For planning the bus trip to Reynolda Village without the
use of a GPS device the individual with CHF and COPD may opt to use free maps
from either the Internet or a local map.
Local maps are provided at various locations around Winston-Salem, including
gas stations and the transportation center located in downtown Winston, which
is where we started our traveling experience.
An occupational therapist may assist the individual in deciding the best
way to gather the transportation maps for them.
They may use their occupational profile to also help choose the most
convenient and enjoyable trip to travel.
With only having 60 minutes to travel round-trip the individual is
assumed to be living downtown near the central transportation station. The easiest route the client may choose is to
print off a free PDF copy of the bus routes online located at http://www.wstransit.com/wp-content/uploads/2014/02/Day-Routes.pdf.
They may also print off the free pdf copy of the times of the bus route
#16 at http://www.wstransit.com/wp-content/uploads/2014/01/Route-16-Oldtown.pdf. While at the transportation center
the individual may also pick up specific timesheets from the office. The individual may wait for bus route #16,
titled ‘Old Town’ and get on at 10:45am.
They will then arrive at Reynolda Village around 10:55am to prepare for
a short visit. Considering the time
constraints of 60 minutes, we decided to continue riding the bus back to
downtown Winston-Salem, although the individual would have an hour to enjoy
Reynolda Village before the next bus would arrive to pick them up.
The conditions of CHF and COPD would create many challenges when it comes to the area of community mobility. When out in the community, the client will have to not only manage their portable oxygen tank, but their other symptoms as well. Symptoms of their diagnosis that will impact their ability when traveling within the community may include shortness of breath, fatigue, coughing, weakness, elevated blood pressure and decreased alertness. These symptoms make it crucial that the client has strategies they can implement to ensure their safety. When using a bus, some obstacles they may encounter will be walking to and from bus stops, standing for extended periods while waiting for a bus or standing if there are no available seats on the bus, and climbing the stairs to get on and off the bus all while carrying oxygen. These tasks will require physical exertion and may exacerbate symptoms of breathlessness and fatigue. Occupational therapy recommendations could include implementation of energy conservation strategies such as sitting whenever possible, taking rest breaks when walking, and utilizing pursed lip breathing techniques.
This travel assignment helped our understanding of the psychological and emotional challenges that come with certain diagnosis when riding public transportation. Individuals living with CHF and COPD may struggle with depression, social anxiety, and overall low self-esteem. Public transportation with an oxygen tank may be difficult due to outsider facial expressions, physically maneuvering into and out of a bus, as well as dealing with the symptoms of CHF and COPD like coughing, increased heart rate, chest pain, and fatigue. These factors may have a negative psychological impact on an individual. Someone may not feel comfortable in social situations holding their oxygen tank and feeling like an outsider. Anxiety with public transportation may come with remarks from others due to taking longer to get into and out of a bus. The biggest psychological impact would most likely be feeling “publically disapproved.”
We were also able to observe a lady on the bus today that had some durable medical equipment (DME) and stares from outsiders on the bus were very apparent. The lady looked very uncomfortable and did not speak to anyone. Dealing with frustration of not feeling “normal” may decrease self-esteem and lead to depression or a fear of social situations. Someone dealing with COPD, CHF, and having DME, may limit their social interactions in order to decrease anxiety provoking public situations. An occupational therapist would be able to assist the individual in support groups and coping strategies to overcome the psychological stressors.
In order for an individual with CHF and COPD to travel on this bus route, he/she will need to transport some type of portable oxygen tank. When choosing which type to use, it is important for the patient to consider the pros and cons to determine which would work best. Compressed oxygen gas is stored in steel or aluminum tanks. Liquid oxygen is cooled oxygen gas, which turns it into a liquid state. This allows the individual to be more active as more oxygen fits in the tank; however, the oxygen evaporates over time. The third option is portable oxygen concentrators, which come in small tanks.
When the individual is determining which portable oxygen tank to use, it is important to consider the weight and size of the device, how it will be transported (carrying case or travel cart), how long it can last, and whether it takes batteries, plugs in, or both. The individual should also consider how often they travel and where to. Individuals with COPD and CHF tire quickly and can have SOB, it might be helpful to ask the bus driver if they can assist in carrying the device up the stairs. Also, it is important to keep the device upright and away from heat, as it supports combustion. An occupational therapist would be able to put together a packet of information on traveling on the bus route for the individual to feel safe and well prepared. As the profession of occupational therapy is solely focused on being client-centered this traveling assignment allowed for us to gain a better understanding of difficulties clients we will work with may face.
The conditions of CHF and COPD would create many challenges when it comes to the area of community mobility. When out in the community, the client will have to not only manage their portable oxygen tank, but their other symptoms as well. Symptoms of their diagnosis that will impact their ability when traveling within the community may include shortness of breath, fatigue, coughing, weakness, elevated blood pressure and decreased alertness. These symptoms make it crucial that the client has strategies they can implement to ensure their safety. When using a bus, some obstacles they may encounter will be walking to and from bus stops, standing for extended periods while waiting for a bus or standing if there are no available seats on the bus, and climbing the stairs to get on and off the bus all while carrying oxygen. These tasks will require physical exertion and may exacerbate symptoms of breathlessness and fatigue. Occupational therapy recommendations could include implementation of energy conservation strategies such as sitting whenever possible, taking rest breaks when walking, and utilizing pursed lip breathing techniques.
This travel assignment helped our understanding of the psychological and emotional challenges that come with certain diagnosis when riding public transportation. Individuals living with CHF and COPD may struggle with depression, social anxiety, and overall low self-esteem. Public transportation with an oxygen tank may be difficult due to outsider facial expressions, physically maneuvering into and out of a bus, as well as dealing with the symptoms of CHF and COPD like coughing, increased heart rate, chest pain, and fatigue. These factors may have a negative psychological impact on an individual. Someone may not feel comfortable in social situations holding their oxygen tank and feeling like an outsider. Anxiety with public transportation may come with remarks from others due to taking longer to get into and out of a bus. The biggest psychological impact would most likely be feeling “publically disapproved.”
We were also able to observe a lady on the bus today that had some durable medical equipment (DME) and stares from outsiders on the bus were very apparent. The lady looked very uncomfortable and did not speak to anyone. Dealing with frustration of not feeling “normal” may decrease self-esteem and lead to depression or a fear of social situations. Someone dealing with COPD, CHF, and having DME, may limit their social interactions in order to decrease anxiety provoking public situations. An occupational therapist would be able to assist the individual in support groups and coping strategies to overcome the psychological stressors.
In order for an individual with CHF and COPD to travel on this bus route, he/she will need to transport some type of portable oxygen tank. When choosing which type to use, it is important for the patient to consider the pros and cons to determine which would work best. Compressed oxygen gas is stored in steel or aluminum tanks. Liquid oxygen is cooled oxygen gas, which turns it into a liquid state. This allows the individual to be more active as more oxygen fits in the tank; however, the oxygen evaporates over time. The third option is portable oxygen concentrators, which come in small tanks.
When the individual is determining which portable oxygen tank to use, it is important to consider the weight and size of the device, how it will be transported (carrying case or travel cart), how long it can last, and whether it takes batteries, plugs in, or both. The individual should also consider how often they travel and where to. Individuals with COPD and CHF tire quickly and can have SOB, it might be helpful to ask the bus driver if they can assist in carrying the device up the stairs. Also, it is important to keep the device upright and away from heat, as it supports combustion. An occupational therapist would be able to put together a packet of information on traveling on the bus route for the individual to feel safe and well prepared. As the profession of occupational therapy is solely focused on being client-centered this traveling assignment allowed for us to gain a better understanding of difficulties clients we will work with may face.