head right now that I don't know what to put first.
The minute we are born, we begin to die. This life is my journey and my destination is heaven.
I do not want to die with regrets, but regrets are part of life and I have a lot of them. I already regret not spending more quality time with my children. I regret the hard times that I put my parents through. I regret making a lot of decisions without praying about them first.
Regrets aside, I have had a very blessed life. When I was younger I would worry about dying and thought about it often. Now that I am older, I do not worry about death. I feel at peace with the thought of dying. I am not ready to leave this world, but I am prepared.
Those who work with hospice are angels on earth. They are the most caring people I have ever met. When a person is suffering from a terminal illness, the support hospice gives can make a big difference to everyone involved in making decisions.
I'm sure everyone would prefer a peaceful, pain free death and I am included in that preference. My definition of a good death? I want to die at the end of the day, satisfied that my God and my family know that I love them. After I have gone to bed, said my prayers, and asked for forgiveness, a peace surrounds me that only God can give.

What Is A Good Death?

Wow, that's a loaded question, and I wish I knew the answer to it! I was thinking about the role a COTA would play in a good death, and after doing some research, it seems that therapeutic touch would be most beneficial at this stage in one's life. After learning about Dementia, Alzheimer's & Parkinson's disease, I now know and have experienced the language barrier in these diseases, but one thing always seems to still be understood and that is being empathetic and applying therapeutic touch.

Click on the title for a very informative article on the benefits of therapeutic touch. It has some great information, including, in 2005, the College of Nursing at the University of Arkansas studied therapeutic touch and came to the conclusion that it decreases prevalent symptoms like restlessness and unrelenting vocalizations.

Guy McCormack is an OT who wrote the book Therapeutic Use of Touch. In this book, he states that the most powerful therapeutic tools ever invented are our hands. Wow, that's a powerful statement! Dolores Krieger is a nurse who developed the treatment modality, Therapeutic Touch which means "the use of hands by the caregiver with the intent to help or heal." Another way to describe this is "touch with intentionality."

I know from my past experiences that I am not good at speaking to people or saying the "right" things in difficult or trying times in one's life, but I can always use therapeutic touch. Also, when one is having visual difficulties, therapeutic touch is almost a necessity in treatment. I believe this is a great treatment modality to use with the client's family as well, because as difficult as it is for the patient, the family is losing a member of their family, and we don't want to leave them out. Even though someone is dying, as long as they are still here, they need to be treated with dignity and respect, just like we would want to be treated!

Last semester, my supervisor and I went to see this gentleman who was dying. He was suppose to receive OT so that he would be strong enough to go home and pass away, but after a heartfelt, honest discussion with him, everybody involved came to the conclusion that, at this point in his life, OT was only going to tire him out, put him in unnecessary pain and decrease his time even faster. It was hard to hear this conversation but it was nice to see the honestly. He was then turned over to Hospice and passed away before I came back the next week. I don't know what kind of individual it takes to work with Hospice but they must be special people. I guess they take solace in knowing that they help make an individual's life as pleasant as possible in their last days.

A Good Death

It was not to difficult to answer the question of what a good death would look like to me. It would mean going to bed after having kissed my family goodnight, told them that I loved them, and never waking up. It would mean a peaceful end to this journey, and a beautiful beginning to the next!
I truly do not believe that many of us will be fortunate enough to have this type of experience. I know of only one person who left this earth in this manner. Talk about a "free ride!!!"
What I know about Hospice is this--in a very simplified form--Hospice provides comfort and compassion not only to the dying individual, but also to their family and loved ones.
What I believe about Hospice is this--Only a very special person is capable of meeting the needs of a dying individual. It would take a person whose caring, compassion, energy, and understanding are unwavering. I believe this person also has to have a remarkable strength in their faith in order to provide the level of care that is needed as they guide an individual through their journey.
I have never experienced Hospice firsthand. Whether that is a curse or a blessing; unsure to me at this point. I have however heard from a friend whose family had needed Hospice not too long ago. My friend told me that her Dad was treated with such dignity and respect, that the whole family was amazed. She explained that "you would have thought he was the most important person on earth." They were very grateful for the care that he received.
I know of a person that worked for Hospice many years ago. To this day, she still possesses all of the qualities that led her to Hospice, and then eventually to her position in the ER. Her undertanding of the human spirit never ceases to amaze me. I am blessed to have her in my life!
As OTA's, we may have the opportunity to speak to our patient's about death. 'Know your patient' stands out when thinking about this. Not only should we know their faith, but also the strength of that faith. In my experience with the senior population, they appear to be very spiritual/religious, which would make for a smoother transition along the journey.
I believe that one of the greatest activities we may provide for the dying patient is to help with a scrapbook that they would leave behind, but that would be of a huge benefit while they are still here. If a patient liked to cook a big meal for family and friends, we may assist in making that a reality. Helping a patient to create a memory blanket with meaningful pieces of their lives on it, is another option. If presented with this situation, there are many options that may be generated.
I would think that the best time to call on Hospice would be at the beginning of a life-altering situation. Ideas, strategies, and information may be shared that would benefit all involved for the journey ahead.
For me, the most ideal situation as my time drew near would be this: I would feel enveloped in love, care, and prayers. I hope to leave this life hearing the voices (real voices!) of those that I have loved. I hope to hear laughter as stories are shared, with music in the background! That would be a good death!
I found two quotes that I thought were appropriate to the subject.

It's only when we truly know and understand that we have a lmited time on earth--and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had.
Elisabeth Kubler-Ross

God's finger touched him, and he slept.
Alfred, Lord Teenyson

Perspective on Death

Dealing with the idea of death is difficult when you are young when both life and death are still pretty new things. Death is unfamiliar and frightening then, hard to understand. It makes you feel vulnerable and insecure. As we all age, we likely experience death many times and in various ways. We hear stories and lose some of our friends and relatives to old age, disease and accidents. Hopefully experiencing death does not make us cold or insensitive to the reality of it, but rather just more accepting of it.

The truth is that life is really just our journey to death. Those who believe in a divine plan look at life as our journey back to God, and so we make the most of our years striving to do His will and hoping for the bliss of heaven. This hope of eternal life somehow makes the idea of death bearable. As we age it becomes easier to accept that our years are limited. At some point we make a decision to make the most of our life and then plan the best we can for death. Nevertheless, dying can be hard. Some people pray for a peaceful death but not everyone gets that.

Those who are suffering leading up to death give others the opportunity to help them manage their last days (or years) with ease and dignity. It is hard to imagine a kinder or more compassionate thing for one human being to do for another than to assist them in this final stage of life.

I’d like to share a prayer pertinent to this topic. The title is Latin for “Body of Christ”

Anima Christi

Soul of Christ, sanctify me.
Body of Christ, save me.
Blood of Christ, inebriate me.
Water from the side of Christ, wash me.
Passion of Christ, save me.
Oh good Jesus hear me.
Within Thy wounds hide me.
Never let me be separated from Thee.
From the malignant enemy defend me.
At the hour of my death, call me.
And bid me come to Thee.
That with Thy saints I may praise Thee.
Forever and ever. Amen.

Dying with Dignity

This week the class is to blog on some aspect of dying. I believe respecting the dying person's wishes give the person dignity and control over his/her life. Hospice assists the dying with many of the aspects of involving the end of life. The attached link explains some of the services offered by hospice.

My father chose to discontinue kidney dialysis after several years. He was did not like how he felt after dialysis and saw many of his co-patients suffer from severe complications of kidney failure. His dialysis shunts in his arms were wore out and the doctor needed to put new shunts into his legs. My father refused and stopped dialysis. This was his wish and how he chose to live and die.

He never wanted to start dialysis in the first place. However, my brother was getting married in 2 weeks. My father agreed to start dialysis so he could attend the wedding. He thought he would stop dialysis shortly after the wedding. However, soon the next son was getting married, grandchildren were coming and other life milestones were happening in the family. There was never a good time to stop because he wanted to see the next wedding or grandchild born.

After 5 years, my father felt it was his time to go. He lived a full life in his 51 year, his children were young adults with families, the majority of grandchildren were born. My mother was financially secure enough that he felt she would be able to survive without his social security.

Hospice was called 3 days before he passed away (he lived 22 days after stopping dialysis). Hospice helped my father pass. Hospice also helped my mother to deal with the details of a person passing away at home, bypassing the need to call the police and have an investigation when a person dies at home.

My father always told everyone to come visit him while he was alive because after he passed he would not know who came. He did not want any type of service for him when he passed. Therefore, my mother did not have a memorial service for him. This really made several other relatives angry, but my mother respected my father's wishes.

Whether I agree with my father's choices, it was his choice to make. I feel it will be a challenge to remember each person has the right to choose how he/she wants to live. My job is to respect the person's choices and help the person with whatever choices he/she has made.

My father lives his live the way he wanted and he died that way too!

The Senior Inmate

I was reading some older post and I saw a blog about the elderly in the jail/prison system. This caught my attention being that I work in a county jail. I now work in the medical department but before that I was an officer for 7 1/2 yrs so I have seen a lot of older people with so many issues come and go over the years. I cannot tell you the amount of grannies I have seen come in with oxygen tanks in tow! Or the amount of grand pops with serious heart conditions. Me being a healthy younger person would not want to stay in jail so I know it has to be worse for the elderly population that is there...no Ombudsman program there! Just thinking of the things the representative spoke about is an eye opener. Breakfast is served between 4:30am & 6:00am; what if that person is not a morning person? Answer: He/She won't eat. Then I was thinking about how modest most elderly people are, well that is going to have to be put on pause during their stay. There is little to no privacy there. If an inmate has to use the bathroom and he/she has a roommate it has to be done in front of that person, there is no stepping out of the cell. Also the shower door is like a half door so there is no shower curtain or anything that will cover their entire body. That is ok for men, but for woman?! I know I would be soooo uncomfortable. And the housing units are over crowded is just the icing on the cake. At anytime there could be 5-7 females sleeping on a matt on the floor of the multi-purpose room because all of the regular cells are full. No wonder there are reports stating that the elderly are at high risk for committing suicide while being locked up. There are also reports stating the elderly is the fastest rising inmate population. Jail is no place to be for the young or the old, but for some reason it is filled to capacity with our cute, sweet lil elders! I have a CNN article with lots of facts & numbers regarding the elderly in jail/prison. http://articles.cnn.com/2009-11-13/justice/aging.inmates_1_prison-inmate-largest-prison-systems-medical-costs?_s=PM:CRIME

Hard work ... for everyone.

This past week at fieldwork, I was assigned to work with a patient in the dementia ward.  Note, I had not prepared a session for this patient, once again the patient that I had prepared for was discharged, and once again, I was flying by the seat of my pants ... but what's new.  It actually turned out to be the best session that I have experienced yet. But I digress, I'll start over ...

I introduced myself to Mr. L for the first time as part of my dementia competency.  He was eating breakfast and the CNA said it would be an hour before he would be done.  An hour?!?  So, my task (we were supposed to engage our patient in an activity) was to try to get Mr. L to feed himself a few bites of finger food.  He, in recent weeks according to the CNA, has stopped feeding himself.  As I approached and introduced myself, he showed no interest in me or in his breakfast.  A challenge.  I was talking to him, trying to find something that would jar him.  This was a little difficult since I didn't know anything about him, his condition or his family.  Eventually, though, I was able to coax him with hand-under-hand, to eat the rest of his pancakes and the whites of the boiled eggs he had on his plate.  He did pick up his bacon and eat a bite and he picked up a piece of egg that had fallen off of his fork.  Boy!  I felt successful ... for about 2 minutes.

My instructor then asked me to facilitate his dressing and teeth brushing and hair brushing.  Up to this point, the only thing that my patient had said was an out-of-the-blue "G#! D@!*."

Back in his room, I asked him to take his pajama bottoms off, so that we could dress in regular clothes.  My instructor had taken out a pair of shorts and asked him if they were okay.  With no response, I guess I thought he had no opinion.  Boy was I wrong.  First of all, we are told in school "don't ask you patient if they want to do something, tell them what they need to do."  He let me know (without distinguishable words, except an explicative) that he was NOT going to be told what to do.  New tactic ... "Help me ... "  He relinquished to a degree, but I had to keep downgrading until he was mod - max (A).  With much ado, he was finally dressed with his teeth and his hair brushed.

The main thing that I came away with from this experience was two-fold.  Though he couldn't speak intelligibly most of the time, he definitely had feelings and opinions that couldn't be ignored.  When I trying to get him to dress, he expressed, very lucidly, "I'm a man!"  He did not want two women helping him to dress.  I can't blame him, I wouldn't want two strange men dressing me, either.

He also knew enough to know he was having trouble.  My instructor told him at one point "your having a little trouble thinking right now and we're here to help you."  He nodded his head and made an "uh huh."  I felt really bad for him.  He knew that he should be able to do these things and was frustrated that he needed help.

After everything was over, I was very glad that my original patient was a no-show.  I found a bit of my therapeutic self coming out, and I enjoyed it very much.  I have been thinking about Mr. L off and on all weekend.  What could be done to help improve his quality of life, make him more independent and reduce the burden on the CNAs charged to look after him?   Here are 2 Youtube videos that show how OT can help patients with dementia.  http://www.youtube.com/watch?v=5QNbMZtDtkw and
http://www.youtube.com/watch?v=0_WREuVAnpU

Memory books for the elderly

One of my class projects was to create a memory book about my life. I was a bit hesitant to get started because I would have to find my pictures, then search through all 1 gazillion of them to find the pictures I wanted to use in my memory book. But I actually enjoyed reminiscing about the "good ole days". It brought back alot of good memories & put a smile on my face... sometimes I even laughed out loud. It made me realize how fortunate I have been to have such a wonderful life & family.

The project was given to help us understand how important a memory book can be for the elderly, especially those with dementia. It helps them to look back & remember the good times, and it reminds them who their family is & what kind of life they use to have. It also helps the caregivers get to know the person better. I've learned that song, music & rhythm are lost later in the stages of dementia, so it helps to have familiar songs & tunes in the memory book.

Our class was given a website that an OT created that discusses memory books for the elderly. http://www.barbarasmithoccupationaltherapist.com/activitybook.html. Barbara shows & describes the activity book that she made for her mother when her mother had Alzheimer's Disease.

When To Retire

Recent changes in law will soon make the new retirement age for full Social Security benefits, 67 years old. The two reasons given for this change are: the strain on funds due to the Baby Boomers starting to hit 65 years old around now, and the fact that in general we Americans are now living longer than ever.

When we look at that on paper, the reality is that for an average man who finishes college at 22 and works until he is 67, he will have worked for 45 years of his life. If he retires and lives to the ripe old age of 97, that is 30 years of benefits, and if he is healthy, he will have plenty time to enjoy the later years of his life. But the reality is that most men don’t live anywhere near that long, and most, by the time they are 67, are suffering some sort of health issues. Obesity, high blood pressure, high cholesterol are the most common issue affecting men at this age and older, and can limit the enjoyment of the retirement years in a multitude of ways.

In my family, the recent loss of my uncle lead me to the realization that ALL the male relatives in the generation preceding mine have now passed. Of the eight men including uncles by blood and marriage and my father, three of them died of disease before age 67, three died in their 70’s and two in their 80’s. So much for the retirement years...

My oldest brother recently announced that he will be retiring early and my first reaction was “GOOD” because at 62 he will still have plenty time to enjoy his retirement years in good health. Here is a link that shows you how your Social Security benefits pay if you retire early: http://ssa.gov/pubs/retirechart.htm

All this pondering of the lack of longevity in my family amidst a clan of widows, and concern over the men in ill health, has lead me to think about what can be done. Here is what I came up with: #1 I want to believe that we can all count on Social Security when we retire so I will hold my breath on that one as a basic cost of living contribution to our life in retirement. #2 To a certain extent we do have control over our health, so the effort put in now to be healthy could mean future payoff in retirement years. #3 The biggest thing that I think we all need to consider is how we will supplement the meager Social Security income and going one step further, maybe even retire earlier than age 67. My solution to that dilemma is simple - financial planning. Probably less than 1% of us knows how to do that, but that is what the pros are for. The link in my title is an example of someone with an excellent reputation in this area who can help any of us with this task. Even those with modest incomes can and need to have some sort of plan for their future retirement.

My own father worked very physically hard his whole life, and died at age 75, but I am glad to say that he retired at age 60 when he physically had to, and enjoyed many years of retirement, doing the things he wanted to and reaping the fruits of his labor financially. Although I am not sure that I will retire at 60, I do know that I will follow his example of planning carefully for my retirement years.

Alzheimers vs Dementia?

As we have been studying, I have become even more confused about the difference between dementia and AD. It seems that the two terms are used interchangeably, so I needed some clarification and came upon a very informative website called Alzheimer's Reading Room, just click on the title to access it. Basically, dementia is a symptom, and AD is the cause of the symptom.

There was this older gentleman in front of me in the line at Kroger the other day. Right before he was going to pay for his food, he asked for his employee discount, and the cashier looked puzzled and asked if he was a new employee because she didn't recognize him. I don't think he ever answered her, but he did still insist on receiving his discount, so the cashier directed him to the customer service desk. He went over there but didn't stay very long. Beforehand, I would've probably just thought he was trying to get out of paying, but now I know, more than likely, he used to work at a Kroger when he was much younger and probably has mild dementia.

When I was doing my fw at an ALF, I saw this pt who always insisted that her husband was her grandpa. I can't imagine how her husband must feel, considering they had been married for over 60 years. Mostly, he would laugh it off, but it must be very lonely. I can't fathom caring for my husband one day and hearing him refer to me as his grandma. I bet it would be very frustrating!

Caring for them

I am really amazed on how fast I began to care for the patients during fieldwork even the ones that you are not treating. As you provide therapy for one, I am always curious about the condition of the other patients there especially if your patient has a roommate. For example, my first patient's roommate seemed friendly and was at RM for rehabilitation. After therapy with my patient, the roommate asked for help to the restroom which I was able to do. Soon after that time, I always stop by to see how she was doing and to to see if she acquired a new roommate, (my patient was discharged two weeks later).

Just this week, while waiting for PT to finish with the patient, I went to speak to my informal patient and she told me she was going home the next day. I was so please that she had gotten better to go home. She had gained weight and was much stronger than when I first met her. I was also glad I had a chance to wish her well. Sometimes we do not get the opportunity to say good bye or good luck.

I understand that caring and being a people person is great characteristics of an OT and OTA, check out this website about some great qualifications.
http://www.helium.com/items/897272-qualifications-you-need-to-become-an-occupational-therapist

If there is no family member......OT/OTA your it!!

I am going over material for a test on Monday. I actually finished reading the chapter on mobility and restraints and couldn't help but think about the different ways family members can get involved in this process. Some of the old myths about restraints are that restraints can keep injuries from happening. Actually, as seen in the linked article, Restraints DO NOT help prevent falls. In fact, Restraints are often actually the cause of injuries or even death. As OTA students we can read all the updated information and educate ourselves on alternatives for restraints because it is in our scoop of practice to help educate family members and clients on different alternatives. We can help provide information to staff and physicians on our clients. If you have a chance to read the linked article, I love the page talking with family members. The advice to family members include talk with staff and MD's about current restraints especially if you don't think they are needed, get a list of different things tried in the past, get information on how long the restraint will be used and how many hours it is on during the day and night, and find out about your loved ones routines and habits. Isn't this part of our job as OTA's? If I have a client who is in restraints I am going to do all of the above plus some. I might even find an item for my client that can make them feel like home or give them comfort. If there is no family member, then in my opinion we become family as best as we can. It may seem like a small thing to do to make sure your client or senior can reach their call bell, remote, or water bottle. These are simple things we can do for our clients now even as students. This can assure dignity and independence. I would want this for my family members and myself. If I am the only family member someone has, I will take that place!!

Leota's Garden

I just finished reading a fabulous book just for pleasure! I know I know…where do I find the time? Well, I’m not quite sure. I guess I’ve given up a lot of time worrying about assignments and just get them done so I can shut my brain off and dive into the world of fiction. It’s my therapy these days. The book is called “Leota’s Garden” by Francine Rivers. I read the back cover at the library and it jumped into my hands!

“Once Leota’s garden was a place of beauty – where flowers bloomed and hope thrived. It was her refuge from the deep wounds inflicted by a devastating war, her sanctuary where she knelt before a loving God and prayed for the children who couldn’t understand her silent sacrifices. At 84, Leota is alone, her beloved garden in ruins. All her efforts to reconcile with her adult children have been fruitless. She voices her despair to a loving Father, her only friend. And God bring a wind of change through unlikely means; one, a college student who thinks he has all the answers; the other, the granddaughter Leota never hoped to know. But can the devastation wrought by keeping painful family secrets be repaired before she runs out of time?”

Can’t you tell this was a good one!?!?! The book let me experience end of life and geriatric issues from an 84 year olds perspective. It was an eye opener on…

*End of life care (residential facilities vs. homecare)
*The loneliness and despair elder adults face with loosing independence and broken relationships
*How much older adults yearn for companionship and friendship. And how easy this can be and how extremely hard it can be also
*I also realized through this book that we have no idea what is good for a person until we understand them fully.

This book went right along with what we are learning in our geriatrics class this semester. I kept thinking though…if we HAD to read this, I wouldn’t have enjoyed it as much as it did There is just something to be said about leisure time! Whenever there is an opening in your leisure time window…I recommend Leota’s Garden

Peds. Vs. Geriatrics. Not THAT much different, I guess...

Today I helped out one of our instructors at a summer camp class that she spent the week running. It beat the geriatrics FW by a million degrees. The kids were age 9-12, not my favorite age group but it beats the alternative. It was so much fun! I had no problem jumping in. If I had to rate my comfort level from 1-10 with 10 being totally uncomfortable, I'd rate myself a 1. I wish that I could say the same for FW. The camp class focused on fiber arts. These kids loved it! The attitudes were so positive and fun. Unlike our attitude as we learned weaving, knitting and sewing in OT Media 1, mainly because at the end of the day we were being graded on our projects. It was amazing to see what these kids had done since only Monday! No one even wanted to stop for lunch. My favorite were the duct tape projects. This one little girl made a skirt, a pair of flip flops, a wallet and something else that I am forgetting. This other little girl made a wallet with 20 pockets in it and another little girl made two pairs of shorts! I was seriously impressed! Being there made me forget how much I loved being a camp counselor and volunteering at camps, schools and after school programs. I stopped doing all of that after I graduated high school. The kids I work with are 0-4, I forgot about how much fun "big kids" are!

So I've been thinking on how I can be more successful out on FW and how I can start to enjoy it. I would love to like old people as much as I like kids, I think at some point I'll get there...hopefully. So basically I'm just going to pretend that these old people are kids. I don't use a baby voice with kids anyways so I think that I can pretend that they are kids without treating them as kids. Also, old people will most likely like the same therapeutic activities/crafts that kids do, so coming up with treatment plans should be easier. For example, a strength building activity is a strength building no matter who you are. I found a website with OT activities for kids, but with some tweeking they could be appropriate for anyone! I think the "therapy snowman" would be enjoyed by geriatrics. It seems kid-ish but they could use it to decorate their room. What I like about this specific project is like it works on B UE use and strength, which seems like a common goal for everyone's patients. Anyways...we'll see how this plan works on Tuesday!

Dementia

Studying dementia this semester has opened my eyes much wider than they were before. Both of my grandmothers suffered from this horrible disease. I have always thought cancer was the worst disease any one could have, but now I think AD is. Watching the hurt that came from my grandmother not recognizing my mother was so painful. I often wonder if dementia will be something I suffer from when I get older. This frightens me to the core. I have often heard what would be worse, having a healthy body and no mind, or having your mind and your body is unable to do anything? I don't know the answer to this question, but I know I don't want to live not recognizing the people I love or not being able to do the things I enjoy. I attached a link about Dementia. It lists the causes, symptoms and signs that you can look for in your loved ones.
One of the class assignments this summer was to create a memory book on ourselves. I have never put together a scrap book on myself before and felt uneasy about starting something that could bring up good and bad memories. I found out the good times definitely outnumbered the bad! I actually enjoyed doing this project much more than I thought I would, and see myself continuing the scrapbook in the coming years.
I read one of the blogs about making a bucket list. I have often thought of sitting down and doing this. I don't think I ever will. Now, when I die, I just want to hear, "well done, my good and faithful servant" Matt. 25:23.

Every Picture Tells a Story, Don't It?

Yet another project!!! I was not looking forward to this scrapbooking project. I was uncertain about going through all of the old photos, worried that I would not choose the best pictures. I was even more uncertain as to my creativity, worried that I would not be able to put this thing together correctly. I was not sure if I was up to this creativity challenge! I was also confronted with the dreaded possibility that someday I may not be able to recognize faces of those that I love, the voices and laughter that entertain, or remember my favorite place, which happens to be my own backyard.
My Grandmother passed away many years ago from degenerate brain disease. A favorite uncle began having bouts of confusion last August when he was in for a family wedding--uncle J and aunt L have traveled extensively looking for answers. About three weeks ago, the Mayo clinic confirmed that he has a form of Alzheimer's. Developing this disease has been a huge concern all of his life. I cannot imagine how this news hit him. He actually knows what he is in for--heartbreaking!
As I began going through the old photos, I saw the smiling faces (or there lack of), the big hair, and the polyester clothes that were in style back in the day. My brother and his family are visiting from PA, (YEAH!) so we were going through pictures the other night. Some that made it in the book, but a ton that did not. Many stories and much laughter was had by all! Hard to believe that my parents were able to get the walls cleaned after my other brother threw the colored Easter eggs at the living room wall (his ill attempt at splatter painting?!) thinking it would be funny! Not our best holiday ever, as seen in the before and after pictures of us with our baskets, candy wrappers everywhere, the newly colored wall, and then 5 unhappy faces.....
I started going through the girls scrapbooking container (yes, my girls have scrapbooked before; I have not), looking for backgrounds, words, and stickers. As I was trying to figure out what backgrounds went with what pictures, I was hit with this reality-- Really no need to have felt threatened by a lack of creativity on this project. I do believe that I have met the criteria for my grade, but I have left a lot of blank pages, as I do intend to continue on with my favorite people and things.
For our patient's in the future, we not be able to make an extensive memory book, but we may be able to provide a favorite story or poem, or a calendar that tells of the days events. Or better yet, hopefully we can engage them in a purposeful and meaningful activity, and create a memory in process!

Amazing Changes

Wow, my patient has improved so much from last week, it is hard to believe she is the same patient. She had been admitted on Tuesday and I saw her for the first time on Thursday. She was a Max Assist +2 to get her to sit at the edge of the bed. It was difficult to engage her and she was extremely afraid of falling. I thought for sure she would not be making much progress over the week.

I talked with her therapist and the patient has improved to Min Assist and is starting to transfer herself to the wheelchair although she still is a little fearful of falling. Also she is engaged and alert to her surroundings. She told me about her children and she has lived in NC her whole life. We connected about grandchildren. This is such a rewarding experience to see a patient improve so much.

She wants to return to her home as soon as she can and is very motivated to work hard. This was kind of surprising since she has dementia and was almost non-responsive the week before.

My first patient was discharged from OT because lack of progress and discharged from the facility. He did not have dementia and had wonderful family support. Working with him was challenging because he did not seem to want to improve. I would have thought he would be the one to really benefit from therapy.

The therapist said "You just never know who is going to improve and who is not." This is a good lesson to learn, patients are full of surprises.

Me ... old ...

As I have been doing the memory book assignment, I have been looking through a lot of pictures.  Pictures of my parents when they were my age.  I look quite a bit like my dad, so I started to think about not only how I will look as I age, but also how I will handle aging.

My dad was 62 when he passed away, so I can't really compare myself to him in my imaginary "retirement world," but thinking about between now and 62 ... that's 21 years, what will I do?  How will I handle aging?  Will I work 60-70 hours/week like my dad?  He loved his job and found it very fulfilling.  I would like to think I would enjoy working, though maybe not that much.  Will I make time to do things with my siblings, my kids, my grandkids.  I hope I will, but you know as well as I do, time FLIES.  I can't believe that my kids are 9 & 11!  Where did the time go?  Did I spend as much time as I should've with them?  Sometimes I think a definite "yes" and sometimes I look at them and wish I had taken the time to really enjoy them when they were babies, instead of stressing over how much they ate (or pooped) or whatever. 

Whatever the case, I am the only one that can directly influence how I age.  It is part genetics, but it is mostly choices.  Choices about what I think is important; what takes priority in this fast-paced life we live.  I've decided to make a "bucket list" so that I at least attempt to do all of the things that are meaningful to me.

Wanna make a bucket list?  Get some ideas here.  http://celestinechua.com/blog/whats-on-your-bucket-list-101-things-to-do-before-you-die/.

1st time with a dementia patient

Before last week I had never met anyone who has dementia or Alzheimer's. But after discussing dementia & Alzheimer's in class, I would be graded on how I interact with a pt with dementia. While at the nursing home last week, I was given an opportunity to meeting a pt with dementia. I wasn't sure what stage the pt would be in & how I would react. But it went very well. The pt was the kindest man! He was also well dressed. The pt was lying in bed when I knocked on his door, but he sat up & patted his bed for me to sit beside him. My treatment goal was to get him to go with me outside to cut a few flowers to put in a vase. At first he was unsure, but once I told him it would only take a few minutes, he was willing to go with me. While he was walking, he mentioned that his wife comes to visit him. He seemed to really like when I told him he should show his wife his vase of flowers. He even cut a gardenia to give to her when she visits. He also seemed to have really enjoyed having company... he hugged & kissed me & the teacher several times when we had to leave. He even told us at the end he hopes we come to visit him again. He tugged at my heart, & I hope I'm allowed to visit him again while I'm at the nursing home.

Adaptive Equipment

Last week I went with my husband to his follow-up appointment. While waiting in the exam room, getting restless, my husband starts to explore the room. He pulls out this piece of equipment and of course being an OTAS I knew what it was.. a dressing reacher! Now he has seen the reacher I have in my car that I use for fieldwork but never asked me what is was used for. He thought I took up another profession; street cleaner, LOL !
The office which we were in, most of the patients are older (my husband is not a senior, smile). I was a little surprise that the reacher was there but was pleased that the practice realized and recognized that some older folks need a little help getting dressed after being seen. I wonder how many other practices have adpative equipment for their older patients, hmm? While researching a website for this blog, I had a hard time finding any information about AE and medical offices. Even in my travels of different doctors for different health issues and check-ups, this was the first office that I found an AE. I wonder who on staff came up with the idea. Do or did they have an OT/OTA? Or was it a patient that clued them in to the needs of the elderly. At my husband's next appointment I might have to ask who idea it was and commend them on helping seniors maintain independence.

Caught Off Guard

First I would like to say that last week's FW was a very good one! Iwas nervous going into the tx session because my pt is one with dementia due to advanced PD and all I can hear in my head as I walk to this woman's room is my instructor's voice saying, "This is a hard one, but you can do it!"...and I'm thinking "yeah right, what did I ever do to you?!" But anyway, my instructor was correct in saying this was going to be challenging but I am up for it because Ms. S is soooo sweet! So after Ms. S and I met I'm feeling much better and I need to go to the linen room for some clean linen and as I am walking down the hall with a lil' pep in my step, feeling good and deep in my thoughts of what I'm going to do with my pt another resident grabs my arm (for a little bitty woman she had quite a grip!) and stops me dead in my tracks. It startled me a bit because she was below eye level in a WC and when Idid not initially see what stopped me it freaked me out. So when I looked down and saw her she still has this dealth grip on my arm and starts puckering up her lips making a kissing sound (you all have to know by now I am seriously having a "what in the world?!?!" moment). I then try to think quick on my feet and I just tell myself to say something so sounding like the biggest dork I'm like "Hello Ma'am!" and she says in a low muffling voice "very pretty" and puckers up again (and yes she still has my arm)! So I kinda pry her hands off of my arm and ask her how she is doing today but all she keeps doing is puckering up and saying "kiss kiss". I'm still a little thrown off, but I do manage to say "No real kisses, but I will blow you one and you catch it"..so I did and that seemed to satisfy her because she "catches" it, smiles and then turned away. I was then moving like a speed demon down that hallway thinking "that was some crazy stuff!" But as I thought more about it later on that was not too crazy and I probably will be met with that type of behavior more often. So I need to learn how to stay calm and not appear like a dear caught in the headlights. That is something I know I have to improve on because believe me when I tell you that really threw for a loop! I found this poem about dementia patients, I think it is beautiful (the last paragraph almost made me tear up because it is so true). Hope you all enjoy!

Dementia-A Poem

I can hear you
I know you said my name
My mind may not know how to answer
But don't ignore me just the same

I am trapped inside this blank slate
Fleeting memories floating by
I know that they were part of me
But I cannot tell you why

I see and hear and touch and taste
A scent can tug at the edges of my thoughts
I know that at sometime I was more
But all of that is lost, is lost

Who are you?

Who am I?

I don't remember...

Even enough to cry...

-Paula Farris

Happy July 4th to ALL......

My family is in the pool, the meat is on the grill, fireworks are ready to entertain and some cold beverages are in ice for the taking......but I can't forget that blogging must be done!! As I sit and think about this July 4th celebration, I can't help but think about how many seniors may be celebrating this weekend. Will they be with friends and family, or are they all alone this year. I am looking at the clock and it's only 10am in NC, but it is HOT already. Seniors this time of year must be very careful of the heat and staying hydrated. I wonder if this keeps them from participating in outdoor activities and family events at the pool or park. Speaking of food, the meat on our grill will be ready to eat by 2:00. We have enough to feed a small town but what if I was all alone this July 4th. Would I cook for myself. This also makes me think of our seniors and wonder what and how they are eating this July 4th. I found a great "alert" article for seniors on-line this morning. I have never thought about this before but seniors are at risk for eating food such as hot dogs and cold cuts that have not been heated and cooked all the way. They can be contaminated with a bacteria Listeria, which can make them very sick. Hot dogs should only remain in the refrigerator after opening for two weeks. I am certain many seniors living alone keep their hotdogs longer than two weeks. All of this to say, I hope seniors can get out and enjoy July 4th with family and friends. If our seniors are all alone, lets just hope we can help educate them of safe habits and protect them when we can. Have a safe and happy July 4th. Remember that at whatever age you are now, you will only get older next year and be thank-ful for this holiday right here today. Happy July 4th everyone!!

To date, the best treatment session ever!

This past Tues. I had the best treatment session ever! My pt. had been admitted to this facility three weeks ago, and had not seen the shower room until this past week. The OT, my instructor, and myself were all on board as we encouraged and provided the safest means possible to allow for this shower. It may seem like such a small thing, but I cannot imagine not having a real shower for three weeks. As she is NWB on R ankle, a lot had to be considered in order to make this happen. For me, I was so grateful for the many teaching moments along the way. I was on the receiving end of reasons and explanations as to why things were done in a certain way. I walked away with a lot of valuable info.
Ms. D was as appreciative as could be. When I got her back to her room, she said that she "feels better all over." Once she was transferred back into the bed, I put some lotion on her back, and before I left the room, she was snoring softly! She worked hard to make it happen--a bit hesitant at first with all of the transfers--but with reassuring words and tones from the OT and my instructor, she was able to pull it off.
I have attached a quote sent out about a week ago from Ms. G. This quote can be put into many different contexts in our lives, but I thought how appropriate it is for this session.

I've learned that people will forget what you said, they will forget what you did, but people will never forget how you made them feel.

Maya Angelou

We as future OTAS, have the ability to provide so many with such simple dignities. Funny thing is this: I know how good that shower felt for Ms. D, but I am fairly certain that I left that day feeling even better than she did!

Conversations

So I'm not the greatest at making conversation with people that I don't know very well. I'm not a social weirdo who lacks conversation skills or anything, it is just an "area for improvement" for this geriatric FW. For example, during my dementia competency my "patient" kept talking about his wife and how they've been married for 67 years and how they always have lunch together. Do I ask him anything else about her? Nope. Not that I don't care, I'm just more focused on making sure that he is doing what I want him to be doing. I should have asked him stuff like, how did you meet? I just don't know what to talk to old people about. For starters I need to stop seeing them as old people and just see them as regular people. So, like a total dork I googled "how to make small talk?" I found some good tips. For me the biggest tip is to just relax! Part of why it is so difficult out on FW is one b/c while making small talk I have to also think about my pitch and my pace and two I have an instructor over my shoulder. Another good tip is paying attention to what they are saying. I think that there is a difference between listening to someone and hearing someone. During my competency I was listening what "he" was saying but I wasn't really hearing him, I was too busy thinking about what I needed to be doing. One tip that isn't on the website is to pretend that your talking to someone that you are comfortable talking with. One of our instructors told me to put her face on all of my patients b/c I can talk to her normally.

Sensory trail

Our group in class will be putting together a sensory trail for a therapeutic riding farm in the next few weeks. I am so excited about doing this project and think about it a lot of the time. This farm has riders from 2yrs of age to 75 years of age. I attached a link of a sensory trail that I really like. Some of the things on this trail we will also have on ours. The tennis balls around the tree will provide tactile and visual stimulation. Also, the riders will need balance control to reach out and touch the tennis balls. We are doing several station that include wind chimes, plants, and foam noodles. I can hardly wait to get started in putting this project together! Our group works so well with each other. We also have the common goal of doing something for others that will be fun while being therapeutic. Please take a look at the website I attached. It is amazing how simple objects can stimulate the senses, young or old. The joy we are getting out of doing this project is huge!