I recorded some small flowers growing on a side street that I've passed a bunch of times before, but often at night so I wouldn't have noticed them in the past.

I was pleasantly surprised to see a group of puppies training to become service animals. I watched as countless individuals went up the puppies and immediately started petting them. I've noticed this is a common occurrence and haven't done much about it before but was introduced to how this really affects people when we visited Sights for Hope and they informed us of the problem it creates. I learned so much from that day and finally saw that as future OTs, we have a huge role in advocating for our clients, but we also in advocating for their needed services, including service animals. It's our duty to inform the public and spread awareness of the importance of asking before petting a service dog, and explaining why they need to remain alert and focused on their owner, because our clients deserve to participate without hinderance. Because of this walk, I learned to think critically about my surroundings and about interactions and framing them in terms of OT and OT practices, as well as how I can use them to gain knowledge and insight in real time.

So I learned that this patient happened to live near my uncle in New Jersey and because I was home this weekend I was able to pay a visit to his community. I took a walk with my little cousin and my dog Mochi (Moe) through the neighborhood and thought of that patient along the way. Some of the things I noticed immediately were the sidewalks and how uneven they were, the noise and foot traffic, the amount of people outside and the roads/safety of those roads. For a patient with L hemiparesis, this route was almost completely unmanageable and un-walkable. For a patient with dementia, this route was not calming or safe. My little cousin was hard enough to manage and keep out of the road because she likes to wander and do cartwheels in the grass. I couldn't imagine having to care for a patient with both his physical challenges and cognitive difficulties. This patient would need so much assistance and cueing to remain safe. The sidewalks were barriers because of his walker and trouble lifting his left leg, the noise and people around would be too distracting and maybe even disorienting, and the traffic/roads being so busy and unpredictable would be so unsafe should he accidentally wander or try to run off, which he did often at the inpatient rehab. He would suddenly get up and take off without his walker and completely defy his deficits, it was truly so interesting. So this walk wasn't eye opening for me necessarily, but it was meaningful, influential for my future and how I think about discharge for my patients in terms of community and not so much in-home barriers. I gained a little bit of insight into how difficult it is to say you can help a patient get back to their community, while also keeping in mind how everywhere is different, and these contexts and factors that are specific to each patient that pose as barriers.