Dr. Eugenia Gonzalez, Dr. Katherine Lawson, Dr. Stephanie Capshaw

Sixteen students from the Master of Occupational Therapy (MOT) classes of 2013 and 2014, and four MOT faculty traveled to San Diego, CA in April to celebrate OT Month and join almost 9,000 other OT practitioners and students at the American Occupational Therapy Association's Annual Conference and Expo. It was a wonderful time of learning, networking, and enjoying San Diego!

The MOT Program extended offers to 24 applicants who will begin the program at the end of May. We look forward to welcoming them to campus. The program remains highly competitive and we congratulate them all on the hard work it took to meet the standards for acceptance! While we welcome a new cohort to UTEP in May, we prepare to send another cohort out on their final clinical rotations. We wish the MOT Class of 2013 (graduating next December) the best as they begin the transition from students to new practitioners!

Reed-Jones, R., Solis, G., Lawson, K., Loya, A., Cude-Islas, D. & Berger, C. (2013). Vision and falls: A multidisciplinary review of the contributions of visual impairment to falls among older adults. Maturitas, 75 (2013) 22- 28.

Christina Sobin, Ph.D. is the interdisciplinary Health Sciences Ph.D. Program Director. 

CS: Kathy, congratulations on your co-authorship of this paper.

KL: Thank you very much. 

CS: What was the topic that you were reviewing?

KL: We did an overview of visual impairments and falls in the elderly. We had been doing a study on falls in the elderly, with funds from a UTEP Interdisciplinary Research grant and we were seeing a lot of visual deficits in the people that we were interviewing, but we weren't focusing on that. We were looking at balance, medications, physical therapy issues, occupational therapy issues. But a lot of older adults were saying, "I've got visual problems and those are causing my falls." So we decided we should be doing research looking at that, at visual acuity. We wanted to include people who had cataracts, glaucoma, macular degeneration, and look at how those conditions might be precipitating factors for falls. There isn't a literature on that.

CS: Who was the "we" that you refer to? How did this group get started?

KL: The "we" is a group of us that first included social work and occupational therapy.   Dean Curtis had been saying, "We really need to promote interdisciplinary research." So when this project started, we wanted to be the first group to have a truly interdisciplinary research approach for understanding and preventing falls in older adults, and specifically in a Hispanic population. We reached out and found somebody from kinesiology, somebody from nursing, and from pharmacy. Then we all came together in one room and basically said, "We all have our own mind sets on how we evaluate people, but now let's all use all those mind sets so each of us looks at this one problem from each perspective."

In one way, understanding visual deficits and falls was probably most in line with Dr. Reed Jones' field of Kinesiology, because those visual deficits cause balance problems which then lead to falls. My interest as an Occupational Therapist was how these visual deficits or "intrinsic" factors, interact with "extrinsic" factors, like the environments that our patients live in. For example, when we go to see a patient in the home, a lot of times you'll see that the house is very cluttered. Even though the person may be used to that environment, with visual deficits, cataracts, with macular degeneration, their visual acuity is poor. Even though they know their own home environment, when the person has to walk to the bathroom in a cluttered environment, or get in and out of the shower, because of the visual problems they may be more likely to fall, because of missed functional transfers and poor ambulation.

CS: What are "functional transfers?"

KL: A functional transfer is, for example, if I go from a sit to a stand, or if I transfer in and out of the shower, or have to step over the lip of the bathtub to get into the shower. If I have visual deficits, I won't see the depth of the step and I'll end up falling.

CS: Kathy, how did the interdisciplinary work on this project develop?

KL: Usually all of us look at a problem from only our own perspective. What's needed is to be able to look at it from someone else's perspective - from a pharmaceutical stand point for example. I knew my patients were on medication but I didn't know what psychotropic medication, for example, did to somebody's vision, or I didn't know what pain medication did to somebody's vision - pain medication can make vision blurred, and it can make patients see dots.

When we started, each one of those people in the room said, "you know, this is what my field brings to the table - this is what you need to understand in how we do these measurements, and what we measure." My approach was to look at only extrinsic factors. Someone else might be looking at an intrinsic factor, and I was able to come back and say, "okay, now I see the intrinsic deficits that you're talking about and they're affecting the extrinsic environment in this way." Maybe they had never thought about how I was looking at the problem. When I started this, my whole focus was on "functional independence." Someone would talk about the intrinsic factor of visual acuity, and I would come back to them and say "visual acuity problems affect functional independence, so they're not able to dress, they're not able to cook, they're not able to reach for things."

It was so fascinating to have 5 people in there, egos aside - which is critical to this - egos aside, each saying, I want you to now be a kinesiologist, I want you to now be a nurse, social worker, pharmacist. And it was difficult to play those different roles! All of us had to set aside for a minute our own perspective and put ourselves in the other person's position.

CS: You used the phrase "egos aside." What does that really mean, how does that play out in a group?

KL: One issue is who will play a leading role - the group dynamics are very interesting. Regarding "ego's aside," as an occupational therapist, I think that my discipline is the most important approach for treating a patient, because I'm looking at overall function.

CS: That's probably why people choose to study one field rather than another.

KL: Probably. But having gotten into the interdisciplinary approach, now I know how important it is for me to understand the pharmaceutical perspective, the nursing perspective, social work, kinesiology. I really wasn't aware of that before, I didn't really have a grasp of that.

CS: How do you think having an interdisciplinary team look at this problem changes what will be done by the team?

KL: Well, we're not publishing single perspective papers, which would be easy to do. It would have been easy for me to look at visual acuity in the elderly and write a paper on how visual acuity pertains to occupational therapy. We're not doing that. Also, the interdisciplinary research leads us to interdisciplinary intervention. For our study, all 5 of us went into the homes of 30 people, and all 5 of came back saying "this is what we saw the problems were for occupational therapy, kinesiology, pharmacy, nursing, and social work. It's exciting, because the interdisciplinary research approach comes full circle, back to interdisciplinary intervention.

CS: Thank you Kathy, for your insights on interdisciplinary research, and congratulations again on your group's publication.

KL: Thank you.