Locus of Control

As a future OT practitioner, it is important to understand locus of control. Locus of control refers to one’s perception of their own control over things in their life. It falls on a continuum from an internal locus of control, where a person perceives everything in their life is within their control to an external locus of control, where a person perceives things to be out of their control. If a client has an internal locus of control, it is important to understand that they may be hard on themselves if they are not progressing as much as they would like. If a client has an external locus of control, they may have a harder time taking an active role in their therapy since they will have a tendency to wait for someone to “fix” them.

            While there can be some downsides to someone having a strong internal locus of control, such as being less likely to admit when there is a problem or wanting to be quick in and out with their therapy, in general we as therapist do want to encourage our clients to have a more internal locus of control. For clients who have a more external locus of control, it is important to guide them to feel like they have more control over their treatment and make sure they understand that we can provide them with some of the tools for success, but at the end of the day they are the ones who have to put in the work. It is important that we can recognize these personality traits early on with our clients so we know the kind of support they may need in order to play an active role in their treatment.  

Media Project: Aluminum Foil

 

   While completing this project, one of the things I learned is that if you use some creativity, you do not need expensive equipment to create an intervention that can benefit the client. This assignment also emphasized the importance of the interview with a client so that the OT can get all the necessary information to create an intervention that is catered to the client. After reading through the case study I realized just how much you have to consider when creating an intervention. Initially seeing that the client was having trouble gardening I wanted to find a way to use the aluminum foil to help her with her big grades, but after seeing she can only do things for about 15 min and that her husband is gone most of the day for work, I quickly realized that having her garden outside alone was not the safest idea so I found a way for her to participate in gardening while sitting down inside her home.

   One thing that I learned from this assignment is that it really is important to always be working on creative and cheap interventions that can be used. Creativity is something that I definitely struggle with at times, but there will be times that I may not have access to the intervention tool that I would traditionally use, or the traditional intervention tool may not match the client's interests. This is another major advantage to creating an original intervention, it can be designed specifically to match the client's needs and interests. Hopefully this assignment will help me in the future to think outside the box when I do not have a clear answer or approach to a problem. 

Neuro Note #5: Dementia

    I listened to Beth Malone's TED talk titled "How my dad's dementia changed my idea of death (and life)". In this TED talk Beth discusses the mental challenges she endured while her father was dealing with frontotemporal lobe dementia. She talks about how hard it was to watch him be trapped in a body that took away his ability to interact with the world the way that he wants to and should be able to. She described it as him being tortured in that body and wanting to get him out of it. Essentially she wanted to kill her dad to free him from the disease. Beth talks about how death no longer seemed like the worst fate and she wished they had talked more about each other's "best death" when the whole family was still healthy. At the end of her TED talk she discusses her realization that she is his daughter, she is not his doctor and therefore the big decisions should not fall on her; her only role should be to be his daughter.

   I chose to do my assignment on this TED talk because the concept was intriguing to me. We live in a society that assumes life is always better than death and we do everything in our power to preserve life. However, this TED talk raises the concern of quality of life versus life. I think this TED talk brings up a really important conversation that people should have about what kind of care they want to receive in situations like this. As Beth mentions, no one wants to have the "death" conversation while everyone is healthy, but knowing how a loved one feels about this topic will help others not feel guilty or confused when decisions need to be made. As a future OT I think it is important to try to help clients and their families open up about these kinds of conversations while the client is still healthy enough to convey his or her opinions and preferences so that everyone can feel confident when making decisions in the future. It is certainly not an easy conversation to have, but it is an important one. I also think it is important to see how much pressure Beth felt to "save" her dad, even though she was his daughter and therefore that kind of responsibility should not have fallen on her. This is somewhere that OTs can help with the family and helping them realize that there is a team of physicians and healthcare professionals that can help guide them in the process. I would recommend other's to listen to this TED talk to better understand the challenges that loved ones of the client might be facing to help them become more aware of how to assist the client and their family. 

Malone, B. (2017). Transcript of "How my dad's dementia changed my idea of death (and life)". TED. https://www.ted.com/talks/beth_malone_how_my_dad_s_dementia_changed_my_idea_of_death_and_life/transcript.

Neuro Note #4: Spinal Cord Injury

   I read a blog post by Elizabeth Forst, "Anything is possible", where she talks about her experience chasing her dreams after a spinal cord injury. In August of 2014 she had a swimming pool diving accident that resulted in C4/C5 injury that led to her having complete quadriplegia. Before the accident she was just weeks away from obtaining her advanced diving certification. While she realized this dream was probably not in the cards anymore, she refused to give up her passion for diving. Just 2 years later in May 2016 she was preparing for her first dive since her injury. Unfortunately, without the use of her arms and legs she cannot dive independently, however she has found ways to adapt the situation to meet her needs and has decided to dive with two trained “buddy divers” who will help her to dive safely. Also, since she cannot use hand signals to indicate distress or to signal “okay”, she has created some of her own signals using her head, eyes and shoulders. 

   I chose to read this because I thought it was really inspiring to see someone has quadriplegia chase such an adventurous dream that even I am terrified to do. Diving can be a dangerous and taxing on a fully able-bodied person and for her to choose to tackle this challenge is truly incredible. I think there is a lot to be learned from Elizabeth’s mentality; she decided to be positive and find new ways to pursue her passions. I would recommend other’s read this because it just goes to show how important to not write people’s abilities off simply due to their diagnosis. Based on what I have learned in my neuro class about C4/C5 spinal cord injuries with complete quadriplegia, I would not typically expect to see that person take a dive into the depths of the ocean, but as she says “anything is possible if you put your mind to it”. As a future OT, I think this is a great example of the importance of the Occupational Profile and the general importance of getting to know your client. Even if two clients have the same diagnosis there abilities, needs, and wants will all be different and it is important to take note of this to help a person feel fulfillment with their life. 

Forst, E. (2016). Anything is possible - Blog. Reeve Foundation. https://www.christopherreeve.org/blog/daily-dose/anything-is-possible-by-elizabeth-forst.

Neuro Note #3: "The Theory of Everything"

   I watched the film "The Theory of Everything" which is about Stephen Hawking, a famous physicist, and his diagnosis of ALS, Amyotrophic Lateral Sclerosis, more commonly known as Lou Gehrig's disease. The film shows what his life was like after he was diagnosed with ALS, along with his wife's experience. Shortly after his diagnosis he married Jane Wilde, with the expectation that caring for Stephen Hawking would be hard, but also only last for a couple of years due to the short life expectancy associated with ALS. Stephen Hawking however far surpassed the average life expectancy of 2 years and lived for over 50 years with ALS. This story gives an interesting perspective on how it can be just as much of a hardship for someone to live so long with ALS as it is for them to die quickly of ALS. Throughout the film the viewer can see how difficult it is for Jane to be a full-time caregiver to her husband as well as her children. I think this film also does a great job of showing how tragic it is for someone to suffer with such a debilitating physical disease and to still have the mind so intact. Overall the film greatly displays the trials ALS can place on a family and really show how devastating the effects of the disease are.

   I chose to look at this film because I have watched it before in the context of entertainment and now that I am taking a neuro class I thought it would be interesting to watch it with a greater emphasis on understanding the disease. As a future occupational therapist I think it is important to watch films and documentaries about people with these various diseases that we may see in our practice because it helps to see what a person's life is like outside of the walls of the clinic. It helps to give insight into their daily world and the world of the families as well, which is sometimes hard to fully grasp and understand through just a series of questions. I would recommend others watch this film because it shows a unique side of ALS where you can see a longterm struggle with a disease which typically comes to a fairly rapid end. I also think it is a good film because it does provide some background information about ALS which helps with the general understanding of what the progression of the disease looks like. Overall "The Theory of Everything" is a heartbreaking film to watch, but Stephen Hawking's story is definitely one worth knowing.

Neuro Note #2: "My Beautiful Broken Brain"

   I watched the documentary "My Beautiful Broken Brain" which is about a 34 year old woman named Lotje Sodderland and her journey of recovery following a hemorrhagic stroke, which was later found to be due to a pre-birth abnormality in her blood vessels. This documentary follows her journey returning home from the hospital, to going to an inpatient rehabilitation facility for people who have suffered a stroke, and even trying a new experimental treatment (which may have been the cause of a seizure that she later experienced). The beginning of this documentary was heart breaking as she showed her everyday struggles with communicating. The hardest part was to see her frustration with herself, knowing that these were things she should know how to do and knowing that she used to be able to. At about 7 months since the stroke, her language was noticeably better and she seemed to be a little happier with herself. She then heard about an experimental non-invasive brain stimulation study which gave her hope for more improvement in her language comprehension. Unfortunately, either from the experiment or from her increased risk following her stroke, Lotje had a seizure which caused a regression in her progress. Seeing both her and her family's experience throughout the whole recovery progress shows just how important it is to have that support system backing someone in the recovery process.
   I have always found documentaries like this are so important because they remind us that the clients and patients we deal with are real people and so are their family members. I also think it is nice to see the reactions in "real-time" since the footage was taken throughout her recovery. I think her story is also very inspirational, because despite her roadblocks along the way, and her frustrations, she shows that after a brain injury like this not everyone will be able to get back to their "old self" but they can still have goals and strive to be successful in other ways in their new life. At one point in the documentary she talks about her new outlook on her life and how she has different goals in life now but that doesn't mean she has failed. I think this is important for all OT's to remember as well as any person dealing with a neurological or physical condition, sometimes one will have to change things about his or her old life, but it does not have to be a bad thing. In my neurological course we have been learning about CVAs (aka strokes) and to see the deficits that commonly follow a stroke through a documentary like this really helps to put into perspective how serious and devastating these effects can be.  I definitely think that others should watch this film to see how Lotje and her family/ friends helped her overcome so much in a single year following her stroke.  Overall I loved Lotje's positivity and courage throughout this whole film and I think there is a lot to learn from her perseverance.

Neuro Note #1: "The Innerkid Philosophy", Huntington's Disease

   I watched a TEDtalk called “The Innerkid Philosophy” given by Kristen Powers who is a teenager who lost her mother to Huntington’s Disease. Her mother was diagnosed with the disease in 2003. By 2005 the physical symptoms were becoming evident and eventually she was deemed emotionally unfit to stay in her home. In January 2011 her mother passed away. After her mother’s diagnosis she and her brothers realized that there was a 50% chance that they would have the disease as well, but they would have to wait until they turned 18 to be genetically tested. Kristen speaks on how she was faced with many difficult topics at the age of 12. She was faced with the thought of potentially having to care for her siblings if they had the disease as well as wondering if a future husband would have to care for her if she had the disease. Knowing the short lifespan following a Huntington’s Disease diagnosis she thought about the possibility of having her independence and life taken away so soon.

   Facing these thoughts led her to the idea of the “Innerkid Philosophy”. She remembered always hearing adults talk about their childhood being the best time of their lives and she did not want to lose that spark of childhood as she began adolescence. Kristen wanted to have fun, but also save the world in the process by making an impact. Since she could not be tested for the disease for 7 more years she decided to embrace the “power of not knowing” and make every moment matter.

   In past classes I have learned about the medical aspects of Huntington’s Disease, but have never really focused on the emotional impact it can have on the family. This TEDtalk had an interesting perspective since it came from the teenage daughter of a woman who had Huntington’s Disease. I also thought this was an interesting perspective given Kristen had yet to be tested for the disease she was able to speak on the challenges as well as the positives to not being able to find out if she will get the disease due to genetic testing laws (which I did not know you had to be 18 for). I chose to watch this video because the perspective was interesting to me. Knowing that Huntington’s Disease is genetic, hearing the daughter’s thoughts and feelings about her past experience with her mother as well as her possible future was very enlightening and something that I think is important, as a future OT practitioner, to understand. I think stories like this help remind people that often times with a client, especially clients with a neurological condition, the family is also important to think about as well so that they are not over burdened with their new roles as caretakers. After watching this TEDtalk I am going to be watching Kristen’s documentary about her journey and decision to get genetically tested for Huntington’s Disease.

Link to Kristen’s TEDtalk: https://www.youtube.com/watch?v=l6JiBiMqiI4

Kristen’s Documentary: “Twitch”

Powers, K. (2012, April 13). The Innerkid Philosophy: Kristen Powers [Video]. Youtube.                                                       

            https://www.youtube.com/watch?v=l6JiBiMqiI4