CANADIAN ASSOCIATION OF OCCUPATIONAL THERAPISTS CONFERENCE 2007

1. CANADIAN ASSOCIATION OF OCCUPATIONAL THERAPISTS CONFERENCE 2007 OCCUPATIONAL THERAPISTS IN THE 21ST CENTURY: KNOWING THE WAY SHOWING THE WAY July 11, 2007

2. The rules break like a thermometer … Quicksilver spills across charted systems. We’re out in a country that has no language, no laws, Chasing the raven and the wren through gorges unexplored since dawn. Whatever we do together is pure invention. The maps they gave us were out of date by years. Adrienne Rich,Twenty-one Love Poems

4. How can we dare Wisdom in the mosaic of our realities? Inès Maria dell’ Eucaristia

5. OVERVIEW OF REFLECTIONS • Setting the Context • Mosaic of our Realities • Expectations of Canadians • Occupational Therapists as Leaders • Readiness for and Response to Trust Given You

6. CHANGES IN WESTERN SOCIETY • Demographic shifts • Increasing urbanization • Increasing cultural diversity • Impact of computerization • Culture of consumerism • Increasing gap between rich and poor • Role of women • Realities of violence and poverty • Understanding of health of environment • Expectations of public service • Credibility of leaders

7. CHANGING UNDERSTANDING OF HEALTH Health is a state of complete physical, emotional, social and spiritual well-being; it is a resource for everyday living. Examples of Implications: • Value of one’s own experiences • Social, psychological and spiritual factors • Gender as health determinant • Health of person, family, community, population and earth

8. CHANGING HEALTH PROFESSIONS • Advances in science and technology • Growing educational opportunities • Changes in law re scope of practice and responsibilities • Loss of control over working conditions • Expansion of guidelines, expectations and recommendations from professional associations • Focus on evidence-informed practice • Shift from profession-centred to patient-centred culture

9. CHANGING HEALTH PROFESSIONS • Blurring professional boundaries • Increased expectations of inter-professional collaboration in education and practice • Increasing demands for accountability and transparency • Internationalization • Move from traditional inward-looking, reactive culture to outward-looking, proactive culture

11. CONCERNS OF PEOPLE • Staying healthy: Will I be able to stay as healthy as possible-through education, health promotion, preventive services, and early detection of disease? • The basics: Will I have access to needed services and will I be treated respectfully and understand what is said to me? • Getting better: If I get sick, will I get better and regain normal functioning? • Living with illness: If I suffer from a chronic condition will I be able to maintain the best possible functioning? • Changing needs: As I face death or disability in my family, will we be able to cope? Lansky, 1998

12. VULNERABLE POPULATIONS • Aboriginal people – poor health status, poverty, violence, substance abuse, lower life expectancy • Lone parents – poverty, financial stress, food insecurity, violence and emotional abuse • Rural women – higher mortality rates • Incarcerated persons – exposure to HIV/AIDS, antibiotic-resistant tuberculosis, hepatitis C, sexually transmitted diseases • Young women – most vulnerable to health risks: smoking, alcohol abuse, anorexia, violence and emotional abuse, depression, AIDS/HIV Women’s Health Surveillance Report (CPHI –CIHI, 2003)

13. CHILDREN AT RISK • Aboriginal children • Children with disabilities • Children living in remote communities • Children of single parent families • Children in the welfare system • Children of recent immigrants and • Refugee children

15. WHAT DO WE CITIZENS EXPECT? • Rights – People have a right to health and health care • Balance – Care of individual patients is central, but the health of populations is also our concern • Comprehensiveness – In addition to treating illness, we have an obligation to ease suffering, minimize disability, prevent disease, and promote health • Cooperation – Health care succeeds only if we cooperate with those we serve, each other, and those in other sectors • Improvement – Improving health care is a serious and continuing responsibility • Safety – Do no harm • Openness – Being open, honest, and trustworthy is vital in health care Tavistock Principles (2001)

16. ROLES OF OCCUPATIONAL THERAPISTS AS LEADERS • Visionary – musician, artist • Catalyst – prophet, disturber of the peace • Partner – one who reaches out, finds gifts in others, appreciates diversity • Decision-maker – one who makes the decision even if difficult

17. ROLES OF OCCUPATIONAL THERAPISTS AS LEADERS • Inspirer – spirit creator, calling forth the good • Facilitator – one who draws forth the energy, hopes, action of the group • Implementer – doer of the often difficult deeds • Evaluator – not just the one who measures but one who celebrates wins, learns from losses

18. OCCUPATIONAL THERAPISTS AS THERAPISTS • Manage diversity within your profession • Respond within changing social realities • Be inclusive • Understand globalization and health care reform • Reintroduce values of flexibility, discovery and innovation • Tell stories • Create environments allowing creativity, questions, risk

19. OCCUPATIONAL THERAPISTS AS RESEARCHERS • Research • Interdisciplinary and collaborative • qualitative and quantitative • investigative and evaluative • Input and participation of therapists at every stage of research process • Link with wider national and international professional community • Research agenda = gender-sensitive and inclusive • Recognition of diverse communities of therapists • Increased number of OT researchers • Means of transforming research results into health policy and practice

20. OCCUPATIONAL THERAPISTS AS VISIONARIES • Stretch into new ways of thinking • Leave behind what is no longer appropriate • Interconnect practice, education, administration, and research • Value your networks • Re-inspire your spirit

22. ELEMENTS OF RESPONSE • Vision • Values • Relationships • Value of Tradition • Celebration

23. VISION • Had, held, shared, grown • “Something significant left to do” • Vision Community

24. OCCUPATIONAL THERAPY VISION Occupational therapy is a health profession concerned with promoting health and quality of life through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists work collaboratively with people of all ages and abilities who experience challenges or obstacles to participation. These obstacles may be caused from an impairment of body structure, a change in function, or from barriers in the social and physical environment.

25. VALUES Values are sets of freely chosen convictions which compel action as they are cherished and publicly affirmed. Charles McCoy

26. Occupational therapists believe About occupation, • occupation gives meaning to life • occupation is an important determinant of health and wellbeing • occupation organizes behaviour • occupation develops and changes over a lifetime • occupation shapes and is shaped by environments • occupation has therapeutic effectiveness

27. Occupational therapists believe About the person, • humans are occupational beings • every person is unique • every person has intrinsic dignity and worth • every person can make choices about life • every person has some capacity for self-determination • every person has some ability to participate in occupations • every person has some potential to change • persons are social and spiritual beings • persons have diverse abilities for participating in occupations • persons shape and are shaped by environment

28. Occupational therapists believe About the environment, • environment is a broad term including cultural, institutional, physical and social components • performance, organization, choice and satisfaction in occupations are determined by the relationship between persons and their environment About health, • health is more than the absence of disease • health is strongly influenced by having choice and control in everyday occupations • health has personal dimensions associated with spiritual meaning and life satisfaction in occupations and social dimensions associated with fairness and equal opportunity in occupations

29. Occupational therapists believe About client-centred practice, • clients have experience and knowledge about their occupations • clients are active partners in the occupational therapy process • risk-taking is necessary for positive change • client-centred practice in occupational therapy focuses on enabling occupation

30. RELATIONSHIPS • Wholeness • Inclusion • Interconnectedness • Interdependence • Enculturation • Appreciation of diversity

31. I’m sittin’ on my stage-head lookin’ out at where Skipper Joe Irwin’s schooner is ridin’ at her moorin’ … thinkin’ about how weak are the things that try to pull people apart – differences in colours, creeds and opinion – weak things like the ripples tuggin’ at the schooner’s chain. And thinkin’ about how strong are the things that hold people together – strong, like Joe’s anchor, and chain, and the good holdin’ ground below. Ted Russell, The Holdin’ Ground

32. RESPECTING THE TRADITION • Image of the dory • Strengths of the past

33. READINESS TO RESPOND • Awareness of complexity • Skills development • Strengths of tradition • Emotional preparedness • Reflection • Ceremonies and celebration • Symbols • Confidence/conviction

35. Beannacht ("Blessing") May the light of your souls guide you. May the light of your souls bless the work that you do with the secret love and warmth of your hearts. May you see in what you do the beauty of your own souls. May the sacredness of your work bring healing, light and renewal to those who work with you and to those who see and receive your work. May your work never weary you. May it release within you wellsprings of refreshment, inspiration and excitement.

36. May you be present in what you do. May you never become lost in bland absences. May the day never burden. May dawn find you awake and alert, approaching your new day with dreams, possibilities and promises. May evening find you gracious and fulfilled. May you go into the night blessed, sheltered and protected. May your souls calm, console and renew you. Adapted from John O'Donoghue, Anam Cara