"Do not cast me away when I am old; do not forsake me when my strength is gone" (Psalm 71:9).
Areas of Focus Program & Policy Development, Education, and Advocacy
Area of Practice Health and Wellness
Project Sites My doctoral capstone project sites include Community Stroke and Rehabilitation Center in Crown Point, Indiana & Colorado State University-Center for Community Partnerships in Fort Collins, Colorado.
Project Vision To advocate for occupational therapy’s role in sleep and individuals’ quality of life through providing education on ways sleep can be enhanced through occupational routines, environment, and sleep modifications.
Project Objective To gain experience and knowledge in the area of sleep within occupational therapy practice, which will lead to program development, advocacy, and evidence-based education for the older adult population.
The Need
- Research demonstrates that greater than 1/3 of the population does not receive the advised amount of sleep each night, leading to worldwide health issues with severe consequences (Centers for Disease Control and Prevention, 2016; Ho & Siu, 2018; Smallfield & Molitor, 2018).
- Research demonstrates that 40-70% of older adults experience challenges with sleep (Leland et al., 2014; Sheth & Thomas, 2019).
- Insomnia symptoms increase with age, with higher rates than ever approaching 50% in older adults aged 65 and above (Miner & Kryger, 2017).
- Buysse et al. (2011 as cited in Ediner & Means, 2005) states, "Although often considered a nuisance symptom in clinical practice, insomnia has repeatedly been shown to be a risk factor for subsequent mental disorders, increased health care costs, occupational and social dysfunction, and impaired quality of life" (p. 1).
The Literature
- The benefits of sleep participation apply to individuals across the lifespan (Smallfield & Molitor, 2018).
- However, not all individuals know how to achieve quality sleep (Perry et al., 2013).
- Research demonstrates one of the most effective ways to enhance sleep participation among the older adult population is by providing sleep education (Sheth & Thomas, 2019).
- Occupational therapy practitioners can provide education on the factors shown to impact sleep, including occupational routines, environment, sleep modifications, and overall health, to enhance sleep quality, awareness, and quality of life among the older adult population (American Occupational Therapy Association, 2017; Ho & Siu, 2018; Perry et al., 2013; Smallfield & Molitor, 2018).
Project Mentors
Dr. Andrew Rivera, OTD, OTR/L, LMT, AEP, CLIPP, CEIM, served as my faculty mentor throughout my doctoral capstone experience. Dr. Rivera is an Occupational Therapist, Licensed Massage Therapist, Certified Living in Place Professional, Educator of Infant Massage, Associate Ergonomics Professional, and Professor at Huntington University. Dr. Rivera is passionate about promoting safety, wellness, and occupational engagement among individuals facing diverse challenges. Dr. Rivera's passion for rehabilitation, home modifications, and injury prevention is apparent through his participation in special certification and training opportunities, course teachings, professional presentations, and his doctoral capstone focus. Dr. Rivera is an excellent example of a strong advocate for occupational therapy's role in health and wellness to promote occupational participation.
Annie Schlecht, MOTR/L, CIMI, Sleep Specialist, served as my expert mentor throughout my doctoral capstone experience. Annie is an Occupational Therapist and the founder of Zen Sleep Consulting, LLC. where she provides individuals with holistic treatment to achieve quality sleep. Annie is a Certified Pediatric and Adult Sleep Consultant, Infant Massage Instructor, and Reiki Practitioner. Annie demonstrates her passion for sleep within occupational therapy practice through participation in special certification and training opportunities, as well as various media, and conference appearances. Annie is an excellent example of a strong advocate for occupational therapy's role in addressing sleep related challenges to enhance the quality of life of individuals across the lifespan.
Project Accomplishments & Impact
- Completion of continuing education courses "Cognitive Behavioral Therapy for Insomnia for Occupational Therapy" and "MBSR: Mindfulness- Based Stress Reduction: Intensive 2-Day Workshop" which have aided in the development of the rest and sleep program.
- Development of a series of evidence-based leaflets supporting an occupation-based approach to rest and sleep for client and health care staff utilization as part of the developed program.
- Observation with a sleep professional, which has led to an enhanced knowledge of common complications impacting the occupation of sleep.
- Creation of two original case studies demonstrating the impact of occupational therapy and value added by its service when addressing sleep preparation and engagement.
- Development of evidence-based education tools with best-practice recommendations for client engagement in rest and sleep.
- Development of an evidence-based program from an occupational therapy perspective that can be utilized for clients now and in the future to address sleep.
- Provision of group and individual client education for increased awareness and positive culture toward sleep efficiency.
- Provision of education to staff and health care providers for implementation of a sustainable rest and sleep program.
I am hopeful that the completed capstone project will continue to provide sleep awareness and be utilized to help enhance sleep quality and overall health and wellness.
Project Deliverables
- Completed outline of sleep program
- Continuing education courses certificates of completion
- Compilation of developed evidence-based handouts, tools, and materials
- Shadowing observation daily analysis of experience with implications for OT practice
- Designed case studies
- Guideline resource for staff
- Marketing materials for sleep education
Future Plans
In my future career, I will utilize the information I have learned throughout my capstone experience to continue providing sleep education to increase awareness and understanding, outlining the importance of sleep from an occupational therapy perspective. Further, I plan to continue building upon the skills and knowledge I have developed to help clients facing various conditions, injuries, and illnesses achieve quality sleep.
Acknowledgments I would like to thank my mentors, Dr. Rivera and Annie Schlecht, sites of partnership, and all that have provided and shared valuable time, expertise, and opportunity that has contributed to the completion of this project.
Contact Information eth1995@comcast.net
References
American Occupational Therapy Association. (2017). Occupational therapy's role with sleep. https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/HW/Facts/Sleep-fact-sheet.pdf
Buysse, D. J., Germain, A., Hall, M., Monk, T. H., & Nofzinger, E. A. (2011). A neurobiological model of insomnia. Drug Discovery Today. Disease Models, 8(4), 129–137.https://doi.org/10.1016/j.ddmod.2011.07.002
Centers for Disease Control and Prevention (2016, February 18). 1 in 3 adults don’t get enough sleep. https://www.cdc.gov/media/ releases/2016/p0215 enoughsleep.html#:~:text= More %20than%20a%20third%20of, Morbidity %20and%20Mrtalit%20Weekly%20Report.
Ho, E., & Siu, A. (2018). Occupational therapy practice in sleep management: A review of conceptual models and research evidence. Occupational Therapy International, 2018, 8637498. https://doi.org/10.1155 /2018/8637498
Leland, N. E., Marcione, N., Schepens Niemiec, S. L., Kelkar, K., & Fogelberg, D. (2014). What is occupational therapy’s role in addressing sleep problems among older adults? OTJR: Occupation, Participation, and Health, 34, 141–149. https://doi.org/10.3928/ 1539449220140513-01
Miner, B., & Kryger, M. H. (2017). Sleep in the aging population. Sleep Medicine Clinics, 12(1), 31–38. https://doi.org/10. 1016/j.jsmc.2016.10.008
New International Version Bible. (1978). Harper Collins Publishers. https://www.thenivbible.com/about-the-niv/history-of-the-niv/
Perry, G. S., Patil, S. P., & Presley-Cantrell, L. R. (2013). Raising awareness of sleep as a healthy behavior. Preventing chronic disease, 10, E133. https://doi.org/10.5888 /pcd10.130081
Sheth, M., & Thomas, H. (2019). Managing sleep deprivation in older adults: A role for occupational therapy. https://www.aota.org/.../ CE Article-March-2019-ManagingSleep Deprivation-Older-Adults.pdf
Smallfield, S., & Molitor, W. L. (2018). Occupational therapy interventions addressing sleep for community-dwelling older adults: A systematic review. The American Journal of 0ccupational Therapy: Official Publication of the American Occupational Therapy Association, 72(4), 7204190030p1–7204190030p9. https://doi.org/ 10.5014/ajot.2018.031211
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Created with an image by Mark Hunter - "A crescent moon with thin clouds in the sky"