occupational therapy and vocational rehab · state vocational rehabilitation agencies • all 50...
TRANSCRIPT
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Occupational Therapy and Vocational Rehab
June 3, 2020
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CEU REQUIREMENTS
If you plan on requesting continuing education credits, you MUST complete all of the following steps:
1. You must have registered online for today’s session
2. Dial-in to the audio portion of the webinarPlease note that participants who “listen-in” on another participant’s line will NOT be eligible for credit.
3. Within 2 WEEKS of this session:
Complete the evaluation*
Complete the post-test & earn a passing grade*
*An email with links to the evaluation and post-test will be sentThursday afternoon (6/4/2020) by 5:00 pm ET.
**Certificates will be emailed within 4 weeks**
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SPEAKERS
Dorra Blacker, CRC, LMHCRusk Rehabilitation, NYU Langone Health
Gabrielle Miskovitz, OTR/L, CHT, CLT Memorial Sloan Kettering Cancer Center
This publication is designed to provide general information on the topics presented. It is provided with the understanding that the author is not engaged in rendering any legal or professional services by its publication or distribution. Although
these materials were reviewed by a professional, they should not be used as a substitute for professional services.
© Copyright 2020 Cancer and Careers, Dorra Blacker, CRC, LMHC, and Gabrielle Miskovitz, OTR/L, CHT
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AN OVERVIEW OF VOCATIONAL REHAB SERVICES
Dorra Blacker, CRC, LMHCRusk Rehabilitation, NYU Langone Health
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VOCATIONAL REHAB SERVICES AGENDA
• Vocational Counseling• Return to Work — Self-Assessment Techniques• Strategies for a Career Change• Diagnostic Vocational Evaluation• Job Placement Services• Community Resources
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VOCATIONAL COUNSELING
• Helping individuals with disabilities identify a realistic plan to achieve their highest vocational, academic or avocational goal
• Counseling addressing adjustment to disability within a vocational context — ”new normal”
• Return-to-work issues• Change-of-career strategies
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QUESTIONS ASKED DURING COUNSELING
• Will I be able to return to my job?
• How do I know if I can go back to work?
• What if I can’t do the same job as before?
• What if I can only do part of my job?
• What accommodations do I need?
• What do I tell my employer?• What other skills do I have? • What if I don’t want to return to my job?
• Should I give up my disability benefits?
• What do I put on a resume?
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CHALLENGES DEALING WITH TREATMENT; RETURN-TO-WORK ISSUES & RECOVERY
• Renewed goals• Physical and cognitive issues — “chemo brain” (cognitive deficits), fatigue, stamina
• Reasonable accommodations- ADA requests• Compensatory strategies• Financial concerns — medical benefits, long-term disability
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RETURN-TO-WORK ISSUES: SELF-ASSESSMENT
• Important to know your strengths and challenges• May experience cognitive or physical deficits• Fatigue issues — may now need to work part-time, flexible hours or a home-based job, frequent breaks
• May require more structured job duties, extra time for tasks
• Reduced distraction in work environment-quieter office, closer to restroom
• Less stressful work environment• Explore consulting opportunities
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CAREER CHANGE: INDEPENDENT SEARCH
• What do you want to do?• O*Net Interest Profiler — structured tool for career exploration, provided by the U.S. Dept. of Labor
• Computerized system to help identify strongest work-related interests
• Knowing interests can help decide the kinds of jobs & careers to explore
• Assists in identifying interests by responding to questions of likes & dislikes
• Interests & categories are revealed, not aptitudes or skill level
• Provides basic information to start career exploration
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OPPORTUNITIES WITHIN THE SAME FIELD
• Explore opportunities within the same field that provide more accommodations needed for functional purpose
• Reach out to current contacts• Coworkers, friends & family can be valuable resources• Contact professional organizations• Think outside the box• Examine your transferrable skills
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LEARNING ABOUT DIFFERENT CAREERS
• Informational interviews• Contact human resources departments• Contact friends and family• Contact professional organizations• Occupational Outlook Handbook• U.S. Department of Labor website• Take a continuing education course• Read college bulletins as to the direction the field is taking
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VOLUNTEER OPPORTUNITIES• Try out a new area of interest• Gain knowledge regarding job duties• Reveals your hidden strengths• Provides socialization and networking skills• Experience and qualifications to put on a resume (under Community or Work Experience)
• Provides a future reference• Excellent environment to assess stamina/cognitive issues
• Can lead to future job leads
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DIAGNOSTIC VOCATIONAL EVALUATION
• More formalized program sponsored by State VocRehab agency regarding return-to-work issues or forming a realistic vocational goal based upon skills, aptitudes and interests
Focus on:• Career development• Enhance self-awareness• Identify cognitive
processing style• Generate worker profile• Generate viable work
goals• Short-term program
• Provide academic/aptitude assessments
• Assess work stamina/endurance
• Assess cognitive status• Assess needed
accommodations and strategies
• Simulate job duties
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JOB PLACEMENT SERVICES
• Job applications and telephone contacts• Writing cover letters & resumes• Finding job leads and the hidden job market• Electronic job search• Social media sites• Interviewing skills & techniques• Disclosure/non-disclosure of disability• Reasonable accommodations• Job-retention & career-enhancement strategies
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CAREER INTERNSHIPS
Pre-requisites• Job goal• Appropriate work
behaviors• Job skills related to field• Job ready
Benefits• Obtain valuable work
experience and a current job reference
• Opportunity to refine and develop job skills
• Increase work stamina
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STATE VOCATIONAL REHABILITATION AGENCIES
• All 50 states, the District of Columbia, and the U.S. Territories have VR agencies
• Provides services to assist eligible individuals with disabilities to obtain employment
• Helps people prepare for and obtain a job
• Provides services (i.e.,: diagnostic vocational evaluation, training and placement)
• Career counseling• Rehabilitation and
assistive technology• Other services necessary
to achieve the employment goal
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REFERRALS AND RESOURCES
National Resources• Department of Labor: www.dol.gov• O*Net: www.onetcenter.org• Volunteer sites: www.idealist.org, www.volunteermatch.org• Google: State Vocational Rehabilitation Agency
– List of State VR Agencies: www.fda.gov/downloads/AboutFDA/WorkingatFDA/UCM277757.pdf• Job Accommodations: www.jan.org• U.S. Equal Employment Opportunity Commission: www.eeoc.gov
NYC Resources • ACCES-VR
• Vocational Rehab: Rusk Rehab, 212-263-6052 • [email protected]
Brooklyn 718-722-6700 Staten Island 718-816-4800
Manhattan 212-630-2300 Bronx 718-931-3500 Queens 347-510-3100
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AN OVERVIEW OF OCCUPATIONAL THERAPY SERVICES
Gabrielle Miskovitz, OTR/L, CHT, CLTMemorial Sloan Kettering Cancer Center
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OCCUPATIONAL THERAPY SERVICES: KEY TOPICS
• Posture• Home & Office Workstation Ergonomics• Tool Modifications• Cognitive Challenges• Strategies for Performance Improvement• Energy Conservation Tips
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WHAT IS OCCUPATIONAL THERAPY?“… a health profession whose goal is to help people achieve independence, meaning and satisfaction in all aspects of their lives.”
“The occupational therapist’s goal is to provide the client with skills for the job of living — those necessary to function in the community or in the client’s chosen environment.”
— http://steinhardt.nyu.edu/ot/definition/
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ROLE OF OCCUPATIONAL THERAPY IN CANCER CARE
“…to facilitate and enable an individual patient to achieve maximum functional performance, both physically and psychologically, in everyday living skills regardless of his or her life expectancy.”
– Penfold S, 1996
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COMMON PHYSICAL ISSUES
• Shoulder pain–Impingement–Rotator-cuff pathology–Adhesive capsulitis
• Elbow pain –Lateral/medial epicondylitis
• Joint pain–Wrists–Fingers
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• Dropping coins, utensils• Difficulty with fasteners• Difficulty using phone• Difficulty manipulating medications
CHEMOTHERAPY INDUCED PERIPHERAL NEUROPATHY
• Numbness• Tingling• Weakness• Cramping
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TREATMENT ACTIVITIES
• Theraputty• Fine Motor retraining• Sensory Re-education• Vibration
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ERGONOMIC ASSESSMENT FOR WORK & HOME
• Workstation setup–Monitor–Keyboard, mouse–Phone
• Seated posture–Back support–Foot support
• Person/tool interface–What is the movement pattern?
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ERGONOMIC TOOLS FOR WORK & HOME
• Keyboard and mouse
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COMMON COGNITIVE CHALLENGES
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MEMORY
• Lost items (e.g., keys, glasses)• General “forgetfulness”• Medications — missed doses• Forgotten conversation/interactions
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MEMORY STRATEGIES
• Categorization• Context• Visualization• Verbalization
• Rehearsal• Repetition• Phone alarms
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ATTENTION
• Breakdown with multi-step activities – meal preparation
• Difficulty reading the newspaper
• No longer reading books• Difficulty with activities later in
the day
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ATTENTION STRATEGIES
• Avoid multitasking – One task at a time
• Challenging tasks – When energized
• Avoid distractions– Earbuds/Earplugs
• Chunking
• Outlining• Focus questions
– What is my point?– What is my plan?– What did I just read/
learn?
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ORGANIZATION
• Medication management
• Community access• Household
management• Multiple work projects
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ORGANIZATION STRATEGIES
• Visualize directions before community access
• Energy-conservation techniques
• Day Planner• Set time limits• Color coding
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• PowerPoint presentations• Managing email• Coping with distractions• Meetings
WORK TASKS
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• Practice use of software program• Immediate notes after meetings• Plan each day
– Periodic email checks– Time limits
WORK TASKS STRATEGIES
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OTHER SYMPTOM SOLUTIONS
• Fatigue mat • Heating / cooling vest • Compression garments• Exercises to increase strength • Mobility solutions • Reaching tools• Get creative!
– What do you need to function best in your work environment?
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ENERGY-CONSERVATION TECHNIQUES
• Seated position• Rest breaks• Gather materials
• Pace activity• Minimize overhead
reaching• Breathe
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WHAT CAN I DO FROM HERE?
• Symptom modulation• Set realistic daily goals• Activity Analysis
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WHERE CAN I GO FROM HERE?
• Tips for finding an OT near you– Must have a doctor’s referral– Check local hospital outpatient rehabilitation
therapy services– Contact state OT association
• http://www.aota.org/advocacy-policy/state-policy/state-ot-associations.aspx
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WHERE CAN I GO FROM HERE?
• AOTA – www.aota.org/About-Occupational-Therapy/Patients-Clients.aspx
• Other National Resources– Oncology OT Fact Sheet: http://www.aota.org/-
/media/corporate/files/aboutot/professionals/whatisot/rdp/facts/oncology%20fact%20sheet.pdf
– Peripheral Neuropathy: http://jama.jamanetwork.com/article.aspx?articleid=185714– Cognitive Challenges: http://jama.jamanetwork.com/article.aspx?articleid=182657
• MSKCC Survivorship Articles and Videos– www.mskcc.org/playlists/neuropathy-care-survivors– www.mskcc.org/blog/managing-chemotherapy-induced-peripheral-neuropathy-after-
treatment
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SUMMARY
• When to seek OT/VR services?• Strategies to improve tolerance and performance of
work– Postural principles– Ergonomics– Cognitive strategies– Energy-conservation techniques
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UPCOMING CAC EVENTSBALANCING WORK & CANCER WEBINAR SERIES ENHANCING YOUR SKILLS: PREPPING FOR SUCCESS
Wednesday, July 8 at 1 PM ET/10 AM PT
Body Confidence, Self-Confidence in the Workplace
Wednesday, August 5th at 1 PM ET/10 AM PT
Setting Boundaries
Wednesday, September 9th at 1 PM ET/10 AM PT
Newly Diagnosed: Getting Started
Wednesday, October 7th at 1 PM ET/10 AM PT
Health Insurance Options
Wednesday, November 4th at 6 PM ET/3 PM PT
Communicating Effectively: Tips and Techniques
Wednesday, December 9th at 1 PM ET/10 AM PT
NATIONAL CONFERENCE 10th Annual National Conference on Work & Cancer
Friday, June 19th at 8:45 AM ET
VIRTUAL PROGRAMSAsk the Experts with Julie Larson, LCSW
Thursday, June 4th at 1 PM ET/10 AM PT
Ask the Experts with Matthew Leone, CFP
Thursday, June 11th at 1 PM ET/10 AM PT
Networking During Social Distancing
Thursday, June 25th at 1 PM ET/10 AM PT
Ask the Experts with Kathy Flora, MA, NCCC
Tuesday, June 30th at 1 PM ET/10 AM PT
Visit www.cancerandcareers.org/en/community/events for a full list of 2020 events.
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CEU REQUIREMENTS
If you plan on requesting continuing education credits, you MUST complete all of the following steps:
1. You must have registered online for today’s session
2. Dial-in to the audio portion of the webinarPlease note that participants who “listen-in” on another participant’s line will NOT be eligible for credit.
3. Within 2 WEEKS of this session:
Complete the evaluation*
Complete the post-test & earn a passing grade*
*An email with links to the evaluation and post-test will be sentThursday afternoon (6/4/2020) by 5:00 pm ET.
**Certificates will be emailed within 4 weeks**