First, cross her arms in front of the chest
The carer should extend her arms under the elder's armpits
and hold her forearms gently
Do not grab too forcefully or it might cause injury
Note that both the elder and the carer should lean their bodies slightly forward
The carer supports the shoulders of the elder from underneath with her forearm
Do not press on her chest or pull her forearms
Never pull backwards in a jerky manner
or it may cause injury to the elder and yourself
The carer should keep her back straight and
put one leg forward to stand with knee bent at wide base
If the elder can cooperate, the carer should give command
Support her with your forearms and help her to sit up straight in the chair
The elder does not need to stand up completely
She only needs to lift her buttocks slightly off the seat
Get into position with the forearms as support
the carer can straighten her back
tighten up the abdomen and bend the knees
Remember to propel with the lower limbs
As long as you extend the lower limbs slowly
you can easily help the elder to sit up straight against the backrest
(source: Department of Health)
2017年3月26日星期日
From bed to chair: front approach
The first case is an elder with weak legs
Help her sit up straight with the whole back against the back rest
First of all, remove all obstacles
Help the elder to be prepared, such as putting on shoes
Don't forget to assess her physical condition
If the height of the bed can be adjusted, adjust it to the level of the wheelchair
Explain what you're going to do to the elder
Pull the wheelchair closer
Get it close to the bed at 90 degrees
Then lock the wheels
And ask her to sit as close to the edge of the bed as possible
If she needs help, the carer can support her shoulder with one arm
and support the bottom of her hip bone with the other hand
Then squat with one leg forward
Propel with your lower limbs
and keep the back straight while you are moving her forward
Move each of her left and right side forward a little at a time
Position her feet properly with the knees more or less directly above the toes
Guide her to position her arms correctly
It is important that she does not pull at the carer
otherwise both of you might lose balance and get injured
The carer should support the elder's shoulders firmly
One way of doing this is to support them with your forearms
Pay attention to the carer's arm movement when she is supporting the shoulder blades of the elder
As for posture, the carer must keep her back straight
Tighten up the abdomen and bend knees slightly
Depending on the strength of the elder's lower limbs
the carer can use different methods to support her knees with your knees
Stand with wide base
The forward foot should point to the elder
the rear foot should point to the wheelchair
Then the carer should give the command "one, two, three"
Lift the elder with your arms
Remember to propel your upper body with your lower limbs at the same time
When her buttocks have just got off the bed
you can transfer her to the wheelchair
Note that during the course of transfer
the elder's body does not have to be completely standing straight
(source: Department of Health)
Help her sit up straight with the whole back against the back rest
First of all, remove all obstacles
Help the elder to be prepared, such as putting on shoes
Don't forget to assess her physical condition
If the height of the bed can be adjusted, adjust it to the level of the wheelchair
Explain what you're going to do to the elder
Pull the wheelchair closer
Get it close to the bed at 90 degrees
Then lock the wheels
And ask her to sit as close to the edge of the bed as possible
If she needs help, the carer can support her shoulder with one arm
and support the bottom of her hip bone with the other hand
Then squat with one leg forward
Propel with your lower limbs
and keep the back straight while you are moving her forward
Move each of her left and right side forward a little at a time
Position her feet properly with the knees more or less directly above the toes
Guide her to position her arms correctly
It is important that she does not pull at the carer
otherwise both of you might lose balance and get injured
The carer should support the elder's shoulders firmly
One way of doing this is to support them with your forearms
Pay attention to the carer's arm movement when she is supporting the shoulder blades of the elder
As for posture, the carer must keep her back straight
Tighten up the abdomen and bend knees slightly
Depending on the strength of the elder's lower limbs
the carer can use different methods to support her knees with your knees
Stand with wide base
The forward foot should point to the elder
the rear foot should point to the wheelchair
Then the carer should give the command "one, two, three"
Lift the elder with your arms
Remember to propel your upper body with your lower limbs at the same time
When her buttocks have just got off the bed
you can transfer her to the wheelchair
Note that during the course of transfer
the elder's body does not have to be completely standing straight
(source: Department of Health)
Knowledge of soap
Biodegradable soap is not biodegradable
when it ends up in a river or lake because it requires soil for it to breakdown
properly.
(Source: backcountryattitude.com)
2017年3月19日星期日
To define volt
Under the action of a battery, charges of
opposite sign move in opposite directions and so a convention for current
direction has to be chosen.
One coulomb (C) is the quantity of electric
charge carried past a given point in a circuit when a steady current of 1
ampere flows for 1 second.
If a steady current I (in amperes) flows
for time t (in seconds) then the quantity Q (in coulombs) of charge that passes
is given by: Q=It
The charge on an electron is 1.60 X 10-19
C
Consider a conductor of length I and
cross-section area A having n ‘free’ electrons per unit volume each carrying a
charge e:
Volume of conductor = Al
Number of ‘free’ electrons = nAl
Total charge Q of ‘free’ electron = nAle
I = Q/t = nAle/t
Drift velocity, v = l/t, therefore t = l/v
I = nAle/(l/v) = nAev
v = l/nAe
The potential different V between two
points in a circuit is the amount of electrical energy transformed into other
forms of energy when unit charge passes from one point to the other.
The unit of potential difference is the volt
(V) and equals the p.d. between two points in a circuit in which 1 joule of
electrical energy is transformed when 1 coulomb passes from one point to the
other.
If a charge of Q (in coulombs) flows in a
part of a circuit across which there is a p.d. of V (in volts) then the energy
charge W (in joules) is given by: W = QV
W = ItV
Duncan, T. (2003). Advanced Physics For
Hong Kong. London: John Murray (Publishers) Ltd.
In physics, the electron-volt is a unit of
energy equal to 1.6×10−19 J. By definition, it is the amount of
energy gained (or lost) by the charge of a single electron moving across an
electric potential difference of one volt.
(en.wikipedia.org)
2017年3月12日星期日
Personal statement
When I was a student in PolyU HKCC,
one of our lecturers encouraged us to join voluntary activities. My classmates
and I participated voluntary work at Elderly Resources Centre under Hong Kong
Housing Society. This centre is operated by occupational therapists and social
workers. It provides body function tests like blood pressure, body mass index,
hearing, vision, and stretching ability for old people. Other than above
physical examinations, elderly’s cognitive functions like memory and attention
are also assessed. Because of this voluntary work, I connected with some
occupational therapists and realized the working nature of occupational therapy
under elderly service. I understood that old people have to deal with
progressive mental deterioration like dementia besides physical health. This
will be one of the main tasks of occupational therapists due to the ageing
population in Hong Kong.
Although I finished my bachelor
degree in nursing, I chose not to be a registered nurse. The main reason is
that I have the problem of hand tremor under medication influence. Meticulous
hand movement is needed for a nurse but I cannot meet this requirement. I
decide to study occupational therapy because my enthusiasm of healthcare
towards elderly and people in need has not diminished. I developed the
characteristic of patience during nursing placement and it is essential for an
occupational therapist in providing care. Moreover, I learnt the general
knowledge of different kinds of diseases such as Alzheimer's disease and mental
illness in nursing program. Fall risk assessment is also covered in my previous
learning.
Before working as a temporary occupational
therapist assistant, I completed an occupational therapy assistant training
course organized by Hong Kong Association of Gerontology. One of the most
useful skills learnt is lifting and transfer. This ensures the safety of
patient and practitioner both. Now, I am working as a customer service
executive in a university bookstore. My interpersonal skill, communication
skill and time management ability are enhanced under working experience. I
learn how to organize my work in a systematic way. I believe these experiences
are useful for my future career as an occupational therapist.
Fossil fuels, clean power and nuclear energy
In the 20th century, crude oil and coal are used as energy source for the industrial revolution. It's not a successful civilization. Plastic is a by-product of crude oil and it is an indicator of imperfect development. Carbon dioxide is a by-product of combustion of coal and other fossil fuels. It causes global warming and rise of sea level.
Natural gas and liquefied petroleum gas are used commonly in recent years. However, they are not renewable energy source and carbon dioxide will also be produced.
With 8.8 MeV binding energy per nucleon, iron-56 is one of the most tightly bound nuclei.
Natural gas and liquefied petroleum gas are used commonly in recent years. However, they are not renewable energy source and carbon dioxide will also be produced.
Renewable energy is energy generated from
natural resources such as sunlight, wind, rain, tides and geothermal heat. Renewable energy technologies range from
solar power, wind power, hydroelectricity and bio-fuels.
(modified from en.wikipedia.org)
Nuclear energy is heavily used in the past decades. Unfortunately, it's a dangerous source and earthquake with high magnitude causes leak of radioactive waste. Fukushima Daiichi nuclear disaster and Chernobyl
disaster are the examples of catastrophic nuclear accidents.
With 8.8 MeV binding energy per nucleon, iron-56 is one of the most tightly bound nuclei.
*The electronvolt is often used as a unit of momentum. A potential difference of 1 volt causes an electron to gain an amount of energy (i.e., 1 eV).
*Nucleons are the proton and the neutron.
(en.wikipedia.org)
If all the nuclear energy is used up, all element in the world will probably be iron. In my opinion, it won't happen before human extinction.
2017年3月5日星期日
2017年3月4日星期六
Occupational Therapy (Part II)
上落樓梯︰好的上天堂，壞的落地獄
攙扶長者時，應支撐他的腋窩，切勿拉他的手臂
Support the person under the arm, don't pull them by the arm
將助行器放前一步距離
弱腳向前
好腳跟上
協助患者從仰臥至坐起︰
1) 提高患者雙膝
2) 將患者雙手交义放在胸前
3) 把手放在患者肩膀及盆骨，(移動上肢的時候，要同時承托長者的肩胛骨和上肢)，慢慢把患者轉身至側臥，其間護老者保持背部挺直
4) 把患者的小腿放下床沿
5) 把前臂穿過患者後頸，扶好患者頸部及肩膀 (按上背)，另一隻手扶著患者大腿 (盆骨)，護老者以丁字腳站立，紮馬，示意患者從一數到三後坐直，數到三時用力扶起患者肩膀，期間護老者保持腰背挺直
6) 留意患者坐起後有否不適
穿臂握法︰
1) 確保已鎖上輪椅鎖掣
2) 請患者交义雙手，護老者在他背後站穩
3) 前臂穿過患者腋下，右手握住患者左腕，左手握住患者右腕
4) 紮馬，示意患者從一數到三後要扶他坐直，數到三時用力提舉患者，其間護老者保持背部挺直
5) 確保患者坐好後才放手
The underarm grip:
Stand behind them, put both hands under their arms, and grip their forearms
肩胛抱法︰
面向長者，雙手穿過長者腋窩，抱著肩胛位置
坐至站︰
1) 坐近椅邊
2) 雙腳平放
3) 手按助行器
4) 上身向前傾
5) 用力站起
6) 護老者於長者較弱一側扶助
*輪椅至床︰
1) 長者健側靠近床，輪椅與床成一窄角度
2) 鎖上輪椅 (如輪椅可以拆除扶手和腳踏，拆除近床的一邊)
3) 長者坐近椅邊，身向前傾
4) 健側上肢按床，雙腳平放地下
5) 站起，轉身
(若長者體力較弱，護老者站在弱側，一手扶腋窩，另一手放在盆骨處，幫助轉身)
*輪椅至床 (一人協助)︰
1) 輪椅靠近床邊，鎖上輪椅
2) 協助長者將身體移前
3) 護老者屈膝，兩人雙膝緊靠
4) 用肩胛抱法，利用身體後傾
5) 協助長者站立，然後轉身
*輪椅至床 (二人協助)︰
1) 輪椅靠近床邊，鎖上輪椅
2) 協助長者將身體移前，護老者手肘扣著長腋窩
3) 長者屈膝，身體前傾，雙腿用力站起及轉身
4) 護老者保持腰部挺直，必要時可紮穩馬步
5) 雙人輔助時，要同時發力，i.e. 一二三後發力，還是數到三即發力
*提醒長者配合轉移的動作
The first principle is to plan ahead and be prepared
Remove accessories that might hinder lifting
Such as watch or jewellery
If he has an unhealed fracture, joint dislocation or severe pain, take extra care
Do not exert force on these areas
If any tube is attached, make sure it does not get detached
If there is a urine bag keep it in a proper position
Keep it below the bladder to avoid urine back-flow
Tidy up his clothes, socks and shoes
As for the environment, remove all obstacles in your way
Don't forget to lock the wheels of the wheelchair
Principle Two is to explain to the elder
It is also important to encourage the elder to take an active part in the transfer process
Because his participation will reduce the carer's load
Most importantly, this gives the elder a chance to use his body
Principle Three is correct posture
When lifting the elder keep your back straight
tighten up the abdomen and bend your knees
Principle Four is to hold firmly
The carer should support the elder with larger joints and stronger body parts
Principle Five is to stay close to the elder
Principle Six: Point one foot towards the destination and lift with the strength of lower limbs
Principle Seven is to give command by one carer
Should carers start the transfer motion after the counting of three? or at the count of three? Make sure you have clear understanding beforehand
Principle Eight : Use assistive devices
From supine lying to side lying
From side lying to sitting at the edge of bed
The following demonstration is about transferring a generally weak and mobility-impaired elder without any available assistive devices
Remove obstacles like beddings and shoes and push the wheelchair close to the bed
If the wheelchair has detachable arm rests and leg rests, remove one side of the armrest and leg rest which are closer to the elder then park the wheelchair properly
Brief the elder about the process so that she'll be ready and knows what the carer will do
If she can cooperate, guide her along or let her participate in the transfer with you
Next, help her to bend the knees
The carer can kneel on the bed with one knee to get extra support
It can reduce the load on your back
Put her arms in front of her chest
Make sure to support her shoulder blade when moving the upper limbs
If you only pull the upper limbs, you may injure the shoulders
Place one hand on the shoulder blade of the elder and the other hand on her hip bone to give firm support
Kneel with one knee on the bed
Keep your back straight
Shift your body backwards with your lower limb and turn the elder to lying on her side
Step two : Help the elder to transfer from lying on her side to sitting up at the edge of the bed
Bring her legs off the edge of the bed
The carer should keep the back straight and stand on wide base with knees slightly bent
Then get as close to the bed as possible
Reach and support the upper back of the elder by putting the arm under the neck of the elder However, do not lift the elder by putting your hand under her neck
The other arm should press against the outside of the hip bone hold her firmly
Pay attention to the direction of your feet
First, point one foot to the direction where the elder will sit
That means pointing your toes to the end of the bed
The other foot should be more or less at a right angle to form a letter T
Keep the back straight and lift the elder by propelling your lower limbs
Shift the carer's weight towards the end of the bed
Bend your knees to secure a firm stance
Exert force with the lower limbs while keeping one arm up and the other arm down
Lastly, check that the elder does not feel uncomfortable after sitting up
If the elder had a hip operation or has an artificial joint replacement
Place a pillow between the legs when transferring from lying supine to lying on her side
When lying on the side do not bend the hip joint more than 90 degrees and do not let the affected limb cross the midline between the legs
Source:
Elderly Health Service, Department of Health
劉進圖在明報專訪時說:「我的左腿動了兩次手術，康復進度不如右腿，所以左腿是『壞腳』，右腿是『好腳』。上樓梯時，右腿先上，雙拐接着放上一級，然後雙手用一點力壓拐向下，帶動左腿上移，完成上一級樓梯，不斷重複這幾個動作，就把樓梯走完。下樓梯時，雙拐先下移一級，左腳隨之，最後是右腳。」
Up/down the stairs
Always step up with the stronger leg first;
and step down with the weaker leg first
The rule is: stronger up weaker down
If you use a walking stick, always place
the stick ahead of you for support
攙扶長者時，應支撐他的腋窩，切勿拉他的手臂
Support the person under the arm, don't pull them by the arm
將助行器放前一步距離
弱腳向前
好腳跟上
協助患者從仰臥至坐起︰
1) 提高患者雙膝
2) 將患者雙手交义放在胸前
3) 把手放在患者肩膀及盆骨，(移動上肢的時候，要同時承托長者的肩胛骨和上肢)，慢慢把患者轉身至側臥，其間護老者保持背部挺直
4) 把患者的小腿放下床沿
5) 把前臂穿過患者後頸，扶好患者頸部及肩膀 (按上背)，另一隻手扶著患者大腿 (盆骨)，護老者以丁字腳站立，紮馬，示意患者從一數到三後坐直，數到三時用力扶起患者肩膀，期間護老者保持腰背挺直
6) 留意患者坐起後有否不適
Bend up both knees
Turn the whole body on one's side
Bring both legs over the bed edge
Sit up (lever the person up by the shoulder, NOT
the neck)穿臂握法︰
1) 確保已鎖上輪椅鎖掣
2) 請患者交义雙手，護老者在他背後站穩
3) 前臂穿過患者腋下，右手握住患者左腕，左手握住患者右腕
4) 紮馬，示意患者從一數到三後要扶他坐直，數到三時用力提舉患者，其間護老者保持背部挺直
5) 確保患者坐好後才放手
The underarm grip:
Stand behind them, put both hands under their arms, and grip their forearms
肩胛抱法︰
面向長者，雙手穿過長者腋窩，抱著肩胛位置
The shoulder hug:
Put both hands under
their arms from the front, and hold them over their shoulder blades
坐至站︰
1) 坐近椅邊
2) 雙腳平放
3) 手按助行器
4) 上身向前傾
5) 用力站起
6) 護老者於長者較弱一側扶助
*輪椅至床︰
1) 長者健側靠近床，輪椅與床成一窄角度
2) 鎖上輪椅 (如輪椅可以拆除扶手和腳踏，拆除近床的一邊)
3) 長者坐近椅邊，身向前傾
4) 健側上肢按床，雙腳平放地下
5) 站起，轉身
(若長者體力較弱，護老者站在弱側，一手扶腋窩，另一手放在盆骨處，幫助轉身)
*輪椅至床 (一人協助)︰
1) 輪椅靠近床邊，鎖上輪椅
2) 協助長者將身體移前
3) 護老者屈膝，兩人雙膝緊靠
4) 用肩胛抱法，利用身體後傾
5) 協助長者站立，然後轉身
*輪椅至床 (二人協助)︰
1) 輪椅靠近床邊，鎖上輪椅
2) 協助長者將身體移前，護老者手肘扣著長腋窩
3) 長者屈膝，身體前傾，雙腿用力站起及轉身
4) 護老者保持腰部挺直，必要時可紮穩馬步
5) 雙人輔助時，要同時發力，i.e. 一二三後發力，還是數到三即發力
*提醒長者配合轉移的動作
Wheelchair -> chair
Position the chairs at an angle of 90
degrees
Encourage the individual being transferred
to assist as far as possible
Don't bend at your waist, straddle if
necessary
For two-person assistance, both must apply
leverage at the same time
Make sure the brakes of the wheelchair are
on before transfer (unless otherwise stated)
Wheelchairs with detachable armrest and footrest
allow easier transfer
The eight principles for lifting and transfer:
Remove accessories that might hinder lifting
Such as watch or jewellery
If he has an unhealed fracture, joint dislocation or severe pain, take extra care
Do not exert force on these areas
If any tube is attached, make sure it does not get detached
If there is a urine bag keep it in a proper position
Keep it below the bladder to avoid urine back-flow
Tidy up his clothes, socks and shoes
As for the environment, remove all obstacles in your way
Don't forget to lock the wheels of the wheelchair
Principle Two is to explain to the elder
It is also important to encourage the elder to take an active part in the transfer process
Because his participation will reduce the carer's load
Most importantly, this gives the elder a chance to use his body
Principle Three is correct posture
When lifting the elder keep your back straight
tighten up the abdomen and bend your knees
Principle Four is to hold firmly
The carer should support the elder with larger joints and stronger body parts
Principle Five is to stay close to the elder
Principle Six: Point one foot towards the destination and lift with the strength of lower limbs
Principle Seven is to give command by one carer
Should carers start the transfer motion after the counting of three? or at the count of three? Make sure you have clear understanding beforehand
Principle Eight : Use assistive devices
From supine lying to side lying
From side lying to sitting at the edge of bed
The following demonstration is about transferring a generally weak and mobility-impaired elder without any available assistive devices
Remove obstacles like beddings and shoes and push the wheelchair close to the bed
If the wheelchair has detachable arm rests and leg rests, remove one side of the armrest and leg rest which are closer to the elder then park the wheelchair properly
Brief the elder about the process so that she'll be ready and knows what the carer will do
If she can cooperate, guide her along or let her participate in the transfer with you
Next, help her to bend the knees
The carer can kneel on the bed with one knee to get extra support
It can reduce the load on your back
Put her arms in front of her chest
Make sure to support her shoulder blade when moving the upper limbs
If you only pull the upper limbs, you may injure the shoulders
Place one hand on the shoulder blade of the elder and the other hand on her hip bone to give firm support
Kneel with one knee on the bed
Keep your back straight
Shift your body backwards with your lower limb and turn the elder to lying on her side
Step two : Help the elder to transfer from lying on her side to sitting up at the edge of the bed
Bring her legs off the edge of the bed
The carer should keep the back straight and stand on wide base with knees slightly bent
Then get as close to the bed as possible
Reach and support the upper back of the elder by putting the arm under the neck of the elder However, do not lift the elder by putting your hand under her neck
The other arm should press against the outside of the hip bone hold her firmly
Pay attention to the direction of your feet
First, point one foot to the direction where the elder will sit
That means pointing your toes to the end of the bed
The other foot should be more or less at a right angle to form a letter T
Keep the back straight and lift the elder by propelling your lower limbs
Shift the carer's weight towards the end of the bed
Bend your knees to secure a firm stance
Exert force with the lower limbs while keeping one arm up and the other arm down
Lastly, check that the elder does not feel uncomfortable after sitting up
If the elder had a hip operation or has an artificial joint replacement
Place a pillow between the legs when transferring from lying supine to lying on her side
When lying on the side do not bend the hip joint more than 90 degrees and do not let the affected limb cross the midline between the legs
Source:
Elderly Health Service, Department of Health
香港老年學會 (Hong Kong Association of
Gerontology)
http://ageing.hku.hk
http://news.mingpao.com
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