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...

Poor body posture is one of the leading causes of low back pain, a problem experienced by 80% of adults at some point in their lives. It is important to teach clients about proper posture and body mechanics in order to help prevent injury, dysfunction, and pain. When the spine is shifted from its proper alignment, discs between vertebrae can become stressed, leading to bulging, herniation, rupture, or fragmentation. Furthermore, disc displacement can cause spinal nerves to become compressed and surrounding areas to experience pain. Using poor body mechanics while performing tasks that involve lifting, reaching, pulling, pushing, bending, and turning (especially in a repetitive manner) can also cause injury to discs, muscles, ligaments, and tissues. Such injuries can interfere with one’s ability to participate in daily activities such as, working, resting, performing self-care tasks, cooking, cleaning, driving, and enjoying hobbies. This can become a costly issue (both spiritually and ...

One advertisement that always affects me is the ASPCA commercial that advocates for animals living (and left to die) in shelters. Before even looking at the television screen, I hear the music that plays during the advertisement and am compelled to look away. The faces of the innocent animals who have been abused, abandoned, starved, and neglected makes me depressed! Even more so, it makes me want to adopt all of them, or give all my money to helping them—both of which are not possible for me. I must use my frontal lobe, especially the executive functions of my prefrontal cortex, to refrain from dialing the ASPCA number each time the commercial airs. The emotional response that I feel can be attributed to my limbic system. Specifically, my amygdala causes me to empathize with the suffering animals. The attachment I feel to animals in general can be traced back to my hippocampus, storing my long-term memories of growing up with dogs, cats, ponies, ducks, squirrels—you name it! Both...

After reading the chapter from "Man from the South," I was intrigued by the life of the wife of the South American man. All we know of her is divulged in a few short lines at the end of the chapter, yet the story of her life quickly becomes complex. Unfortunately, the woman cannot even take the time to wash her hair without having to fear that her husband is engaged in dangerous and costly schemes. Moreover, she has lost at least three digits having to "un-do" the bets that her husband has lost. If the soldier had lost the bet, the woman's livelihood would have become even more unstable. For example, the couple may have had to move once again to prevent the southern man's incrimination. However, I will focus on her occupation as "care taker" of her scheming husband. If the bet had ended badly, the wife would assume that she could go absolutely no where without her husband -- even to shower, to sleep, to eat, or to shop alone. One strategy that co...

Implicit bias includes the innate opinions and beliefs we have about the world, and specifically, the people in it. Our implicit bias is like a lens that we see others (and ourselves) through. It is shaped by our culture, our experiences, and our education. In her talk, "You Can't Be What You Can't See," Dr. Gibbs asserts that our cultural identity is a complex thing. Cultural identity is not limited to race, ethnicity, and religion. Someone who is the same race as me could be raised in a far different culture! Identifying with others culturally, nonetheless, is an important part of occupational therapy. Thus, it is essential to identify our biases in order to truly understand our clients. Listening to and grasping the needs, wants, desires, and fears of our clients requires humility and open-mindedness. Our presence (our therapeutic use of self), can lead our clients to be comfortable with who they are and with trusting us with that precious, vulnerable knowledge. ...