Hello, everyone.

Welcome to Episode 2 of Beyond Barriers Navigating Health and Function.

I am your host, Pam Hung, an occupational therapist living in Edmonton, Alberta.

Over the next few episodes, we are talking to occupational therapists that work with clients of all ages in different practice areas to learn more about the many ways occupational therapists promote engagement and participation in everyday life activities.

Today, we are speaking with Michelle Palmer.

An occupational therapist working in private practice and continuing care in Lethbridge, a city in southern Alberta.

Michelle completed her occupational therapy studies at McMaster University in Ontario in 2016 and began practicing in Alberta in 2019.

Today we will dive into what brought her to this area of OT practice, how she has supported clients to participate in everyday life activities that are important to them, and how OTs are unique members of the healthcare team in continuing care.

Let's get started.

All right.

So welcome, Michelle.

please tell us a bit about the practice area that you work in and what drew you to work in this area.

So I work in a combination of long term care and in private practice.

So with my private practice, I work primarily with WCB.

I do some work with ICBC and WorkSafe BC, and then I do some work with long term Disability insurers as well.

And in long term care, I work in a long term care facility in Southern Alberta one day a week, there are a lot of service gaps for occupational therapy.

In this part of the province, and so there was an opportunity for me to try and fill some of the service gaps and help some of the residents that were in care, not able to get equipment and things like that.

So, that is why I'm doing that 1 day a week in long term care.

Okay.

how long have you worked in long term care the one day a week?

I have been doing that since January of this year.

So that would be 7 months now that I've been doing that pretty consistently.

And in the beginning, in particular, I was there.

Sometimes a couple days a week, just when we were trying to really get things up and running, but it's with the funding structure, it's pretty solidly one day a week right now.

Okay.

Yeah.

I guess just another question kind of around the logistics of that.

Did they have an occupational therapist in that facility prior to you working there, or was that just something that you were developing the role kind of, as you go?

So I think that they have in the past had an occupational therapist there, mainly on contract and, that position had been open for about a year when I started there.

So that's why things were pretty, Messy when I got there, there was just a lot of people waiting for services.

So they did have someone there previously, but again, because they, there are a lot of service gaps here.

There's just not a lot of occupational therapists in this part of the province.

I'm in the Lethbridge area.

So, they had not been able to find anybody for about a year.

When I started.

Yeah, and it can be really tricky to fill those gaps in services when, there are services that are already stretched as well.

so looking at your role In long term care right now, what types of challenges do your clients face with doing their everyday activities in long term care?

So primarily in the facility, it's mobility.

That seems to be the number one thing that we are looking at.

And so we are dealing with people a lot of the time that have some progressive issues.

And so they may have gotten a wheelchair a year ago or two years ago that is no longer working for them.

or, you know, they now have pressure.

issues and so they need a different type of cushion.

I have quite a few residents that when I first got there, only 7 months ago, were walking with a walker and are now no longer able to use a walker and they've now transitioned to a wheelchair.

So there's a lot of focus on mobility.

There is some focus on, transfer training.

And, ADL functions, so can somebody participate in the recreational activities that have been planned?

can people eat properly at the table with the other residents?

do they need any assistance with, brushing their teeth?

Grooming?

Dressing?

Toileting is always a big one because people can't necessarily wait for, The two healthcare aides on staff that are on shift to come and help them.

So it's a lot of figuring out how we can make things as, easy as possible, given the resources that are available.

Yeah, and helping to support people and feeling like they can participate in some of those daily activities as well as much as they're, much as they're able to, I'm sure, too.

Yeah.

And then I think another part of it is we have quite a few, residents that do have dementia and there are different stages of dementia.

And so there's also an element of.

how to care for people with dementia respectfully and with dignity.

And so that is something also that I'm approached about quite often, in the facility.

So what kinds of things do you do to help people that experience these challenges?

So if someone's, you know, having challenges with some of those personal hygiene tasks or even mobility activities, what are some of the things that that you do?

You might either work with the individual or maybe their family or other staff in the facility.

What does that kind of look like for you?

So most of the time, again, the emphasis is on mobility and, being as independent as possible, being as comfortable as possible with mobility as well.

And so, some of the challenges are definitely funding.

So, is the person eligible for, AADL, Alberta Aids to Daily Living?

And if so, are they cost share or cost share exempt?

Because even the, the cost share which is a minimal cost, can be a lot for people that are paying a pretty substantial amount to live in long term care.

Cognition is always a challenge, so you can train somebody how to do transfers a certain way.

They may not remember that, and also making sure the staff knows that that has been trained to the resident and trying to be consistent with that.

those are the main barriers I think, and then when we see barriers with things like eating, feeding, then there's assistive devices a lot of the time that we can offer.

There is a dietician on staff who deals with a lot of the swallowing type of issues, so I'm not necessarily looking at that, but do we need built up cutlery?

Do we need weighted cutlery?

Does somebody need a rocking knife?

Those type of things we can definitely look at.

And then there's a lot of assistance already through the nursing staff and other staff in the facility.

So there's a lot of adaptive clothing already being used and things of that nature.

Then we get into the dementia side of things.

Recognizing that somebody is genuinely confused and asking questions, not necessarily trying to be attention seeking, which is a lot of the time with the misinterpretation of that is, um, keeping things very straightforward, like one maximum two step directions, being very calm and soothing with your voice, not contradicting people, agreeing with them, making sure that we are redirecting when possible, keeping people busy because I think when you start to see a lot of issues with boredom is when you see some of the more like responsive behaviors, people be coming agitated, etc.

So just finding things for people to do that has some meaning for them, not just.

Giving them something to do that's, you know, kind of generic.

So those are some of the challenges and those are some of the ways that we deal with them.

And keep in mind that I do that only one day a week.

So it's usually a very busy day when I'm there, everything's really packed into it.

And then you just kind of get done what you can get done that day.

And then you start again the next week, that one day, right?

So It's definitely challenging to manage the demands that you have in the one day, but, you see people making progress or you see things improving and that's what makes it worth it as a therapist for me.

Yeah, for sure.

And I was just going to say, like, that does make for a very busy day, as you said, looking at all those different things.

And it sounds like, advocacy is actually, a significant part of your role, whether that's related to, looking at what the funding options are for people and, helping other staff to kind of understand someone's behaviors and that kind of thing, which, You know, that's another role in itself almost beyond helping with those day to day activities, of daily living for people.

Yeah.

and it is challenging when you are only there one day a week and everybody else is there full time.

I only see what I see the moments when I'm there.

it's not necessarily.

conducive to having a lot of collaboration just because I'm not there all the time.

So we just also have to make do with the way everything is set up and be very good at documentation

Yeah.

reading each other's notes, right?

Yeah, that communication piece for sure,

hmm.

So how do you support caregivers, when you're working in continuing care?

Yeah, that is definitely something that I have been doing since I started there because we've had a lot of newly admitted residents in the past seven months.

there's a huge transition for caregivers.

So when I say caregivers, I'm referring to the family caregiver.

First, I'll talk about that.

there are spouses that are really adjusting to a very huge change in the dynamic with their spouse.

They are now living separately.

There's a lot of spouses that were the primary caregiver at home and now they are kind of out of that role, so there's a lot of finding what your role is now that your spouse is in long term care, and that can be really difficult for people at times.

So I do Discuss a lot of times, I'm discussing with spouses why we're doing things, why this is beneficial, reassuring people that this is not, we don't, nothing would be absolute written in stone.

We're going to try this.

If this doesn't work, we can try something else.

Everything is open for discussion.

We just want to make sure your spouse or your family member is well cared for.

that has been a larger part of the job than I was expecting, honestly, is dealing with family members, sort of adjusting to their new normal, as we would say, right?

in terms of the.

Caregivers that work at the facility.

there is a lot of collaboration that's required, obviously, and because I'm only there one day a week, I rely a lot on what.

other staff members see when I'm not there.

And I have to really rely on that because I can't be there all the time.

And so, there's a lot of give and take in terms of what are you seeing?

This is what I can do.

This is what I know to do to address this situation.

And I think, one of the main things that I've really been, working with the, facility staff on is understanding how equipment provision works.

We all know that there's way better wheelchairs out there available than what this person was just given, but that's what we can get with the system that we have, right?

That unless you buy something privately and you have a lot of money to spend, this is what we are able to provide.

And so I think expectation versus reality with the staff, because there hadn't been somebody on staff.

prescribing equipment for quite a while.

I think that was definitely a disconnect.

And so got a lot of education on, you know, this is what NIHB does.

This is what ADL does.

This, this is the equipment that they are willing to provide to people.

Anything over and above that, it's an upgrade charge or it's, you're just buying privately, right?

And I think, the other thing that, was really surprising to them was to learn just how expensive equipment is.

Like wheelchairs are very expensive.

We can't just go out and buy the fanciest wheelchair or provide someone with the fanciest wheelchair.

That's just not how the system works.

So there's been a lot of support and I think education provided on, what we can and can't do in terms of equipment.

And that seems to have been the main area that I've worked on since I've started there because we are still really, trying to get everybody, the backlog cleared.

And so there's been a lot of discussion about equipment in the past seven months.

Well, and even, navigating those conversations about, the way that the whole system of setting up equipment and getting funding for equipment and all of that, between staff and.

residents that you're working with and their family members is that's, that's such a, that's just a significant role and having to be able to be really flexible and adaptable.

And that is so, so, so important.

Oh, my gosh.

Yeah.

And also why it's important to not switch equipment in between Residence, which was something that, you know, people didn't really know any better.

So they would just be switching things around.

And so that that creates a big issue.

If you're trying to figure out whose equipment is this, is this your actual AADL wheelchair?

Because I need to look it up by serial number, right?

I need to know when it was provided to you and all those type of things.

So, again, a lot of education on the importance of keeping prescribed equipment with the person it was prescribed to as well.

I even that, yeah, and depending on where, you know, maybe other colleagues have been working that, You know, different practice settings where equipment is more commonly, used for multiple people, like an acute care or something like that is so different than, a long term care setting, depending on what it is, for sure.

what other health care practitioners do you work with?

I know you mentioned the, like, nursing staff and the dieticians.

who else, do you collaborate and communicate with in long term care?

So the main staff that I'm working with would be nursing.

So we have always RNs on shift and LPN is always on shift and healthcare aides.

And those are the main people that I work with.

There is also a social worker on staff and a registered dietitian.

they also work one day a week and they are usually.

different days than I'm working.

So again, the communication, written documentation is very important.

and then we have physicians that visit the facility weekly.

And so if I'm not there when they're visiting, again, we're writing notes back and forth.

I'm inquiring something, they're answering something, and it's all done by written documentation or by phone call.

Sometimes I can call when I'm there.

So those would be the main, Professionals that I work with at long term care.

Okay.

when you think about the role of OT and, you know, you mentioned there hasn't been an OT that, worked at the long term care facility that you work in for about a year.

How do you see kind of that?

unique contribution that OT offers in long term care.

So that is, that's the big question.

And I think, um, I feel like as an OT, I'm always answering that question.

Uh, I think one of the main benefits that we bring to clients and to a professional environment is our ability to break things into smaller pieces and to really, look at the task and understand the task As a whole, and then look at the separate little steps of the task and figure out where can we make improvements?

How can we make this easier?

and so there's that joke.

I don't know if anybody else has heard it, but in OT school, when I was going to school, we used to say OT stands for obvious things, right?

So, There's things that seem quite straightforward, but it just hasn't been assessed in a certain way, just the way that we are trained to look at things and break things down.

And so that has been, I think, very beneficial, especially for busy staff that have, you know, we're very constrained with the amount of people that can be on shift at any one time, right?

it's just budgetary.

Restraints.

And so, showing people that you can maybe break things down and try this instead of looking at it as just one big thing to rush through sometimes can be very helpful.

I think the advocacy that OT offers to clients is really important.

something that makes us stand out, really looking at what does the client want?

What is their desire?

What is their goal?

Not what is best for us getting through a whole case, a whole shift as quickly as possible, right?

But like, what do they want?

And so there has been, a lot of moments where I have pointed out that perhaps that person doesn't actually want to go to bed right now, because There's other things going on.

It's the middle of the day and it is easier for the staff at times, but not necessarily what the client is interested in doing.

So I feel like that is a big part of what I do as well.

and I think Also, we, we do have quite an expertise in assistive devices, mobility aids, assessing mobility, looking at transfers, fall safety.

And so that is really an area of strength for occupational therapy.

And as a therapist, I spend a lot of my time at the facility.

On that one day a week I'm there, we're almost always looking at.

How can we reduce the falls risks?

This person's been falling out of bed at night.

why might that be?

and actually that's another good thing that we offer that a lot of times maybe is not offered, necessarily by other professionals in the same way is we ask, well, why is that happening?

So we know someone is falling out of bed.

But why are they falling out of bed?

What could they be doing up until that moment that is leading them to fall out of bed?

And then looking for the solutions to that, I think is very uniquely, Occupational therapy.

Yeah, and you're really highlighting that real functional perspective that occupational therapists take, you know, not necessarily just looking at sort of maybe what the problem is, but what else is going on that, and, you know, how can we adapt all of that.

You know, at multiple points to, make something, either easier for someone to do, or help them to feel more independent, or be more comfortable and safe where they're at too.

so when you think about all of those things, how do you think this contributes to your clients or the residents health and well being at the end of the day?

Well, I think that just having some personalized interaction with people can be very meaningful.

Honestly, I think sometimes it's just that taking that 5 or 10 minutes to talk to somebody and really ask them questions about themselves, their past, what they would like to be doing, are you comfortable, whatever the conversation may be about, I think that one on one interaction can be very helpful.

Um, really meaningful to people.

And I think bringing that personal meaning to people's lives is really a huge part of what we do as occupational therapists.

So one other thing that I would add is that, I think as occupational therapists, we really do put a focus on being trauma informed and considering what people may have been through up to that point in their lives.

And so, really bringing that into the forefront of how we are treating people in long term care, I think is key.

We're dealing a lot of times with people who If not all the time, they don't necessarily want to be there, right?

That's, I don't think anybody's goal is to be in long term care away from their family with strangers looking after them.

And so that is traumatizing in itself.

And then you're dealing with maybe, confusion, Cognitive decline, chronic pain, all different types of things.

So just making sure that we are approaching things in a trauma informed way I think has been beneficial.

I've noticed a difference with clients who have been sort of categorized as having behaviors, right?

That catch all phrase of behaviors.

And you know, if you spend 10 minutes speaking to someone and really listening to them and just giving them that human interaction, it's amazing how much those behaviors.

in quotes, can start to decrease.

So that would be another way I think, really, coming at things from a trauma informed, approach and being very aware that everybody there has their own history and moments that have led up to them being there and, taking that into consideration.

It's just providing them with dignity and respect as well, right?

Mm hmm,

Yeah, and I mean, that really supports, patient centered care, which, everybody is deserving of, regardless of, their history or situation where they're at, at that moment in time.

you spoke a little bit about how you've spent a lot of time since you started working in long term care, educating, healthcare providers, practitioners about equipment.

is there any other things that you wish healthcare practitioners knew about OT, that you think would help improve patient care?

I think What I would say is that what I wish is that people understood how many things we can do as OTs and that it's not just equipment, which I feel like, especially in a setting like long term care, when the resources are limited, I understand that we sort of need to get in there and do what you need to do and get out, but there are other things that we can contribute.

And so, It would be great if there was a way to really easily relate to other people what our entire scope of practice is.

It's very big.

And so that could be sometimes overwhelming or confusing, I think, for clinicians, but I think that's what I wish we could mostly Relay to other professionals is that we can do a lot of different things.

We can, we're, I think, underutilized in a lot of ways.

and there is a lot that we can offer as one professional, right?

So you don't have to have five different people doing five different things.

We can do Those five things, and they're all within our scope of practice, and they're all things that we are highly trained in and highly skilled at.

Yeah, so if you spend a lot of time, talking about equipment what other things do you think you, like to focus on with clients in addition to equipment?

Or what do you kind of, what do you wish you had more time for?

Yeah, I think really identifying what is the meaningful occupation that each individual would like to be focusing on, because there are, of course, there's recreational therapy.

That's another profession I work with.

There's always recreational therapy, um, there when I'm there, and they plan amazing activities for people all day long, but they're the same activity for me.

It's sort of generalized, right?

So it would be nice to find out what's meaningful to each person.

Is there something that we could do outside of the group that would really bring them that sense of satisfaction and, and, personal meaning to their work?

their daily occupation.

I would really love to be focusing a little bit more on, cognitive work.

So trying to maintain people's level of cognition, challenging their, their cognitive abilities and trying to, Maintain them in some way.

It's just really challenging to do, and you're only there one day a week.

It's challenging for the rest of the staff to do because they are very, you know, tightly scheduled as well.

I would love to be focusing more on that as well.

You can really see how.

Boredom affects people in long term care.

It's very clear when you're there that someone can come in and be very, functioning at a certain level and just having, you know, hours of nothing to do can very quickly cause somebody to decline.

Yeah, and it sounds like something a bit more tailored for each resident, right?

you mentioned the, universal group programming that is awesome.

but at the same time, if there was ways for people to either, engage in something that was, particularly meaningful to them, that would be ideal, really.

I would say, you know, 75 percent of the people love bingo and love every time bingo is on, they're going to come and play.

And then the other 25 percent hate bingo, will never come and play bingo.

And they play bingo a lot in long term care.

So what are they doing?

during that time, right?

So it would be nice to find some alternatives, something that is more tailored to each person, something more individualized so it wouldn't feel so, um, generic isn't the word, but just so generalized I guess is the word, yeah.

Yeah, and I mean, that's something that OTs really bring is that, you know, looking at the individual's history, their interests, where their function is at and bringing those together to identify something that's really meaningful.

But, given some of the time constraints and some of the other, resource challenges.

You know, being there only one day a week makes it really challenging to do that.

I can appreciate that for sure.

so if you were thinking about, um, you know, if you were getting referrals to occupational therapy, what are some things that healthcare providers could be looking for, in long term care where, an occupational therapist might be referred to?

I think anyone who's having difficulty with those daily activities, or what we call our activities of daily living, ADLs, so that could be dressing, toileting, grooming, bathing, feeding, transfers, mobility, any of those type of things, or even your, more complex activities like, finances, medication, management is a big one, transportation, things like that.

Any sort of productivity issues connected to what we were just talking about.

So, what are some productive activities that people would like to be participating in?

So, if you're not in long term care, that could look like work, school, volunteering, something like that, within, long term care, um, Facility, obviously, we're looking at more, leisure activities that would be considered like a productive activity, right?

So those are some of the things that I think those are the pretty much the key ones, especially in a long term care facility.

We're looking for the IADL.

Issues or challenges and then, leisures, leisure activities or hobbies and any sort of productive activity needs.

Yeah, and I know, sometimes it depends on sort of the different roles that other health care providers.

have within, a particular facility, right?

Like, you know, you mentioned the dietitian might focus on swallowing, but maybe in another long term care facility, the OT might have a bit more of a role in that, depending on the complement and skills of practitioners, which is kind of across every practice setting, I think.

would you kind of agree with that?

Or what do you think?

I would say that because we have, as OTs, such a large scope of practice that we particularly deal with that overlap as opposed to maybe some other, Professions where they might have some areas of overlap, but we have many areas of overlap.

And so I feel like that is actually part of what contributes to some of the confusion when we arrive somewhere, is that, maybe they've worked with an OT that did do something before.

It's not necessarily something that we are experienced in or that we have ever had to do before.

So there's an expectation that you would be able to do anything and everything or on the other side of that, You're only expected to do one thing and everybody else is overlapping with other things that you would typically do.

So in long term care, for me, that experience has looked like I am primarily asked to work in on mobility equipment and some of the other things that I could be contributing.

To or that I would normally be working with in, like, say, in private practice with other types of clients, other professions are doing that.

So it really does vary, depending on the practice setting and the funding, the funding set up and staffing and so many different things.

But I think it's a pretty unique challenge for OTs just because of, our larger area of practice compared to other professionals.

I meant to ask this earlier, but do you, like, is there a physiotherapist that you work with, or is that a role that you also kind of take on if there isn't coverage by a physio?

it comes to that misconception that OT and PT are the same thing, because we certainly are not, right?

I, I don't have the same type of training and expertise as a physio for in a number of areas.

There is a physio that in the community that does come in at times, for very specific referrals.

but there is no.

Physio on staff.

So I get a lot of questions that are actually not appropriate for an OT to deal with, and then we refer out to the community physio.

So, but I do think there's a lot of long term care facilities that have OT or PT, and usually not both.

So, That probably happens quite often to OTs in, in long term care and, and to PTs too, right?

They're being asked not to do things that aren't necessarily their area of practice either.

Well, and regardless, there's, you know, that really significant overlap between those two rehab professions in particular, right?

In different areas where it's tricky to have enough of everybody, that's for sure.

Yeah, definitely.

Yeah, so I guess kind of getting to some of our last questions here, maybe a little bit more general, but what is one thing that you think everyone should know about OT?

I think just how much we can help in so many different areas.

Again, it's, it's sort of a theme that I have going on today.

that we can do a lot of different things and we can do them, uh, at the same like for the, the same client.

We don't have to have.

Five, necessarily five, six, seven, eight different people involved.

We can do a lot of multiple things with one client.

that's what I would love for people to understand is that we have such a large scope of practice.

We can do a lot of things.

Not just equipment.

Yes, yes, we really like to focus on those meaningful, functional and meaningful activities for people that,

absolutely.

Yeah, bring meaning for them, right?

okay, one question I haven't asked you that I had meant to, but can you share an example of a time when you worked with a client or resident and, your involvement in their care kind of, really contributed to, their quality of life in the facility that you work in?

Yeah, I can actually.

So there was a resident who'd been there for a while.

I mean, definitely for at least a year before I arrived, who was essentially bedridden, has a progressive diagnosis which affects mobility and at times can affect cognition, although that's a bit intermittent.

And so, there was not a wheelchair there that could assist, this bariatric, it's a bariatric client as well, bariatric resident, and a lot of tension and push and pull between, um, daily staff that's trying to do, you know, personal care and that type of thing, get somebody out to the dining room to eat.

and the resident.

So there was a, there was quite a bit of pushing and pulling and a lot of tension that was pretty obvious from the time that I walked in.

And so again, going back to what I was saying earlier, it's really just about trying to find that personal connection with the client and figure out, you know, but why are you not going into the dining room to eat?

Why are you not doing these things?

So the first thing was pretty clear, they needed a wheelchair.

And there hadn't been anybody there to provide a wheelchair.

So that was the 1st thing that we looked at.

And then, and then we started into a deeper discussion about, but, you know, what is the barrier with going into the dining room to eat?

And, um.

Then the resident shared that it has to do with how the MS has affected their fine motor skills, their gross motor skills even, and eating has become something they're very self conscious about.

Right?

And so eating in front of a large group of people, feeling like you are being messy, not something that they were interested in doing.

And I think just sharing that with the staff made such a difference.

Um, humanizing somebody and making it, you know, that this is an actual person with real things that are going on.

And so, uh, that made a big difference.

Then getting them the wheelchair also made a big difference so that, uh, there is ability now to actually leave the room and participate in what's going on.

Recreational activities, in particular going outside, which was really a personal goal that the resident had, and in the course of that unfolding, becoming more comfortable being with the other residents in the facility, and then the self consciousness about the eating starts to decrease as well.

there was a lot of different issues that we were able to address just by having a couple of different conversations and asking, but why, right?

But why is that happening?

What is it exactly that is, uh, the barrier?

And I think, Phrasing it as what is the barrier as opposed to what's your problem or why don't you want to do that makes a big difference to just, definitely more conversational, more personal, right?

So I wouldn't say that that's 100 percent solved.

It's still a work in progress, but you can see the tide starting to turn with somebody coming out of the room or becoming more attractive with other residents.

Being able to get outside was huge, being able to plan appointments in the community and get things like dentures fixed, right?

Which is another reason that eating is maybe not something that they're really excited about right now.

So, Going to the optometrist, things like that.

So those were, that didn't happen overnight either.

It was a whole series of interactions with somebody and slowly gaining that therapeutic rapport and digging deeper every time and figuring out what is going on.

And now we've become, you know, a lot more understanding, I feel as a staff, as a, As the professional representation in the, in the facility, there's a lot more understanding of that client, which makes them feel more comfortable and have more meaning.

So, um, I, I think that one really stands out to me because it was such a tense environment when I first arrived there of resident versus staff, right?

Almost like a standoff, and now it's become a lot more collaborative.

That's yeah, that's such a wonderful story.

Thank you for sharing.

Um, and yeah, I think it's quite interesting.

My, um, like, my PhD research is.

about obesity, actually.

So, I mean, that's, that's something I find quite personally interesting too.

And, you know, you kind of started out the story with, well, it was kind of all about mobility, but I mean, it turned out into something, you know, much, much bigger and broader once you're able to, um, once everyone was able to build a relationship with that.

With that resident, um, and really demonstrates how, you know, it can make such a difference to, you know, find out what's meaningful to people.

And yeah, sometimes it's, you know, not necessarily all about the mobility piece.

It might be about enjoying being outside.

And it's not necessarily just about being bariatric, right?

Because there was a lot of, well, it's because of, you know, there's, that is the barrier and it's part of the barrier.

It's not the barrier.

So, and again, I think that's still something that we are working on addressing because there's also other issues in terms of, like, why don't we have a bariatric bed in the facility?

Uh, what is the barrier there?

There are some logistical barriers and so everything is a work in progress, but I think it's just building that understanding has been very helpful for that particular resident.

Yeah, and even just being able to look at that whole picture, right?

And, you know, what are all the things that are going on?

It's not just, just one thing that's, you know, causing the barrier.

It's, you know, there's all, there's always a lot of, a lot of factors, but sometimes that often means there's also lots of opportunities.

So, yeah, that's wonderful.

Um, I just have one, one last question.

if there was someone who wanted to become an occupational therapist and was maybe listening to this podcast episode to learn a bit more about OT, what kind of qualities or skills do you think would be really important to have?

Well, first of all, if there's somebody listening to this, who's thinking about becoming an OT, I would say do it a hundred percent, especially if you're in Southern Alberta, because we need OTs here.

Um, I think one of the most important qualities is, um, I've said this to people before and they kind of think I'm joking, but really, if you're like a nosy person, if you like to ask a lot of questions, if you like to really figure out what is going on.

That is an excellent quality to have as an occupational therapist because a lot of what we do is asking questions and digging deeper and figuring out how one thing is affecting the other and the other and the other, right?

So that's, that is definitely, um, like not being afraid to ask those questions.

And, you know, if you're the kind of person that always likes to Solve problems.

I think this is a great profession for you.

I also think obviously being very compassionate and understanding of our fellow humans and, um, maybe having some lived experience in some way with the health care system and knowing what it's like to be on the other side of the The desk or whatever can be very helpful.

I think you need to be very flexible, um, in your thinking and your approach to problem solving, because, uh, because we do have a lot of ambiguity in some way with our profession.

We, we have to be very willing to work with other professionals, to sometimes do something, sometimes not be doing something, Resources can be limited, so figuring out how to solve problems with limited resources.

So there's a lot of reasons why I think flexible, being very flexible is so key.

And, um, being really interested in people, I think is, is really important, right?

It's not a job.

It's a, it's a profession.

It's a calling.

It just is so impactful on other people's lives, right?

So, um, Just, yeah, being really interested in people, helping people and, um, wanting to make a difference in people's lives.

Thanks, Michelle.

Yeah, that's wonderful.

And I think really, like, sums up kind of what you even said at the beginning that, you know, you fill in the gaps and you're, you ?Know, saying that, you know, it's really important to be able to find ways and be flexible in finding ways to fill some of those gaps.

So I really appreciate that.

I really appreciate your, insights and perspective as an OT working in long term care, even if it's, you know, one day a week, you're filling in the gaps as best as you can and being flexible too.

So thank you so much for spending some time with us today, Michelle.

You provided us with some really great insights into your experiences and how OTs help.

help to promote participation in meaningful activities and continuing care, while working with other members of the healthcare team and residents families.

So I really appreciate it and thank you so much for being here today.

Yeah, absolutely.

Thank you for the opportunity to talk about occupational therapy, my favorite subject.

Awesome.

This is a podcast produced and developed by the Society for Alberta Occupational Therapists.

Our podcast is hosted by occupational therapists and is intended to educate and get listeners excited about all the different ways that OTs support health and well being for people at all stages of life.

If you enjoyed this episode, Feel free to subscribe and follow Beyond Barriers, Navigating Health and Function on Spotify, Apple Podcasts, or wherever you get your podcasts.

Thanks for listening.