Pondering the future

In the same way that working with elderly clients can make you a little morbid, it can also have you question your future. Specifically- what kind of old lady am I going to be? Cranky in the morning, but that's a given. Are my popping knees going to deteriorate badly enough for me to need replacements? Will I be a regarded as a whiny wuss during my rehab by a bunch of young punks? Will I get osteoporosis and become the new record holder for most fractures? Will my rehab from whatever afflicts me go slow, and require me to toil away at a long term SNF for months on end when all I want to do is go home? Will my family offer me physical assistance or leave me to languish alone? Will my body decay before my mind, or vice versa?

I don't worry about this stuff too often (although the knee replacement issue does eat at the back of my mind) but it is interesting to contemplate. I try to adapt my approach to different age groups. I can be a real dictator for the under-60 joint replacements, but do try to show my kinder, gentler side to the 85+ crowd. Not that I'm not nice to everyone, but I'm more likely to let an older pt. say, "I'm too tired" and have it be enough to call off a treatment. I try to impress more on the older clients that they can refuse treatment, that they can take rest breaks, because more often than not they feel obligated to participate as much as physically possible, and really do need the rest. For those of you who haven't worked in a SNF or other environment with the elderly, you've probably never contemplated the physical exercise and strain of sitting up in a chair for the morning. I know with the 85+ crowd that the physically/mentally straining activities need to be in the morning, before sitting up too long tires them out. If I do anything in the afternoon, I usually preface it with "I only need a few minutes" or "we just need to do 1 thing today" or "we will do this and go back to bed." Please don't send me emails about how I'm simplifying this too much or patronizing my clients... this is just a description of the typical response for the age group, not your overly active grandma.

I also ponder my near future a good deal. I have a habit of throwing myself into whatever I'm currently doing, which sometimes makes it hard to plan farther ahead. I've been investing a lot of time into pediatric and sensory stuff, even though that wasn't an area that I thought I'd ever go into before I started this job. I don't want to leave this knowledge behind and start from scratch on my next job, but I don't know what exactly I want to do on my next job. Or the rest of my life. This is part of why I went into OT as a student- because there are lots of options and you can completely change your daily job life without needing more education. But, I don't want to keep starting from scratch bouncing into different settings. I've often thought that my next job should be back into that demanding world of inpatient rehab, but that can really be stressful. I don't have the experience at this point to go to a top-shelf place, and also don't know if I could take the pressure. I feel a responsibility to myself and a lot of different people to do great things, go great places, live up to potential. Probably more of my 'great things' that I actually end up doing will be pretty mundane and in small places, and deep down I know that's ok too and that no one will be disappointed. Still... need some good career goals.

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