Aqua Therapy and The Power of Water in Rehab: Improve Body, Mind and Spirit

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Aqua Therapy and The Power of Water in Rehab: Improve Body, Mind and Spirit

The healing properties of water have been utilized by civilizations for centuries. From the Egyptian royal baths infused with oils and salts to the communal pools used in the great cities of Rome during its height to the still famous baths of Budapest, Hungary, societies have known that water heals. The history of the calming, revitalizing waters of these locations has reinvigorated the physical rehabilitation practice of Aqua Therapy.

Aqua Therapy (also called hydrotherapy) takes many forms, each of which contains one underlying theme: utilizing the pressure, heat, resistance, buoyancy and uniqueness that exercising in water holds.

Aqua Therapy can and should be included in any therapy regime that seeks to reduce stress, improve physical fitness, or simply escape gravity for the otherworldly feel of H20.

As stated in Joanne Koury’s report, Aquatic Therapy Programming: Guidelines to Orthopedic Rehabilitation,

“Clients report that not only is movement easier in the water, but less painful, promoting earlier rehabilitation.”

The benefits of water go well beyond reducing pain and increasing mobility, as aqua therapy provides much needed cardiovascular exercise and musculoskeletal strengthening that is more risky on land due to balance or neurological impairments. Having personal experience working with people of all ages in a pool setting for the past decade, I have witnessed the engagement that water requires from a person. While I would not go as far as to write that aquatic therapy should precede dry-land exercises (as most of life is lived with the effects of gravity), a combination of both modalities could more efficiently rehabilitate someone with any number of physical maladies.

The water shares its benefits with more than just the body. A quiet pool offers an Aqua Therapist the setting to initiate stress reduction techniques such as deep breathing, visualization and employing slow, deliberate movements while concentrating on the ‘feelings’ the water elicits.

One of the goals during this process is the ‘melting away’ of stress that is often described by clients who face unfamiliar and new pressures due to a Motor Vehicle Accident. Anecdotal evidence of this is easy to find if you have ever noticed someone’s face and body language change as they enter a hot-water whirlpool. Exercises focusing on removing the tough, outer layers of strain, pain and stress are integral to this component of rehabilitation. A constructive, shielded environment where the survivor can confront their psychological deficits and develop methods to rebuild themselves allows for progress to be made in every aspect of their lives.

The practice of Aqua Therapy shares one common element. Water. But there are many paths to achieving successful rehabilitation in the water and mending the body, mind and spirit. In future entries I will focus my analysis on specific strategies and modalities Aqua Therapists use to tailor their programs to a client’s individual needs.

In conclusion, I offer the inspiring words of Margaret Atwood from The Penelopiad, who sums up the unstoppable power and natural appeal that water possesses:

“Water does not resist. Water flows. When you plunge your hand into it, all you feel is a caress. Water is not a solid wall, it will not stop you. But water always goes where it wants to go, and nothing in the end can stand against it. Water is patient. Dripping water wears away a stone. Remember that, my child. Remember you are half water. If you can’t go through an obstacle, go around it. Water does.”

Submitted by:  Sean McGhie

sfsdfsdsdfd

Three Approaches to Evaluating Back-to-Work Readiness After an Accident

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Three Approaches to Evaluating Back-to-Work Readiness After an Accident

While it’s easy to understand that following an injury, trauma, or accident an individual may no longer be able to work, it’s much harder to understand when, if ever, that person will be able to return to work.

How do we evaluate anyone’s ability to return to work, and how do we know if it’s being done in an effective manner?

First we need to look at what work evaluation really is. Work evaluation is an experiential evaluation that uses reality-based techniques and operations. For some clients this observation may be the optimal way to understand how they may function in a particular situation.

The purpose of the work evaluation is to gather information to allow for decisions related to the client’s potential to work, the types of jobs which may be considered, and the types of training that may be required.

All types of individuals who have suffered an accident may be suited to a work evaluation. This list includes those with any combination of physical, cognitive, emotional or behavioural impairments. In addition, a work evaluation may be helpful for an individual who is unsure of their capacities or those who may be over- or under-estimating their own capabilities.

Work evaluation allows for understanding the client’s ability to:

  • Work independently
  • Maintain their attention
  • Retain information and instruction
  • Maintain necessary levels of stamina or strength.
  • Interact with co-workers
  • Respond to criticism or accept supervision

When attempting to evaluate an individual’s ability to work, three work assessment approaches can be taken:

1. Work Samples

These are well defined work activities making use of defined tasks, materials and tools similar or identical to those in an actual job or in a cluster of jobs. Work samples may include use of evaluation systems (Valpar, etc.) to provide information regarding client skills, interests, physical capabilities, work behaviours and learning styles.

2. Situational

This type of assessment is typically used to evaluate clients regarding general employability behaviours, with emphasis on assessing work potential. While this assessment does not necessarily involve the client’s current or previous line of work, it helps to assess many performance areas, which can then be extrapolated to general employability.

3. On-the-Job Evaluation

This form of evaluation provides assessment of functional capacity in an individual’s actual workplace. Evaluations of this nature can take place anywhere from one day to over a 1-2 week period. It is important to work with both the client and the employer to assess performance.

An effective approach to evaluating an individual’s ability to work could involve one or all three of these approaches. However, as with any other type of evaluation of treatment, the approach which is the most realistic and functional for the client is always the most appropriate.

Once all of the client’s strengths, weakness and functional capacities have been identified, it becomes easier to understand the individual’s ability to return to work, their need for ongoing rehabilitative treatment or workplace modifications, or their potential need for retraining in an entirely new field.

sfsdfsdsdfd

The Importance of Education Before Using a Walker After Neurological Injury

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

The Importance of Education Before Using a Walker After Neurological Injury

Usually, when I first meet a client with a recent neurological injury (such as a stroke, brain injury or spinal cord injury) walking is one of their primary physical rehabilitation goals.  Many of these clients do regain the ability to walk, often with the aid of a walker or a cane.

A gait aid can be a useful tool, with the caveat that it is used the right way.  Addressing the way the gait aid is used early on is important since developing good habits will save the client from complications down the road and allow him/her to further improve in function.

For many individuals, gait aids are necessary because they allow for compensations, which can enable them to walk safely.  Compensation is defined as a movement substitution that replaces normal movements to accomplish a functional goal (such as walking).  Compensations can be divided into “appropriate compensations” and “undesirable compensations”.

Appropriate compensations are those, which use movement patterns resembling normal movement.  Undesirable compensations do not teach normal movement patterns the individual may have the potential to learn, but instead lead to atypical movement patterns.

A lot of movement patterns are repeated between differing actions.  For example, a sit-to-stand movement uses the same pattern of trunk and leg muscles as walking.  If an atypical walking movement is learned, then that learned pattern will affect the client’s ability to sit-to-stand as well.   This may limit the client’s ability to get up from a low chair, despite having the muscle strength to do so.  The same normal movement patterns are repeated in a lot of different actions besides walking and sit-to-stand, such as reaching, rolling, lie-to-sit and stair climbing.

Learning atypical movement patterns usually leads to other limitations in the above actions.

A gait aid can result in either appropriate or undesirable compensations depending upon how it is used.  It is undesirable for an individual to use a gait aid by fixating on it with his/her upper body.  A body without fixation is using normal movement patterns.  This includes using different muscles at different times in order to maximize efficiency.

Fixation on a gait-aid occurs when an individual is leaning on the aid, using many of their upper body muscles excessively to help support their weight.  In addition, the person will have poor posture while walking since he/she is leaning forwards on a walker or sideways onto a cane.

These atypical movement patterns are very hard to unlearn.  They often persist, even if the individual recovers muscle function which would otherwise allow for more normal and efficient movement.

Instead, a gait aid should be used in a way that the individual is not fixating upon it, but rather using it as an aid for balance and stability.  It should be used to train normal combinations of leg, trunk and arm movements.  This can be done by ensuring the individual is not leaning on the aid, but rather standing up straight while using it.  In addition, the client should not be using the walking aid to support his/her weight.  When a gait aid is used appropriately, as the individual recovers more muscle function, he/she may eventually be able to walk without the aid.

The timing of when a gait aid is introduced is also important.  Just because an individual can walk using a gait aid, does not mean they should be walking.  As a physiotherapist, if I am working with a client who cannot walk without fixating on a gait aid, that tells me he/she may not be ready to walk.  We work on exercises to improve his/her strength and balance including exercises in standing until they can begin to take steps and walk with the gait aid without fixating on it.

There are always exceptions to every rule and there may be some individuals who may never be able to walk without some degree of fixation.  As a therapist, I work with each client to ensure that fixation is minimized and only used when absolutely necessary.

Submitted by: Farhana Jaffer

sfsdfsdsdfd

Sensory Defensiveness Following Brain Injury

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Sensory Defensiveness Following Brain Injury

‘Sensory defensiveness’ is one issue individuals with brain injury often struggle with.  This problem can manifest itself in many different forms.

It may present itself as increased negative reactivity to environmental sounds/noises. For example, someone may find himself to be very agitated by background noises from fans, clocks or even the hum of the refrigerator — things he may never have noticed before.  Or a person may become overly startled and have trouble regaining his or her composure after hearing a loud car horn or siren.

These examples relate to an over-responsiveness of the nervous system to one kind of sensory input: auditory or sound input.  This increased reactivity can occur in response to other forms of sensory input as well, including touch (e.g. from clothing tags on the skin), visual input (e.g. bright lights), movement (e.g. while in a car or on a bus) and even tastes and smells (e.g. from scented sprays or perfume).

Underlying Mechanisms

On the surface, these symptoms may seem strange or be interpreted as weird behaviours. So, you may wonder how a person’s brain injury could lead to these new sensitivities and responses. What’s going on in the brain here?

Well, part of the answer is related to the Autonomic Nervous System (ANS).  This is our ‘protective’ nervous system.  When it is activated, a person’s body and brain become prepared for danger (i.e. heart rate increases, muscles are activated for movement, pupils dilate, etc.).  When the ANS is activated, a person will often go into ‘fright, flight or fight’ mode.

After the danger has passed, a person’s Parasympathetic Nervous System (PNS) takes over, activating all the calming and restorative processes required to maintain health and equilibrium.

Both these systems are thus equally vital and important.  However, when ‘sensory defensiveness’ develops, the regulation of these two systems goes awry.  The ANS becomes triggered very easily, by not only signals warning of danger (e.g. a screaming child), but also by non-threatening sounds (or other inputs). When this happens, a person has ‘defensive’ reactions to sensations which may have never bothered him or her before.  As well, the decreased regulation of the ANS/PNS leads to poor activation of the PNS when recovery processes should be occurring.  This leaves a ‘sensory defensive’ person distressed and agitated long after the sensation has passed.

What can be done to help?

There are many different types of therapeutic approaches to address this issue.

For example, cognitive-based approaches rely on the use of our conscious thoughts to affect the lower-level processing in the nervous system.  Of equal value however, are sensory-based strategies.  We can use input to our basic senses to both raise and lower the activity of our nervous systems and to decrease the negative ‘reactivity’ to sensations experienced by a person with ‘sensory defensiveness’.

Certain sensations have a calming effect on the nervous system.  One form of input to the tactile system can directly calm the nervous system: deep pressure touch (e.g. from massage, wrapping up in a blanket or wearing spandex clothing).  As well, slow, rhythmic music – picked up by the auditory system – can also directly organize the nervous system, leading to a calmer state.

Another valuable sensory system is the proprioceptive system.  It receives input when we do any heavy muscle work (e.g. push ups, using hand weights) or when our joints get compressed (e.g. during jumping, or while holding ourselves in a plank position or even a head or shoulder stand).

This ‘proprioceptive’ input has a very powerful organizing effect on the nervous system.  Therefore, it can be used to bring someone to a state of calm (if their ANS is over-active) or to increase a person’s level of alertness and readiness for action (when their ANS is under-active, such as when a person is extra groggy and slow to move in the morning).

Our movement experiences send signals to the brain which can have an excitatory effect (e.g. fast movements with changes in speed/direction – such as felt when on a roller coaster) or a calming effect (e.g. slow gentle rocking – such as that used to rock a baby to sleep).

With our knowledge of how sensations affect the nervous system, we can use specific activities which provide calming and organizing sensory input, to help a person with sensory defensiveness.  For example, a person with TBI may have become over-responsive to noises and bright lights.  This could make a routine doctor’s visit become a very agitating and draining experience.  The person may get bothered and feel unable to tolerate all the background noises in the waiting room (e.g. from cell phones, conversations, medical equipment, background traffic, etc.) or the fluorescent lighting or glare from the windows.

In this case, use of sensory-based activities 1 to 2 hours before the visit can actually help.  Before leaving, the person could potentially apply deep pressure to his arms and legs by applying lotion with heavy strokes or by taking a long shower while using a loofah/scrubber.  He could also have a family member apply ‘joint compressions’ to his body or take a rest under a weighted blanket.  If able, he could do heavy muscle work by performing wall or table push-ups or even walk around with weighted ankle bands in the morning.

On the ride to the doctor’s office, the use of car window screens could help decrease the glare.  And, listening to calming slow rhythmic music or a nature sounds CD may also help to calm his nervous system.  These activities could be used to prepare his nervous system to be calm and balanced and this would in turn directly decrease his over-reactivity to sounds and bright lights that would otherwise bother him.

Each individual has very different needs and responses to sensations.  The above activities may not be calming or organizing for everyone.  And the properties of all sensory systems and input must be considered.  For that reason, it is essential that an occupational therapist trained in Sensory Integration be consulted for an assessment when developing one’s own ‘sensory diet’ of activities for the above-mentioned purpose.

However, with the help of a trained occupational therapist, a person with ‘sensory defensive’ symptoms can develop a personalized ‘sensory diet’ to meet their nervous system’s needs.  This can make a person’s return to regular daily activities so much less of a struggle and even more enjoyable!

sfsdfsdsdfd

Using Home-Based Paraffin Wax Units for Wrist Pain and Stiffness

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Using Home-Based Paraffin Wax Units for Wrist Pain and Stiffness

I recently had success treating clients with a paraffin wax unit designed for home use.  I’d like to share the case study with you. As a community occupational therapist there are often restrictions in providing home-based therapy to clients due to the nature of the treating environment. In hospital, paraffin wax treatments are often used, but the medical-grade equipment is large, cumbersome and not conducive to home use. This means that clients receiving home-based OT treatments due to mobility restrictions or other limitations may lose out on potential therapeutic modalities.

Why Paraffin? Since paraffin is heavy in molecular weight, it increases the blood supply to the area being treated and traps moisture from underlying layers of the skin. Paraffin therapy is commonly used to reduce pain and stiffness around joints by removing excess fluid from surrounding tissue, providing heat and added lubrication to the skin.

The Solution I recently purchased a portable paraffin wax unit from a home health store at the cost of $60.00 for use with a client experiencing dominant-hand wrist pain and stiffness as a result of a wrist fracture. The fracture occurred approximately one year prior and she had attempted massage treatment on the affected area with no symptom relief. Using the paraffin unit involved some set-up including pre-heating the wax for approximately two hours prior to use. The client was asked to plug in the paraffin wax unit prior to me arriving at her home to reduce therapy time spent preparing the wax. To complete treatment, the client’s affected hand was placed into the wax 10 times quickly after which time her hand was placed in a plastic sleeve (60 were provided in the kit). After 15 minutes, the wax was removed and her hand was washed. Several towels were used to reduce wax spillage during treatment. This treatment was continued over subsequent OT treatment sessions with the client reporting a reduction in overall wrist pain and stiffness. Additionally she noted that the treatment was relaxing and assisted towards boosting her mood. As therapy progressed both the Personal Support Worker and the client herself were taught how to use the unit independent of OT treatment sessions, thus increasing her exposure to the treatment without using extra OT therapy time.

Summary    At a low cost the use of paraffin wax treatment can be brought into a client’s home by a community-based occupational therapist. The treatment modality is cheap, effective and acted towards increasing mood as well as pain and stiffness symptoms. If appropriate, the client can be taught how to use the device outside of therapy sessions thus increasing the benefits of treatment.

Submitted by Melissa Tobros, MSc. OT, OT Reg. (Ont.), CCLCP

sfsdfsdsdfd

Bridging Tangents: What is a Rehab Support Worker?

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Bridging Tangents: What is a Rehab Support Worker?

Bridging Tangents is a forum for brain injury survivors and the people who support them. .

A Rehab Support Worker (RSW) is an unregulated hospital  and community care professional who follows rehab goals prescribed by a number of regulated professionals such as Physiotherapists, Occupational Therapists, Speech Language Pathologists, Social Workers, Psychologists, etc.,  when working with brain injury survivors.

RSWs implement functional activities designed from these goals and practice them with the ABI survivor in their natural, community-based setting.

One of the main goals of an RSW is to put the ‘fun’ in functional activity.  Why?  Because relearning a skill or a strategy following a brain injury often involves an incredible amount of repetition. You can imagine just how frustrating and time consuming this can be!  And when you’re having fun, it doesn’t really feel like you’re working.  This helps to pass the time needed to learn or re-learn the skill or task at hand.

Rehab Support Work has such a wide scope of practice I find it necessary to focus on what I believe should be its main function…bridging.

Like a damaged brain trying to repair itself, recovery is all about making connections.  RSWs help survivors identify bad connections, repair old connections and create new ones, by bridging different environments, activities and communication between all members of the treatment team.

Tangents do not intersect, they go off on a completely different line of thought or action.

The transition from hospital to home and the relationship changes that occur pre/post brain injury are common examples of rehab tangents.

Our RSWs at Galit Liffshiz & Associates hold degrees, diplomas and certifications in Kinesiology, Psychology, Behaviour Therapy, Occupational/Physiotherapy Assistant, Qqua Therapy, mindfulness and other health-related fields of study.

So fellow adventurers, please put on your safety belt and helmet (both literally and figuratively).  We are about to embark on a journey into the mysterious world of ABI Rehabilitation.

3-2-1. Let’s bridge some tangents!

Submitted by: Kris Mamaril

sfsdfsdsdfd

Cognitive Rehabilitation’s Tremendous Potential

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Cognitive Rehabilitation’s Tremendous Potential

I have worked as an Occupational Therapist with acquired brain injury clients for the last 20 years. And that’s why I get really discouraged when the doctors in the acute, and even rehabilitation hospitals, call cognitive rehabilitation mental stimulation and tell the clients to do random quizzes and Sudoku etc. to help in their cognitive recovery following a brain injury.Cognitive rehabilitation as we have seen in the recent literature is a science, just like physical rehabilitation. It takes a detailed assessment by a neuropsychologist and an occupational therapist to identify the impairment areas, followed by developing and implementing a well-defined plan of action to obtain the optimal results.

It uses some of the same principles as physical rehabilitation; namely, the use of the right challenge to progress the clients. For example, you would not expect a client who is disoriented to his/her surroundings and has a very limited attention span, and who just came out of a coma two days ago in an ICU, to do Sudoku or cross word puzzles. It would only lead to frustration and failed outcome for the therapist and the client.

Cognitive intervention has to be tailored to the specific client, their educational background, their cultural and social beliefs and their level of functioning. It’s not one-size-fits-all.

Another issue is the assessment tools being used for screening and assessing cognition. The MOCA and the MMSE for the acquired brain injury clients is being used as the first line of action by the occupational therapists in acute care hospitals. However, these are very simplistic ways of looking at and assessing a very complicated area i.e. cognitive functioning. I would suggest that clinicians execute caution in using and reporting the results from these screening tools.

Occupational Therapists have to be careful about the assessments/screening tools they use and the interventions they employ to obtain the optimal results for their acquired brain injury clients. The biggest piece of the puzzle is to educate the team members on the very complicated nature of brain injury and recovery and veer them away from oversimplification of assessment and intervention techniques!!

Submitted by:  Meeta Gugnani, BSc. OT, MSOT, OT Reg. (Ont.)

sfsdfsdsdfd

Treating Executive Functioning Dysfunction with Occupational Therapy

  • by glarehab
  • Nov 30, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Treating Executive Functioning Dysfunction with Occupational Therapy

Treating Executive Function Dysfunction with Occupational Therapy.

In early October 2012, a number of therapists from Galit Liffshiz & Associates attended a three-day workshop on cognitive perceptual deficits and cognitive rehabilitation. The course was presented by Dr. Joan Toglia, PhD, OTR, who is an Occupational Therapist and educator at Mercy College in New York. She has over 20 years of clinical experience in acquired brain injury awareness and specialization in issues related to cognitive rehabilitation.

The focus of the workshop was on assessment and treatment of Executive Functioning (EF) dysfunction.

Generally, EF is an umbrella term for cognitive/brain processes which regulate, control and manage other brain processes. The five domains of EF include:

  • Initiation and Inhibition
  • Cognitive Flexibility
  • Working Memory
  • Planning and Organization
  • Self-regulatory/Monitoring

EF symptoms can be seen in a number of populations, including stroke, head injury, Multiple Sclerosis, schizophrenia and peripheral vascular disease. These deficits can be either prominent or subtle and can influence balance, motor function and one’s ability to complete daily activities.

Of the five domains, one of the most commonly referenced is working memory (WM). WM allows us to hold and manipulate information in our mind and keep track of all aspects of an activity as it is being performed (for example, following a recipe while cooking). Symptoms of poor WM can include losing track of what was just done or said, difficulty remembering what the next step of an activity is or the inability to process a large amount of information simultaneously.

There are two main approaches to treating working memory deficits: compensatory strategies and remediation.

Remediation is based on neuroplasticity;  the brains ability to reorganize itself by forming new neural connections. It allows parts of the brain to compensate for the injured areas.

Cognitive remediation is becoming mainstream and is often referred to as “brain training”. Internet and computerized programs encouraging ‘healthy brains’ have quickly gained popularity. An example of this type of program is Luminosity. iPhone applications and other electronic devices allow you to access games that promote mental stimulation. Combining periods of mental exercise with regular physical activity is recommended for positive outcomes.

Compensatory strategies are required when recovery of lost brain function is unlikely. Individuals with poor WM can become easily overwhelmed when too many steps or instructions are provided simultaneously. Compensatory strategies for poor WM include grouping similar information together (e.g. grocery items by department), rehearsal/repetition (e.g. a phone number or address) and association (e.g. linking a name to a well known person).

Resources for online Brain Fitness Exercises:

sfsdfsdsdfd

Caregiving after Brain Injury: Preventing Burnout

  • by glarehab
  • Nov 29, 2012
  • Blog
  • 0 comment
Categories
Blog
Categories
Blog

Caregiving after Brain Injury: Preventing Burnout

Few illnesses or injuries result in the overwhelming changes which can accompany severe brain injury.

Your loved one that has sustained a brain injury may seem to to be a different person. They may behave differently, think differently and/or interact with their environment differently.

When a family member suffers a Traumatic Brain Injury (TBI), the entire family is affected. Caring for a loved one can be very rewarding, but it also involves many stressors: changes in the family dynamic, financial pressure, routine disruption, and of course, the added workload.

Caregivers of people who have suffered a brain injury may experience feelings of grief, guilt, burden, distress, anxiety, anger, depression and even embarrassment. Caregiver stress can be particularly damaging for caregivers of a person who has suffered a TBI, since their challenges are typically long-term and chronic.

If you are caring for a family member, spouse, child, relative, or a close friend with TBI, it is important to recognize how stressful the situation can be and to seek proper support.

One of the ways to prevent burnout may be to develop a circle of care and ask your support system of family, friends and community members for help with your loved one’s care.

In addition, services that would be helpful include in-home assistance (personal support workers or home health aides); respite care to provide breaks from caregiving; brain injury support groups and ongoing or short-term counseling for caregivers to adjust to the changes in the family dynamics as a result of the injury.

Keep in mind that it is not selfish to focus on your own needs when you are a caregiver.  In fact, it is an important part of your role to prevent the burnout of yourself, as you are responsible for your own self-care in order to continue and take care of others.

Focus on the following self-care practices:

  • To avoid compassion fatigue, take time for yourself without feeling guilty. You will not be able to take care of your loved one if you are physically or emotionally exhausted.
  • Learn and apply stress-reduction techniques (An Occupational Therapist or a social worker can assist you with this).
  • Attend to your own healthcare needs include keeping your own doctor’s appointments and, if you are on medications, keeping your own medication schedule.
  • Get proper rest and nutrition.
  • Exercise regularly.
  • Participate in enjoyable and nurturing activities.
  • Be assertive in getting the support and help you need. Accept the support from others when it is offered.
  • Find a caregiver support group. Educate yourself about available resources.
  • Identify and acknowledge your feelings. Do not ignore intense feelings of depression or anxiety. Seek professional help if you need it.
  • Try to identify and change the negative ways you view the situation.
  • Set SMART (Specific, Measurable, Attainable, Realistic, Timely) goals.

Submitted by: Miranda Mo, OT Reg. (Ont)

sfsdfsdsdfd