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Occupational Therapy

OCCUPATIONAL THERAPY

The primary focus of occupational therapy is enabling individuals to participate actively and meaningfully in their day to day lives. Occupation is defined as any meaningful activity a person may do throughout the course of a day, including taking care of one's self (self care), contributing to society through paid and unpaid work (productivity), and simply enjoying life (leisure). Individuals may experience many obstacles to participating in occupations as a result of the aging process, disability, environmental change, or other circumstances. Occupational therapists may work in the home, hospital, clinic, or community setting to enable clients to adapt to or overcome obstacles and optimize their involvement in daily life.

The ability to perform an occupation is impacted by interaction between the activity, the skills, and attributes of the individual and the environment. Occupational therapists strive to optimize performance by facilitating a positive interaction between the components of the person, environment, and occupation. Identified areas of concern for occupational therapy can be grouped into the three broad categories: self care, productivity, and leisure.

Self-Care

The area of self-care encompasses all of the tasks an individual does throughout the day to look after his or herself. It includes activities such as personal care, functional mobility, and community management. Personal care includes such tasks as feeding oneself, bathing, personal hygiene, dressing, and toileting. Activities involved in community management may include driving, taking public transportation, grocery shopping, completing community errands, and managing one's finances.

The aging process or disabilities affecting an older person may lead to difficulties in completing self-care occupations. For example, decreased balance or strength may make it difficult for older people to get about their home or community independently and safely. Disabilities such as arthritis can make seemingly simple tasks such as washing one's feet or doing up buttons or zippers extremely difficult. The onset of a dementia such as Alzheimer's may impact a person's ability to carry out effectively personal care activities or to manage their finances.

Occupational therapists play a valuable role in addressing the difficulties encountered in performing self care occupations as a person ages. The occupational therapist can assess the client's ability to complete a chosen occupation, such as bathing. During the assessment process, the therapist needs to consider a variety of factors including the client's goals, individual abilities and limitations, the environment, and the nature of the task itself. Depending on the situation, intervention may focus on the individual, adapting the environment, or modifying the task. For example, a goal identified by a client may be to regain independence with bathing. In this situation the therapist may work to help the client to develop the strength needed to get in and out of the tub, they may recommend modifying the environment to include an assistive aid such as a grab bar, or suggest the client consider adapting the task by sitting on a bath chair. Regardless of the method of intervention the focus is on enabling the clients to reach their goals, in this example independence with bathing.

Productivity

Productivity refers to an individual's contributions to society through both paid and unpaid work. Older adults often take part in the productivity occupations of household management, caring for family members, volunteer work, or paid employment. The physical and/or cognitive limitations that older adults may encounter can affect an individual's ability to fulfill productivity roles and responsibilities. For example, following a stroke individuals may experience a loss of function in their dominant hand making many household taskscarrying a pot, opening a can, or pouring a cup of teadifficult with the use of only one hand. The occurrence of a stroke may also impact an individual's memory, concentration, or attention span, leading to potential safety concerns in the kitchen, such as leaving items on the stove unattended or forgetting to turn off the burner.

The maintenance of skills necessary to manage a household and remain in their own homes is often of primary importance to older adults. Occupational therapists work with individuals and their families to promote independence and safety in the home environment. By addressing the physical or cognitive limitations, modifying the task or adapting the environment and support structure, the occupational therapist enables individuals to meet their household management responsibilities.

Leisure

In late adulthood, individuals place great importance on their leisure time, often pursuing hobbies, interests, and opportunities for socialization. Leisure activities may include quiet recreation such as reading or crafts, active recreation such as travel or community outings, and socialization such as visiting with friends and family. Many older adults have hobbies which they have participated in throughout their lives and may now have difficulty completing due to new physical or cognitive limitations. For example, knitting can become difficult as a result of pain experienced from arthritis in the hands. An occupational therapist can facilitate a hand therapy program to improve the range of motion and strength of the client's hands or adapt the knitting needles so the client is able to continue knitting. Spending time with family often plays a meaningful role in an individual's life. Occupational therapy is beneficial in providing suggestions to allow a client to interact with family or friends. For example, a therapist might suggest adapting a telephone for an individual with a vision impairment to facilitate communication with family members.

Summary

Occupational therapists are integral members of the older adult's health care team. By promoting the maintenance and development of the skills required for the job of living, occupational therapists enable clients to participate in those activities that are most important to them. Whether the goal be continuing to live independently, caring for a family member, or maintaining participation in individual pursuits, the occupational therapist can foster and enhance an older adult's quality of life.

Tobi Flewwelling Heather White

See also Home Adaptation and Equipment; Home Care and Home Services; Frailty; Functional Ability; Multidisciplinary Team; Physical Therapy; Rehabilitation.

BIBLIOGRAPHY

Canadian Association of Occupational Therapy. "Position Paper on Occupational Therapy with the Elderly Population." Canadian Journal of Occupational Therapy 55, no. 2 (1988): Centerfold.

Cutler Lewis, S. Elder Care in Occupational Therapy. Thoroughfare: N.J.: Slack Inc., 1989.

Hobson, S. "International Year of Older Persons: What Occupational Therapists have to Celebrate." Canadian Journal of Occupational Therapy 66, no. 4 (1999): 155160.

Law, M.; Baptiste, S.; Carswell, A.; McColl, M. A.; Polataajko, H.; and Pollack, N. Canadian Occupational Performance Measure, 2d ed. Ottawa: CAOT Publications ACE, 1994.

Townsend, E.; Stanton, S.; Law, M.; Polataajko, H.; Baptiste, S.; Thompson-Fransom, T.; Kramer, C.; Swedlove, F.; Brintnell, S.; and Campanile, L. Enabling Occupation: An Occupational Therapy Perspective. Ottawa: CAOT Publications ACE., 1997.

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occupational therapy

oc·cu·pa·tion·al ther·a·py • n. a form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life. DERIVATIVES: oc·cu·pa·tion·al ther·a·pist n.

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occupational therapy

occupational therapy Development of practical skills to assist patients recovering from illness or injury. Therapists oversee a variety of pursuits, from the activities of daily living (ADLs), such as washing and dressing, to hobbies and crafts.

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occupational therapy

occupational therapy n. the treatment of physical and psychiatric conditions through specific activities in order to help people reach their maximum level of function and independence in all aspects of daily life.

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