Caretaking 102 - The Aftermath

The occupational therapy my mother went through was focused on daily tasks such as bathing, cooking, and so on. Yes, it did touch on adapting her house in some ways to be safer, but mostly it was designed to help her do the things she had to do every day.

Peggy, it often seems that way but it's about how you adjust the environment for your needs rather than you adjust to it. 

So in the bathroom maybe you need smoother entry to the shower, different barriers to keep shower spray away from the floors (hence prevalence of hand-held showerhoses), bath chairs, maybe rails and extra hand-grips...

There maybe towel rails that double as extra-firm hand-grips in case of falls, mirrors at specific heights, basins set at special heights, lights of a specific colour set at a specific place to be operated in a specific way...

Toothbrushes might have special grips; toilet seats - well, there's a whole debate over seats and pedestals vs bidets let alone whether either should be heated, the water should be heated, there should be recessed safety lighting in the skirting boards around them... 

So once you've got all that sorted then you learn to use them safely. With memory loss, a routine needs to be created and reinforced so use is smooth and easy. 

Physio, on the other hand,would build up your muscles and stamina and help you adjust to using the aids you need to complete a task. 

Joanne:  Things may be a little different over here.  It is our physical therapists who will inspect the home environment and make recommendations as to how the environment can be modified for the ease and safety of the patient.  Occupational therapists here work more on finding alternative ways of performing daily tasks as Peggy described.

Internationally, these are the definitions of the roles. 

How you see them carried out is another thing. 

What you think of as 'physical therapists' is a mix of physio and OT, especially in relation to home visits. However the study disciplines and the research areas are the same internationally. (Confirmed in the mix of courses via Open University and other such MOOC which are pooled from real campuses. The Exercise Prescription course I'm currently doing is via Trinity College in Dublin, and around 40% of the references are US sourced)

You can get a lot of helpful info from the OT resources pages here: 

http://www.aota.org/Practice/Productive-Aging.aspx

From the APTA website, the Physical Therapists' association site, is this statement about thir work: "

Physical therapists are health care profes-
sionals who maintain, restore, and improve
movement, activity, and health enabling an
individual to have optimal functioning and
quality of life, while ensuring patient safety
and applying evidence to provide ef cient
and effective care. Physical therapists evaluate,
diagnose, and manage individuals of all ages
who have impairments, activity limitations, and
participation restrictions. In addition, physical
therapists are involved in promoting health,
wellness, and tness through risk factor identi-
cation and the implementation of services to
reduce risk, slow the progression of or prevent
functional decline and disability, and enhance
participation in chosen life situations" (there's more)

They work primarily to mitigate pain and restore function, not so much to modify environment. 

http://www.apta.org/ScopeOfPractice/

(I must sleep - it's 3.30am )

Joanne, when Mom had occupational therapy, it wasn't done in her home, it was done at the rehab facility where she was for a time, so I don't really see how it could be about adapting her environment. And nothing was changed at home, so I'm puzzled about this. The part she was particularly dreading was when she had to demonstrate for them how she would do simple cooking tasks, which she always hated. 

Sounds to me as if different countries' healthcare system use different terminologies.

Also, I suspect there could be some overlap as needed.

It's sad she was scared, Peggy. Although that's not uncommon. And when we say 'home', it's wherever the individual lives. 

I've given you the US associations' home pages, so you can check their definitions, not mine. To the observer it appears the same, but a PT works with body systems, mainly muscles and soft tissues, and the OT works with the environment to support the body moving & working in it. 

The PT asks 'how does it hurt?' And tries to make it better as you move. 

The OT asks 'what do you want to do?' And tries to find an easier way for you to do it. 

Whatever the definitions might be, that is not what was happening when my mother had a broken hip and four months of healing and rehab. So we will have to agree to disagree.

not what happened when I was in rehab after a car accident in my 20's either.  

I think of OTs as helping with activities of daily living or adls that can mean altering the environment, or it can mean helping the person with learning a new way to do things.  I also think of them as more fine motor and PTs as gross motor.  

Another thing OTs are known for is working with kids with Sensory Processing Disorder. They help these kids integrate their sensory systems so they can handle life in the world.  

Thanks to Peggy on Joan's behalf. I went through this at DMV and was easier because it was joint ownership. But it is clear from the above what you need.

Just saw family for first time (a close cousin) since husband's death. Balm to spirit...they live so far away.

Just got the original insurance card in the mail!  

I was lucky in regard to inheriting a car, BTW. We realized Mom was never going to drive again, and she actually asked me at one point whether I could use another car. We were only too happy to take her Passat, since we were trying to get by with only one car when we first moved to CT. She signed her car over to me, and I used it for my own needs but also to take her places while that was still feasible.

This approach won't work for every family, but it did for us.

Title has been transferred.  Registration has been renewed and transferred to my name.  I needed all of the documents I brought with me; thankfully, not any others. The only question I couldn't answer was the number of miles on the odometer since a dear friend drove me over and I didn't think to get that information from the car before we left..

Congratulations on getting that done! Red tape institutions like the DMV are awful. I'm very glad you had all you needed to get it done.

We were told by the PT today that my husband will have an OT evaluate his needs in about a week.

She said it would deal with dressing himself, showering, etc, getting around the kitchen (that would a first ) the little things which will give some independence.

Peggy:

Not quite everything ... I didn't have the odometer reading.  I was told to just put anything down since I was both the buyer and the seller!  

Forms required included the short form from Surrogates Court, original title, registration, and my driver license.  I did not need the insurance card but I did need the name of the insurance company and the policy number from that card so I could have used the emailed duplicate or just used the card in Bernie's name.

mtierney said:

We were told by the PT today that my husband will have an OT evaluate his needs in about a week.

She said it would deal with dressing himself, showering, etc, getting around the kitchen (that would a first ) the little things which will give some independence.

That's real progress and the increased independence, even if he chooses to stay our of the kitchen, will be a blessing.

joan_crystal said:

Peggy:

Not quite everything ... I didn't have the odometer reading.  I was told to just put anything down since I was both the buyer and the seller!  

Forms required included the short form from Surrogates Court, original title, registration, and my driver license.  I did not need the insurance card but I did need the name of the insurance company and the policy number from that card so I could have used the emailed duplicate or just used the card in Bernie's name.

Ah, but you got it done. I'm glad they let the odometer slide just a little.

Mtierney, this sounds like good news. I hope the occupational therapist helps empower him a bit. 

I am wondering if Father's Day is going to be a trigger for my son this year.  We always spent at least part of the day together as a family.  This year, Dad will be unable to join us.  I already have plans to take my son and DIL out to dinner since son's birthday is coming up shortly.  Is there anything else I should say or do to make the day easier for him? Am I anticipating a problem that isn't there?

Depending on your son, it will be rough.  I avoided the card sections of drugstores in June for the first couple of years after my dad died.  

It's normal to miss him.  Oh and I find the first is always the hardest.  The first year is a challenge.  It's ok to be sad.  

 ><  In our family, we all knew we were all missing the person who was no longer with us, but we didn't make deliberate references to it. If something came up that reminded us of the person who was missing, we would mention it, maybe wipe a tear, but not linger. Different families handle these things differently, and every grieving process is unique. I think you and your son will know how to handle anything that comes up and support each other. No need to plan. 

After our son died suddenly in 2014, it seemed all we did was talk about our John and how handsome he was, how funny, and recounted the many stories of happy occasions throughout his life. His girlfriends -- three of whom came to his funeral. We laughed and cried. The family photo albums were looked at many times. Two years later, he is very much still a part of the family.

A remarkable fact is that I frequently dream about my son. He is so alive in my dreams and is happy.

I dreamed about my mother last night, as she was at the time when we realized she couldn't be in the house alone any more. It was actually very sweet... She was still recognizable as Mom, a little confused, but the relationship was still the way I remember it. I can't believe it will have been two years come October.

Driving update:  Drove to Livingston ShopRite this morning!  Kept under the speed limit but given 35 and 40 mph roads, I drove at a faster speed on average than I have previously.  Trip took about 35 minutes.

Then I drove a second much shorter trip with my son in the car.  Usually, he makes me nervous but this time all went reasonably well.  Biggest problem was parking when I got back to the house.  That is what I need to concentrate on most at the moment.

yay Joan!  

Great progress!!

yay Joan!!!

So proud of you Joan ! Yippee!