April 30, 2014

Re-Admits
Yesterday was a tough day at work. Two of our patients who were discharged a few weeks, were readmitted due to another fall at home. This made me wonder about the safety of elders after they are discharged to return home. The patients are assured with the prospects of home health services or a caregiver, however neither those resources are everlasting. Without family support or the inability to hire a full-time caregiver, the patient is eventually left to take care of themselves. As much as we promote independence in our patients and teach them compensatory ways to increase safety awareness, ultimately they require ongoing attention. A typical patient will spend a few days at the hospital, then approximately another month at a rehab facility where they're provided with a structured schedule and more importantly, a safe environment. Most of the patients I have seen in my short time as a therapist, I have noted that as  much as they look forward to being in their own home, they are just as apprehensive about being on their own and taking care of themselves. Granted, not everyone feels this way. There are many patients that are able to fully manage on their own and also take care of others. However, in the case of the two patients who lived alone and had yet another fall, I wonder if there was something more that could have been done to assist them in remaining safe in the home, all the while promoting as much independence as possible. Both patients were trained on safety awareness, safe and proper management of adaptive devices, safe transfer techniques, falls recovery techniques, etc. Ultimately, I feel that not having frequent family support or increased social interaction can greatly decrease a person's quality of life.

The Administration on Aging reports there will be 72.1 million older persons by 2030, more than twice that of year 2000. In 2010, approximately 29.3% (11.3 million) older persons lived alone. The figures are staggering for a population that is reporting increased disabilities with increased age. Would it be invasion of privacy if video monitoring systems were placed in homes of residents to monitor them on a regular basis throughout the day, every day? 

January 11, 2014

Studying for the NBCOT

I am a licensed and registered Occupational Therapist. That rings music to my ears. How wonderful it feels to say that yes, I am a licensed therapist. The licensure didn't come easy though. It was months of hard work and lots and lots of studying to get to the point that I was able to pass the dreaded NBCOT exam. From all the months spent studying, reading all the books, online forums, doing practice exams, biting my nails and losing hair, I've learned a thing or two on how to effectively study for the exam, which at least worked for me.

Now, generally if you've just graduated from OT school, I would say to pick up whatever study book you have and start reading. The sooner you take the exam after you graduate, the more easy it will be to recall and retain information, especially since you're still in the studying mindset. I, on the other hand, planned a wedding after I graduated then went on a month long road trip and moved across the country. Granted, I had lots of fun taking pictures in front of the World's Largest Totem Pole, World's Largest Praying Hands, Largest Blue Whale and largest anything the country had to offer along Route 66. However, I had fallen behind and it became difficult to remember all that I had learned in the three years of grad school and it also became difficult to stay focused and study for more than a few hours a day.

So, what's the solution. First things first. Make a schedule and STICK TO IT. Seriously.
Give yourself a solid two to max three months to study for the exam and take it at the end of the 3rd month.

1. To begin with, create a calendar up to the day of your scheduled exam.
2. For each day write down what chapters you will be reading and which book you will be using.
3. Make flash cards for the items you have a hard time memorizing and review every other day.
4. Start taking practice exams mid-second month. Schedule the practice exams 1-2 days apart so you have at least one day in between to review all the questions. When reviewing, understand the rationale behind the correct answers.
5. Schedule the practice tests at the same time as your actual exam.
6. After taking the first few practice exams, narrow down which domains you need help in. Go back and review that material from your study guides/books.
7. Note: don't keep re-reading the books. You know what you know. It's about applying the knowledge you already know. Learn how to answer the questions instead. You already know the material.
8. Update your study schedule as you progress. It's motivating to see how far you've come along and how much material you've covered.
9. Along with studying, keep your health in good shape also. Go to the gym, do yoga or even some simple breathing exercises. Go out for a run. This will get oxygen flowing to your brain and keep you more focused and alert. Don't forget to schedule this time in your study calendar.
10. Eat proper food. Schedule time to eat a nutritious breakfast, lunch and dinner. You can get carried away with studying and think you're wasting time eating when you could be studying. Trying to study on an empty stomach won't be as productive as when your body properly fueled and doesn't have to work twice as hard to keep going.
11. Get a good night sleep every night. This is even more crucial as you get closer to the day of your exam.
12. Most importantly, don't forget to give yourself a day or two off from studying. Don't go 7 days a week studying all the time. Give yourself a break over the weekend. Do something fun, not related to studying. Your body and mind will reward you.
13. The day of your exam, remember to relax. Don't freak out thinking you don't know anything. You have worked hard and studied as much as you can. Do yoga before your exam. Have a nutritious breakfast and lunch. You can do this!

Additional things that can help your studying: group study (in person or via Skype or phone), flash cards, post-its around the house, tape-recordings, Quizlet.com, OT professionals, teachers or fellow classmates.

Some topics which are a MUST know for the exam:
Rancho Los Amigos Scale
Allen Cognitive Levels
OT & COTA collaboration
CVA symptoms
SCI levels
ASIA Scale
TBI
Cerebral Palsy
Burns
Hand injuries and their splints
FIM
MET levels

Suggested books:
Therapy Ed
NBCOT Official Study Guide
Johnson's OT Examination Review Guide
JB Review
AOTA's NBCOT Exam prep
Castle Worldwide (*these exams do not give the correct answers or rationales. You only receive a score, which you can use to gauge where your weaknesses are.)

Remember, SAFETY and CLIENT-CENTERED.
Focus on what the question is really asking: what you would do FIRST or NEXT, MOST IMPORTANT, INITIAL. Is the question asking for a remedial or compensatory approach? Narrow down your options based on these key words.

Lastly, practice, practice, practice! Do as many practice tests as you can get your hands on. You've studied for months and now it's your time to show the exam who's boss.

Be confident!
&
Good Luck!!

*Feel free to email me if you need further advice on any topic or if you simply want a few words of encouragement! I will be more than happy to speak to you.



Disclaimer: I am neither employed by or promoting any of the books, study guides, or websites mentioned in this post. This writing is voluntary and not in exchange for any type of credit. I am simply posting what materials worked for me and solely for blog purposes.