1. Appreciates the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan. 1. One of the beauties of the world is that no two people are the same. When it comes to the field of occupational therapy, it is key to have an open and accepting mindset. In order to meet the needs of our clients we must strive to build optimal rapport, appreciate diversity and learn to accommodate our clients needs to the best of our ability. In doing so, we are able to connect, guide and assist our clients in overcoming their barriers. Within the acute care setting, I was evaluating an older male from Japan. When assessing his abilities to complete BADLs, he informed me that there were many things that were common to me that he did not complete or completed differently. Instead of forcing him to demonstrate the tasks anyways, we worked together to simulate his typical routine in the most appropriate and safest way available. For instance, instead of deodorant he used soap and wash to wash underneath his arms. At the time, I was assessing his abilities to perform BADLs so I was looking for components like fine motor skills, coordination, sequencing, strength, range of motion, endurance, etc.
2. Communicates effectively with a wide range of clients, peers, and professionals both verbally and non-verbally. 2. During my three level II fieldwork rotations, I have developed communication skills necessary for interacting with a variety of individuals. Developing these communication skills has been one of the more challenging aspects during my level II rotations. I have expanded on my communication abilities for working with individuals with dementia, cognitive deficits, severe hearing loss, severe speech deficits, passy muir valves, level II Ranchos Los Amigos, visual deficits, receptive and expressive aphasia. I have advanced my skills in providing verbal and visual information, appropriate speech volume, simple language, gestures/demonstrations, and the ability to assess comprehension. For instance, while completing a rotation in the adult day center I assisted a very sweet lady that had survived many strokes and had severe difficulty with speaking. While at the day program, she had a hard time engaging and participating in groups. When I would lead a group or assist a group I would often sit close to her so that she could be more involved. I often utilized pen and paper or a white board for her to write but we also incorporated a communication app on her tablet with generic statements for her to use. Taking a little extra time to allow her to write things out or use her tablet allowed her to participate and engage in the opportunities the program offered increasing her quality of life.
3. Collaborates with clients and caregivers in establishing and maintaining a balance of pleasurable, productive, and restful occupations to promote health and prevent disease and disability. 3. While completing a clinical rotation at an adult day center, I collaborated heavily with clients and caregivers/family in order to increase the quality of life for both the clients and the caregivers/family. At the adult day center the overarching goals for participants were to improve quality of life, promote engagement, prevent deterioration, and increase social participation. In addition to the goals for the participants, the overarching goals for the caregivers/family members were to provide respite care and prolong their ability to care for their loved one. To provide the best care for participants, there was in-depth collaboration between the client, families/caregivers to establish an appropriate client centered plan of care. Collaboration included items completed by client and/or caregiver such as: interest checklist, role checklist, history and physical information, educational history, work history, family history, personality traits, equipment needs, equipment repairs, request/inquiries for additional services, tips/advice for handling changes, caregiver education, caregiver support groups. For example, one day a gentleman at the adult day center was complaining that he was uncomfortable in his wheelchair. He typically used his wheelchair throughout the days he attended the adult day center except for the times when myself or the wellness coordinator would walk with him. I was concerned about him being uncomfortable in his wheelchair as he utilized the wheelchair frequently throughout the day. After investigating the cushion and the wheelchair, I realized that he desperately needed a new cushion and eventually a new wheelchair. So I mentioned this to him and offered to assist him in figuring out what his insurance would cover for him. He agreed but said that his mother typically handled these situations so I gave her a call. After collaborating with his mother and receiving consent, I began to call the suppliers and his doctors office for an order. Eventually after about a week and half, we were able to get him a new cushion. Additionally, we were also able to start the process of getting a new wheelchair.
4. Inspires confidence in clients and team members. 4. Through establishing positive relationships and building rapport with clients and team members, it has revealed the opportunity to inspire others and be inspired by others. During my clinical experiences, I have frequently built relationships with those aspiring to go to OT school. Through these interactions, I've strived to give them a better understanding of the career and the great opportunity to become an OT but also promoted confidence into putting everything they've got into their aspirations. In addition to inspiring those looking to become a part of the occupational therapy field, there have also been multiple opportunities to help team members build confidence in their skills. During all three of my rotations, I have had different circumstances to work alongside COTAs, recreational therapist, nursing aids, and rehabilitation technicians. One particular instance that stands out to me was when I was at a skilled nursing facility and I working with a sweet lady who had dementia and recently fractured her hip from a fall. While I was assisting this lady in getting out of bed and ready for the morning, I called for extra assistance and a new nursing aid with big, unsure eyes came in to help. In the same manners I was demonstrating and explaining everything to the client, I was also doing so for the new nursing aid. I taught techniques for communicating with the client, how to build rapport, and ways to assist her in safely completing tasks and functional mobility. The nursing aid was amazed at how well the client responded and her ability to complete tasks when set up and cued properly. As we were wrapping up with the client, I instructed the nursing aid to take the lead in completing the final transfer to the chair utilizing the same techniques as before and that I would be there for assistance and guidance. Allowing the nursing aid to take an active role and utilize some of the techniques that I found beneficial with this client allowed her to become confident in her ability to care for this client. As we left the room, the nursing aid stated she was glad to have learned new techniques and felt more assured in her skills.
5. Considers client motivation when using occupation based intervention to maximize functional independence. 5. A particular client was struggling with motivation and in denial of the changes that had occurred due to having a stroke. This client really enjoyed sweet treats and also giving sweet treats to all those around her. She was consistently offering treats to the staff and clients at the facility. During the last few weeks of my rotation, I mentioned that since she liked sweet treats so much that we could make brownies during one of our final treatment sessions. Her face lit up when I mentioned that and she brought up making brownies on multiple occasions. However, before we could accomplish this we needed to be able to improve her standing tolerance/endurance, upper extremity strength, weight bear on the affected extremity, cognitively process the steps, and sequence through the steps. On my second to last day, it was finally the perfect day to make brownies and it was a success. After the brownies were done baking we proceeded to deliver brownies to staff members, family, and other clients at the facility. This activity tailored to the client's motivation allowed her to improve her self esteem enhancing her functional independence.
6. Applies theory regarding the therapeutic use of occupation and adaptation to screen and evaluate, plan, and implement intervention, while establishing and maintaining a therapeutic relationship with the client. 6. Behind every occupational therapy evaluation and intervention, there is a theory, models of practice, and/or frame of reference to defend the rationale of the interaction. While it is common to innately skip over thinking about the reasoning behind the actions we are performing, it is beneficial to always refer back to the theories, model of practice or frame of reference so that all involved understand the rationale. Commonly I refer back to Model of Human Occupation, Occupation Adaption, PEO, Ecology of Human Performance, Cognitive Behavioral Theory, Biomechanical FoR, Sensory Integration, and Rehabilitation FoR for guidance. I found that it is beneficial to explain to clients, families and caregivers the foundation behind my interaction in order to build a greater therapeutic relationship. For example, within the acute care setting we dig deeply into finding out information about the client, their prior level of function, home environment, social context, cultural context, etc. Referring back to the PEO model, I explain that occupational therapy assesses performance components, occupational based skills, and environment conditions are necessary for determining how the individual may achieve the highest level of independence to live a meaningful, fulfilling life. To go into further detail, I explain that the environment impacts the performance of an occupation but that the environment is often the easier component to change. Being able to integrate theories and models into practice allow our clients to better understand our rationale while developing a strong, dependable relationship.