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Embracing Challenges, Enhancing Participation

 
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What is Participation?

Participation is the “involvement in a life situation”. It involves having adequate accessibility to resources for the engagement in work, play, or activities of daily living that are meaningful or necessary to one’s wellbeing.

(Source: World Health Organisation, 2001 and Larsson-Lund & Nyman, 2016)


 

Built

  • Architectural structure (e.g. sidewalks, roadways, stations)
  • In consideration of individual's physical and cognitive accessibility, social / communication, sensory impairments
 

Natural

  • Climate and weather conditions in the natural environment (e.g. rain, heat, cold, outdoor air quality)
  • Geographic location (urban / rural)
  • Topographic features of the environment (hills, elevation, outdoor spaces, ground cover)
 

Transportation

  • Vehicular travel from one location to another via
    • private (e.g. driving self, others drive)
    • public modes (e.g. buses, train)
    • alternative transit systems (e.g. taxis, planes, boats)
 

Assistive Technology

  • The use and availability of specialised devices/products/tools to facilitate participation in everyday activities
    • Mobility devices (e.g. wheelchairs, scooters, walkers, canes)
    • Activities of daily living equipment (e.g. reachers, bathing and toileting equipment)
    • Home modifications (e.g. installations of grab bars, ramps or lift)
    • Specialised communication and technology access (e.g. augmentative communication devices
 

Information and Technology Access

  • Devices and technology to access information
  • Usability of information (e.g. user interface, literacy level, ease of navigation and accessibility options)
 

Social Support and Societal Attitudes

  • Social support:
    • availability of physical assistance
    • material support
    • emotional supports
    • networks
  • Societal attitudes:
    • perception towards disabilities (positive and negative)
    • towards overt disabilities vs less detectable features (e.g. cognitive / communication issues)

(Source: Hammell, 2015)



As Occupational Therapists (OT), we use occupations as our interventions, such as self-care, play, leisure, school and work. OTs are heavily involved in rehabilitating patients and helping them attain independence, or to maintain and retain as great a level of functional ability as possible. Participating in meaningful life occupations continue to be as important in human who suffer from a progressive physically disabling disease, psychiatric disorders or pandemic changes like COVID-19.

  • Educate

    To impart knowledge and information about participation to enable individual to acquire meaningful activities.

  • Advocate

    Advocacy focuses on improving function, providing education and ensuring access to services and supports. The role of advocacy for OTs is to share the distinct value of OT, speak out to achieve reform in healthcare policies, and help patients receive needed services when they encounter obstacles.

  • Empower

    To focus on facilitating the participants to understand themselves as occupational beings and the relationship between participants and their health.

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Role of OT - Educate

Role of OT - Advocate

Role of OT - Empower



 

How has your life been affected by disability, illness or COVID-19?

Disability, illness and COVID-19 can hamper and affect our routines, lifestyle, work, income and future plans. Generally, many of us are trying to adapt to this new normal to the best of our ability. For the elderly frail and people with disability, they are more disproportionately affected. Let's walk you through the concept of participation to understand and identify the enablers and barriers in our environment, and how an Occupational Therapists can guide us to resume the activities we used to enjoy, in the following story.

 

Mr Ali is a 60 year old gentleman who enjoys sports and led an active lifestyle. He participated in Tai Chi almost daily with his friends. He had a stroke that resulted in weakness in left arm and leg.

 

He now requires assistance in his activities of daily living (ADLs). He is upset and experiencing low mood, as he has lost the ability to go out and most importantly he is unable to do Tai Chi with his friends.

 

For Mr Ali, his participation was in sports and Tai Chi previously. But stroke robbed him of his ability to participate in his familiar occupation.

In Occupational Therapy, "Occupation" is defined as:

Everyday activities that people do as individuals, in families and with communities to occupy time and bring meaning and purpose to life. Occupations include things people need to, want to and are expected to do. (Source: WFOT, 2012)

 

As we read in the story, Mr Ali is upset that he loses his ability to do sports and Tai Chi. In essence, Mr Ali is experiencing "participation restriction": which is defined as "Problems an individual may experience in involvement in life situation."

Continuing with Mr Ali's story, by understanding his environment better and identifying if they are facilitators or barriers to his occupations, he will be able to participate in the meaningful occupation post stroke.

  • Facilitators

    Assistive Technology
    Mr Ali is prescribed a light-weight wheelchair for community outing.

    Information and Technology Access
    Mr Ali has the opportunity to access information.

    Social Support and Social Attitudes
    Mr Ali has a group of friends who motivates him to continue with his Tai Chi.

  • Barriers

    Built
    Mr Ali is unable to push his wheelchair in and out of his home due to the curb at the main door.

    Transportation
    Mr Ali is unable to access public transport alone due to train plaform gaps or steps leading to buses.

  • Recommendation

    Modification of main door curb to fit a ramp.

    Explore use of wheelchair accessible routes and transportation.

    Be empowered to approach people around to ask for assistance.

​

 

Mr Ali's understanding of Participation and the influencing factors alongside the collaboration he had with his Occupational Therapists has enabled Mr Ali to resume participation in sports and Tai Chi.




Explore these resources to help improve your daily life Participation.

Disclaimer: The sites and applications shared here are for reference and informational purposes only. It is not intended as substitute for professional advice and it does not imply any affliation with or endorsement by Tan Tock Seng Hospital.

Category

Organization

Services/ Description

Smart Home Technology

Koble

The Koble Smart Home system was launched in 2017 - a platform accessible by voice and by a phone app that seamlessly connects everything in a home anywhere, at any time.

Our services including:  Automated Curtains, Blinds & Gate, Security & sensor, Lighting, Air Conditioner & Switches (connected to phone app)

Sports 

Special Olympics Singapore

The charity provides year-round sports training and athletic competition in a variety of Olympic-type sports for persons with intellectual disabilities. 

Sports 

Paracycling Federation Of Singapore

To develop disabled athletes by promoting para cycling as a competitive sport, as a recreational activity and as a means of rehabilitation for persons with disabilities.

Sports 

Para Athletics (Singapore)

As part of promoting a healthy lifestyle, the PAS offers opportunities to take up sport for people with disabilities. As a result, they can pursue their sport interests in Singapore on a competitive level. Through strength and conditioning programmes, education, and rehab, PAS addresses each person's needs individually.

Sports 

OnWheels Dance Group

Wheelchair dance group formed by a group of physically challenged

Transportation

Vimo services

Aimed to bring affordable essential medical rides to those in need with our limited means.

It is just another way for us to return to society quietly.

Leisure

Edible Garden City

Edible Garden City is a social enterprise dedicated to creating social change through community-centric agriculture. We teach and support fellow urban farmers and hires from disadvantaged communities, and delivers therapeutic horticulture programmes that improve wellbeing.

Leisure

ARTDIS (Singapore) Ltd

ART:DIS, formerly known as Very Special Arts Singapore, is a leading charity dedicated to creating learning and livelihood opportunities for persons with disabilities in the arts. Started in 1993, ART:DIS organises art programmes, workshops, projects, collaborations, exhibitions and performances for persons with disabilities so that they may express themselves, gain confidence and be part of a community that is rewarding&.

Meaningful games and activities 

Silver activities

Silver Activities develops easy-to-use products and services for the elderly to enable increased independence, avoid social isolation, and stay engaged. Silver Activities products include Silver Pad with cognitive games, dementia-friendly worksheets, digital games and activities.

Meaningful games and activities 

AIC

We reach out to caregivers and seniors with information on staying active and aging well, and connect people to services they need. We support partners in strengthening their capability to deliver quality care, and bring partners together to meet the needs of our ageing population. Our work in the community brings care services and information closer to those in need.

Our services include: Financial assistance, Care services, Caregiving training services and Toolkit and booklet for activities engagement. 

Meaningful games and activities 

Fast Tap (Android)/ Fast Tap 30 (iOS)

  • Finger tapping as many times as possible in a pre-fixed time period.

  • Encourages speed of movement and can be performed with one or more fingers.

Meaningful games and activities 

Balloon Frenzy (Android)/Balloon Pop (iOS)

  • Tap and pop the balloon.

  • Finger dexterity, fine motor weakness and neglect.

  • Works on eye-hand coordination.

Meaningful games and activities 

Tap the Tile Challenge (iOS)

  • Tap on single tiles wherever it appears on the screen within 30 seconds.

  • 3 modes of difficulty.

  • Works on finger dexterity and eye hand coordination.

Meaningful games and activities 

Bowling 3D
(Android and iOS)

  • Swiping motion with single finger (finger isolation) and ability to drag finger across the screen.

  • Encourages eye hand coordination and accuracy.

  • Encourages wrist movements.

  • Able to play as double players , which encourages social interaction as well.

Meaningful games and activities 

Paper Throw – Aim and Toss (Android and iOS)

  • Swiping motion with single finger (finger isolation) and ability to drag finger across the screen.

  • Encourages eye-hand coordination and accuracy . Encourages wrist movements.

  • High success rate, good to start with to increase confidence.

Meaningful games and activities 

iTrace (iOS)

  • Finger movement across the screen to trace alphabets and letters.

  • Encourages eye hand coordination, finger control and stroke sequencing. 

  • Intuitive and user friendly interface, but may be too childish for adults.

Meaningful games and activities 

Word Tracer – Learn Chinese (iOS)

  • Finger movement across the screen to trace Mandarin characters.

  • Encourages eye hand coordination, finger control and stroke sequencing. 

  • May be suggested for adults that are more familiar with Mandarin letters.

Meaningful games and activities 

Chinese Alphabet, Chinese Letters Writing (Android)

  • Finger movement across the screen to trace Mandarin characters.

  • Encourages eye hand coordination, finger control and stroke sequencing. 

  • May be suggested for adults that are more familiar with Mandarin letters.

Meaningful games and activities 

Classic Labyrinth (Android)/Labyrinth (iOS)

  • Tilting of the screen to get ball to go through maze

  • Hand control, wrist/forearm stability and bilateral hand use.

Meaningful games and activities 

Rolling Balls into hole (Android)

  • Tilting of the device to get the balls into a single hole. 

  • Encourages hand control, wrist and forearm stability.

  • Can be used with single or bilateral UL depending on type of device use. 

Meaningful games and activities 

Lumosity (Android and iOS)

  • Variety of games that focuses on attention, memory, executive functions, language and speed.

Meaningful games and activities 

Peak (Android and iOS)

  • Games are focused on specific areas such as planning, problem solving and memory.

Meaningful games and activities 

NeuroNation (Android and iOS)

  • Exercises targeted at reasoning, attention, memory and speed.

  • Free version allows access to few selected games and allows users to choose the exercise to work on.

Meaningful games and activities 

Visual Attention therapy lite (Android and iOS)

  • Practice Left to right scanning. 

  • Visual attention- neglect, inattention training.

Meaningful games and activities 

Flow Free (Both Android and iOS)

  • Spatial activity requires users to connect same-colored dots without overlapping the connecting lines.

  • Visual-spatial, problem-solving training

Meaningful games and activities 

Attention Test (Android)

  • Schulte table.

  • Visual attention, speed of reading training.

Meaningful games and activities 

FamilyWall – Family Organizer (Android and iOs)

  • Basic version: Shared Calendar, Shopping & Grocery lists, Family Locator, Photo/Video Albums, secure and private messenger. 

  • Allows for included members within the application to share and provide reminders for important events

  • Useful for individuals with memory deficits

Meaningful games and activities 

Medisafe (Android and iOS)

  • Provides pill reminders and alarm for all medication needs.

  • Provides information on the drug and checks on drug-to-drug interaction.

  • Peer support via “Medfriend” functions. 

  • Provides refill reminders when supply runs low.





















2023/12/26
Last Updated on