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Summary
In this "Care Lab" podcast episode, hosts Dr. Brandy Archie and Emilia Bourland hold a lighthearted "game show" about caregiver scenarios, testing each other on common challenges caregivers face. They explore solutions, resources, and guidance on what to do—and what not to do—in specific situations. Topics range from managing nutrition and medications to modifying homes for safety.
Key Takeaway
- Respite Care for Caregivers: Consider available financial resources and the care level needed, then contact local agencies (like the Area Agency on Aging or VA services) to coordinate respite.
- Navigating Low Vision: For progressive vision loss, involve a low-vision specialist or occupational therapist to help modify the environment and maintain independence.
- Assessing Nutrition Concerns: If a loved one struggles with eating, consult with primary care, occupational therapy, and possibly a dietitian to uncover and address the underlying issues.
- Supporting Medication Management: Primary care physicians, pharmacists, and occupational therapists can offer strategies for simplifying complex medication schedules safely.
- Environmental Modifications: Before installing devices like grab bars, consult with an occupational therapist to ensure optimal placement and to avoid counterproductive solutions.
Transcript
Emilia Bourland
Hi, welcome to Care Lab.
Dr. Brandy Archie
It's Care Lab Day, everybody. Thanks for tuning in.
Emilia Bourland
Yeah, I hope everyone's ready for a good time today. Because we've got, I think, a really fun show planned with just you and I. It's going to be a surprise for both of us. So neither one of us really knows what's coming here.
Dr. Brandy Archie
which is interesting and you know, when we don't have a guess, we kick it to be unhinged. So, you know, let's go.
Emilia Bourland
Totally, totally, yeah. Can I just point one thing out though before we get started? I'd like to point out, not for you or our general audience, but specifically for your parents, Brandy, that I am wearing a nicer shirt today.
Dr. Brandy Archie
Okay.
Emilia Bourland
Hahaha!
Dr. Brandy Archie
my gosh, they're probably turning red when they listen to this. Okay, now I gotta tell the backstory that I told my parents, listen to the podcast. They give me lots of good feedback. So if the podcast is good, that's because they give us feedback.
Emilia Bourland
Which by the way is wonderful. Thank you Brandy's parents for listening. I am quite sure my parents don't listen. Or if they do, they're not telling me about it for whatever reason. So thank you for listening, Brandy's parents.
Dr. Brandy Archie
Exactly.
now they're getting shamed into listening?
Dr. Brandy Archie
But they said that I should dress nicer and that I should like, you don't gotta put on nice pants, just at least put on a nice shirt. And I was like, okay, that's fair. I don't have to wear a t-shirt. Cause they always watch on YouTube.
Emilia Bourland
That's funny. Whereas I am usually in some sort of t-shirt or something. But in my defense, it's usually a higher standards caregiver training t-shirt. Like that's my work uniform. I'm branded. So, but today I did, I put on a button up, a nicer shirt for you. And I was thinking of y'all as I made that selection. So you're welcome.
Dr. Brandy Archie
Branded. Exactly.
Dr. Brandy Archie
Hahaha!
Dr. Brandy Archie
Let's see what kind of feedback I get on this when it goes live.
Emilia Bourland
No. Okay. All right. Should we do this?
Dr. Brandy Archie
Let's do this. Okay, what are we doing?
Emilia Bourland
Okay, so today we have a game show style episode where of course, since it's just you and me, the only two contestants are you and me.
Dr. Brandy Archie
Is there a prize?
Emilia Bourland
if there is, I'm putting that in your side of the court.
Dr. Brandy Archie
Dang, okay, there's no prize in. I don't know one.
Emilia Bourland
No, no. Listen, I didn't think that far ahead. I had an idea. I put it down. You know, we agreed and here we are. So we do our best work flying by the seat of our pants, though, I think, on CureLab. So and this is really going to be one of those episodes. So OK, so here's the premise of our little game show today. So you and I are going to take turns asking each other questions based on like very
Dr. Brandy Archie
All right.
So yes.
Emilia Bourland
simple scenarios, like a one problem kind of case scenario. And then the other person's job is to answer, OK, who is the correct person or people to call in this situation? Like, who are the experts who can actually help with this? And if relevant, what is something that you should absolutely not do? OK. OK. All right. OK.
Dr. Brandy Archie
Got it.
Dr. Brandy Archie
Got it. Yeah, this is doable.
Emilia Bourland
Do you want to go first or do want me to go first? Asking, asking I mean. Who wants, do you want? Okay. Ooh, okay.
Dr. Brandy Archie
I'm gonna go first. I'm gonna go first asking questions. Yes, let's do that. Because you came up with the idea, so let's put you in the hot seat first.
Emilia Bourland
Ugh, my gosh, now I'm feeling like I've been rude to myself. Okay, go ahead.
Dr. Brandy Archie
Okay, let's say you're the caregiver for someone and you are going to try to go out of town and maybe they live with you or they can't be by themselves, but they also aren't going to go out of town with you for whatever reason. Who do you call? How do you make that work? How can you get respite?
Emilia Bourland
Yeah.
Emilia Bourland
Okay, so that's a really good question. This is a layered response, right? Partly it depends on, really it depends on what kind of resources are there and available to you. but we know that the idea is we have to have someone else who's gonna be able to come in and care for that person. So our options are we can find a like community or facility where that person can go stay temporarily for respite care.
Dr. Brandy Archie
which would be like assisted living probably.
Emilia Bourland
could be assisted living depending on the level of care that person needs. It might even be more like a long-term care type of facility, but it just depends on the level of care that someone needs. So we're gonna see if there's a place where they can go and stay and get that care, or we can see if there's someone who can come in the home. And that could be either a paid professional caregiver. So it could be a home care agency or a...
private caregiver that you're hiring to come in for that amount of time. Or it could be a combination of other friends and family or other services that are coming in to help. Really, there are two big questions here. One is, again, what kinds of resources are available to you? So are there financial resources that are available to you that can help you pay for that professional level of care that someone might need?
Is this something where you're going to need to bring together different aspects of maybe social services in the community, as well as your friends and family to help? And then the other aspect of it is how much care does this person need? Those are the two big determinants of exactly how you're going to get this done. I do want to share a couple of good resources to know about if you're trying to pull together respite care.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
one, it is particularly if, if you have limited financial resources, cause it can be very expensive, of course, to have someone go and stay somewhere or to bring professional care into your home for the amount of time that you're leaving, depending on again, how many hours of care that person is going to need. So if it's someone who has more limited financial resources, then, we want to think about calling our local area agency on aging.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
here.
Emilia Bourland
That's a great place to start for finding low cost or even free respite services. Now, sometimes those lower cost or free respite services, they can't always provide like high level hands on care. But often it is possible to get someone to come into the house and do some, you know, supervision, some help with housework. And really, it just kind of depends on what services are available in your community. So
Your local area agency on aging is a wonderful resource to call and start finding those services. Also, 311 or whatever your city's version of 311, that is a great place to figure out what resources are available to you. Certainly for respite care, honestly, for like just about anything, it's 311's job to like know all the things that are out there. So calling them can actually be a great
place to start and like saying, okay, this is my problem. Are there any resources in the community that can help with this? That's a great place to start to. If you're a veteran and you are service connected, it is also sometimes possible to go stay at if you have a local VA hospital that has like a community living center, a CLC, it's sometimes possible to go get respite care there as well. So that can be a huge, huge resource. So again, it kind of depends on what
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
your financial resources is the level of care that someone needs and some other social connections that you have in the community. What I would tell you not to do though is don't give up and say that it can't be done. Because sometimes it feels like it's more work than it's worth to take the vacation or plan your day off or whatever it is.
Dr. Brandy Archie
yeah. Mm-hmm.
Emilia Bourland
But you really can't survive forever without that. You have to, you work so hard to care for this person that you're caring for.
Dr. Brandy Archie
You need those breaks.
Emilia Bourland
Be willing to do a little bit of that work for yourself as well so that you can take a moment and really, really have some time for yourself. It's so worth it. I know it feels like a lot of work. I know that feels overwhelming. But it's one of those things that I would absolutely say, don't give up on it. Don't give up on your vacation. Don't even, whatever it is, like don't give up.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
You can do it!
Emilia Bourland
You can find a way to make this happen. I promise there are services in the community. You know people in your community. People are more helpful than you think they are a lot of the time if you go and you ask. Not only can you get this done, but your village, you can get it done.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Perfect, absolutely. I agree.
Emilia Bourland
Great! Do you have anything to add to that? Because I feel like you probably do.
Dr. Brandy Archie
No, I think that was really comprehensive. The only other thing I'd add is that if 311 feels unhelpful because it's a very city focused service, I think this works everywhere. I'm not sure, but 2-1-1 is the United Way. And I'm pretty sure you can do 2-1-1 in any city and get your like United Way of greater Kansas City is at 2-1-1 here. And they are a wealth of resources for all of the social services that would exist in your area.
Emilia Bourland
Mm-hmm.
Emilia Bourland
I didn't know that.
Emilia Bourland
Okay.
Dr. Brandy Archie
including respite care. So I would just throw that into the pot too.
Emilia Bourland
Okay, awesome. Perfect. Okay, are you ready for your first question? Okay, I have to look at my notes here because otherwise I'll ramble. Okay, what do you do if someone gets diagnosed with a progressive vision disease? So we're talking about something like maybe diabetic retinopathy or immaculat degeneration, something that's probably gonna get worse over time.
Dr. Brandy Archie
I'm ready.
Dr. Brandy Archie
Yes, okay. Outside of the see the eye care professional who I'm sure you just did because they diagnosed you and make sure you follow up with them. The next thing to think about is how we're going to manage our everyday life things in order to make keep our lives as independent as possible. So the very first person I think I will call is a certified low vision therapist or a excuse me let me back up make it a little bit easier. Find somebody who's
Emilia Bourland
Mm-hmm.
Dr. Brandy Archie
low vision certified and there are multiple types of certifications and Occupational therapist is a great place to start at so we have some baseline knowledge in the first place and then people who specialize in low vision to help with that treatment and so That way you can even if there's nothing actually Challenging at that moment. It's really important to have somebody on your team who's gonna help you
Understand what things could be changed and modified so we can maintain our independence instead of here's the thing not to do Letting the person waste away and just take like let their life get smaller and smaller and smaller Because there's fewer and fewer things they can do because their vision is continuing to go there's multiple programs depending on what city you're in in order to learn new skills in When your vision has changes you get older because it's very common as you get older to have some of these age-related
eye diagnosis that are not just like I need to wear readers, you know, and so and and the other thing I would say to Definitely do is to talk to your person and that person gets diagnosed. Let's actually talk about What things are hard for you now? Because if y'all went in to get checked, that means they already notice changes, right? And so that means there's already some deficits and let's take them head-on especially because they're gonna get worse and you're gonna need
some solutions that will change over time in order to help manage that. So get help with that. So find an OT, an occupational therapist, who specializes in low vision. And you can message us if you want more direct resources for finding that because there are lists of those people.
Emilia Bourland
I really, I really love that answer. I'll just like, I don't have anything to add onto it specifically, but just like real world stuff. This kind of thing happens all the time. I can't tell you the number of times I've like gotten evaluation order or something like that to go see someone who it's an evaluation to prevent falls because they have this new low vision issue or, and, and the thought of sometimes.
the doctors, the family, even the person with a low vision is like, is that their world is going to shrink, right? And there's everything that they can't do. And maybe there's already a ton of stuff that their family has totally taken over for them that really truly with the right device or the right support or the right environmental modification, they could do it. And I don't claim to be a low vision specialist at all, but I know enough to know how to direct someone to the right resources.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
and how to show them enough to show that there is hope and that they're way more capable than they think. So, and I think vision is one of those areas that it feels like someone losing their vision is just, it's devastating, right? That's a devastating, but it is so important to know that it doesn't, is life going to change? Yes, but it doesn't have to be a devastating.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Totally.
Emilia Bourland
like your world is over, you sit it alone and you can't do anything kind of event. You can still participate. People can still participate and be very successful and independent and highly functional in their lives. With low or no vision, we just have to give them the tools to do it. So I really, I love that answer. Thank you for sharing that. Because I know you are a low vision specialist, right?
Dr. Brandy Archie
Yes. Yep.
Dr. Brandy Archie
Yes, my certification is not up to date, but I still know the knowledge is still in there. I just didn't pay them the money. But yes, certified low vision therapist.
Emilia Bourland
Got that. Gotcha. It's got, you know, you gotta gotta gotta pay him some money for those letters to keep those letters, right?
Dr. Brandy Archie
to keep those letters. So don't come for me. I know I'm not certified anymore, but I definitely have spent a good part of my career doing that.
Emilia Bourland
okay. What's, what do you got next for me?
Dr. Brandy Archie
okay. Yes. So let's see. What should you do if, let's see which one I'm going to ask you. Okay. Let's say my, can tell that my person is not eating well or eating enough. They live by themselves. Let's say they don't live with me. What are some strategies I can do to try to make sure that they're getting enough nutrition?
Emilia Bourland
I'm a little nervous.
Emilia Bourland
Okay, I love this question actually. And can I tell you, this was a question that I had on my list to ask you too.
Dr. Brandy Archie
Cause this is like real life stuff that we're dealing with on regular basis. Yeah.
Emilia Bourland
It is real life stuff that we deal with on a regular basis. And it's really important, obviously, for health, nutrition, but also eating is an important aspect of quality of life for people. So a lot of times when someone isn't eating, it is assumed it is because they have an appetite issue. And of course, sometimes that is the case. But a lot of the times it is because there are some access barrier to them eating.
Dr. Brandy Archie
Absolutely.
Dr. Brandy Archie
Mm-hmm, mm-hmm.
Emilia Bourland
whether it is that the environment is maybe if someone has a cognitive impairment, maybe the environment is too distracting to allow them to focus on eating. If they have a visual impairment, maybe it's that they can't see the food that's in front of them. So we need to make a modification to the way that food is presented. Right. Or maybe it's an issue with how do we actually get the food to the mouth.
Sometimes it's an issue with taste, et cetera. So we could go down, I could talk about that all the time. But what I'm supposed to be telling you is who you should actually call about this thing. So obviously, if someone is not eating and getting proper nutrition, we definitely want to talk to that person's primary care doctor if we have a concern about how much someone is eating. But we don't want to just stop there, right? We also, I really highly recommend
Dr. Brandy Archie
Lots of rabbit holes.
Emilia Bourland
having an occupational therapist come on board and take a look at the larger situation. It is highly possible. It's possible that a speech therapist might need to be involved. And I would say the occupational therapist is gonna be a good, if you have to have like one person in the door before the other, the occupational therapist is gonna be a good person to help flag. Okay, I think that we need to get speech involved here to see if there's some kind of swallowing issue or if there's an oral motor issue that's making it
difficult for this person to eat or to swallow. It's causing problems or nutritional intake issues. So occupational therapist, absolutely. Doctor, absolutely. Speech therapist, good likelihood that that is going to be a need too. And then also I would say dietician. I think registered dieticians are really underutilized, great partners in our health care system.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
experts on diet and nutrition. And they can also give really good tips for, okay, so maybe this person has to be on a low sodium diet, or there are certain things that they can't eat because of the medications they're on, right? That's really common. And so the dietician can give you good ideas for how to create an enjoyable diet for someone that is also going to meet their nutritional needs and help to make sure it's not gonna have any...
Dr. Brandy Archie
Mm-hmm. Mm-hmm.
Emilia Bourland
spent any kind of interactions or anything like that. So I would say that those are the, it seems like a simple problem, But like, talking about it, probably four people that there's, I'm gonna say at least two to three who really need to be involved in that and probably more likely four, depending on the situation. So what you should not do is you should
Dr. Brandy Archie
have a lot of root causes it could be.
Emilia Bourland
Probably you should not assume again that it's because this person is not hungry necessarily. Of course, appetite can be part of it, but I never want to assume that it's because someone's not hungry because so often I've seen that it's these other issues that really become involved when someone stops eating or doesn't want to eat. And then.
I guess the other thing I would say, this is sort of tangential. It's not directly related to like if someone stops eating. But the other thing I would say, if you feel like someone is having a problem eating, you don't want to take it in your own hands to like modify their diet on your own. Like if you think someone's having a problem swallowing, if you think someone's having a problem, you know, chewing or whatever, that is really something that you probably need to be working with like the doctor and the speech therapist.
about if there's a potential issue with something like that. So that's what I would say. When in doubt, reach out, get help, use your resources. For most problems, there is actually a really great expert out there who knows how to help solve this problem. The issue is that we're so siloed, it's hard to know who to talk to and to get connected with them. And that's kind of the purpose of this episode, right? It's like, if you're seeing these problems,
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
who that is.
Emilia Bourland
Here are the people that you can advocate for to actually help you solve a problem. Because there's someone out there who can help you solve it, who knows all about it. The challenge is, how do we get connected with them?
Dr. Brandy Archie
Mm-hmm. Mm-hmm.
Dr. Brandy Archie
Yeah. And one thing I would just add to that because that's a very complete answer is the why behind if you notice that swallowing is part of the problem that you shouldn't just modify on your own. Because the modifications aren't challenging to do, right? You can come up with soft foods or cut up meats or stuff like that. But what you don't want to have happen is there be aspiration happening where there's food still going into their lungs, which causes risk for pneumonia, which is like a downhill spiral a lot of times.
Emilia Bourland
Mm-hmm.
Dr. Brandy Archie
for people depending on their age and what the rest of their conditions are. And so while the speech therapist might evaluate and might decide that you need this level of consistency, all soft foods are not the same. And you need somebody to check because what you don't want to happen is pneumonia. And so that's much more likely than like choking and not being able to breathe. The pneumonia is much more likely. And there's all kinds of reasons why somebody might be less motivated to eat.
And so that's why an OT is really important to help like dive into the bottom of that and like ask questions or maybe just talk to your person and just ask. Cause that might be, it's too much work for me to walk over there. can't stand long enough. My balance is not good enough. I might not be hungry. My taste buds have changed. So the stuff that you've been buying me, I don't really like anymore. they don't, they're not enjoyable anymore. Cause my tastes have changed. So there's lots of reasons. So one other thing I would just add, like talk.
Emilia Bourland
Mm-hmm.
Dr. Brandy Archie
to the person and like take some time to like ask for real instead of proclaiming, hey, here's some insurer, drink this because you're wasting away, know, like talk.
Emilia Bourland
Yeah, for sure, for sure. The most important part of the care team is the person being cared for, right? And you, that person's direct care partner. Like, y'all are the center of the care team. So we can't exclude the person who actually needs care from any of these conversations. They have to be central to it and giving their input in whatever capacity they're capable of giving that input in. Like, they have to be a part of it.
Dr. Brandy Archie
Thanks.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
I actually, I do want to add a little bit, because you made me think of something else. Sometimes people also don't want to eat because eating is such a social activity, right? And sometimes, like eating by yourself or just having food handed to you, like, it's not as interesting that way. there anyway, point being, there are so many different reasons that people stop eating or start eating less. And so it really merits a good conversation and investigation from the right people in order to get down to the bottom of what's going on.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
And a lot of times we can affect really, really positive change in these situations.
Dr. Brandy Archie
Yep. Yep. Okay, what you got for me?
Emilia Bourland
Okay, okay, okay. What if the person that I care for keeps sliding out of their wheelchair? What should I do? Who should I call?
Dr. Brandy Archie
who should I call? Yeah, I should probably not tell you what to do, I guess. Okay, so the person.
Emilia Bourland
I mean, you can do a little bit of both. I can't help myself, clearly. I've been doing both.
Dr. Brandy Archie
Here's what I'm going to start with. If this wheelchair was purchased with insurance, you should have a wheelchair provider that gave that to you. And they are your teammate for the next five years until it's time for a new wheelchair. And so if that is how this wheelchair was acquired, you should call that company and tell them that. Because what they will do is send out a assistive technology professional or a tech or somebody.
to come and see if they can make some modifications for you to the chair. And there are a few different things that can be done to help modify a chair and make it easier to stay in it. When you make one change though, it affects something else. And so what I don't want you to do is to try to make those changes independently without having somebody to like bounce that idea off of, right? So I'll give a good example. Sometimes, most of the time your wheelchair is sitting at a 90 degree angle like this, this is the back of the chair is the seat.
And if that chair gets tilted like this by lowering the back axle, then it's a lot harder to get out of the chair or slide forward out of the chair. And that might be the answer, but that also might make it much harder to do transfers. And so you need to talk to a professional about it so you can be assessed and make a decision about what's thing to do. So that's the first thing I would say. If you don't, if there's no sticker on the chair,
and you don't know how to contact that person, I'm gonna go back to the old trusty handy OT because we're gonna figure that out and then also get to the root cause of what the problem is for why we're sliding out of the chair, because there could be many. And then an OT can be a great conduit to get to whoever else might be the next right person to help with the situation. Yeah, that's my short answer to what could be a complex problem.
Emilia Bourland
Okay.
Emilia Bourland
That's a good, short and sweet answer. think the, can I add just a little bit to that there? Like just in terms of why it's so important to appropriately address someone's seating system. And like sometimes like a wheelchair is a seating system, right? But like a seating system being the whole thing, like how are we supporting someone's body appropriately for like safety and function? That's how I think of this overall. And if we have someone sliding out of a chair, to your point.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
There could be a lot of reasons, but absolutely we have to address the underlying problems and make sure that that seating system is appropriate for them. Because if we don't, of course there's a risk of falls, falling on the chair, right? But there's also risk of wounds developing for that person.
Dr. Brandy Archie
Yes, because you're going back and forth like this sliding all day.
Emilia Bourland
Yeah, and did you know that wounds can develop from the inside out? So even if you are not seeing the wound on the skin first, particularly for these kind of wounds where it's like the bones of the pelvis that are rubbing on the soft tissue inside, that wound can actually develop almost from the inside out. And that can happen particularly when someone's seating system
is not appropriate for them. like the overall impact on health and wellness, but again, also back to quality of life, a good seating system helps support someone's function. It should make it easier for them to participate. It should make it easier for them to do things like feed themselves or brush their teeth or, or, you know, plant something in the garden or arrange the flowers or read a book. It should make it easier for them to
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Yeah.
Emilia Bourland
use their hands, their arms, the rest of their body as much as they can. You almost can't like overstate the importance of a good seating system. So yeah, okay, I'll stop now.
Dr. Brandy Archie
So let's get it right. And there's professionals that are specifically for that purpose to make sure that we get that seating system right so we can accommodate them well. The other thing I might also add to this is if it's...
Dr. Brandy Archie
It's also important to move. So some of it might be because they're getting weaker and their core is not holding them up as much as they should. And if that's the case, then maybe we need to add physical therapy so that we can improve that core strength and make sure we're as strong as possible. So those would be some solutions to deal with sliding out of the chair. But it's definitely a concern that you should deal with.
make it a real issue. It's not like an annoyance. It's an issue and it should be dealt with. That's what I'm trying to say.
Emilia Bourland
Yeah. Yeah. Yeah. I'm really glad that you brought up like that we can also make the person stronger a lot of the time too. And like, maybe that's part of the solution as well. Can I add one other like big do not do this to this one? Cause this is something that I have like seen and heard a lot and enough that it it's quite like frightening to me what we don't want to do if someone is sliding out of their chair. We do not
Dr. Brandy Archie
Mm-hmm.
No.
Okay.
Emilia Bourland
want to strap them in the chair. Like, don't use a gait belt to strap someone into a chair. Applying a seat belt to keep someone from sliding out of their chair is not going to be an appropriate solution, either for preventing injuries or falls or for any of the other things that are going to go along with that. like, go back to what Brandy said, do that. Strapping someone into a chair is
is not going to be the appropriate solution if they are sliding out.
Dr. Brandy Archie
I'm gonna push back on that a small bit because wheelchairs do come with seat belts. And sometimes it is important that if we, like I said, the core strength isn't as good as it used to be, we can try to strengthen it or maybe it's gonna get worse because of whatever diagnosis. We add support at the hips at the right place on the wheelchair to give that stability.
Emilia Bourland
Okay.
Dr. Brandy Archie
And that might be enough to create stability. I think what she's saying specifically is don't put a gait belt up here to try to keep them their back against the backrest so they're not sliding down. Because what can happen is they can slide down and choke themselves and still in that thing, especially if it's not a seatbelt that was made for the wheelchair. If the seatbelt's made for the wheelchair, you should try that because it's there for a reason.
Emilia Bourland
Yeah, yeah, I'm not saying that, obviously, seat belts can be important parts of seating systems, again. obviously, they can be an important part of that seating system. But what I have seen and what I've seen, unfortunately, is the inappropriate applications of those and just going straight to someone is sliding, let's strap them in. And to me, from my perspective, that should be
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Mm-hmm.
Emilia Bourland
That is an option, but it's part of fixing all of the other things that go along with it too. So it's not the thing that you do. It could be part of the thing that is like the overall solution. But I think, you know, just going like, okay, let's just, let's just strap them in there. That, that is not my first go to, I would always go back to your original device first. Like as you said,
Dr. Brandy Archie
Yeah.
Emilia Bourland
Call the vendor if you know who the vendor is and you got that wheelchair from the vendor and call an occupational therapist.
Dr. Brandy Archie
Mm-hmm. Yep.
Okay, should we do one more each?
Emilia Bourland
Okay. All right, yeah, let's try. I'll try to be shorter.
Dr. Brandy Archie
Okay, okay. What if you need a, what if you think you need a Grad bar installed? Who'd you call?
Emilia Bourland
If you think you need a grab bar installed, you should call an occupational therapist.
Dr. Brandy Archie
Not a contractor?
Emilia Bourland
No, you should not call a contractor first. Here's the reason why. Because I like pause there because I couldn't believe you threw me such a softball, Brandy. I was like, there's got to be there's got to be more to this. No, you should call an occupational therapist first. Contractors, of course, they're they're necessary in this process. We want to work with good qualified contractors. But the fact is that a contractor, even if they're cap strained, they are not
They are not healthcare providers who understand both the past, the now, and the likely future that's going to happen for a person. And they can't possibly understand all of the implications for a disease or disease process, or all of the functional implications for how and why that grab bar may or may not be used, right? That is the job of the occupational therapist. It is to literally see all of those possibilities
and apply them to you in your very specific picture or the picture of everyone in your household, right? Because grab bars are not often used by just one person. Like there's usually more than one person in that household that that bar might affect. So it is our job to go and look truly holistically at that situation, both now and how it's going to likely develop in the future and make the best possible recommendation for you, such that sometimes we might even recommend, actually, I don't think you have a grab bar here. Right.
Dr. Brandy Archie
Right?
Dr. Brandy Archie
Exactly. Yes.
Emilia Bourland
Sometimes a grab bar is not actually the solution. So call an occupational therapist first. Get that expert to work with you again as a partner to figure out what the real actual best solution is. And then after that, we want to call in the appropriate contractor or handyman to get the grab bar properly installed for you if the grab bar is actually what you needed in that location.
Emilia Bourland
That's it. That's all I got. Okay, let me look at another question for you. Okay.
Dr. Brandy Archie
That's it. That's the answer.
Emilia Bourland
Okay. So.
So what do you do if the person that you care for is having trouble managing their medicines? Who do you call?
Dr. Brandy Archie
Ooh, yes. Okay, there are multiple people who can be involved in this situation. The very first person I'm probably gonna want you to call is your primary care physician, because it's important that you actually go through all of those meds and see if all of those are still warranted. Because sometimes managing a bunch of meds is easier if you don't have as many to manage, right? Let's just see if we can cut them down some. A lot of times things get prescribed and then nobody ever thinks about.
can we come off of it? So if you're having this trouble, then this is a great touch point to be like, let's review the meds. So let's start there. The second thing I would say is then we need to figure out what's the root cause of the problem with managing the medications. Is it vision? Is it coordination? Is it memory? And once we figure out what that is, then we can come up with a tool that will work the best. And I'm saying this in this detailed way to say that, yes, you maybe could do this and problem solve this with your person.
but an occupational therapist is set up to do that specific thing. So that we come up with the right set of solutions for your person because it's not, I can't give you a blanket answer like buy a pill dispenser. know, like sure that might work, but it depends on what the reason is that managing them is challenging. And so that is what we are set up to do is to come up with those root cause analysis and come up with the simplest solution for it.
Emilia Bourland
And then, course, like you said, that also could involve phone calls to the doctor, maybe conversations with the pharmacist or whatever it is to see, depending on what those root causes are, how we can help simplify the situation. But yeah, OK.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
And I'll add a a small little bit in that, yes, things are prescribed a certain way for a very particular purpose, but with a conversation, you might be able to find some work around. For example, if remembering to take them twice a day is too much of a challenge, but they can maybe do it once a day on their own, maybe we talk to the doctor, say, is there any way to change these prescriptions so that they can just take them all one time? Because I'm there every morning, I can help her take them every morning. If I'm not there every night or whatever, the conversation is important because there is
sometimes a fair amount of flexibility in this, but that's not safe for you to do on your own. And so you need to have that conversation with the prescribing physicians or the pharmacists to at least understand what could be changed in order to make the situation of taking them easier.
Emilia Bourland
So is that you're like, what's your, but don't do this.
Dr. Brandy Archie
that's my don't do this. Don't change them yourself. Don't change what you take or when you take it, when your person takes it to try to make it easy on your own. It could be changeable, but don't do that on your own because they are very particular reasons for particular drugs. Changing to a once a day setup might mean changing the drugs entirely because the drug that you're currently on is set up to be twice a day and it works particularly in your body because of that. And that's super important. So definitely do not make any changes.
Emilia Bourland
Okay, yeah.
Dr. Brandy Archie
to the medication timing or amount on your own.
Emilia Bourland
Yeah, nailed it.
Dr. Brandy Archie
Boom. I hope that this was helpful to people. And if you have more of these scenarios that we can go through, we promise the answer is maybe not always call an OT, but it's the answer a lot of times because we are awesome and we're here to solve these problems. That's literally what our job is. But we put some other professionals in there too, so we're not 100 % biased. But yeah.
Emilia Bourland
Boom, done.
Emilia Bourland
I hope so too.
Emilia Bourland
Yeah.
Emilia Bourland
Well, if you yeah, and I do hope this this episode was helpful. Like Brandi said, if you have a particular question or scenario, definitely put it in the comments. We are happy to address that as as often and as well as we possibly can. If you made it all the way to the end of the episode, please make sure you are liking subscribing. Leave us a review. Share a comment. Those are the best ways to make sure that other people who could benefit from the information who might just think it's fun to listen to the podcast can actually find the podcast. So take a moment to do that.
Dr. Brandy Archie
Mm-hmm.
Dr. Brandy Archie
Exactly.
Emilia Bourland
that right now and we will see you next time right here on Care Lab. Bye.
Dr. Brandy Archie
Bye.
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