Cambridge Brain Sciences (CBS) uses the latest technology and scientific data to get better insights from modernized versions of classic tasks – they only take a few minutes each. CBS has developed endless test sets, so there is negligible “test learning” risk for a test-retest situation. And, important in our new virtual world, the link for the testing can be emailed to our clients, where they are provided step by step instructions and even tutorials allowing them to perform the tests without therapy staff being present in their home environment. OTs can use some or all of these cognitive screens to not only assess cognitive difficulties but to also monitor progress of treatment which is helpful to illustrate when requesting more funding for occupational therapy services.
OnTrack is a program designed to help youth who have experienced severe injury by providing access to a range of supportive personal and vocational services. The goal of this multi-disciplinary program is to support youth through key life experiences to help them get back “On Track” with their peers and achieve long-term success. Services include career and education planning, life skills coaching, and one-on-one support or academic tutoring. All services are coordinated to improve collaboration and seamless care outcomes.
Our Occupational Therapy Assistants (OTA) work alongside the client’s health care team to provide one on one treatment that is specifically designed for the individual. OTA program goals as described by the client and the rehab team with a client centered approach.
OTA Cognitive Compensatory Strategy Program
The OTA will take the time to understand strategies that best suit the client’s personality. Tools are suggested (using adult learning principles tailored to client’s strengths) and demonstrated to ensure effectiveness. OTA can help the client to predict barriers and develop strategies in advance. These programs vary from creating strategies for remembering appointments to new learning such as how to take public transportation. The program goals are directed by the client to include meaningful activity that promotes a positive outlook for the future.
OTA Community Integration
Often client’s present with a lack of motivation due to mood dysregulation or as a symptom of acquired brain injury. Many are fearful of re-injury or their inability to manage their limitations if they go on a community outing. Early OTA intervention can drastically reduce many psycho-emotional symptoms. Outings encourage re-integration into pre-MVA hobbies/interests, provide opportunity to problem solve areas of difficulty such as taking public transportation and to increase the client’s independence with ADL. Job coaching is also available for those with return to work goals.
OTA Gym/Pool Exercise Program
OTA specialized fitness trainers can develop a specific fitness program to meet client specific rehab needs. The program can be centered in a home gym or community gym/pool. Community based fitness programs can also be used in a community integration program as it introduces and promotes a healthy lifestyle post injury. Goals can include increased strength and activity tolerance; improved range of motion and endurance; pain management and mood regulation. Water is the perfect environment for clients experiencing high levels of pain due the body’s natural buoyancy in water which minimizes the harsh jolts the body experiences during regular exercise.
Both physical tasks and non-physical/cognitive requirements are assessed when considering the position of work placement. These two elements are measured in order to establish return to work goals or determine whether the position remains to be fit for the client post-injury.
Following an injury, physical limitations may exist immediately or develop over time. Establishing the client’s safe maximum abilities once the benefits of physical rehabilitation have plateaued, an FCE is ideal for further planning and goal setting with respect to return to work, vocational exploration or other meaningful activities. (i.e. sitting tolerance, overhead reaching)
At a reduced combined cost, the Physical FCE can be combined with a Cognitive/Behavioural FCE to determine Global Functioning.
This assessment- as the name suggests – assesses global physical, cognitive and emotional functional capacity that one might need to perform a specific job or any job in general. Capacity is the key word here –a capacity assessment measures how much or how long one can perform a certain function. It also takes into account the effect of pain and fatigue on all the realms of function. This type of assessment is helpful to determine if a person who has physical impairments, as well as cognitive and/or emotional issues related to pain, brain injury and/or psychological disorder, can do their job or any job. It can also help to determine and provide opinion on what accommodations or adaptations they might need to succeed.
The Cognitive/Behavioural FCE is the next logical step in functional capacity evaluations. A Physical FCE examines only physical capacities, and ignores the cognitive and emotional ones that are often real barriers to returning to the workforce. Which is why at LDOT, we employ certified Matheson Cognitive/Behavioural Functional Capacity Evaluators to perform the Cognitive/Behavioural FCE assessment. The Cognitive/Behavioural FCE includes cognitive functional testing and integration of behavioural observations to ascertain functioning. Hands-on work tasks are also included and designed to reflect tasks that the client would typically complete on a daily basis. Tasks test sustained attention, multi-tasking, distraction tolerance, ability to retain information, effective organization and prioritization skills, and ability to persist through fatigue and pain.
At a reduced combined cost, the Cognitive/Behavioural FCE can be combined with a Physical FCE to determine Global Functioning.
If you are in the position to purchase or modify your “forever home”, you may want to give some thought to how your home will accommodate you as you age. Ageing in place is something that you may be able to do relatively easily, if you take aging in place into consideration when you purchase or renovate your home. These are a few things that you should consider…
Access, Access, Access
How easily can you access the home? If you do not have a level walkway and front entrance, is there enough room to have a lift or ramping installed (ramping requires 12 feet of run for every one foot of rise), or is there easy access through the garage, where you are protected from the elements? Did you know, if you build a walkway at 1:21 it no longer is a ramp, and you can landscape it to beautify your curb appeal?
Can you access the main floor? Is it open and without those pesky changes in level (think split level townhouses, or even those pesky 1960’s sunken living rooms) You will need this if you have any mobility issues and need to use a walker or wheelchair.
And speaking of walkers and wheelchairs, are the hallways and doorways wide enough to accommodate you and your mobility aid around a corner? If you have a narrow door to the bathroom, and you are renovating it, budgeting for door widening is a must!
And the last thing about access – is there a bathroom on the first floor that has or is big enough to accommodate a three piece bath suite? Not having the ability to accommodate a bathroom is the number one reason people with mobility issues move residence.
While you’re at it…
Already mentioned was widening the doorway to the bathroom. While you’re at it, widen the door to your bedroom, or any room in which you have an expectation of privacy.
And if you are renovating the bathroom, consider installing a rite height toilet – it saves scrubbing a raised toilet seat. Grab bars are no longer a sign of disability. They can be a design statement. Several bathroom fixture manufacturers have designed soap holders and towel racks to double as grab bars. Lastly, those fancy bathtubs are great to soak in, but treacherous to get in and out of safely if your balance or strength is compromised. Think ahead – and think of your lifestyle – do I prefer bathing or showering? Barrier free showers and walk-in baths may be something that you adopt now, rather than in the future.
Managing the elements
We have mentioned the garage, but this is such a under utilized space. With some careful planning, you can avoid using the garage as the main storage space for your home, and have your accessibility to your home sorted out. It protects you from the elements when getting into your home, but also in and out of your car. A shorter driveway will lessen the need of contracting snow removal services as you age. Also, if you have your ramping or lift in the garage, you do not change the curb appeal of your home, nor do you advertise that a vulnerable individual may live there.
If you have any questions about Ageing in Place – contact us at info@LDOT.ca
Insomnia is the single most commonly reported health problem in adults, and is often related or co-exists with reports of depression and /or anxiety, Chronic pain, PTSD, and other disorders. What we also know, is that if someone has insomnia, the stress associated with going to sleep, in order to fall asleep keeps mounting.
We have training to help with the behavioural aspects of insomnia that can:
- Assess your sleep in a non sleep lab setting
- Provide sleep management strategies
- Teach you how to determine your optimal “sleep window”
- Provide techniques for managing ruminating thoughts and an overactive mind during the night
- Help troubleshoot the common issues related to sleep conditions
Sessions are available through auto insurance coverage, some extended health insurance coverage and private pay options.