Occupational Therapy + Covid-19 and Health Equity - OTNZ
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Occupational Therapy + Covid-19 and Health Equity ISSN 1174–6556 Vol.41 No.6 October 2020
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From the Editor
Welcome to the October issue of OT Insight
As the coronavirus spread around the
everyone equally and striving to address
inequities, and historical and contemporary Contents
injustices to eliminate healthcare disparities.
world, people went into lockdown to Features
This may be easier said than done but here
prevent an unprecedented health disaster.
again, innovative thinking found a way.
This was a shock to the system, as 7 The Issue of Mispronunciation
Georgia Browns article is a breath of fresh
alternative ways of living and working had 8 Lockdown – Reflections of an
air as it explains the positive outcomes of a
to be established - quickly. Some people Occupational Therapist
cultural intervention for Māori tangata
found new and innovative ways of living
whaiora (seeking wellness). Equally, Ema 10 Finding Oneself in a Pandemic:
their life and/or adapting their practice,
Tokolahi shares critical thinking on ethical Covid-19 Incarceration Journal
others were able to work from home.
behaviour around colonisation. Ema calls 13 Weaving Wellness With the Ancient
As the articles in this issue will show,
on us to recognise and acknowledge the
technology has come to the fore, while Māori Art of Rāranga
broader colonial, capitalist and neo-liberal
wearing a face mask and social distancing 16 #BLM in WEIRD Societies
logics that govern health services in New
are common practice. Being a health 19 A Reflection on Telehealth Practice
Zealand.
profession, it’s our responsibility to learn
During Covid-19 Lockdown
about the effects of lockdown as well as More than ever, it is important to place
the ways in which people lived with the equity at the very heart of our actions, and 21 Impact of Covid-19 on Fieldwork
pandemic. Covid-19 has important lessons to care for everyone in our community Education for Year-1 Occupational
for the future of health and health care. equally, including family/whānau, friends Therapy Students at Otago Polytechnic
and/or clients. This is especially true for 25 Applying the Perceive, Recall, Plan,
Within this issue, Joy Aiton sees a future full
those who are vulnerable, be they elderly or Perform System of Task Analysis
of opportunities for occupational therapists
young, those who are ill, have a disability, Assessment in Practice
and encourages us to step up to a new way
injury, or are living alone. By looking out for
of being. Beth Gordon has generously 26 Does the Extended International
each other with a caring heart, we can
shared her lockdown journal and in doing Classification of Functioning Disability
overcome Covid-19 and health inequities.
that she has given interesting insights into and Health Core Set for Stroke,
how occupational therapy knowledge and Finally, I want to mention a new column Capture Community Stroke
experience helped to offset social isolation. we have put in place this month. Titled Intervention?
Equally, Lynda Mance found that using ‘Because It Matters’ the aim of the column
technology was both inspiring and liberating is to help those of us who do not have a Regular columns
as it provided opportunities for progress deep understanding of Māori culture and
while improving time management. Still on language, to learn more. With no specific 2 Executive Director's Message
the topic of Covid-19, Narinder Verma tells format in mind, we are open to ideas and 2 Project Managers Report
us of the ways in which student education suggestions. As always, we hope you will 3 News & Events
took on a whole new meaning thanks to enjoy the content in this issue, and look
28 CPE Calendar
online teaching and learning. forward to any comments and feedback.
Moving on from Covid-19, we have two Thanks,
thought-provoking articles around health Grace O’Sullivan (Editor) Cover photo: Canstock
equity. Health equity means valuing Email: editor@otnz.co.nz
OCCUPATIONAL THERAPY NEW ZEALAND WHAKAORA NGANGAHAU AOTEAROA
Founding Officer: Hazel Skilton | Executive Director: Peter Anderson
OTNZ–WNA COUNCIL
President-Tangata Whenua President-Tangata Tiriti Council Member Council Member Council Member Council Member WFOT Delegate -
Tangata Whenua
Georgina Davis To be elected at To be elected at Gilbert Azuela Julia Battersby Penny Ngaheu Isla Whittington
E: georgina.davis27@ the 2020 Annual the 2020 Annual Ph: 021 197 1211 Ph: 022 306 9492 Ph: 027 270 9463 E: isla@whittington.nz
gmail.com General Meeting General Meeting E: gilazot@yahoo.com E: julia.battersby22@ E: penny.ngaheu@
gmail.com gmail.com
SPECIAL INTEREST GROUPS: Convener contact details at www.OTNZ.co.nz
Acute Care • Adults with Intellectual Disability • Child & Youth Mental Health • Children & Young People’s Occupational Therapy • Driver & Passenger Assessment & Rehabilitation
• e-Health/Telehealth Hand Therapy • Health of Older People • Independent Practitioners • Leaders and Managers • Mental Health • Neurology • OTNZ–WNA Issues Occupational
Therapy Supervision • Occupational Therapy & Sustainability • Oncology and Palliative Care • Pain Management • Physical Community • Primary Health Care Rheumatology •
Spinal Cord Injury • Tangata Whenua • Vocational Rehabilitation and Occupational Health and Safety • Wheelchairs & Seating • World Federation of Occupational Therapy
OTNZ–WNA OFFICE: Level 3, iPayroll House, 93 Boulcott Street, PO Box 10493, Wellington 6143; Tel: 04 473 6510; E: Office@otnz.co.nz
EDITORIAL OFFICE: Editor: Grace O'Sullivan. E: editor@otnz.co.nz. Submissions: Please refer to OTNZ–WNA website for author guidelines. Letters to the editor may be abridged over 300 words.
Publishing & Advertising Management: Adprint Ltd, Wellington, NZ. Advertising Manager: Pam Chin. Tel: +64 4 384 2844, Fax: +64 384 3265. Email: pam@adprint.co.nz
Dates: Distributed on or about 17–Feb, 20–Apr, 15–May, 24–Jul, 17–Aug, 19–Oct, 1–Dec. Author submissions most welcome, please email the editor.
Printed by Adprint Ltd, 60 Cambridge Terrace, Te Aro, Wellington 6011, NZ
Disclaimer: OT Insight is published by Adprint Limited for OTNZ-WNA. Views expressed in articles and letters do not necessarily represent those of the Association, and neither OTNZ-WNA nor
Adprint Limited endorse any omissions or errors on products or services advertised. Neither OTNZ-WNA nor Adprint Limited accepts liability for its contents or for any consequences which may
result from the use of any information or advice given.
OT Insight October 2020 | 1
Executive Director's Message
Kia ora koutou Annual General Meeting (AGM)
Kia ora koutou As previously advised, the 71st Annual General Meeting (AGM)
of Occupational Therapy New Zealand/Whakaora Ngangahau
By the time you receive this edition of Aotearoa will be held on Thursday 26 November 2020 via
the OT Insight we will be very close to Zoom, from 11am to 12.30pm.
this year’s e-clinical workshops which
will run from 10am to 12pm from In the wake of recent council resignations, I can advise that
Tuesday 27th of October through to Gilbert Azuela has been appointed to the role of President
Friday 30th of October/Rātū 27 ō tangata tiriti and council has co-opted Dan Johnson (WFOT),
Whiringa-ā-nuku – Rāmere 30 ō Linda Bowden and Andrea Dempsey to the roles of councillors
Whiringa-ā-nuku. The theme for both OT Week and e-Clinical at large tangata tiriti. The WFOT position will be voted on at
Workshops 2020 is Covid-19 Lessons Learnt and Health the 2020 AGM should we receive more than one nomination,
Equity/Ngā akoranga mai i Kōwheori-19, me te mana taurite whereas the positions of president tangata tiriti and
hauora. We look forward to welcoming you. councillors at large tangata tiriti will be open for nomination
and voting at the 2021 AGM (please note that this information
The e-clinical workshops which replace the usual in-person differs and supersedes that provided in the hard copy of this
workshops form an integral component of OT week. Our edition OT Insight).
international presenter is Professor Winnie Dunn, Chair of the
Department of Occupational Therapy Education, University of All are welcome to attend the AGM. The agenda and
Kansas in the United States of America. Professor Dunn will supporting items of business will be published at least 14 days
discuss some of the ways that the disruption of Covid-19 has prior to the date of the AGM. To join at the meeting time,
moved us toward health equity. Considered an expert in the follow/copy and paste this link: https://us02web.zoom. us/
ways in which sensory experiences affect our lives, she has j/83353483484
featured in Time magazine, Cosmopolitan magazine, and the We encourage attendees to advise their intention to attend
London Times newspaper as well as on Canadian public radio. the meeting ahead of time. Further, and subject to the
Speakers during the week will also include members of our Covid-19 restrictions in effect at the time, we are encouraging
own team. We will be putting out more information on the groups of attendees to share a screen. It is important that
website as it becomes available: https://www.otnz.co.nz/ members of such a group advise Peter Anderson of the names
otweek2020/e-clinical-workshops-2020/ of those in the group to assist the process and ensure the
We hope you enjoy the events. numbers form a quorum. Please send your details to
peter@otnz.co.nz any time up to 10.30 am Thursday 26
OT Week November 2020. Further information regarding the procedure
The e-clinical workshops are shared with OT week and World of the AGM and guidelines to ensure everyone can participate
OT day (27 October) this year. Lily Simmons-Donaldson our will be circulated closer to the meeting.
Administration Support person has put together an exciting Finally, we offer warm congratulations to Fi Graham who,
and engaging programme. OT Week will run from the 26th having published her first book, joins the ranks of New
to the 30th of October/Whiringa-ā-nuku. We have a range of Zealand’s occupational therapy whakaora ngangahau authors.
resources on our website which you can view here:
https://www.otnz.co.nz/otweek2020/ We will also be running
two competitions and daily quizzes throughout the week,
so look out for those.
Project Managers Report
Kia ora koutou katoa the schedule of sessions, and managing all the little ‘behind
(greetings to our the scenes’ details that are too numerous to mention. We
members). Over the hope you’ve noted the date and time but for those who
last month we’ve been haven’t, here they are again.
working on a number
What: OT Week
of projects, most of
When: October 27-30
which we’ve already
Time: 10am to 12 noon
told you about in
Where: On the Zoom screen!
previous columns. While work on these projects continues,
this month and next, most of our time will be put into working Ngā mihi nui
on the e-Clinical Workshops and OT Week 2020. This includes Tui Poff-Nuku and Ruth Spain
making contact with those who’ve offered to present,
encouraging others to consider presenting, putting together
2 | OT Insight October 2020
News & Events
World Federation of Occupational Therapists
Column
By Isla Whittington with Joy Aiton
and human rights, and will support and supportive of health and well-being.
action initiatives that enable justice. The link will also take you to the
Occupational Therapy Global Day of
The COVID-19 pandemic has brought
Service page which coincides with World
unprecedented trauma and change.
Occupational Therapy Day. Practitioners
WFOT has a number of responses,
and students are invited to volunteer a
resources and support networks to
day of service in their community. A link
assist education, research and practice.
to a list of examples are included on the
According to Marilyn Pattison:
page and keen participants are
New research demonstrates the encouraged to register online.
value and need for occupational
Last but not least, special acknowledgment
therapy rehabilitation for people
and thanks to Joy Aiton for support in the
affected by COVID-19.
role of WFOT delegate and especially the
Isla Whittington Rehabilitation is beneficial in the
preparation of this newsletter. I wish her
acute and long-term recovery
Email: isla@whittington.nz the very best in her exciting adventures
phases from COVID-19, as well
and projects ahead.
as for individuals affected by
physical distancing measures Kia hora te marino, kia
Tēnā koutou, tēnā tātou katoa stemming from the pandemic. whakapapapounamu te moana, kia tere
During this period of unprecedented WFOT acknowledges that many te karohirohi, ā, ko to hoahaere, ko te
turmoil, the World Federation of people do not have access to rangimarie. May calm be widespread,
Occupational Therapists (WFOT) has occupational therapy and may waters glisten, light be on our path
issued a Statement on Systemic Racism advocates for equal opportunities and peace as our friend.
in which Marilyn Pattison (WFOT to rehabilitation for people
President) stated: affected by COVID-19 as a human References
right. WFOT conducted a needs
We have been shocked and World Federation of Occupational
assessment that will inform our
saddened over the events in the Therapists. (2020). June Newsletter.
future actions on this issue. We
past weeks that demonstrate the https://mailchi.mp/wfot/wfot-june-
thank the over 2500 individuals
systemic racism and inequities 2020?e=9396e759da.
who have responded to our
that continue to pervade our online COVID-19 survey for this World Federation of Occupational
global community. There is assessment. (19 June 2020) Therapists. (2020). International
clearly much work to be done Practice Guide. https://mailchi.mp/
in our pursuit of occupational Please see the June newsletter for further
wfot/wfot-newsletter-july-
justice for all. (18 June 2020) information and resources which are
2020?e=9396e759da
available online. In addition, access to
The President’s message includes links the WFOT Bulletin special issue on World Federation of Occupational
to resources including template letters, Sustainability can be read online. Therapists. (2020). Reimagine Doing.
relevant WFOT position statements and A reminder that you will need to be a https://wfot.org/world-occupational-
a dedicated online interactive forum for registered member on the WFOT website therapy-day
discussion, debate, and feedback. for access. The July and August newsletters World Federation of Occupational
Guidance on developing an advocacy feature the WFOT International Practice
strategy is also available on the WFOT Therapists. (2020). Statement on
guide and access to free training in the Systemic Racism. https://wfot.org/
website. In that spirit, you are welcome to Quality Evaluation Strategy Tool (QUEST)
share experiences where you have news/2020/wfot-statement-on-
which you can find online. systemic-racism
actively promoted and stood for and with
others, to facilitate equitable engagement World Occupational Therapy Day is 27 World Federation of Occupational
in occupation. This includes direct actions October and this year’s theme is Therapists Bulletin. (2020).
that substantially and positively impacted ‘Reimagine Doing’. The link, which is in Sustainability. https://wfot.org/bulletin
systemic racism in the areas of nutrition, the reference list, takes you to a range
education, housing, economic stability, of promotional resources from social
and social supports. Like WFOT, OTNZ- media packs and posters, to guides that
WNA remains strongly committed to help plan an event, the resources
organisational changes that reflect equity promote equitable access to occupations
OT Insight October 2020 | 3
News & Events
Congratulations Mary Butler
On behalf of council, staff and to hold this academic rank in the South Island, should have
members of the New Zealand delivered her Inaugural Professorial Lecture in March 2020
Association of Occupational however, the event was delayed due to the Covid-19
Therapy Whakaora Ngangahau lockdown. So, better late than not at all, a celebration of
Aotearoa warm congratulations Professor Butler’s academic achievement went ahead on 31
go to Mary Butler who was August 2020 at Otago Polytechnic, Dunedin. Mary, we wish
recently promoted to the you every success and fulfilment in your new role.
position of full professor of
occupational therapy. Mary, who
is the first occupational therapist
Congratulations Romelli Rodriguez Jolly
Occupational Therapy New to stand strong and advocate for our clients in our
Zealand Whakaora Ngangahau professional settings. I’m currently working on a master’s
(OTNZ-WNA) warmly thesis looking into co-production approaches to rehabilitation
congratulates Romelli Rodriguez programs in forensic settings.
Jolly on their recent appointment
I’m super passionate about cultural safety, as espoused by
to the executive board of
nursing theorist Dr Irihapeti Ramsden, and working in ways
OraTaiao: New Zealand Climate
that address the inequitable outcomes caused by institutional
and Health Council. Brought up
racism. Strengthening my own multicultural identity through
in a Peruvian/Pākehā family in
language, occupation, relationships, and decolonisation
Kirikiriroa Hamilton, Romelli has
discourse has been liberating. I also lean strongly on a human
lived in Tamaki Makaurau
rights discourse, especially advocating to address occupational
Auckland since 2008. They studied occupational therapy at
injustice in secure settings. I am also passionate about
Auckland University of Technology and their area of interest is
environmental sustainability, and the occupational therapist
psychiatric rehabilitation and recovery. Romelli currently
role in raising consciousness and facilitating occupations that
works in the Kaupapa Māori service in forensic mental health
enhance and support respectful and mutually beneficial
services for Waitematā District Health Board.
relationships with Mother Earth/Papatūānuku/Pachamama.
Romelli uses gender neutral pronouns to refer to self.
In essence, singular they/them/theirs. What can you tell us about the OraTaiao initiative?
For more info: https://www.rainbowmentalhealth.com/ OraTaiao: NZ Climate and Health Council was set up in 2009
https://ot-magazine.co.uk/transitioning-occupations/ by a group of health professionals concerned about climate
change. OraTaiao is focused on working towards climate
What brought you to occupational therapy? justice and advocating for policies, strategies, and
Kia ora, interventions that promote equitable health and social
Napakullayki (Hi), outcomes rather than further perpetuating inequities. The
organisation now represents a collective of around 700 health
I originally started studying engineering as I was interested in
professionals. OTNZ-WNA joined OraTaiao as an organisation
bionics, however, I decided not to continue. Instead, being a
member last year.
classical and folk musician, I set about exploring music
therapy. Through a series of serendipitous events,
How did you become involved in this organisation?
occupational therapy came onto my radar. The people focus
and the holistic ethos resonated with me and 10 years later, I found out about OraTaiao through my partner who is a
here I am, proud to be an occupational therapist and to have nurse. They were working on some climate change policy
the occupational therapy leadership that we do in Aotearoa submissions for the New Zealand Nursing Organisation.
New Zealand. The supportive nature of occupational therapy I started attending meetings last year so that I could learn
and our supervision model is a treasure. how the organisation worked. The opportunity arose to step
up onto the executive board and, since representing
Influences occupational therapists is important to me, I went for it.
I’ve never been on an executive board before and so I
In my journey so far, I’ve appreciated the postgraduate
appreciate the kind support of the executive board
opportunities in mental health and addictions that help
members.
support new graduate occupational therapists into being able
4 | OT Insight October 2020
How will occupational therapy skills and knowledge Take away message for occupational therapists:
be helpful in this role? If you care or are worried about climate change and want to be
Occupational therapists really understand the complexities of part of working towards climate justice, then join OraTaiao -
human occupation. We are solution focused and have valuable https://www.orataiao.org.nz/join_us. You’ll be connected with a
enablement skills in supporting people to achieve change that network of like-minded health professionals and have
is personally meaningful and important, even when the barriers opportunities to get involved with calls for action. There are
seem insurmountable. Occupations are part of the cause and only a handful of occupational therapists in the organisation
the solution. In these times of climate uncertainty, people are and I would love to see more of us be involved in this kaupapa/
having to adapt and acknowledge that occupations do not work. If you have any questions, you are most welcome to get
happen in isolation but in complex interrelation with our in touch with me: Romelli.r@waitematadhb.govt.nz
environment. We are well positioned to contribute to advocacy
Sulpay (thank you), Mauri ora.
and policy development that will influence the everyday
practical implications of climate change action on occupation.
Embracing indigenous leadership and indigenous paradigms of
relating to our natural world are paramount to our climate
change response.
OT Insight October 2020 | 5
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6 | OT Insight OctoberCheck
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Because it Matters
The Issue of Mispronunciation
By Tui Poff-Nuku
with mispronouncing [Māori] names is By asking the person to help you with
that it “diminishes the deeply personal the pronunciation of their name, you are
meanings [their] names hold”. shifting the power back to them. If
“Mispronunciation is a type of ignorance. appropriate, take a recording of the
When people do it, they aren’t person saying their name. Use the
acknowledging the potential foundations recording to practice and persevere. You
of what a name is built on.” Pronouncing can measure your success by asking the
Māori names incorrectly can not only person if you have it right. Similarly, ask
change the meaning, it can be for help from a Māori colleague or even
disrespectful and … demoralising (Te a colleague who has mastered
Aniwa Hurihanganui). As occupational pronunciation. Managers also have a
therapists, we know meaningfulness is responsibility to ensure the team is
essential and names are very meaningful developing toward pronunciation
Tui Poff-Nuku - before we even get to the meaningful mastery. Especially in commonly used
occupations. names and words. If you are seen to be
Email: tui@otnz.co.nz
genuinely trying i.e. improving each time,
There is a regulatory expectation within
this will usually suffice.
the Health Practitioners Competency Act
section 118 “to set standards of clinical Fortunately, we live in a technical age
competence, cultural competence where we have the perfect resources at
Nīkau was named after his Koro (including competencies that will enable our finger tips and there are no longer
(grandfather) and the dense grove of effective and respectful interaction with any reasons not to try. Try one of the
Nīkau native palm trees that grew in the Māori), and ethical conduct to be many online resources such as the Māori
forest at the edge of the whānau (family) observed by health practitioners of the dictionary or download the mobile
farm. Essentially, his name holds the profession.” Therefore, as health phone app. Insert a name for an audio
history of his whānau, the wairua (spirit) professionals we have a responsibility to of Māori phrases, words and names
of his ancestors and the whenua (land) honour correct pronunciation and take - including the name Nīkau.
that has sustained the generations. It is practical action until correct
his identity. pronunciation is achieved. With regards References
to this Te Aniwa Hurihanganui tells us
In his school years, the teachers called Māori Dictionary https://maoridictionary.
“Almost every Māori sound we have
him Nee-cow regardless of the times co.nz/
exists in English phonetics. It is almost
Nīkau’s parents corrected the Te Aniwa Hurihanganui. https://www.
impossible for an English language
mispronunciation. When he started tepapa.govt.nz/discover-collections/
speaker to mispronounce Māori names
working as a builder’s apprentice, his read-watch-play/maori/te-wiki-o-te-
if they try.”
workmates called him Nick-oh regardless reo-maori-stories-wireless/
of the times he corrected the
Pronunciation Development mispronunciatio-0
mispronunciation. His construction
Starts With You.
manager, not wanting to offend him,
decided to call him ‘mate’ using a subtle Take a few moments to stop, notice and
social norm to bypass making an effort. reflect. The following questions are not
In hospital for treatment, the staff called meant to make you feel uncomfortable,
him Nee-koh - close, but not close instead they are intended to shine a light
enough. Nīkau wondered, “Why is it that on the most common practices that I see
I can pronounce their names but they every day in society and you may relate
can’t take the time to learn how to to them. Are you feeling embarrassed to
pronounce mine? Is it really that hard?” try? Ever wondered where that
It’s Nī (Nee) kau (ka-u: blend the vowels embarrassment stems from? Are you
so it almost sounds like ‘oh’). afraid you will offend the person by
getting the pronunciation wrong? Do you
According to Te Aniwa Hurihanganui feel like it isn’t your responsibility? Are
(journalist at Radio New Zealand) this you too proud to try? Are you too busy
could give him “… the impression that it to try? Do you forget to try? Did you try
wasn’t important to learn my name and but get a bad reaction? Do you expect
it affected [me] because I didn’t feel people to pronounce your name
comfortable around [them].” The issue correctly?
OT Insight October 2020 | 7
Opinion
Lockdown – Reflections of an Occupational
Therapist
By Joy Aiton
In this unpredictable and surreal time of nutritionists, doctors, nurses and others
global disaster, I find myself, an giving this advice? Where are the
occupational therapist, musing over how occupational therapists?
far we have come and where we might go
Historically, the profession of
in the future. We are living in uncertain
occupational therapy has grown and
times; the Covid-19 pandemic is
developed though both man-made
unprecedented in the modern world, so
disasters, such as war; natural disasters,
we are all managing the best we can.
such as earthquakes; and even
Listening to the Orwellian Covid-19 tuberculosis outbreaks. We have come
announcements on the radio, huddling from being craft-based assistants to the
around the technology of the moment to medical profession, keeping people
get the latest announcements, spending ‘occupied’, to having a scientific
time with loved ones in our bubbles and foundation for our practices as well as
Joy Aiton
via technology, cooking meals together, our own ‘professional’ language.
Email: joy@notia.nz playing with our children, being at home,
We have become essential to a social and
having time to go out for exercise,
Joy Aiton qualified as an occupational holistic model of health care using
enjoying the moment, and being kind to
therapist in 1989. She worked in the occupations and meaningful activities.
our neighbours. It all conjures up images
United Kingdom, United States of With that in mind, we are now in a
of times gone by. What have we learned
America and Aotearoa New Zealand in position of great opportunity. I feel we
from the Covid-19 lockdown experience
most clinical areas of occupational are at the crux of a new metamorphosis
and how will this impact our profession
therapy and in positions of leadership and we need to act NOW. How can we
going forward?
and management. She now works in take advantage of this new awareness of
private practice on the West Coast with It is ironic that the technology which the value of occupation? How can we be
a special interest in rural health. In seemed to be changing society’s ways of acknowledged as experts in this field?
2015, Joy was elected to Occupational communicating, creating a potential How can we become the Claire Turnbull
Therapy New Zealand Whakaora future of faceless texts, tweets, and (she seems to get everywhere) of
Ngangahau Aotearoa Council holding Messenger and WhatsApp chat for a occupational therapy?
the positions of council member at generation who appeared to have little
We need to get out there and to take
large and audit and finance chair need for face-to-face engagement, is now
ownership of our knowledge. Let’s take
before taking up the role of World bringing people together. We are learning
this opportunity to highlight the
Federation of Occupational Therapy new skills, attending meetings, providing
importance and the value of occupational
representative for Tangata Tiriti. therapy services and socializing - virtually.
therapy. As we emerge from lockdown
Working from home via technology with
and enter into a new way of being in the
telehealth is the new norm.
world, let’s be optimistic and resilient.
What are the implications of these Let’s own the new normal: use technology
disruptive forces and rapid changes for to our advantage, become mentors and
people with disabilities, medical coaches, and develop roles as
conditions or those who live in rural and occupational therapy consultants and
remote locations? In this new practitioners. We can do this.
technological age, activities of daily life as
What I have learned from this lockdown:
we knew them are changing and
geographical barriers as experienced in • age old values of communication,
many rural areas are breaking down. community and kindness work
Which brings me to occupations - our • meaningful activity and occupation
bread and butter – and our interventions, are essential to thrive in this new
outcomes, and therapeutic tools. From world
the very start of lockdown, focus has • it is important to embrace new ways
been drawn towards meaningful activity, of doing old things
occupation, routines, communication and • use disruption to your advantage
learning but … I find myself in a
• be flexible
dichotomy here: why are psychologists,
8 | OT Insight October 2020Get yourself a LIFT
• be brave and make life easier
• consider the needs of many before the needs of a few
• be relevant and essential
• take time to smell the roses and taste the tea (take a
moment to be in the moment)
• be thankful.
I could go on, but essentially, I want to say that we must seize
this opportunity to learn, grow and develop even more than we
have in the past. A new chapter in occupational therapy is
unfolding … bring it on! POOL HOIST
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LEARN MORE & REGISTER ONLINE WWW.GEMTINFO.COM.AUFeature Article
Finding Oneself in a Pandemic:
Covid-19 Incarceration Journal
By Beth H. Gordon
Journal: On Sunday 22nd March upon entering
As the global pandemic of Covid-19 virus McHugh’s restaurant, we applied the
hit the news headlines in January 2020, provided hand sanitiser. I also used my
New Zealand was only awakening to its own soap and handtowel for hand
threat and possible impact within our washing. The birthday girl was seated at
islands. Come late February 2020 the viral the welcome table where she greeted
threat had arrived across our borders, on each guest and supervised the required
a rampage unless transmission could be signing in. She reminded us about
contained. I pondered what possible non-contact and social distancing, and
health measures would be put in place invited us to be seated at the long dining
and how any decisions would affect the table. The usual self-service buffet was
New Zealand population. I was living in a against the rules, so waiter service was
low-risk geographic area; I was healthy provided. After the soup course, which
Beth H. Gordon and fit enough to mow my lawns plus the was served individually, the guests
Email: beth.gordon@xtra.co.nz council’s large grassy berm. I trusted that served each other from central dishes.
my knowledge of health services through Thus the movement and spacing among
Beth Gordon (nee Bunt) completed the past experience and a degree of common the reduced guest numbers met the
State Examination in Occupational sense would govern any decisions I rules of Level 2. When invited, I risked
Therapy in 1960. As a qualified needed to make. giving a younger colleague a brief hug.
occupational therapist, she worked in
It became apparent that the Ministry of Society aimed to protect the over 70s
New Zealand for 4 years and in
Health was following many of the World but I needed to prepare for the
Canada for 10 years. She returned to
Health Organization’s developing uncertainties of lockdown. On Tuesday,
New Zealand, and in 1975 was
guidelines and recommendations. Active I continued my usual volunteering. On
appointed Fieldwork Tutor, Auckland
cases were being reported, early Wednesday, I used the automated teller
at the Central Institute of Technology
quarantine strategies put in place as well machine to have ready cash, purchased
until redundancy in 1991. She then
as voluntary social isolation for incoming postal supplies at the post office, bought
studied at Auckland University and
travellers. On 21st March the computer paper from The Warehouse,
achieved a Postgraduate Diploma in
Government introduced the 4 Covid-19 ointment from the chemist, and stocked
Public Health (1993) and Master’s
alert levels and announced Level 1 would up at the PAK’nSAVE supermarket. The
Degree in Public Health (1994). In both
be changed to Level 2 immediately. Public bank was already closed, so doing
Canada and New Zealand Beth held
televised announcements became errands was not straight forward.
roles of responsibility within
occupational therapy’s professional regular events by the Prime Minister and Suddenly, the next day on 25th March,
organisations. the Director General of Health. The the announcement was made about
population was to quickly follow stricter moving to Level 4 that night. So, the
approaches according to ‘the rules’ of rules of ‘lockdown’ and ‘bubbles’ were
each level change. At this time, ‘the elderly upon us. I checked the bank website,
over 70 years old’ were strongly which said the branch would be open
encouraged to ‘stay home’ and refrain between stated times on Thursday 26th
from supermarket shopping. March. I inadvertently broke the rules
As I live 10 kilometres out of Thames, when I visited the bank to set up on-line
this was my first challenge. I had banking and I had a business cheque to
accepted an invitation to attend an 89th deposit. My risk came to nought as the
birthday lunch at a North Shore bank was closed anyway and so the only
restaurant event and was taking a rule I broke was driving 10 km from
70-year-old passenger with me. I figured home.
it was risky to attend, firstly because an So, I was as ready as I could be for
Australian visitor had only left on Friday age-related incarceration. The ante was
20th, and secondly, the guest list up, Covid-19 was the talking point as
included many age contemporaries so at neighbours emerged out onto the
Level 2 we ought to be socially isolating. street. Feelings were aired as everyone
Still, notwithstanding the risks, I decided kept well distanced across road and
to attend.
10 | OT Insight October 2020footpaths. I was working in the front garden and so joined my phone call intentions had gone and my indoor activities
various informal discussions, but soon realised I was on a had reduced to crosswords, card patience, CD music listening,
very different response pathway to most of the others. They radio talkback and television. Apathy had set in very solidly,
were expressing anxiety about the virus spread, the threat to so once again I searched for my wairua/inner spirit through
people’s health, individual vulnerability and potential the whenua/land patch I tend. Lawns got mown, edges tidied,
mortality of elderly persons, whereas I was extremely angry and I paid homage to sunny weather.
about my loss of autonomy and what I perceived to be
ageism relating to the elderly over 70. Yes, vulnerable people
were at high risk if they contracted the virus, but such
persons are from all age groups. Luckily, I was able to vent
my anger outdoors in the sunshine. I attacked and dug out
the rampant kikuyu grass throughout the lawns, and by
practising mindfulness, I managed to gain satisfactory
emotional equilibrium.
During the first week of lockdown, I made an ‘options list’ but Since the restrictions had
refrained from making a ‘to do’ list. I told myself to phone a scuppered my 80th birthday
family member or a friend each day either at morning coffee plans, I decided I would have a
time or during happy hour. This was to become part of my “bubble and bubbles” celebration.
new routine along with the usual routine of fetching the New I got dressed up, set up a special
Zealand Herald from the letterbox, reading it over breakfast round table adorned with roses,
and doing the crosswords. I took up writing when one Herald cards, sparkling wine and
columnist wrote an opinion piece which aroused me enough stemmed glasses. After many
to send an email response; it was not acknowledged. I decided wonderful phone calls, emails
to pen a letter to the editor and submitted it to the Herald. and Facebook messages I was ready to put on the music, open
They published an abbreviated version on 23 April 2020. I also the bubbles and dance in my red shoes.
wrote a poem titled “Time Out”.
Before and after the birthday I tackled some deadlines and
Thus I was able to settle in a bubble of one. Level 4 allowed dealt with some personal business. Still, the medical
me to walk to the local dairy, which had a ‘one out one in’ appointment for renewal of my driver’s licence was cancelled
system set up. The first time I went for the Sunday paper, a so the application form is waiting to be done when permitted
chocolate bar and ice-cream. Two other times I walked there, by Ministry of Transport. From 9th May my lethargy increased
I enjoyed strolling through the field and seeing again the noble as we waited for the politicians to make the next move as case
Pohutukawa tree I adore. numbers were reducing markedly. It was time I got phoning
friends again to check on them. Remarkably, I regained
The closure of banks, post offices and various businesses
enough concentration to spend one day reading a whole book
really frustrated me. I had to rely on 0800 numbers and email
and then a couple more light reads.
to conduct what I deemed essential life business management
– no internet banking yet. I had other responsibilities to deal On Wednesday the 13th May at 11.59 pm we moved to Level
with too, but I did learn to take an “it is what it is” approach to 2; the cafes reopened and travel between regions was
things beyond my control and left them in abeyance. I also got allowed. On Friday, I celebrated my freedom and had two
the sewing machine out and made bags out of scrap fabric, coffee meetings en route to Auckland. There I dropped off
which satisfied my desire for productivity. annual records to the accountant, banked a cheque, bought a
vacuum cleaner and visited family members. I stayed with my
As the weeks passed my opinion of the rules and the likely
sister to drive her to buy a car and do supermarket shopping.
downward economic downturn spun my thoughts into
She was in Covid-19 shock and extremely anxious the whole
overload. So more kikuyu, gardening and mindfulness was
weekend.
required. I also needed to stop procrastinating and tackle
family history-related tasks. The new camera was still in its On Monday, I was back in my local environment and a slack
box, and objects around the house were waiting to be daily routine. I am unsure whether I want to resume the
selected, photographed, cropped and filed. Then the next pre-lockdown lifestyle. My inner being has been quite fulfilled
challenge was to upskill my use of Microsoft Word software so in social isolation. I am feeling impartial even to the fact that
that I could insert images within my lengthy document. It took my planned September month’s holiday in Canada has been
resolve, but I completed the task and was rewarded when the cancelled. At the time of writing I do not know whether the
screen view printed out correctly. airfare, hotel room and travel insurance will be repaid. No
doubt I will have to accept any losses incurred. Over my adult
On 27th April we dropped to Level 3 but access to business
years I have developed certain principles, including self-
premises was restricted. One day, I risked doing in-person
responsibility, personal risk management, positive ageing
payments: tradesman invoice and a charitable donation. Then
(anti-ageism), think globally act locally, and participation for
I had coffee with friends on their deck after I had been to the
community benefit.
supermarket - the over 70s ruling had disappeared. By now
OT Insight October 2020 | 11Postgraduate Study
Enhancing practice through enquiry
I ka- whetu-, ka whakatere te waka
Last week, I resumed volunteering and shall continue
henceforth. As community organisations restart, I will take a
hard look at whether I wish to contribute and participate as I
have done previously. My focus on maintaining my own Are you looking for professional development
well-being has shifted during lockdown, so I intend to check opportunities to enhance your practice?
out a movement to music-type activity. I know I wish to avoid Check out our courses below for options:
situations that have the potential to raise my anxiety and
negativity. For now, any desire to travel and stay away from 2021—Semester One
my home base is absent. Forward planning is cancelled, too. Vocational Rehabilitation Utilising evidence-based theory and
research for effective Vocational assessment and return-to-work
This coming week the country is awaiting the latest Covid-19 planning. You will explore factors that influence vocational
announcement hoping we shall return to a form of Level 1. rehabilitation and develop strategies to enhance practice in
Aotearoa New Zealand.
The health risk aspect of decisions have not raised much fear
and anxiety within me, but the economic decisions for the Motivation and Behavioural Change This course will provide you
with frameworks that will enhance your interventions when working
country are very challenging. I fear for individuals and families with people presenting with issues related to motivation and
who face loss of employment and reduced incomes, especially behavioural change within the New Zealand bicultural context.
if they have not been financially prudent. Cognitive Approaches across the Life Span Cognition is the
ability to think, act and solve problems. These elements are the
I am reminded of my redundancy about 30 years ago and the underlying components necessary in everyday occupational
enforced redirection of life. I will resist opening old wounds so engagement. Unpacking cognition requires understanding how
bring on the kikuyu pulling and outdoor mindfulness. Too bad people learn, process, retrieve information and use this information
to solve problems within their life.
winter is here.
Research in Practice Justify the selection of appropriate research
Beth Gordon: 7th June 2020 process for practice within the NZ bicultural context and explore both
qualitative and quantitative methodologies. On completion you will be
PS: Earlier than expected the Prime Minister announced on able to critique published research related to one area of practice,
Monday 9th June that Level 1 will become effective this day at justify research methods and analyse ethics relevant to the topic.
11.59 pm. Negotiated Study Explore a topic of interest related to your current
occupational therapy practice or up skill in an area of interest to
future practice. Course outcomes are negotiated with the lecturer so
Reflective comment dated 1st September 2020. that they meet your specific learning requirements.
It is with relief I discontinued my journal. Introspection and 2021—Semester Two
reminiscing is counterproductive as I enter my 90th decade. Trauma Informed Practice Trauma informed care is a growing
The personal challenges I face have to be measured besides field of practice, which acknowledges and then works with people to
the issues facing my family, peers and friends together with assist them with managing and moving through the stress response
that continues to occur due to a trauma experience. You will learn
societal expectations of what is normal. Perhaps it is time I say underpinning neuroscience theory and intervention strategies.
“no” to external requests and to give myself permission to “do
Adventure Therapy Theory and application to practice – utilise a
it my way” as per Frank Sinatra’s lyric. mix of nature, activity based therapy and experiential learning
principles in order to achieve therapeutic outcomes. These
outcomes often include development of resilience and adaptive
Poem coping strategies, enhanced relationship, and communication skills,
and strengthened sense of self, self-esteem and mastery.
Time Out 2020
Virus threatens globally Negotiated Study & Vocational Rehabilitation
Time to act locally as listed above
Extra minutes to swat flies
Take time for making fries Courses will run subject to numbers.
Sun, sky, sea, bush and mountains remain Blended delivery in your time at your place.
It only takes successful completion of 2 one semester (14 week)
All to be worshipped from my domain courses to be awarded with a Postgraduate Certificate.
Past adversity, loss and ageing
May strengthen resolve adapting
Contact us now to discuss your study options:
Yet again years on this earth Debbie Davie -Postgraduate Administrator
Influence and threaten mirth I mera-: Debbie.Davie@op.ac.nz
Time not to remember Sian Griffiths -Postgraduate Coordinator
But to ponder September. I mera-: Sian.Griffiths@op.ac.nz
BHG: April 2020 Masters enrolments accepted
Semester One & Semester Two 2021
Follow this line to apply online https://www.op.ac.nz/apply/
Disclaimer: The views and opinions expressed in this article
belong solely to the author and do not reflect those of 100% BLENDED LEARNING in your time at your place
Occupational Therapy New Zealand Whakaora Ngangahau
Aotearoa.
12 | OT Insight October 2020Feature Article
Weaving Wellness With the Ancient Māori Art
of Rāranga
By Georgia Brown
Three years ago, I worked at Te Aho Mai, the Acute Mental beliefs of the Māori people… Weaving is more than
Health Unit at Middlemore Hospital. The occupational just a product of manual skills. From the simple rourou
therapists role in that setting is to develop and facilitate to the prestigious kahu kiwi [kiwi feather cloak], weaving
therapy based groups on the ward. It’s important to have is endowed with the very essence of the spiritual values
activities that are not only enjoyable and provide an of Māori people … Of all the Māori weaving techniques,
opportunity for new skills to be learnt they also have to be rāranga is the one that has best survived colonisation.
safe in terms of the equipment used. I noticed that some - Erenora Puketapu-Hetet, (1989, p. 44).
people seemed to enjoy the actual ‘doing’ of tactile activities,
A lot of people joined in with the rāranga group including
rather than the talking therapies. We had a lot of Māori
visitors. Rāranga started conversations and they would all get
tangata whaiora (a person seeking well-being ) on the wards
comfortable, feeling more relaxed and able to engage.
but we didn’t get much engagement, I think because they
Rāranga incorporates tikanga (customs, a system of values
didn’t connect with the activity options. There are many
and practices that have developed over time and are deeply
elements that have a strong influence on tangata whaiora
embedded in the social context) such as, no kai (food) on the
recovery other than what happens in groups. I felt that
table with the harakeke, cutting harakeke a certain way and in
cultural needs for recovery were not being addressed because
certain conditions, karakia (prayer), where you’re placing the
the kinds of activities on offer, were not culturally meaningful
harakeke, how you hold the harakeke, handling the harakeke
to Māori tangata whaiora.
off-cuts and more. For some, tikanga was second nature while
Many of the group activities were westernised and while some for others, we needed to kōrero (explain/discuss) what we
tangata whaiora did like talking therapy, generally the talking were doing and why. After a while tangata whaiora began to
groups made people feel exposed. They preferred not to talk realise and appreciate we were following the tikanga steps
about their mental health issues as it can be confronting for that our ancestors followed. It was a learning opportunity to
them and their whānau (extended family, friends or group of reconnect with their culture. We would take tangata whaiora
colleagues who may not have any actual kinship ties). At the with us to cut the harakeke so that they were involved in the
time, they are acutely unwell and feeling quite vulnerable whole process. This gave more context and added meaning to
however, engaging and participating in meaningful activities the activity. It involved a change of environment from the
with others, could make them feel more comfortable. I believed ward, getting out in nature, doing something tactile in a Māori
that if we started with the process of whakawhanaungatanga (a cultural activity with connections to tikanga, ancestry and so,
process of establishing relationships, relating well to others, their own identity. Tikanga provided boundaries which people
feeling comfortable in each other’s presence) then they might could choose to stand inside and thereby strengthen their
be more inclined to open up and share information about sense of belonging.
themselves. I was inclined to think that being in the present and
The whole rāranga process incorporates a lot of sensory
‘doing’ something they respected and enjoyed at their own pace
modulation - a model that we regularly used. When cutting
was the best thing for their recovery. At the time there weren’t
harakeke, there’s all the different smells, visual and tactile
many opportunities for Māori cultural-based groups still,
sensations and movement. All that is going on alongside
tangata whaiora did seem to enjoy the variety of arts and crafts,
spirituality in karakia. It’s very therapeutic in that it is a
and cooking opportunities. To enable them to connect with
relaxing way for tangata whaiora to distract and settle
their tupuna (ancestors) and Te Ao Māori (the Māori world view)
themselves and more, there is a valuable product at the end
we wanted to incorprorate a cultural element that was age
of the processes. They get to see and hold their own creation.
appropriate and suitable for various skill levels. Some tangata
For instance, a kete (basket) or putiputi (flower) or whatever
whaiora were really good at painting while others wanted to try
they wanted to try and make.
a different craft or activity, one that they could really get
involved with and do independantly or alongside others, Then there’s tikanga around rāranga - gifting your first piece to
regardless of their skill level, with or without input from the someone, to share it with whānau or another person. There’s a
occupational therapist. We chose Rāranga. bit about rāranga being an ancestral occupation and a bit
about giving, that can help with healing. By bringing all of this
Rāranga into one space at the same time, a lot of tangata whaiora
Rāranga is an ancient Māori art that involves weaving with would come back, wanting to continue on with rāranga. The
harakeke (New Zealand native flax) to create products such as activity was free-flowing. We didn’t want structure, we just let
rourou (a type of food basket), fishing nets, snares for catching the activity shape itself and I think that worked really well
animals, mats, decorative pieces, hats etc. because you have people at different levels of function and
insight. Some know how to sequence the task and don’t need
Māori weaving is full of symbolism and hidden any support or prompts while others need one-on-one
meanings. Embodied with the spiritual values and
OT Insight October 2020 | 13You can also read
