"When I let go of what I am, I become what I might be."
Lao Tzu
November 29, 2013
Weekly Mind Bender
Give your brain a workout with the following riddles.
credit: smarteruniversity.com
Be sure to check your answers on our Weekly Mind Bender Solutions Page.
November 28, 2013
Daily Dose of Inspiration
The following is an inspirational video by Unicef about children living with disability and helping to make change in the world.
When Children Can’t Communicate Pain
A few years back my daughter (age five at
the time) seemed a bit “off” when she came home from school. She was withdrawn, tired, and “didn’t want to
talk about it”. She is my kid that
struggles to communicate her needs, especially when she is upset, so I tried to
give her some time and control over when she would be comfortable talking about
it. Eventually, I went over to her and
in stroking her hair realized this had blood in it. I pulled her bangs aside and noticed a bump,
large bruise, and blood on her head, in her hair, and around her temple. When I asked her what happened, she burst
into tears. Through some coaxing, I got
her to tell me that she had fallen on the playground, hit her head, and was so
embarrassed about this she didn’t want to tell anyone. Her teacher picked up on the fact that
something was wrong and sent her to talk to the principal. To the principal she reported nausea, a
headache, and was visibly upset, but wouldn’t tell the principal what happened,
and the bump and blood on her head and hair was not noticed. After I got her to calm down, and did some
basic mommy first aid, I explained to her the importance of telling adults
about these things in case they are serious and need immediate attention.
The ability to communicate pain and
discomfort is invaluable – it not only allows a person to express how they are
feeling in order to receive medical attention, but also can help them to obtain
medication or treatment to make the pain more manageable. However, many children (and some adults for
that matter) are unable to express their pain due to a difficulty with
communication, or a developmental or intellectual disability. This can make it very difficult for health
practitioners and family members to decipher their level of pain following an
injury, medical procedure, or with illness.
For children that cannot verbally communicate
pain, there are other methods that can help.
For example, the Non-communicating Children’s Pain Checklist (NCCPC-R)
was designed for children who are unable to speak due to a cognitive
disability. The NCCPC-R can be completed
by a caregiver within the child’s home environment, and measures observations
of the child’s vocalizations, social interactions, facial expressions, activity
level, appearance of body and limbs, physiological signs, eating, and
sleeping. In addition to the home-based
version, a postoperative version of the NCCPC-R also exists.
Interestingly, studies have shown that the
expression of pain by children with Autism Spectrum Disorder is not
significantly different from typically developing children or even from
children with intellectual disabilities. However, what does seem to be
different is the length of the behavioral reactions of children with Autism,
after the source of pain has been removed. This information may be surprising
to some, as it is often thought that children with Autism are insensitive or
have a high tolerance to pain.
Therefore, caregivers and healthcare professionals need to be aware that
although a child with Autism (or any developmental disability for that matter)
may be unable to verbally communicate their level of pain, we cannot assume
that they are not in pain. We need to be
able to look beyond verbal communication.
One method, using observation, is the FLACC scale (Face, Legs, Activity,
Cry, Consolability). With this, pain in
children and adults who are unable to communicate are observed through are
range of symptoms that are scored from 0 to 2.
So while my daughter is capable of
communicating verbally, emotional upset and embarrassment prevented her from
taking the important step of telling an adult about what happened. Through her behavior and presentation, her
teacher, the principal and I were able to see that something was wrong, and
eventually, when she was comfortable talking about it, I figured out what
happened. Thus, behavior, verbal or not,
is a key indication of how a child is feeling. It is important for parents and healthcare
providers to be aware of the signs of pain in children, verbal or non-verbal, as
their bodies can very well communicate their level of pain when they cannot do
so through words.
November 27, 2013
Daily Dose of Inspiration
"But when the night is falling, you cannot find the light. You feel your dreams are dying, hold tight. You've got the music in you."
The New Radicals: "You Get What You Give"
Find on iTunes
The Benefits of Yoga: Body and Mind
Yoga is a fantastic, low impact way to exercise and take care of your mind and body. Its increasing popularity in the Western world has created many easy ways for you to get involved. Yoga is a great way to achieve balanced living as the principals of Yoga promote peace, kindness, and overall well-being. The following infographic from the Huffington Post shows the impact yoga can have on your body and mind whether you try it once or practice for years.
Namaste.
Namaste.
Read the full article:
November 26, 2013
Winter Is On Its Way: Stay Safe on The Road
Winter is well on its way!
Snow has fallen and temperatures are dropping. It's time to get out your boots, hats and snow
gear, but also time to ensure your vehicle is prepared for the blustery winter
weather ahead. Winter weather can
provide many pleasures: building
snowmen, skiing, outdoor skating and the beauty of the freshly fallen
snow. However, winter weather can also
bring many dangers, especially on the road, and can take a toll on your
vehicle. From tires to wipers, the
following article from MSN Autos gives tips on how to prepare your vehicle for the
cold and stormy weather that awaits. Be
sure you and your vehicle are prepared for winter, and to keep yourself and others safe, always drive according to weather conditions.
November 25, 2013
Daily Dose of Inspiration
"Obstacles are those frightful things you see when you take your eyes off the goal."
Henry Ford
The Many Faces of Occupational Therapists
The following is a wonderful video created by UBC's Master of Occupational Therapy class of 2013. Learn more about the many ways Occupational Therapists work and help in your community.
November 22, 2013
Daily Dose of Inspiration
"Every child is an artist. The problem is how to remain an artist once he grows up."
Pablo Picasso
November 21, 2013
Healthier Portion Sizes
Eating out is always a treat. More recently restaurants are even expanding menus to include healthier options. However, the portions are often excessive. In fact, the following from care2.com discusses how portion sizes have increased dramatically over the past 60 years. What can you do about it? Remember, the size of your fist is the size of your stomach. Next time you go out to eat, count how many fists worth of food are actually put in front of you. Ask your server, before receiving your meal, to pack up half in a take out container and eat the half that is given to you to help control the size of your portion. You'll be doing your body a favour and you'll have tasty leftovers for the next day!
Care2.com: Portion Sizes Have Grown This Much in 60 Years
Care2.com: Portion Sizes Have Grown This Much in 60 Years
November 20, 2013
Daily Dose of Inspiration
"I will provide you with a reason to believe, I will not desert you in your time of need."
"Take Care" by City and Colour
Find on iTunes
National Child Day
Written by Justine Huszczynski
Today marks the date when Canada adopted
the United Nations Convention on the Rights of the Child (UNCRC). Simply put, the UNCRC is a treaty that
outlines the basic human rights for children and youth.
Among other rights, the UNCRC outlines
“survival and development rights” which are explained as “the basic rights to
life, survival and development of one’s full potential”. Looking into this a little deeper, Article 23
under the “survival and development rights” states:
“Children
who have any kind of disability have the right to special care and support, as
well as all the rights in the Convention, so that they can live full and
independent lives.”
So, how is Canada ensuring that the rights
of children with disabilities are being fulfilled? Of course, we have public healthcare which
provides children prompt access to medical attention. But Article 23 goes beyond this. It also includes the right to services – therapy services perhaps - that children
with “any kind of disability” should be able to access such that they can
become independent adults and experience a fulfilling life.
While Ontario offers plenty of publicly
funded early intervention services for children with disabilities (based on the
availability of twenty government-funded children’s treatment centres across
the province), how are the outrageous waitlists for some of the most valuable
services offered in these centres acceptable?
For example, last year the Toronto Star surveyed nine of the government-funded
treatment centres and found average waitlist times ranging from one to FOUR
years for a child to receive intensive behavioural intervention (IBI) therapy.
So how does this follow the guidelines of
the UNCRC? Honestly, it doesn’t. Simply
having a service available to a child
with a disability is not enough. The
service needs to be provided. Long waitlists do not allow children to “live
full and independent lives” but in fact can stifle a child’s development by
denying access to programs that are most effective as “early
intervention”.
Therefore, while we celebrate how far we
have come to secure the rights of children, we need to look ahead and aim for a
brighter future for those children that may need some extra support – sooner
rather than later. An example of
striving for a brighter future comes from the parents of one of my clients who devoted
their time to being their child’s advocate when “he didn’t have a voice”. After this young client was denied services by
one of the government-funded children’s treatment centres in Ontario, his
parents scheduled a meeting with their local Member of Provincial Parliament
(MPP) to advocate for their son’s dire need for early intervention
services. As a result of the advocacy
skills of my client’s parents, the MPP ordered the treatment centre to complete
a reassessment and the child was granted the early intervention services that
he absolutely deserved and required. During
a conversation with the mother of this client, she stated, “It is my job to be
make my child’s life better”. This
statement is heartwarming, and perhaps we should view it as a challenge. A challenge for all of us – therapists,
health professionals, teachers, citizens, governments
– to truly make it our “job” to ensure children are given the best life
possible. So take the challenge and
advocate for our children – ask more questions, get second opinions, research
the available charitable funding, schedule meetings with your MPP, school board
trustee, and don’t take no for an answer.
November 19, 2013
Brain Health and Sports: Use Your Head... Don't Abuse It
Earlier on the blog we discussed the dangers of concussions in both football and hockey; however, many across the world are now concerned about potential brain damage that can occur from other sports such as soccer and rugby. Although these sports do not have as much hard contact as hockey or football, they are rough and knocks to the head are still likely to occur. The following from Reuters Canada discusses the growing instances of head injury in sports other than boxing, football and hockey. It is so important no matter what your sport to wear a proper equipment, and to know the signs and symptoms of a concussion or brain damage. Remember, play smart and play safe!
Reuters: Brain damage concussion fears seep into rugby and soccer
Reuters: Brain damage concussion fears seep into rugby and soccer
November 18, 2013
Daily Dose of Inspiration
"Whatever you can do, or dream you can, begin it. Boldness has genius, power and magic in it."
Johann Wolfgang von Goethe
An Uprising?
I recently wrote paper for my business law course. In this, I talked about the auto insurance industry and demonstrated through case law examples of insurer negligence, failed fiduciary duty, professional and assessment issues, and how some insurer behavior even seems to violate the Charter of Rights and Freedoms. Once I know I passed my assignment, I will post some of the findings here.
But what I realized in writing my paper is that third party assessors are immune in law. These are the assessors insurers hire when they want a second opinion. While I believe in the need for a “check and balance”, the quality of these opinions is deteriorating. Now, we are seeing completely unsupported benefit denials, issues with assessor behavior (questionable comments made to the claimant, very short exams costing thousands), errors in reporting (sometimes the client’s name is even wrong in parts), and even some fudging of professional credentials and experience (no Dr. Grant is not an Orthopedic Surgeon). As a treating OT, I see the aftermath of this – clients feel victimized, some even abused, some angry, and some sink deeper into a depression from the comments they read that have so wrongly captured the problems they have. People are trying to go to the Colleges to complain, but are saying this is ineffective.
I also discovered with my paper that third party assessors do not owe a claimant a “duty of care” and as such cannot be negligent. They can breach professional standards, and for that be held accountable by a College (if they have one), but cannot be sued for negligence or failed fiduciary duties. Does knowing this make these assessors more ruthless? Or, perhaps they don’t know this as I too used to be one of these assessors and always felt that I did owe a duty of care and ensured I provided a level of professional courteousness and respect for the client, even if the intent was not to form a treating relationship. I never saw a line between me as an “OT” and me as an “assessor”. They were always one and the same. But maybe that is why I never had a college complaint, or a client or other therapist call me after an assessment and tell me I was out to lunch.
I feel an uprising coming. A time where the people of Ontario, who rely on their insurer to fulfill a contract after an accident, get sick of the way they are being treated by some adjusters and assessors and demand a solution. One such solution has presented itself in Colorado. With this, Colorado’s uprising resulted in new Independent Medical Examination Legislation that is working to solve the problems that bad assessments were creating. Here are some highlights:
The legislation requires that independent assessors be in the same specialty as the treating practitioner (including chiropractors, psychologists, or orthopedic surgeons), and earn less than half their income from disability assessments. Most important, their process ensures that the assessor is acceptable to both the insurer and the patient. Assessors are held to a higher standard than treating providers, considering their position of power. In the new system, 75% of assessments have concluded that the initial diagnosis and treatment was appropriate, 20% partly appropriate, and only 5% inappropriate or unrelated to the accident. Further, dispute times have been greatly reduced, saving significant dollars (www.colorado.gov).
How about we try something like that FSCO, IBC and friends? But I know that before you can do this, you first need to recognize how the behavior and actions of some insurers are driving up costs, that bad assessments are ultimately resources wasted, and that costly disputes in court are resulting from both. Could it be that maybe, just maybe, fraud is only one of your problems?
November 15, 2013
Daily Dose of Inspiration
"Happiness is not something
readymade. It comes from your own actions."
Dalai Lama
Weekly Mind Bender
Billie was born on December 28th, yet her birthday always falls in the summer. How is this possible?
November 14, 2013
Daily Dose of Inspiration
The following is an inspirational example of people choosing to not to place the "dis" in their abilities.
OT for Obesity
There is significant media surrounding obesity, and the general impression is that being overweight is a “choice”. However, in many cases obesity may be caused by other factors including a medical condition or injury, genetics, mental illness or disability. While the societal focus has been on helping people to lose excess weight (through programs, even gimmicks, and reality shows), there is another lingering problem. Living with obesity can make routine tasks difficult, and can make daily living a struggle. Mary Forhan, an Occupational Therapist from Edmonton, has worked with many obese individuals over the years and is now dedicating her focus to helping these and other patients struggling with obesity live their lives to the fullest. The following article from the Edmonton Journal discusses how Occupational Therapy can help.
The Edmonton Journal: Edmonton lands obesity expert in occupational therapy
The Edmonton Journal: Edmonton lands obesity expert in occupational therapy
November 13, 2013
Daily Dose of Inspiration
"I hope you still feel small when you stand beside the ocean. Whenever one door closes, I hope one more opens. Promise me that you'll give fate a fighting chance. And when you get the choice to sit it out or dance. I hope you dance."
Lee Ann Womack: "I Hope You Dance"
Find on iTunes:
November 12, 2013
Senior Safety Week
This past week has been dedicated to National Seniors Safety awareness in Canada and this year's focus is on drug safety for seniors. It's no secret that our aging population relies on a great amount of over the counter and prescription drugs for many ailments and conditions. With so many pills and vitamins in the daily regimen, it's important to ensure you or whomever you may take care of is taking these properly and as directed. The following article from Canada's Safety Council discusses great drug safety tips for seniors and caregivers.
Canada Safety Council: Senior Safety Week
Canada Safety Council: Senior Safety Week
November 11, 2013
Daily Dose of Inspiration
"The only way of finding the limits of
the possible is by going beyond them into the impossible."
Arthur C. Clarke
How is Ordering a Wheelchair the “Cost of Doing Business”?
The new wave in insurance denials (from assessors and adjusters) is that planning and communication time is “the cost of doing business”. Huh? Until you spend a day with me, at my desk, in my car, on my phone, and in my client visits, how do you know my “business”? I can tell you that it goes like this: for every hour I spend with a client, I spend an equal hour doing the follow-up that came from the visit in the first place. And for CAT files, make that two hours. What am I doing in that time? I am calling vendors to source equipment, trying to get the best price, best client service, and the most appropriate devices. I am researching practical and inexpensive solutions on the internet. I am calling other team members to discuss functional issues, and to ensure collaborative but not duplicated service. I am arranging attendant care as if they need attendant care, they often need someone to coordinate it. I am trying to obtain funding approval from the insurer, or trying to save the client’s rehabilitation dollars by hooking them up with public services. I am receiving calls from my client to tell me the cast came off, that the new medication is helping, and that they are trying to use the cognitive strategies we discussed. I am reminding them of the things I am waiting on, or sourcing for them, or the calls that have not been returned.
Sound like case management? It is not, it is OT and those services are necessary for the provision of our therapy. And believe me, calling to get quotes on devices is a lot cheaper than driving to the client each time to meet with a different vendor. “Planning and communication time” actually saves money.
But what is concerning, and also comical, is that the people who are telling us what “is the cost of doing business” are getting paid the entire time. The adjuster that denies planning time and spends 30 minutes on the phone arguing with us is getting paid. We are not. Or, the examination OT that got paid to review our plan and cut us off from a few treatment hours. When was the last time that OT actually treated a client anyway?
I have had two epic conversations with adjusters that drive this point home. In one case, the adjuster and I got off topic and started chatting about housing. After 30 minutes he said “are you charging me for this phone call”? I responded with “first of all, I don’t charge you, I charge my client, and no, I am not going to charge my client because you kept me on the phone for 30 minutes”. I then said, “but you are getting paid to talk to me, right?” He said “well I make less than you”. My response was “not in the last 30 minutes”. He laughed. The other conversation was even more interesting. An adjuster was going to arrange for an assessment to question our kilometer costs (which had been approved on the file for the last three years but she was covering the desk due to a vacation). Again I spent 30 minutes on the phone explaining that this has never been challenged. I did the math and she was disputing $4.80. I asked her if she was seriously going to arrange for a $1500 assessment to question $4.80? Apparently she was. So I said “don’t worry about it then, I will eat the $4.80”. I wonder if her employer knew that they paid her probably an hour of salary to save them $4.80. Ridiculous.
But the biggest thing insurers and assessors need to remember is that the CLIENT has approved that time and those costs. We are required to review our plans with those we are treating, and to get their signature and authorization. We explain to people that often we spend significant time behind the scenes getting the job done. They understand this and approve those expenses as “necessary” for their treatment. Then, we demonstrate this to be the case as we remain in contact with them and are very proactive at helping them to function better – directly and indirectly. Honestly, the nickel and diming is ultimately costing the industry more, and reducing the quality of care received by injured people.
November 8, 2013
Daily Dose of Inspiration
"Everything you’ve ever
wanted is on the other side of fear."
George Addair
Weekly Mind Bender
Which is correct to say, “The yolk of the egg is white” or “The yolk of the egg are white?”
November 7, 2013
The Push For More OT
Ontario Take Notice! As the world's population ages, the need for more OT's is being recognized as a valuable part of elder care.
Australian Ageing Agenda: Push for More OT's in Aged Care
Australian Ageing Agenda: Push for More OT's in Aged Care
November 6, 2013
Daily Dose of Inspiration
"I am a new day rising, I'm a brand new sky to hang the stars upon tonight."
"Times Like These" by the Foo Fighters
Find on iTunes
Keep the faith...in insurance? I think not.
I think as a society we have lost faith in insurers. I don’t know many people who still believe that an insurer, any insurer, will be forthcoming with benefits or reimbursement at the time of claim. I see many people, before claiming, actually weighing the pros and cons between the monies they should be entitled to and possible insurer delay, deny, mistreatment, and likely future rate increases.
My parents have some epic insurance examples in the world of travel. Once, the place at which they were booked to stay went bankrupt. They requested reimbursement through their travel insurance. Surprise! It does not cover bankruptcy, only if the place became unsafe for occupancy. So my mom said to them “it is unsafe for her to vacation at a place that is bankrupt”. In another instance, extensive flooding caused the vacation destination to cancel the trip. So, they again turned to cancellation insurance. Surprise! Their trip cancellation insurance did not cover trips being cancelled. What?
I work in the world of insurance and I can tell you that there are still a wonderful number of insurers that really try to make the application and claims process as painless as possible. After all, most of the people I see are in enough pain already and plenty of insurers get that. Then, there are the ones that don’t. Those are the insurers that have been jaded through poor training, company culture, talk at the water-cooler, or the one too many surveillance videos that caught someone being fraudulent. I often wonder if some insurers are trained to make the process of claiming so difficult so that people eventually just give up and move on.
My solution to the perils of insurance is for people to start shopping for insurance based on feedback from people who have claimed, and not just on who offers the cheapest price. Like most things, you will get what you pay for and cheaping out on insurance can result in crappy treatment at the time of claim. And what happens when people are treated crappy? They turn to the legal profession, and guess what? This costs the insurers more. In all insurance, especially auto, insurers need to exercise good faith, respect, understanding and compassion and this will go a long way in creating a more sustainable product.
November 5, 2013
Movember Is Here: Embrace the Power of the Moustache
Halloween is over, but for men across the world it's time to sport another new look: the Movember Moustache.
Movember is an extremely popular movement across the globe which involves growing a moustache for the 30 days of November in an effort to raise money and awareness about men's health issues, specifically prostate and testicular cancers, and mental health.
Movember began in Australia in 2003 and has gained global popularity ever since.
The following video, as part of the global Move initiative, discusses some common men's health issues and gives one simple prescription for each.
November 4, 2013
Daily Dose of Inspiration
"The only person you are destined to become is the person you decide to be."
Ralph Waldo Emerson
Howdy Partner!
I believe in all those wonderful phrases that encourage risk taking and that try to convince people that fear drives personal growth and development. I took a major risk two years ago when I decided to return to school for my MBA. Having little formal business training beyond an entrepreneurial father and my own school of hard knocks, and even less faith in my math abilities, I knew that this challenge would be the intellectual stimulation I needed to take my brain to the next level. And it has – time and time again. I now think differently and approach problems with more strategy and big picture thinking than ever before. I can also calculate bond returns, but I will save that as a party trick.
Fast forward to last Friday, and I embarked on major risk # 2. With my new-found business thinking, and general desire to do more with my business than my abilities as one person allows, I joined forces with a colleague to forge a new journey. Exciting, fun, a bit scary, but a great decision. Entwistle Power Occupational Therapy was born!
People are mammals. We need each other. It has been well studied that people with reduced social outlets, a lack of love, or even animals and babies not nurtured at birth, do not fare as well as mammals that receive love, socialization, and affection. I believe that while studies highlight the challenges of business partnership, people need to treat this like a marriage. It needs to be entered into with respect, trust, and an absolute faith in the skills of the other person. There will be ups and downs, challenges and successes, but in the end, two will be better than one. I believe this to be true in business also.
In the words of Garth Brooks: “don’t stand along the shorelines and say you’re satisfied. Choose to chance the rapids, and dare to dance the tides”. I agree Garth, I agree.
November 1, 2013
Weekly Mind Bender
If a rooster sits on the border of Kansas and Oklahoma, where would the egg drop?
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