University of Southern California
University of Southern California
USC Chan Division of Occupational Science and Occupational Therapy
USC Chan Division of Occupational Science and Occupational Therapy
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Student Blog | Daniel

Daniel

Meaningful Occupations and Routine Changes During Quarantine
Posted , by Daniel

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During the COVID-19 pandemic many of us have lost our normal routines and had to either adapt or stop engaging in certain daily occupations. Occupations are activities that we need to do, want to do, or are expected to do in our everyday lives. Everyone has a different definition for what a meaningful occupation is, for example, going to school, working, taking walks, interacting in the community, etc. Social distancing has changed the way we work, socialize, and how we take care of ourselves. Right now, more than ever, occupational therapy plays a crucial role in guiding patients through the process of creating and/or adjusting habits and routines that are personally meaningful and health promoting. Occupational therapy has the ability to address the physical, mental, and spiritual wellbeing of individuals. 

During my remote fieldwork at the LAC+USC Adult West clinic, I have had many conversations regarding increased levels of fear, anxiety, anger, and depression. These are completely normal feelings to have during a time of so much uncertainty. People are worried about their health, financial responsibilities, food insecurity, their loved ones, social injustice, etc. Furthermore, the inability to engage in their usual daily occupations has taken a toll on many of the patients at the clinic. Yet, it is important that we do not let these feelings control our lives, and instead, find healthy ways to cope with these feelings and find ways to begin to engage in meaningful occupations. For example, many people are worried about not being able to work which leads to stress and anxiety about how they will provide for their families the longer this continues. To many this is an extreme change in their lives and are not able to engage in what they have considered a meaningful occupation (working) for the last 10-20 years. Often, our phone visits will focus on exploring coping strategies to manage stress or anxiety, and connecting them to resources that may support them with basic necessities. Without the ability to take care of their basic needs, patients have difficulty focusing on managing their health. Furthermore, we support patients by finding ways to increase activity level and engage in safe/appropriate socialization.   

Below are some resources that you can use with your future patients and for yourself:

Patient Resources:

  • My Therapist Aid: A tool for mental health professionals that includes worksheets, audio, videos, guides, interactive activities, and products. Resources can be searched by topic to tailor activities to client’s needs (i.e. stress, anger, anxiety, depression, grief, self-esteem, relaxation, substance abuse, etc.).
  • UCLA Guided Meditations: different types of free meditations in English and Spanish, that can be played as audio or read using a transcript. The meditations can also be accessed via the “UCLA Mindful” app for free.
  • YouTube meditations: YouTube is a great resource for many of our patients because it is free and it has so many options! Patients can explore different types of meditations such as guided meditations, sleep meditations, meditations with music, etc.
  • Deep Breathing: a relaxation technique that focuses on taking slow deep breaths to provide relief from stress and anxiety. This reminds you to breathe, bring that heart rate down, and relax your muscles.
  • 211LA: A hub for community members and community organizations looking for all types of health, human, and social services in Los Angeles County.
  •  

Personal Coping Strategies:

  • Music/Lo-Fi Music: Music has always been a coping strategy for stress and anxiety for many years. More recently, I really enjoyed simply playing lo-fi music, which is a type of music that is mostly beats.
  • Exercise: Strengthening exercises and running have been one of my biggest coping strategies during moments of stress. Since gyms began to close, I had to re-invent the way that I exercised at home. I started to do more bodyweight exercises and lots of stretching!
  • Reading: I know this probably sound exhausting because we usually already have so much to read for school or work! However, I have found it therapeutic to spend at least 20 minutes per day reading books I have genuine interest for and does not feel like more work. A strategy I have been implementing is setting a timer for 20 minutes to read every day.

As I reflect back on the first 7 weeks of fieldwork, I have learned a lot from hearing patients’ personal experiences under these life-changing circumstances. This has been a challenge as I try to support them through a computer monitor and phone. However, this experience has also improved my problem solving, communication, and collaboration skills as the clinic team finds ways to better support patients. This experience has served as a reminder that occupational therapy provides the adequate training to help with challenges that occur when a person is confined to home and is unable to engage in their meaningful occupations.

Daniel

A Busy Day in Primary Care Fieldwork…from Home!
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This summer I am doing my level-2 fieldwork with my OTD residency site under the Lifestyle Redesign for Chronic Conditions Lab (LRCC) in primary care at the LAC+USC Adult West Clinic. This OTD residency is designed to expand occupational therapy (OT) services in primary care, focused on addressing chronic condition management among patients with diabetes and/or hypertension, using a Lifestyle Redesign® approach. This summer I am being trained by the current OTD Resident in preparation to take over the full caseload this Fall.

Currently, the primary care clinic does not have a video platform and we are not allowed to use Zoom to interact with patients, thus all of the appointments are three-way phone visits using Doximity (HIPAA compliant) with supervision from my clinical instructor (CI) through the phone and Zoom. I am able to lead appointments in English and Spanish, which is valuable for our predominantly Spanish speaking community at the clinic. The phone visits can be beneficial for some patients as they don’t have to travel far to get to their appointments and can talk to their providers from the comfort of their home. However, there are also barriers for our patients such as not having a quiet space at home or disconnected phone lines due to being unable to pay their phone bill as a result of the pandemic. We do our best to contact all our patients and provide as much support as possible to help them navigate these barriers and be able to manage their health. 

Each day can look very different when doing telehealth in primary care, and below I wanted to share an example of a typical busy Wednesday! On this particular day, I started my day with an OTFP in-service learning about mental health when utilizing Lifestyle Redesign® approaches. Next, my CI and I started calling patients since we had done chart reviews the day before. During our phone visits, we discussed topics such as healthy eating, physical activity, stress management, medication adherence, habits and routines, resources, etc. to support their diabetes and/or hypertension diagnosis and overall health management. In the middle of the day we had consecutive meetings to discuss patient progress and how to better support them (care management); fieldwork/residency updates, logistics, and an opportunity to ask for guidance with clinical approaches (fieldwork supervision); and daily clinic updates and projects (daily brief). And perhaps you are wondering…when do you eat? Well, there are days when we don’t get an official lunch break, so we do our best to get food in between meetings! Thereafter, we began calling patients again for the rest of the day and documented in between appointments and during our assigned admin/documentation time at the end of the day.     

Typical Wednesday:

  • 8AM-9AMOccupational Therapy Faculty Practice (OTFP) In-Service
  • 9AM-11AMPatient Phone Visits
  • 11AM-12PMCare Management Meeting
  • 12PM-1PMFieldwork Supervision Meeting
  • 1:05PM-1:30PMClinic Daily Brief
  • 1:30PM-4PMPatient Phone Visits
  • 4PM-5PMAdmin Time/Documentation

Workspace

My workspace at home (please don’t judge my ergonomics/set-up, I’m still working on it).

Tips for working from home:

  • Take stretch breaks: This is one of the most important things you can do for your body. Taking stretch breaks is important to prevent pain, aches, and cramps later on! You can even do stretches while sitting down.
  • Snacks & water: Don’t forget to stay hydrated and have snacks in reach to have energy throughout the day!
  • Ergonomics: Posture, posture, posture! Please take care of your bodies and follow proper posture and chair tips when working from home. This can easily be overlooked and if you don’t have fancy equipment, there are ways you can get creative! Your body will thank you later.
  • Prepare meals: This can save you time on days when you may have a short lunch break or none at all!

I hope this paints a picture of what a busy day of telehealth primary care may look like! My intention is to be transparent with you all and share the good, the bad, and the busy days. I am often exhausted at the end of the day, but I am excited to continue to learn and the patients make it all worth it!

Daniel

Why I Chose the OTD?
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For me, pursuing the OTD means much more than just pursuing an education. It represents years of overcoming systematic barriers and paving the way for more first-generation Latinx students. Along the way, I have been fortunate to have a support system that believed in me, which I call my village (family, friends, mentors). As a first-generation Latinx student, pursuing an education comes with many other responsibilities. Personally, my entire college career I’ve had to work almost full-time, financially help my family, deal with imposter syndrome, and felt lost along the way since I am the first in my family to pursue higher education. My dream has always been to earn a doctorate degree, however, I never thought it would be financially possible. During Fall 2019, I began contemplating my options and whether it was possible to pursue the OTD. I struggled with constant questions of, “How can I pay for this?”, “Should I just start working after graduation to help my family out?” This was a time full of emotions and feeling stuck. Fortunately, I was able to ask questions, lean on my support system and this provided clarity. I reflected on my future goals of wanting to teach someday, starting my own non-profit organization, and promoting Latinx representation and leadership in OT, and decided the OTD would better prepare me to pursue these goals. Furthermore, I reflected on the communities I seek to make an impact on and decided to pursue a USC Chan Residency in primary care. Now that I am starting my residency training at the LAC+USC Adult West Primary Care Clinic, I truly believe I made the right choice. I am excited to continue to grow working along my faculty mentors Dr. Beth Pyatak and Dr. Jesús Díaz, and learn the necessary skills to expand OT services in primary care. I look forward to sharing my OTD journey with you and helping you find yours!