Makin' Rice Balls

 Sweet Potatoes above and below

 Rice balls

cooking rice balls

Red Bean Pancake

We waited in line for over 30 minutes just to try one! Many people in line drove from places over an hour away to order! And yeah, they were really good!

Wound Care with Traditional Chinese Medicine--Client 80 yr male s/p 1 mo VMA fx L hip and fx R fibula

 The black stuff is a traditional herb mixture in Chinese culture believed to cure all. This man used it on a previous fracture of the humeral joint (not sure what bones were involved). He refused treatment claiming this herb works. He has VERY limited mobility in his right shoulder joint (maybe 20 degrees flexion max). He uses his left hand to move his right arm around. We explained to this man that he is at great risk for losing all function in B LE. He still refused treatment.

 You can see the herb has removed some of the skin from his thigh. The herb is applied hot and there have been reports of 2nd and 3rd degree burns due to hot application. The herb is also very sticky and can pull off skin. This man refused medical treatment for his fractured hip because he has faith that the herb and several months of bed rest will fix the bone. He cannot move his L LE.

 The man also has DM 2. You can see poor blood circulation and problems with wound healing. He also refuses medical treatment for this condition, claiming it just started and will go away. He has no sensation to pressure or temperature below the waist. We explained why he has poor blood circulation and that he is at great risk of infection due to open wounds and poor circulation which may lead to amputation in the future. He told us we didn't know what we were talking about.

 Damage to the thigh due to the herb application.

 Pitting edema on B UE as well as poor wound healing from abrasions caused by VMA (This is his "functional" side). These woulds are about 4 to 6 weeks after the accident. He has no sensation to pressure or temperature in B UE.

Again, more problems with wound healing.

Home Visits

 Doing the old "nose over toes" technique.

 Demonstrating a transfer this older gentleman's primary caregiver. She is from Indonesia and was brought here to care for this man as a job.

 OMG that room was hot! I was sweating. Elders are kept bundled up with a heater directly on them. It is believed by doing such they will not catch cold. It felt more like heat stroke.

 55 yr old male s/p CVA.

Nursing Home Care in Taiwan

 We're not sure who made the splints but its pretty clear they don't fit this man or have a purpose--at least a splinting purpose.

 Poorly made splint.

 There are 15 people on this floor that require maximum assistance with all ADL. Everyone has a feeding tube and wears a diaper. Independence is not encouraged. Two nursing aides are in charge of this floor.

 Me trying to do passive range of motion on a man who sustained a TBI about 3 years ago. His wrist and MCP joints have a lot of tension and are showing signs of contracture.

 Look at that "amazing" splint. This is why one-size does not fit all.

 First signs of skin breakdown caused by splint made by staff. They were not aware of this when we showed them.

 Again, skin breakdown around the wrist.

 A rolled up towel does a better job of maintaining a "C" position of the hand than the splint. Aides were encouraged to use rolled up towels and to keep the UE in extension rather than flexion patterns.

 A better position for this man. The splint fits better on the right and the left was replaced with a towel. Arms are down by his waist with pillows to support is position.

 Higher level care in nursing home. There are 10 on this floor with one nurse. Everyone is a severe SCI or TBI. The majority are non responsive to visual, auditory, and touch. I have dubbed this room the "vegetable garden." There is no DNR in Taiwan and people are maintained on life support regardless of responsiveness and prognosis. Many of the people on this floor have been like this for 10 plus years!

Severe contracture of the wrist and deformities in the fingers. I was unable to passively move his wrist and fingers out of this position. This man has been in a vegetative state for 15 years!

 A traditional Taiwanese treat--strawberries, tomatoes, and prunes with a hardened sugar shell. Like creme brulee fruit style :). This is my Taiwanese OT friend, Hsin-Hsui.

 Taipei 101 building--tallest building in Taiwan. Consists of offices for world trade and business.

 View of Taipei City from Psychiatric Hospital

 Wheelchair ramp--its not even wide enough to fit a wheelchair, more like a stroller ramp! And steep!

Dan shui is known for this dish. Tofu with green bean noodles in spicy sauce. Also fish ball soup. Both are yummy!