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I used the energy conservation techniques during my morning routine on 6/28. The night before I neatly laid out all of my clothes and items I needed to get ready in the A.M. I set my alarm clock for 45 minutes earlier than normal and prepared the auto program on the coffee pot. When I woke I took a shower seated on the shower ledge and quickly learned that hose extension would be needy if I were to have to do this everyday.  I began grooming, hygiene, and dressing following the shower. Even though I thought I had gathered everything I needed the night before there were a few necessary items I had neglected. Retrieving these needed items required a lot of getting up and down and back and a trip from bathroom to closet. The extra activity forced me to consider an addition rest break. When I went to make my cereal I realized my husband had placed the gallon of milk on the back of the top shelf of the refrigerator the night before. I had to reach here to retrieve the milk because he was still a sleep.  I let the dishes soak while I drank my coffee. Then washed them before leaving.

I was a little surprised to see, even though I woke up 45 minutes early, I didn’t have much time between when my routine was completed and when I needed to leave the house. Thankfully my husband was home for the day and everyone was still asleep. This allowed my to eliminate feeding and taking the dog on the walk as well as getting my son ready.  If I had to complete the full morning routine with pacing and rest breaks it might require me to get up much earlier. Additionally, I should have put more time into the organization and preparing of my needed items. I would imagine a list would have been a better approach to ensure I had everything I would need the next morning. I can also see how the cooporation of those living with you would be important to successfully conserving energy. Overall the strategies required much more effort and planning than I initially thought they would and I can see how patients may face challenges and frustration in implementing energy conservation especially if they have a schedule to keep and no caregiver present to assist them.

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Using energy conservation techniques proved to be a lot more difficult than I thought it would be. On any given day, my schedule consists of getting out of bed, getting ready for work, working, food preparation, completing homework and studies, and finally the gym. Normally, the food preparation takes place at night for the following day. This typically takes about an hour, and I complete additional house cleaning chores while food is cooking. For this exercise, I decided to implement energy conservation techniques during food preparation. While it was pleasant to slow down my usually hectic routine, I realized how time consuming it really is. I pulled out all of the ingredients ahead of time instead of reaching for them individually as I'm cooking. I also slowed down my pace as I was cooking, taking time to open jars, containers, and food packages,  rather than rushing through the process.  Most importantly, I decided to sit down at the dinner table and wait for my food items to be fully cooked, instead of continuing my usual cleaning routine that I do in between. I did notice I was far less exhausted once I was actually done.

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I used energy conservation techniques during my morning routine of showering, brushing teeth, getting dressed and making coffee, before heading out to work. I set my alarm to a few minutes before to give me enough time to slow down and take a small break after each task. I went straight to the bathroom where I brushed my teeth and then proceeded to take a shower. I had a small bench I was able to use and I tried not to put the water too hot but that was really hard. I like hot water when I shower. The bench was nice for shaving my legs since I didn’t have to do a lot of bending. From there I went into the room and gathered everything I needed to avoid walking back and forth to get things. I also used a chair for dressing. I grabbed my purse, which was way too heavy so I organized it the night before and dumped a lot of things out. In the kitchen I grouped all the items together to make coffee and I seated while it was brewing whereas I typically stand. Overall, it was hard because I’m used to doing everything so fast that I had to remind myself to take small breaks in between and to slow down the pace.

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My typical morning routine consists of getting out of bed and showering, brushing my hair, brushing my teeth, shaving, and then of course getting dressed.  The first thing I decided to do is allow myself more time for all of these activities.  I usually hit snooze 2-3 times before getting up, but this time, I got right out of bed and went straight to the shower.  I made sure to have my towel right next to the shower and all of my shower supplies right next to me so I could sit down while showering and dry off while still sitting down.  After my shower, I got dressed while sitting on the toilet directly next to the shower, which required advanced planning to bring my clothes and place them on the shelf next to toilet.  While doing my hair, brushing my teeth, and shaving, I was able to sit next to the sink.  All of my items were already within reach, as I had placed them on the counter the night before.

Overall, this experience taught me how important routines are.  I have a set routine based on my current abilities when it comes to my morning ADL routine.  It took a lot of forethought and planning to try to create a different routine than I am used to, and I still forgot things!  I forgot to place my clothes in the bathroom the night before, so I had to walk around the bedroom to my drawer and then the closet to pick my clothes out.  I also forgot to bring a chair into the bathroom to sit at while I brushed my teeth and hair and shaved.  This, along with the bending and carrying that the task required certainly took a lot more energy than if I had prepared better.  Also, while in the shower and while brushing my hair, I had to keep my arms up for long time because I have a decent amount of hair to wash and brush.  Maybe considering a shorter more manageable haircut would be a good idea to consider.  The shoulders seem to tire out very quickly compared to other muscles.  I also did not have any long handled shower tools, so I had to do a lot of reaching and bending in the shower to wash my whole body.

For people that are dealing with cardiac conditions, I can see how important our job as an occupational therapist is to them.  Helping them create brand new habits and routines and making sure they have the proper equipment to use good energy conservation tasks is of utmost importance for these clients.  I definitely have a greater appreciation now for this aspect of occupational therapy.

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This morning I used the energy conservation techniques with my morning routine. I pre planned the night prior in order to make things easier throughout the routine.  I set my alarm for an earlier time in order to give me enough time to have rest breaks in between my tasks. I began with a shower, which I was able to sit down for.  All of my toiletries were within easy reach and I slid them to me rather than picking up multiple items throughout the process. I showered in lukewarm water which I did not enjoy at all! I typically like my showers as hot as I can stand them! Prior to getting in the shower, I placed a terry cloth robe, as well as the clothes I would be wearing that day, in the bathroom and in a spot that I could sit down while dressing. I used the terry cloth robe to pat myself dry and took a rest break prior to dressing. I sat to brush my teeth but had to stand up at one point because the sink is too high. I rested on my elbows while doing so to conserve energy. I sat to put on my make up and do my hair. Next I went to get the baby up. I sat down while changing her diaper, which I usually stand for. I sat down at the kitchen table to make her bottle. The night before, I had washed everything and placed on the table to air dry. I typically keep her bottles in an overhead cabinet. I slid everything to me while sitting and making her bottle. Once again, I used this time to take a break and pace myself. I then sat with her while feeding her bottle. She refuses to hold her bottle and I usually have to hold it but this time I used a pillow to help prop it up for her. I was able to rest while doing this as well. Then my 8 yr old and 6 yr old woke up and my energy conservation techniques essentially went out the window! All in all, I found that pre planning definitely helps things run smoother. I can completely understand why there is a high incidence of depression in this population. I'm very independent and have a lot of people that depend on me for a lot of different things. It would be very difficult for me not to be able to care for my children the way that I'm used to or to ask for help. It would be difficult to accept that I could not do things how I once did.

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This morning I attempted to incorporate the energy conservation strategies from this unit to the best of my abilities. I found pre planning and setting things up prior to be very easy and helpful. I woke up, sat on the edge of my bed and drank a bottle of water that I had already put on my table the night before so I wouldn't have to go downstairs into the kitchen first thing, as I usually wake up thirsty. I went to the bathroom to brush my teeth, where my tooth paste and brush were already on the sink. I then proceeded to change into my work clothes which were also already laid out, then headed downstairs to make breakfast. I woke up in plenty of time before work so I could calmly go about this routine without any rushing. I did find it more difficult to organize things to where I wasn't reaching or excessively bending. My cabinets are all significantly higher than me, as well as I always put the milk on the bottom shelf of the fridge, forcing me to bend. I also found myself standing whiling doing many morning tasks, such as brushing my teeth, getting dressed, even making and eating my cereal. I think it would be easy to sit and conduct all of these activities except for brushing your teeth because the sink would be to high if you sat down. Other habits I found myself difficult to break out of was taking breaks in the morning. I found myself constantly going from one thing to another without really thinking about it.

Overall, I found it easy to plan ahead, set up in advance and wake up earlier to make life easier and conserve energy in the morning. I did find it difficult to break old habits. The standing up to make your food, get dressed, and eat without sitting down for breaks in between activities is just something I did without even thinking. Activities such as brushing your teeth forces you to stand or reaching/bending seem more difficult to break because the necessary placement of  items (high cabinets and sink/big space at bottom of fridge for milk) forces you to do these movements.

Smith-Gabai, H. (2011). Occupational Therapy in Acute Care. Bethesda, MD: American Occupational Therapy Association Inc. p. 584.

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This morning I incorporated the energy conservation strategies as indicated in this unit. It wasn’t as easy as I thought it would when incorporating it into completing my daily activities. The hardest aspects of the conservation strategy for me was planning and pacing. Today when I began my morning routine for cleaning the house I had to plan out the chores I wanted to complete for the day. This was a change for me because I normally just begin and have no rhyme or reason to the order or what tasks I would like to complete. I decided that I wanted to clean the sink, tub, toilet and do one load of laundry for the day. Planning I feel helped me manage my time better and I was able to complete my chores in a more timely manner.

Pacing has always been something I have struggled with and this energy conservation model was no different. I always have just wanted to get all of my chores done and out of the way but I was always tired by the time I finished. With the pacing strategies I learned in this unit I found that not rushing and taking breaks helped to conserve my energy and I didn’t feel as tired as I normally do (Smith, 2011). When cleaning the sink, tub and toilet I tried to consistently take breaks between each of these chores. I found that sitting on a short stepping stool when cleaning the tub help elevate back pain which I normally have once I am done. I also used the stepping stool when taking the clothes out of the drier before I folded them. I found that using this helped with back pain and allowed me to better conserve my energy. Another aspect of pacing that I included into my routine was breaking up my chores throughout the week (Smith, 2011). Not having to finish cleaning the house all in one day was a way I was able to have more energy and complete other things in the day as well. Ultimately I have tried to organize my chores so that I am able to space them out throughout the week. This has been a tough task but I have had more energy so far by doing that this week. This was a challenging exercise but I feel that planning, pacing and prioritizing are all components that would be useful in my life to help conserve my energy allowing me to complete my schoolwork and weekly cleaning chores (Smith, 2011).

Resources:

Smith-Gabai, H. (2011). Occupational therapy in acute care. Bethesda, MD: American Occupational Therapy Association, Inc.

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Today morning I used the energy conservation strategies indicated in the unit.

When I know that I need to wake up very early in the morning or that I will not have a long night sleep I try to set up my clothes and objects that I know I would need the night before, just to have it all together in the morning. I usually do this as a safety measure because I know that in the morning I might not be cleaver enough, so I do not need to think much or I do not waste time and stress myself trying to find something that I need within a time constrain. In this case I used this technique to be more relax and conserve my morning energy. Other technique that I used was to plan my grooming, showering, dressing, and having breakfast. The whole ideas was to have the less amount of trips back and forth between bed, bathroom, kitchen and out of home. At the bathroom I used the toilet to sit and from there try to do my toothbrush and also get shaved with my wireless electrical shaver. The shower space is big enough so the night before I left a plastic chair in there, so I showered from there (I leave my wife's comments about this chair in the bathtub for another post). I do not have a towel robe so I tried to let myself dry with the air and then while still seated I used a towel to pat dry instead of rubbing. Then I moved to the chair where I left my clothes the night before and got dressed almost seated. When I got to the kitchen I realized that cereals, milk,  coffee, microwave, etc are not placed following an energy saving plan (of course with 2 kids my energy saving is not the priority on a daily basis). I got seated while waiting for the microwave. Following these techniques I figured out how low into my regular priorities is energy saving. I think that if the objects needed are organized with this priority in mind it might be much easier to do it on a daly basis.

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I tried using energy conservation techniques during my nightly routine of showering, dressing, and hygiene activities. Although I do these ADLs before I go to bed, I do not always do them in a certain order. In order to conserve energy, I had to come up with a plan that I thought would conserve the most energy. Before showering I gathered all my clothes and put them above the toilet where they could be reached easily after I got out of the shower. After I gathered my clothes I had to remind myself to take a rest break before organizing shampoo, conditioner, soap on the shower bench. I also gathered a “no tangle” hairbrush that I’ve never used to help when washing my hair and eliminate me having to comb my hair after getting out of shower. During the shower, I sat on the shower bench and used the hose extension while sitting which I’ve never used as well. I took my time during the shower and took rest breaks as well. This I found difficult because I am used to taking very fast showers. On the other hand, I did feel like it didn’t require as much energy as I think it normally feels.

When getting out of the shower I used a terry cloth robe to wrap into to avoid drying off and using energy and sat on the toilet seat until I completely dried off. Once I dried off I was able to reach up and grab my clothes to put on. To avoid excessive bending and raising my arms up, I put on a long gown that zips in the front. After I finished getting dressed I brushed my teeth while sitting on the wide edge of my tub to avoid standing.

Even though it took a lot of reminders to perform these techniques during my routine, I found it helpful to conserve energy. I can see how it would be difficult for someone to have to learn new principals to apply to their routines, but I also think the benefits outweigh the difficulties.

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I used these conservation techniques during my morning routines and this was not easy for me.  I tried to create more time for my activities so I would not rush. For this technique, I set my alarm clock earlier so I had ample time to get ready.   I tried to sit as much as possible while doing my morning activities.  I am usually on the go and rushing for time so I do not usually sit and eat breakfast or sit to put on my shoes.  This morning I could do both things while sitting because of the first technique I used.  I planned my day so my activities would be spread out evenly allowing time for breaks in between. On Tuesdays, I work out with a trainer in the morning and then after that it is hard to get into the routine of my day.  This technique allowed me to follow through and stay on task with all my school assignments and chores around the house.
Overall, I think I did ok with these techniques.  I am use to being on the go and rushing to get things done in the morning.  Implementing these techniques helped me to not only better manage my morning but my whole day.  I am highly independent and I am sometimes stubborn when it comes to asking for help so this could lead to being noncompliant.  For instance, if I was to implement the technique of avoid lifting and carrying heavy objects I would have broken this rule as I like to work out and lift weights.  I know that there are different ways to continue these exercises without lifting weight, therefore, I would just need to modify my workout to fit these restrictions.

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I implemented energy conservation techniques while doing my morning routine of showering, dressing, and cooking breakfast. I used pacing to start my morning. I woke up without snoozing my alarm to give myself enough time to complete my morning routine without rushing. I took frequent breaks so that I could balance rest and activity. I focused on using proper body mechanics and breathing throughout.
For showering; I sat on the toilet to undress. I also have an area where I can sit in the shower, so I sat while taking my shower. Sitting also allowed the shampoo and conditioner to be right next to me so I could avoid bending. I slid them instead of picking them up to conserve energy. I used lukewarm water to reduce steam and had my towel on the rack inside my shower to make it more accessible.
For dressing; I used planning to think about what I was going to wear and laid it out the night before so that everything would be easily accessible and to decrease my morning rush. To avoid steps, I put different layers on at the same time. I made sure to sit while I was dressing, dress my lower body before my upper body, and to use my breathing techniques while bending and raising my arms.
For cooking; I used planning to prep my food the night before (veggies for my omelet). I gathered all of my items before cooking and used an apron to carry my cooking utensils to minimize my steps. My stove is too high for my chairs so I could not sit, but I focused on breathing and taking a lot of breaks. The recipe was quick and didn’t take much effort.
Following these techniques would be beneficial for someone who really needed to conserve energy. It was a little different for me because I usually do everything very quickly and I don’t have time to plan. This did take effort on my part, but I also found it very relaxing 😊

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I implemented energy conservation strategies while doing my morning showering, grooming, and dressing routines. I don’t have a shower seat, so I had to stand while showering. I did some pursed lip breathing before showering to prepare and afterward before moving on to the next task. What struck me the most was how much energy I use to take care of my hair. Shampooing, conditioning, brushing, and drying demands muscular strength and endurance, and I think this is where I would need to focus my efforts to save the most energy in my morning routines. Using a two-in-one shampoo and conditioner to save myself a step would help and I could get a smaller bottle that would be lighter.  If I changed what time of day I shower, I could use an absorbent hair towel and then let it air dry. If I still found myself fatigued or short of breath with these modifications, I think I would then have to consider cutting my hair or having someone else do it.

At first I forgot to pat dry instead of rubbing, but then stopped and wrapped up in a robe so I could dry the rest of the way while completing my other routines before dressing. I sat while brushing my teeth and putting in my contacts by opening the bottom cabinet doors of my vanity to give clearance for my knees and found this more comfortable than I expected. I was also able to rest my elbows on the counter while completing these tasks. I brought all my clothes into the bathroom before showering, so after I sat to brush my teeth, put on lotion, etc., I could take a break to do pursed lip breathing and then have them within reach to get dressed while sitting.

Overall, I felt like I would be able to comfortably incorporate most of the techniques, but I would be resistant if I was told to consider cutting my hair or having someone help. Being independent is important to me, so any loss of independence or having to admit that I couldn’t take care of my long hair anymore would be an adjustment.

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I utilized energy saving techniques to help with my morning routine on 6/26/2017. My wife just began helping with a summer camp so these techniques came at a very convenient time. I set out my kids outfits the night before and made sure breakfast was prepared and in the refrigerator. I woke up 45 minutes earlier than normal to get ready for the day before the kids woke up. Trying to get ready for the day while also helping the kids with their morning routine can be difficult so this really helped the morning go smoothly. Even with these conservation techniques I feel that if I really had cardiac precautions, it would be easy enough to complete these strategies, but to make it through the entire day would be very problematic. I would need to make sure everything that I would need throughout the day is prepared the night before in order to minimize the amount of work that I would have to do while the kids are awake. Although this is possible, and is what I typically try to do, there are unexpected situations that are impossible to predict.

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Utilizing the energy conservation techniques was difficult for me to implement in my daily routines. I see how hard it would be to have to change these routines and habits for someone who has cardiac problems. I stopped and took rest breaks in between taking a shower, getting dressed, and ready for the day.  It was hard to make sure everything was well prepared so I did not have to reach and bend down as much as I usually do. The hardest for me was getting my clothes prepared and sitting down while getting dressed so I wasn’t standing as much and didn’t have to bend over quite as much. I realized that if I had not done this and had cardiac problems I would be completely worn out. I think the most important part is the planning and preparing. Even though this is difficult at first, it will end up helping in the long run so you do not tire and get worn out so easily.

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While I was cooking today, I planned what I was going to cook and put all the ingredients out on the counter so I wouldn't have to visit the refrigerator or pantry multiple times. This is an example of planning, and having food items at the same level minimizes reaching and bending. It is easy to plan, however, I needed rest breaks while prepping the food and after opening and closing the oven, which requires me to bend and reach down. Cooking in general can be very frustrating because most of our meals need to be prepped and cooked in an oven, microwave, or on a stove and requires upper extremity movements. You naturally want to reach down and open the oven or use utensils to combine ingredients. Meal preparation without any reaching, bending, or lifting can be arduous and time consuming. Another task that was difficult and required pacing and positioning was getting in and out of bed. To get out of bed without reaching down for support, I had to cross my arms and hug myself and utilize my legs to get enough balance and strength to get off the bed. I also had to take a rest break as soon as my legs were off the bed to ambulate and get my breathing back to normal. Simple tasks such as cooking and getting out of bed would require a lot of patience for a cardiac patient and I understand how depression would be very common because you become dependent.

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I attempted the energy conservation techniques this morning (6/25/17), in preparation for waking up and making breakfast. I am familiar with some energy conservation techniques from my previous work experience. And like Kaytelynne mentions below, it was tough to break out of the normal patterns that I go through daily.  I used rest breaks after grabbing oatmeal, and a bowl to pour it in (from a high to reach cupboard).  I took a seated rest break at the kitchen table while waiting for it to cook in the microwave (normally I would never do that). In doing these simple tasks, I can easily see how frustrating it would be for a cardiac patient who has been living the same routine day in, and day out for countless amounts of years. It feels like it limits independence, even though I accomplished the tasks on my own, the pacing makes a tremendous difference. I realized that reaching to grab the bowl from the cupboard, and placing the bowl in the microwave (both slightly overhead) and having to press the buttons for the timer could be exhausting.

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I utilized energy conservation techniques this morning while attempting to prepare to go to work. Some things I found moderately easy to uphold, but most activities presented a struggle with remembering the conservation techniques or completing them. Remembering the energy conservation techniques presented as my biggest challenge. So much of my morning is consumed by routines, that the switching of that routine took a lot of slowing down, and constant reminders. I began my morning with planning out my activities: shower, dress, breakfast and while developing the plan proved to be simple, executing the plan was a bit more difficult. Getting distracted was something that continued to happen; seeing something in the moment that I wanted to complete (ie feeding the cats) and it not being a part of the plan. I also focused a lot on deep breathing as a means of energy conservation, which the activity itself wasn't difficult, but remembering to slow down consistently was. If I was in a permanent position to try and conserve energy, a lot of my belongings would need to be rearranged as a multitude of things were placed high, or were rather heavy. Energy conservation sounded simple at first, but when you are rushing to get to work on time an array of challenges present themselves. Thankfully I did not tire easily while executing my routines but I realized that if I were in the position where I did tire easily it would be even more difficult since no one was home to ask for help.