Appreciates the influence of socio-cultural, socioeconomic, political, diversity factors, and lifestyle choices on engagement in occupation throughout the lifespan
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After 36 weeks of Level 2 Fieldwork, I feel that I can appreciate a variety of factors that influence a person's ability to engage in occupations on a daily basis as well as throughout one's life. I believe that my fieldwork assignments provided a wide range of learning experiences based on financial, cultural, political, and a variety of lifestyle choices found amongst my clients across the lifespan. I learned how these factors influenced my client's ability to participate in occupations and daily activities. For instance, one of my clients was stationed in Germany for 3+ years and wanted to further his learning of the language and culture but had to return home after the war. He reminisced about the beautiful language but became sad that he had no one to talk to in German. Due to political powers influencing his departure from Germany, it affected his ability to continue participating in occupations that provided meaning to his life. I also learned that some of these influencers improved my clients' abilities to perform a desired task, while others hindered my clients' occupational performance. For example, my aforementioned client was raised in a generation where the belief was that men were considered to be superior to women, and that individuals from oriental descent could not be trusted. These cultural beliefs influenced his behavior and social interaction with various therapists throughout treatment sessions. And, of course, I learned how those performance patterns change as a person develops and ages over time. I will continue with my client's story: His cultural upbringing determined his mindset and behavior towards women and descendants of the oriental race, plus his cultural experience in Germany and politically-influenced departure from the country influenced the direction of his life. I feel this gave me better insight and a solid foundation for social, cultural, financial, and lifestyle factors that influence a person across the lifespan. As an entry-level OT practitioner, this is important for me to be aware of because I will work in an area with a diverse population, and it's necessary to be able to provide appropriate services to a variety of clients in order to ensure quality care to each person.
My first placement was at a skilled nursing facility (SNF) where I worked with adults and older adults occupational performance while taking into consideration sociocultural, socioeconomic, political, diversity factors and lifestyle choices. For instance, one woman enjoyed writing letters to her daughter and grandchildren, but her rheumatoid arthritis made the knuckles in her hand swell and impacted her ability to write legibly. My client was an 82-year old Caucasian female who lived most of her life in Indiana. She recently moved to Memphis to be near her son and grandchildren. My client had been married for 40 years and bore two children, a boy and a girl. Her husband had passed away several years ago but she did not desire remarrying nor seriously dating anyone. She was not close to her daughter and that obviously frustrated her since she was so family-oriented. My client also worried about paying for the SNF she was living in, and knew that she had little money left to cover expenses. At one point she had divulged that her son was having to pay a large amount of her living expenses because her daughter seemed disinterested in helping the brother support her. My client explicitly told me that she felt like a burden and she had never intended for this to happen. Unfortunately, there were a lot of factors at play in this woman's life, many of which impacted her ability to engage in meaningful occupations. Nevertheless, I took all of these factors into consideration when I planned her interventions because not only did I want her hands to improve enough for her to write her letters to her family members, but I also wanted to alleviate her worry and redirect her focus onto more positive and current topics to improve her overall quality of life. I implemented writing activities into her plan of care, and utilized these interventions as a means to help her express her worry and change it into a more positive note to herself. She enjoyed writing to friends and was always open to meeting new people. I encouraged her to write to her friends that had moved out of the SNF to help take her mind off of the negative things in her life and focus on the positives, such as her new friends. I also actively listened to her concerns, which provided her a sense of self-worth and allowed her to think more positively about her situation. I believe that I made an impact on my client's ability to engage in meaningful occupations because she progressively appeared more happy and vibrant with all aspects of her life; however, I know that her own cultural beliefs and values influenced her desire to work toward improving her PIP, DIP, and MCP joint pain in order to write letters to her grandchildren and her friends.
My first placement was at a skilled nursing facility (SNF) where I worked with adults and older adults occupational performance while taking into consideration sociocultural, socioeconomic, political, diversity factors and lifestyle choices. For instance, one woman enjoyed writing letters to her daughter and grandchildren, but her rheumatoid arthritis made the knuckles in her hand swell and impacted her ability to write legibly. My client was an 82-year old Caucasian female who lived most of her life in Indiana. She recently moved to Memphis to be near her son and grandchildren. My client had been married for 40 years and bore two children, a boy and a girl. Her husband had passed away several years ago but she did not desire remarrying nor seriously dating anyone. She was not close to her daughter and that obviously frustrated her since she was so family-oriented. My client also worried about paying for the SNF she was living in, and knew that she had little money left to cover expenses. At one point she had divulged that her son was having to pay a large amount of her living expenses because her daughter seemed disinterested in helping the brother support her. My client explicitly told me that she felt like a burden and she had never intended for this to happen. Unfortunately, there were a lot of factors at play in this woman's life, many of which impacted her ability to engage in meaningful occupations. Nevertheless, I took all of these factors into consideration when I planned her interventions because not only did I want her hands to improve enough for her to write her letters to her family members, but I also wanted to alleviate her worry and redirect her focus onto more positive and current topics to improve her overall quality of life. I implemented writing activities into her plan of care, and utilized these interventions as a means to help her express her worry and change it into a more positive note to herself. She enjoyed writing to friends and was always open to meeting new people. I encouraged her to write to her friends that had moved out of the SNF to help take her mind off of the negative things in her life and focus on the positives, such as her new friends. I also actively listened to her concerns, which provided her a sense of self-worth and allowed her to think more positively about her situation. I believe that I made an impact on my client's ability to engage in meaningful occupations because she progressively appeared more happy and vibrant with all aspects of her life; however, I know that her own cultural beliefs and values influenced her desire to work toward improving her PIP, DIP, and MCP joint pain in order to write letters to her grandchildren and her friends.
Some of my favorite clients were at my second fieldwork placement, which was a school specifically designed to provide functional skills to children with Down syndrome and other diagnoses. The school was grant- and fundraiser-funded and taught individuals from 4 years of age to 32 years. It was one of the most unique school-based programs I have ever had the pleasure to work in. There was one 13-year old African American boy with cerebral palsy who had the sweetest disposition but certainly didn't appreciate people talking down to him. On several instances, I observed his caregivers picking him up in the family car, music bumping and two other siblings singing along. Aside from getting out of his wheelchair and into the car, his family members treated him like any other child, and talked to him like he was 13 going on 18. I also took the time to converse with his nurse to learn more about my client since he was nonverbal. From these conversations I learned what he liked to watch, who he looked up to, and what he did the previous weekend. When I wasn't talking to the nurse, I observed my client interacting with his teachers, his classmates, and his family members, which gave me a better idea of things he liked and didn't like. In order to learn about things that my client liked, I would play YouTube videos of topics boys his age typically enjoyed (i.e. Marvel superheroes, Hip Hop artists, celebrities, NBA and NFL athletes) while we worked on motor coordination activities at the table top. I instructed him to make a noise when I read a topic that he wanted me to select on YouTube. It took some time going through each video until we found one that he liked, but it was one more way that we bonded and I learned more about him in order to establish rapport. Ultimately, I was able to integrate my newly acquired information into my interventions. This information served as influencers which impact his ability to engage in occupations like feeding, exercise, and education. Each day that I worked with my client, I addressed him the way he wanted to be addressed; I greeted him, asked if he saw the latest Grizzlies game, complimented his green wheelchair, and asked if he wanted to go with me to OT. I noticed that he engaged with me when I didn't talk down to him like most other adults in his life, and I believe this really helped our therapeutic relationship. As the weeks went on, I would start a therapy session with him on the platform swing to help his body relax and stretch out. Normally the OT would sing nursery rhymes but one day I asked her if I could play some clean rap music for my client. She obliged and I kicked the session off with "Move That Doh". Over time we developed a positive relationship that motivated him to want to continue to do well in therapy to ultimately do better in school. When he would do something right, I would holler and clap my hands, motivating him to keep trying and doing it right. For instance, I remember working on placing rings on a thick rod to improve his hand-eye coordination to be able to participate in classroom activities. As soon as he got that ring on the rod his head whipped around to me, his eyes big, smile on his face, anticipating for me to praise him for getting it right. He continued to succeed, and I knew that he would if I met him where he was at culturally as well as by cheering for every move he made like he was ZBo.
My third and final fieldwork placement was my mental health rotation at a transitional center for young adults who had experienced personal and environmental hardships early on in life coupled with a mental illness. It opened my eyes to a variety of lifestyles that an individual has assumed based on childhood experiences, homelessness, societal stigma, or as a side effect of the individual's dosage. I have learned that every person is different. The "norm" experienced by a person while growing up influences how he or she handles the present situation and what he or she will tolerate in the future. The values and beliefs an individual harnesses will also influence the decisions made at the moment as well as several years down the road. For instance, one of my clients was subjected to sexual and psychological abuse at an early age and now she has no interest in developing relationships with males, but would rather have them with females due to her past experiences of exploitation. She identifies with this lifestyle and proudly proclaims her sexual orientation. Nevertheless, when engaging in certain occupations, I have to take her triggers into consideration or else she will not be able to participate in the activity, which will affect her overall quality of life. Over the course of 12 weeks, we have collaborated to identify and implement coping strategies to improve her ability to overcome these triggers in order to participate in the occupations that she wishes to be a part of.