Making Sense of our Senses
To understand our environment we receive information through our senses, our brains process the information, and respond, helping us do our everyday activities.
 
Most of us are familiar with the five senses – sight, hearing, smell, taste, and touch. However, there are two other senses we use:

• vestibular(movement and balance sense). This sense tells us where our head and body is in space, allowing us to stay upright while we sit, stand, and move.

 

• proprioception (body awareness sense). This tells us where our body parts are relative to each other and the force to use for different activities eg how hard to throw a ball across a field or to someone next to you.

 
We all experience sensation in our own unique way, some of us may overreact while others underreact to sensory input.  Someone may find a certain smell nauseating while others don’t even notice it or they may find a fabric irritating on their skin while others don’t.  
 
People who overreact to sensory input will tend to avoid the sensory experiences.  A person who underreacts will often seeksensory experiences, eg loud music or rollercoster rides.
 
Children with autism or learning disabilities often have issues receiving, processing or appropriately responding to one or more of their senses, making it hard to function in everyday life.
 
Our ability to use this information matures over childhood in an orderly and predictable manner. There may be some variation in the speed with which children acquire each milestone. If milestones are not reached there may be implications for the child’s health, wellbeing, learning and understanding of the world around them. 
 
The chart below has some developmental milestones and the behaviours, which may result if the milestones are not acquired.  If you have a child who has not yet mastered the milestone at their current age, contact our friendly Occupational Therapists.

Chart designed by Australian Curriculum, Assessment and Reporting Authority. 
 
This chart was designed to serve as a functional screening of developmental skills per age group.  It does not constitute an assessment nor reflect strictly standardised research.
 
If a child is found to have trouble with sensory input there are things we can do to help, just contact us:         Phone: 03 3774280  or email: admin@tpl.nz

  

Many people mistakenly think because they, or the people they are caring for, have no teeth or are fed via tube, there is no need to clean their mouths. This is simply not true. 

Oral and dental diseases can be a contributing factor to pneumonia as the levels of bacteria in the mouth and saliva are increased. If saliva or food/fluid contains these bacteria and enters the lungs (aspiration), it can increase the risk and severity of chest infections. If oral care is not maintained oral and dental disease is more likely and so are chest infections, including pneumonia. 

Is oral care for everyone? 
Yes. Each individual should have a plan for oral care including anyone without teeth and even those who do not eat/drink orally (ie are tube fed). 

Why is oral care important?

• clears residue/food from the mouth and teeth
• reduces risk of chest infection 

• maintains comfort and moisture of mouth 

• promotes saliva flow 

• prevents bad breath 

• prevents tooth decay  



How often? 


• Two – three times a day 

Equipment that can assist with oral care: 

• soft toothbrush or foam swab 

• a dry, clean towel or facecloth 

• high fluoride or low foaming toothpaste 

• lubrication for the mouth eg KY jelly 
• lip moisturiser or balm can be good for people who do not take food or drink orally, to help keep the mouth moist.
(NB these should not be used for continuous periods as they can reduce moisture in the lips).
• Water and/or mouthwash should be used with caution and will be dependent on both the individual’s oral control and swallow safety 

How to do oral care/tips: 
 
Sometimes it can be hard to remember to do oral cares. 

• to help, do oral cares as part of your daily routine ie after every meal. 

• if the person is seated make sure they have good head support. 

• If they are in bed, ensure they are in a good upright position, tilt bed and use 
pillows to help support them. 

• remove any food debris from their mouth 

• brush gums and tongue using soft toothbrush or foam swab. 



If you are having any trouble implementing oral care, please don’t hesitate to seek help either from an oral hygienist, dentist or our friendly Speech Language Therapists.

For advice especially for those with disabilities talk to our friendly Speech Language Therapists who are experienced with disabilities. 
 
Just contact us at Therapy Professionals 


      Phone:        03 3775280
      Email:         admin@tpl.nz
      Website:     www.therapyprofessionals.co.nz

Beat morning stiffness

If you have arthritis you will probably find it difficult to get moving in the mornings.  You’re not alone.  Early morning stiffness in the joints is common for people with Arthritis. It pays to wake your joints and muscles up slowly before you rise in the morning.  Our friendly Physiotherapists suggest you try this daily routine before getting up in the morning 
 
Do each of these exercises 6 times in this order.
 
While still in bed:

1.  Wiggle our feet up and down vigorously.                                       2. Bend your legs up and down, one at a time

Get onto your feet, PAUSE, and get your balance before continuing with your day.
 
These exercises will help your joints and muscles ease into the day.
 
Take it easy when you change from lying to sitting or sitting to standing as you may experience dizziness which can result from rapid changes of position – lying to standing or sitting to standing.
 
Make a point of moving regularly during the day and even better join one of our Arthritis exercise classes. To find out where they are contact our office..
 
If you wish to have some additional advice on managing your Arthritis our friendly Physio’s can help.
 
Just contact us:       Ph:    03 3775280                                       Email:   admin@tpl.nz  
 
                                              Compiled for you by our friendly physio’s.


                                             Therapy Professionals Ltd, PO Box 7807, Christchurch 8240              
                                                         Phone: (03) 377 5280  Fax: (03) 377 5281 
                                Email: admin@tpl.nz          Website: www.therapyprofessionals.co.nz
 

Seating Advice for Residential Care
 
The frail elderly and disabled in care spend much of their day sitting, often in unsuitable chairs, which restrict their mobility and cause them to adopt slumped postures.
 
Correct seating allows clients to:

• breathe more easily reducing the risk of pneumonia
• swallow with less effort
• maintain good posture reducing the chance of developing painful fixed deformities
• participate in more activities
• mobilise more easily reducing the stress on care staff

 
When a resident has difficulty rising from an armchair, consider the seat height, depth, width, slope and firmness, and the armrest height. 

When choosing an armchair for your residents consider these things: 

a) Height:  For comfort and ease of getting out of the chair:

• allow a 90° angle at the hip, between the thigh and body 
• feet need to rest comfortably on the floor 
• have enough heel space under the chair for standing. 

 
b) Width:   There needs to be a space of 2-3 fingers either side of the body to allow wriggle                                                                     room and to keep the armrests comfortable. 
 
c) Depth:  The depth needs to ensure a good upright posture and for ease

• user’s bottom needs to be at the back of the chair while feet still on the ground 
• ensure seat edges are curved to prevent pressure behind the legs. 
• space between chair and back of the knees needs to be a 2-3 fingers space to avoid pressure behind the legs 

d) Back rest:  needs to: 

• support the lower spine, neck and head 
• be wide enough to support shoulders 
• lean back only slightly 

 
e) Arm rests:   need to: 

• support the forearms and hands without raising the shoulders 
• allow a 90°angle at the elbow, between the forearm and upper arm 
• be firm enough to help with standing 

f) The chair surface needs to: 

• be comfortable and firm, for ease of getting out 
• easily cleaned 
• a fabric that won’t cause sweating

​Residents come in all shapes and sizes, we recommend Residential Providers 

• purchase a range of different height, width and depth chairs 
• use chair raisers for taller people
• purchase chairs with height adjustable legs if possible

 
 
Choosing wheeled chairs
 
For staff safety when choosing wheeled chairs, ensure the wheels are larger enough to push easily on all floor surfaces while allowing the ambulant person’s feet to rest on the floor so they can stand easily. If your current wheeled chairs are hard for staff to push, see if you can get larger castors or wheels, or check that fluff is not restricting the wheels..
 
Couches
 
We don’t recommend couches as they are harder to get out of and harder to assist someone to stand.  

If you need any advice on purchasing suitable chairs our friendly physios and occupational therapists can help, contact us as follows:
 
                                               Ph:                  03377 5280    
                                               Email:             admin@tpl.nz
                                               Website:         www.therapyprofessionals.co.nz

Osteoporosis and Diet 
Therapy Professionals Ltd’s Dietitian reports on Osteoporosis and Diet
 
Bone is a living tissue that is continually remodelled and rebuilt throughout a person’s life. Calcium deposits make bones strong. Eating a balanced diet that includes calcium rich foods is important in maintenance of bone strength.
 
As the body grows, bones become stronger, peaking in mass at about age 30. After this, bones lose calcium as part of natural ageing both in women and men.
 
Oestrogen helps to keep calcium in bones, so when levels drop at menopause, women lose calcium from bones more rapidly than men do.
 
Things that reduce bone strength:
 
Smoking  Among the many health benefits of stopping smoking, this will improve absorption of many nutrients from the diet, including calcium.
 
Alcohol   Four or more alcoholic drinks a day can reduce calcium uptake by the bones despite dietary intake.
 
Weight   Being overweight may add stress to bones, however generally leads to a decrease in mobility and weight bearing exercises.  Research shows being underweight or having a slight frame also can increase the risk of osteoporosis.

How to keep my bones strong?
 
Exercise   
Regular weight bearing exercise where some strain is placed on the bones builds up bones in young people, and slows down loss of bone density in older people. Weight bearing exercise requires your muscles to move against gravity eg walking, jogging and playing sports (swimming, cycling and rowing are not weight bearing activities). 

Sunshine 
Vitamin D is needed for calcium to be deposited into bones.  Sunshine (ultraviolet light) is needed for the body to produce its own Vitamin D. If exposure to sunshine is limited during aNZ winter especially in the south island, food sources of Vitamin D are important. These include fish oils, sardines, tuna, eggs, butter and margarine and liver.
 
Healthy diet 
A diet rich in calcium and a variety of foods from the four food groups - fruit and vegetables, breads and cereals, meat or meat alternatives, and milk and dairy products ensure good general health. 
 
How do I achieve a healthy calcium intake
 
Adult men and premenopausal women need 800mg of calcium per day. Adult men and premenopausal women need 1000mg of calcium per day. Post menopausal women (over 51 years) and men over 70 years 1300mg per day.

​The table below shows how to achieve a healthy calcium intake.

Dietary Supplements
 
The preferred source of calcium is from food and the preferred sources of Vitamin D are sunlight and food. Food also contains other important nutrients such as phosphorus, zinc and magnesium, protein and other vitamins.
 
Vitamin D
If you are unable to get outside regularly you may need a Vitamin D supplement.
 
Calcium
If you don’t like, or can’t eat calcium rich foods, calcium supplements may be necessary.
 
Discuss with your doctor whether dietary supplements are necessary, and which type is best for you.
 
Therapy Professionals Ltd has dietitians available who are able to provide information to groups or individuals on many aspects of nutrition.
 
Just contact us
 
            Phone:           03 3775280             Email:            admin@tpl.nz           
 
 
 
References
Arthritis Foundation of NZ and DAB ‘Your Bones, Your Future’
Arthritis Foundation of NZ and DAB ‘Look after dem bones’
Mann, J, Trusswell S, ‘Essentials of Human Nutrition’

​Footwear Matters

Here at Therapy Professionals we know the value of comfortable feet. Good footwear is important throughout life, however, as we age it becomes even more important. 
 
Poor footwear can cause foot, back and knee pain, and discomfort from corns, calluses and fungal infections. High heels and sloppy fitting shoes can affect our balance and walking, making us prone to falls.  Any of these make us less inclined to walk affecting our health, wellbeing and independence.

To avoid pain and discomfort caused by ill-fitting shoes and to maintain your fitness and independence as long as possible, just follow this advice from our friendly Physiotherapists.
As we age our feet change shape and become larger so it’s important to get your feet re- sized when you are buying new shoes.  Here are some tips on buying shoes:
 
The essential components of good shoes are that they:

• fit well,

• help the wearer stand and move comfortably and safely,
• maximise stability,
• protect the feet and keep them warm without overheating them.
• are easy to put on and take off, fasten and unfasten,
• suit the person’s lifestyle.

 
The shoe

• fastenings must be adequate and hold the foot well back in the shoe.
• laces need to be long enough to accommodate different shaped feet.
• fastening for disabled people may be better with Velcro fastenings.
• vamp openings should provide easy access for feet.
• soles should be non-slip except for Parkinson’s patients who find leather permits slippage facilitating movement.
• uppers should be a soft and washable fabric for those who are incontinent as it’s more hygienic than leather and suede.
• Insoles should be well padded to add cushioning which reduces the strain on arthritic joints especially knees.
• should be lightweight and supportive.

 
If you need advice about the best type of footwear for you, Therapy Professionals friendly Physiotherapists can help, just contact us
 
         Phone No:   (03) 377 5280
         Email:            admin@tpl.nz
         Website:      www.therapyprofessionals.co.nz

Can People on Modified Diets have Food Treats?
 
At any celebration - Christmas, Birthdays and Easter, it’s common for us to have food treats like sweets and nuts.  Unfortunately we notice a great increase in choking incidents and chest infections caused by aspiration over holiday seasons, because people forget these treats are food.  
 
Yes, people on modified diets can have treats however they need to be modified in the same ways as their usual foods. 
 
In order to help you keep your clients safe from choking and chest infections our Speech Language Therapists have come up with a few alternatives for you to try.
 
Pureed diet:  (smooth and uniform texture)

• chocolate sauce
• flavoured toppings eg caramel, strawberry
• melted chocolate – try adding a little whipped cream to help slow the resetting time
• chocolate mousse

 
Minced and Moist diet:  (needs to be very finely cut or mashed).
 
All options suggested for a pureed diet plus:

• finely grated chocolate
• mashed cake or muffin with cream or yoghurt
• trifle, tiramisu (with custard, cream or ice cream)

 
Easy to Chew diet: (must be able to be easily and cleanly cut with the side of a fork)
 
All of the options in pureed and minced and minced and moist plus:

• chocolate fudge
• Russian fudge
• some soft centred caramels
• muffins or cake with cream or yoghurt

• softened chocolate (placed in microwave until soft)
• Turkish delight (made with jelly and icing sugar)
• some soft lollies such as ‘eskimos’ or ‘bananas’ (test as if left out or shelved too long, they become hard.

This list is not a complete list; you may come up with some of your own ideas as long as what you’re giving your clients is the correct texture prescribed.
 
If you require any assistance, our Speech Language Therapists can help.
 
Just contact us:
 
     Phone:      03 377 5280            Email:     admin@tpl.nz

 Assisting someone to walk
 
Keeping older people mobile and on their feet is good for families, their carers and the older person.  The more people can do for themselves the less physical strain there is on the carer.
 
Often carers try to help older people get up from sitting and walk by hooking the older person under the arm, which could easily damage the older person and the carer’s shoulders. The other mistakes we often make are: 

• not get their attention
• rush them, 
• not explain what we want them to do.

 
If you want to assist an older person walk, first we need them to stand. Just follow the guidelines:

• Get their attention and tell them you want them to get up and walk.  

             -  put their hands on the arms of the chair
             -  shuffle their bottom forward in the chair 
             -   place legs shoulder width apart
             -   tuck feet under chair 
             -   lean forward, feet on the floor, nose over toes 

• Place your arm across their back and hand on their bottom or hip
• Tuck the back of their shoulder into the front of your shoulder
• Place your other hand on the front of their shoulder (their shoulder should be sandwiched firmly between your shoulder and hand).
• Keep yourself close to the person

           -    rock their body back and forth (if required)
           -    on the count of “Ready, steady, stand” ask them to push up through
                their hands and feet to stand 

Walk the person while holding them with your arm across their back and hand on their bottom or hip. Their shoulder should be sandwiched firmly between your shoulder and hand. They may use a walking stick or walker.
 
You may wish to use a hand grip instead of the shoulder sandwich hold.
 
Hand grip
 
Have your hand open upwards and allow the person to grab it.  If you can avoid them grabbing your thumb do so especially if the older person has dementia.