sOcial buTterfly

Social determinants of health – a big term with an even bigger impact on the well-being of our communities – encapsulate all of the external factors that affect health and health outcomes. For example, the conditions in which a person is born, lives, and works all influence health. The education, economic stability, and the accessibility of healthcare experienced by an individual all play a role in the type of lifestyle a person will live, the type of care they will receive, and the amount that he or she will adhere to interventions when given them.  Social determinants of health can affect one’s susceptibility to neurodegenerative conditions. For example, people with a lower socioeconomic status are at higher risk for having epilepsy, a neurodegenerative disorder involving seizures. External factors such as extreme early adversity, exposure to lead, and low birth weight can predispose people to developing Attention Deficit Hyperactivity Disorder (ADHD). Highly stressful work ...

When helping a client select an adaptive device, it is important to find the best “fit” for them in order to promote comfort and function. Comfort is achieved by ordering adaptive devices, such as crutches or canes, that are measured to accurately suit the client. If axillary crutches are too tall, the patient could experience uncomfortable scapular elevation and pressure beneath the axilla. If a cane is too short, the client will have to hunch over with poor posture to grip its handle. Discomfort would discourage the use of each of these improperly fitted devices, ultimately defeating the purpose of the mobility aid. Another important reason to correctly match clients with their adaptive device is to promote functional mobility and activity. If a client is paired with a standard walker, but they do not have the upper extremity strength necessary for lifting the device, then functional mobility is not possible. We also would not want to limit the mobility of a client by fitting them f...

After an illness or injury, it important to take the proper steps of restoring mobility and function with a client. The sequence of mobility with increasing confidence and activity demands is bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. Rather than quickly throwing him (or her) into "the ring,” a therapist starts small to help the client restore strength and confidence before providing them with greater challenges. In addition to promoting safety of the client, this method helps prevent further injury and disappointment.  Before starting OT school, I had not seen every step of this sequence because many of the clients I encountered were highly mobile. However, it makes sense to work from the most basic to the most complex skill in a sequential manner. We don’t try to teach our babies how to walk before they c...