Philip Lamoreaux

OC TH 6960
Reflective Diary paper

Aspen Ridge of Utah Valley is a transitional rehabilitation center that

takes patients that were being discharged from the hospital, but were too sick
or weak to return home.

Their purpose was to help the individual focus on

getting back to a state of independence that was acceptable for their given
situation. This was accomplished through therapy with both occupational and
physical therapy up to 6 days a week. I learned how important occupation
was in helping an individual gain motivation and progress enough to go
home and live. I had many experiences that contributed to my future
practice, but Lud was the start of my belief in occupation and a major turning
point in my clinical career.

1) Factual Strand: Write a brief description of the incident, state WHY this is
significant to you.

Lud had fractured her femur after leaning forward to pick something
off the ground. She lost her balance and landed awkwardly on her thigh/hip,
which caused the fracture. Upon evaluation Lud had slow speech and
complained of losing the use of her right hand a few months back. I
discussed with my clinical instructor all the possible conditions that could
have done this and we felt it was most likely a stroke. The use in her right
hand was not the reason for her admittance into the rehab facility, but it
affected how she was able to hold on to the walker and grab bars. I
remember starting with preparatory activities in order to address the
biological problems that were preventing her from being able to function and
complete her activities of daily living (ADL) such as strengthening upper body,
core, and increasing her endurance. After she was stable enough to stand I
decided it was time to try using a knife, which was an occupation-based
activity that she had mentioned she liked doing during her evalution.

I remember Lud was positive and motivated through the whole process

up to this point. She was always able to focus on the little victories that she
experienced and had a good outlook on life. So, when I brought a head of
broccoli for her to cut while using her right hand, I expected no change. She
stood up and grabbed the knife with her left hand and started to cut the
broccoli. After gently reminding her to use her right hand she reluctantly
took the knife in her right hand and grabbed the broccoli with her left hand
in order to hold it in place. She slowly cut the broccoli with her right hand.
After cutting off two heads she put the knife down, reached back and sat
down in her wheelchair. She looked at me with a tear falling down her cheek
and said, I never thought I would be able to do that ever again! She was
truly happy and couldnt hold in her emotions. She stood back up and
proceeded to cut the rest of the broccoli up. After cutting the broccoli I
helped her understand that the more she used her right hand, the easier it
would be to use it. Up to this point I had only seen motivation out of
necessity.

This was different because it was motivation to live life by doing

the things they truly wanted to do.

2) Retrospective Strand: Record your feelings during the incident, what

new knowledge was discovered? What other influences contributed to
your experience?

I had been struggling with the concept of preparatory vs

occupation based throughout my fieldwork up to this point. I
remember thinking as she looked at me with tears coming down her
face this is the feeling I have been searching for. I felt joy, satisfaction
and that I had empowered someone to take control of their life by
helping her become more independent in the activities she liked to do.
I learned that finding the occupation an individual wanted to
accomplish was important in order to have the person drive their
therapy on their own. I no longer had to persuade Lud to come to
therapy, she came into the room 10 minutes early.

Lud was anxious to

do everything in her power to become independent and do what she

though she had lost.

I had read about this happening in case studies and examples

from professors. I had longed for this experience to happen to me, but
was unable to find it until this moment. I believe coming up with my
own personal why/cause motivated me to change the way treatments
were being done. I wanted to empower others to take control of their
own destiny and future. I had decided this as my cause in life at the
beginning of the soccer season. I always try to empower my boys to
take control of their own progression. This belief led me to do this in
the situation with Lud. It took a few weeks, but I finally found what she
needed to experience in order to feel control of her own future.

3) Substratum Strand: What past experiences influenced your actions?

What beliefs and values underpinned your behavior?

I have always been taught to be responsible for what I want in

life. My mother always taught me to stand up and get done what I

need to get done in order to achieve my hopes and dreams. These
beliefs have motivated me to accomplish what I have in my life so far.
During my experience with Lud, I kept asking myself about what were
her hopes and dreams.

She would talk about being home with her

family, seeing her grandkids, and being able to take care of herself.
These were what I had focused on up to this experience because I
wanted her to take control of her life and be motivated to do therapy
on her own.

I also believe that when you put your mind to something, you can
accomplish it.

Lud and I had many talks about how it is about creating

goals and putting her mind to accomplishing those goals.

The issue

that I had with doing this was that I had not focused on her true hopes
and dreams. I believe that everyone has something that makes them

feel connected and human. This feeling of humanity is what motivates

us all to get up in the morning and go through the stresses of life.
Without them we might as well stay in bed.

This activity that made

Lud feel human was the key to her motivation.

4) Connective Strand: How has this experience influenced your future

practice? What have you learned from this? Where do you need to
grow?

I am unsure of what I really want to do with my occupational

therapy degree. At the beginning of the school year I had wanted to
focus on children and not adults. After this experience I realized how
much I liked being an occupational therapy in the adult population.
This situation has given me the desire to work with adults.

This

experience has also pushed me to find the thing(s) that make

individuals feel human. This are the occupations that give us hope in
life. These are the activities that we want to spend out time doing. I
will use this experience as motivation to always focus on the
occupations an individual desires to do and not spend most of my time
with preparatory activities. I realized that I need to develop my
evaluation skills. I need to improve my ability to gain the trust of an
individual so they will feel comfortable about telling me their dreams. I
also need to get better at utilizing occupation-based treatment in order
to find more individuals hopes.

Plan for future clinical progression

Goal: Become more efficient at obtaining individuals true goals, hopes

and dreams.

Goal: Be more occupation based as early as possible in order to

increase motiviation.
How: I plan to break down activities that the individual likes to do and
help him/her do parts of them in order to help them see how they can
accomplish them. I also plan to describe occupation in a more
functional and less technical way. I will open up with this definition and
have this be the main focus of my interviews.