Posivite Care with Teepa Snow

        In this epidsode of Foxcast OT Podcast, Teepa Snow, an OTR/L shares insight into her specialization, dementia. The title of the podcast is "The Positive Approach to Dementia Care." Teepa treats individuals, coaches caregivers, hosts conferences, and travels the country promoting a possitive approach to treating individuals with dementia.
       The three biggest tips that Teepa shared were these: Support, Environment, and Ques. For individuals living with dementia they may not have the capacity to understand the disease. So essentially, trying to explain that parts of their brain are dying is only more confusing and futile. We can make suggestions and alter the environment that they are living so that they can best be supported. She suggests the importance of visual and physical queing rather than verbal as several words can become mixed up. Instead of saying, let's get up and go to the therapy gym you can use your hands to signal getting up and point to the therapy gym.
         Teepa refers to different stages of dementia as gems. She uses the Allen Cognitive level test but instead of numbers, she sees clients as "diamonds, emeralds, ambers, rubies, and pearls." As the last stage is a pearl, you do not have the beauty you once had and may be living in a shell of reflexes. A pearl may not always shine and a pearl needs support to get out of the shell. However, if a pearl is supported, they can still play a role. If a pearl has the right environment, it can still be beautiful. A pearl is not the diamond that it once was but has unique and endearing qualities to share.
          The biggest takeaway,to me, was listening to the words that Teepa encourages using in caring for individuals with dementia. Instead of saying, "you're not going to get better, Jimmy so we have to get on medicine", you can say "where would you like to keep your medicine, Jimmy?" Instead of telling an individual that they are not allowed to drive, you can suggest "how about I drive today". Sentences with many words run together and to these individuals. "Do not go out the door" and "go out the door" might seem the same. We can avoid these situations be eleminating "not" from our conservations. "Let's stay inside" might be more affective. Teepa also encourages avoiding the word "remember." By asking if they remember the exercise you did last week, you are only reminding what little they do remember. Quite frankly, they do not, so let's just avoid asking.
          I think that this podcast was very beneficial to hear because it addresses topics that can only be learned through experience. Teepa shares wisdom that she has gained in twenty years of supporting individuals with dementia. As an occupational therapy student, it is so important to put on a coat of empathy and truly consider the whole situation. While their brain is changing and they may not know the words that you express, a person living with dementia has feelings, emotions, volition, and motivation. They are human beings with hearts and it is important to see them this way. This podcast gave me a new understanding of dementia and an always-welcome reminder of the power of positivity.

McKay, Jimmy.(2019, May 23.) FOXcast OT: The Positive Approach to Dementia Care with Tepa Snow. [Audio Podcast]. Retrieved from https://www.stitcher.com/podcast/fox-rehabilitation/foxcast-pt/e/60963029.

Innovators Statement- OT (q)- Tips

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            In brainstorming and working on this assignment, I took a moment to reflect on what it would be like to be in Susan's position. Susan is a 55 year-old mother who was diagnosed with ALS. I thought about my mother who is close to Susan's age and is also an elementary school teacher. I thought about the giant that is ALS and the feelings associated with such a disabling and progressive disease. This assignment gave me a perspective of what would be meaningful to an individual that is living a life with ALS and the importance of involving the entire family. Her husband and children are going through a time of change and we, as OT's, can help Susan to express her feelings and support her loved ones.

Two scrapbook pages made using paint and q-tips

             The average prognosis for individuals with ALS is 23-52 months and it is common for individuals to lose speech abilities. Using the q-tips to scrapbook will give Susan the chance to express herself. This activity is allowing Susan to reflect on her life as a mother and wife while creating work that makes her proud. Creating scrapbook pages will promote function in her upper extremities and will conserve energy by designing paper, not spending time at the craft store. As she moves her arm from paint to paper and grips the Q-tip, Susan will be maintaining range of motion in the upper extremities and grasp in fingers.
            Going forward, after completing this project, I have gained an appreciation for supporting the needs of an individual with ALS, the challenges that they might face, and the impact that the disease can have on families. I now know to think outside the box, knowing that something as simple as a q-tip can be a useful tool in treatment. As a therapist, I will spend time getting know my client's, especially those with a progressive diagnosis, to meet their needs the best that I can. I will consider their emotional concerns, not just physical. I will explain their disability but highlight their ability. I am grateful for a chance to try my hand in the topic of treatment and look forward to learning more.

"OT, Stem Cells, and Stroke"

In this podcast, OT Potential, Sarah Lyon explores an article that was named the #3 occupational therapy related journal article. Sarah, an OTR/L, explains the research that this article explores and how that might have an impact on the profession of occupational therapy. I chose this article because I have an interest in strokes. Strokes are a part of my OT origin story as I was first introduced to occupational therapy after my grandfather suffered from a left-side ischemic stroke.
This podcasts explains the development of medical science in regards to stem cell therapy after strokes. Sarah explains that the he stem cells that this research is presenting is not the embryonic stem cell research that has caused great controversy but cells from an individuals' own body. Research is being done to suggest that cells can be injected into areas of the brains that have been damaged and create new pathways. This has been practiced on animals and is now being tested for adverse side affects in humans. It is believed that this could be common and available practice within the next 5-10 years.... just in time for our cohort to be joining the working community as occupational therapists.
This research is important because it shows that injecting cells into damaged areas is not as effective without the use of therapeutic movement. While science can support neuroplasticity, as I have discussed in previous posts, movement is crucial for reforming the neural pathways. This is where OT shines in this possible treatment. Research will continue to be pushed to learn what type of therapy and how much should be given.
Cell based therapy can also play a role for clients that have suffered from a stroke and reached a "chronic stroke phase." Sarah defines this as a client that suffered a stroke more than 6 months ago and have not shown improvement in 2 months. These clients will reach a plateau and might even be discharged from OT because we cannot prove that it is necessary or making improvements. The possibility of cell based therapy and it's combination with movement and physical therapy could play a huge role in the lives of these clients. Having this medical intervention as a possibility would increase the hope for many individuals that have suffered from a stroke and encourage the role of OT in the process.
I think that the OT Potential Podcast is a great resource for students because it breaks down important and sometimes daunting journal articles into relatable and interesting information. This post is similar to a recent post that I wrote about cell therapy intervention in spinal cord injuries and the incredible impact that it could make in rehabilitation. I have an interest in neurological damage and rehabilitation and the Neuro Note assignments have allowed me to explore amazing breakthroughs and difficult truths of this topic.

Lyon, Sarah.(2019, March 29.) OT Potential Podcast: OT, Stem Cells, and Strokes. [Audio Podcast]. Retrieved from https://www.stitcher.com/podcast/ot-potential-podcast.

Pillars of Parkinson's Rehab- Neuro Note 2

          The OT Potential Podcast, hosted by Sarah Lyon OTR/L, highlights the 50 most influential journal articles published that are related to Occupational Therapy. Sarah, alongside a research librarian, have worked to feature the articles that can be the best resources for fellow OT's. Sarah explains that about 1,000 articles are posted per year. Sarah and the librarian have narrowed down the 50 "most cited" out of 4,923 articles. Sarah's podcast breaks down the message of each journal article and how it can impact the field of OT.
          The podcast that I chose is called "Pillars of Parkinson's Rehab". The first pillar should come as a confidence booster to OT's. It states that rehabilitation intervention for Parkinson's is most effective when it is "goal-based." That is just a small part of our OT Toolbox that we use everyday and should reassure OT's that are treating client's with Parkinson's that they are probably already on the right track. The journal article outlines mirroring, virtual reality and imagery as helpful to the treatment as well. The pillar that I found most interesting and is seen as the most beneficial relates to exercise. Sarah explains the pillar as "exercise-induced neuroplasticity."
Exercise-induced neuroplasticity is the term that we use to describe the impact hat aerobic activity can make on the progress of a disease. Neuroplasticity is the way that our nervous system can reorganize connections and reroute a message after damage has been made. Dr. Lancaster's visual example of neuroplasticity explains the concept in a realistic way. Imagine you're driving home and see a large pot hole in the road ahead (Memphis drivers, sound familiar?). You can continue driving and come to stop once you hit the pot hole or you can change directions, shift lanes, or make a turn. This is what our signals from the brain are able to do after a neurogenerative disease like Parkinson's has made its mark.
           Sarah explains that research shows that those with Parkinson's that were treated with an intense exercise program, 2 times per day for 5 weeks, showed a significant decrease in a need for medication for 12 months. Levadopa, described as the gold standard medication for Parkinsons, can mask and maintain symptoms but does not hinder the progression of the disease. Exercise however, is proven to slow the progression of the disease and allow individuals to maintain gait, balance, and coordination for longer. The article outlines the benefits of aerobic exercise like dancing, kickboxing, and tai chi. It also provides research pointing to intense and resistance training. Even done just weekly, monthly, or annually, it is shown to better the prognosis of individuals with Parkinsons.
          Had I listened to this podcast before taking this course, I would not have appreciated many of the references such as levadopa, neuroplasticity, dopamine production and motor mirroring. I chose this podcast because it aligns with particular topics that I find interesting. I have always enjoyed running and yoga and have a new-found interest in neurodegenerative diseases. I hope to one day become a certified exercise instructor and am curious about exercise facilities such as "Rock Steady Boxing", designed specficially for individuals facing this disease. I would recommend this podcast to anyone that is pursuing a neuro focus, occupational therapy, or caring for a loved one with Parkinson's. We all know that exercise is good for us but when it is outlined in a way that could slow this disease in it's tracks, it may inspire a certain client or caregiver to think differently!

Reference:
Lyon, Sarah.(2019, July 7.) OT Potential Podcast: Pillars of Parkinson's Rehab. [Audio Podcast]. Retrieved from https://www.stitcher.com/podcast/ot-potential-podcast.