Occupational Therapy (OT)

Occupational Therapy works on adjusting to a new way of doing things. It helps you learn how to accomplish tasks safely.

Laid out below are the different stages of OT you are likely to go through.

Occupational Therapy empowers the individual to complete everyday tasks – known as activities of daily living or “occupations” more independently. These can include personal care tasks, domestic tasks, accessing community and leisure tasks, work or studying, voluntary and other roles such as caring or parenting. Occupational Therapy intervention can include using different techniques or strategies to complete a task or using adaptive equipment.

Occupational Therapists work with people of all ages and in a variety of physical, psychiatric and learning disability settings such as hospitals, schools, social services, housing and other community settings including independent practice.

Neuro Occupational Therapists specialise in working with people following a neurological event such as a stroke, or traumatic brain injury or following a diagnosis with a long-term condition such as multiple sclerosis, Parkinson’s disease or motor neurone disease.

More information about occupational therapy can be found on the Royal College of Occupational Therapists website:

What is Occupational Therapy? OT Explained - RCOT

Acute:

Occupational Therapy in the acute setting (Hyper Acute or Acute Stroke Units) focuses on finding out about you and your usual life before your stroke and assessing where you are after. This would include evaluating your movements, muscle power, sensation, thinking skills and functional tasks such as personal care or kitchen tasks.

Often, this assessment period explores the best and safest place for further rehabilitation - whether you could safely go home and have therapists visit you in the community or whether a period with in-patient rehabilitation would be more beneficial.

Discussions about home may occur early into your admission: who do you live with, what type of property it is, what help or support you might need, and what roles and responsibilities you have. The Occupational Therapist may suggest a home visit to explore what going home may look like. This is like a trial run to see if equipment or help (a care package) may be needed and whether you will be referred to the Early Supported Discharge community team for more rehabilitation at home.

In-Patient rehabilitation:

Suppose you need to stay in the hospital for more rehabilitation. In that case, the acute therapy team will refer you to your local rehabilitation unit, and you will wait for a bed to become available there. Once admitted, you are likely to stay for up to 12 weeks. Initial assessments will include the areas outlined above in greater depth as well as goal setting – what do you need to be able to do safely at home; what is important and meaningful to you so that your rehabilitation can be more focused and orientated to your needs?

In-patient rehabilitation will often follow a structured timetable of 1:1 treatment sessions with each of the therapy disciplines needed, as well as group sessions with other patients with similar needs. During your stay, you may be able to try spending time at home for the day or possibly overnight, following a home visit and provision of any required equipment. As your discharge date approaches you will be set up with exercises or activities that you can complete more independently once you go home to prepare you for leaving the hospital. It can be quite an unsettling time thinking about leaving the hospital and going home. The team is there to support you, and your OT can explore any concerns you may have about going home in more detail.

Community:

At the core of Occupational Therapy (OT), intervention empowers our clients to be more independent in important and meaningful activities. So a good starting point is to ask:

What is important to you?
What do you want to achieve in your rehabilitation?

Rehabilitation is a partnership between yourself as the client, your family and carers and your therapy team. The most important aspect is YOU! As an occupational therapist, we can explore and build a programme with you to work towards your goals. As OTs, we often talk about grading tasks – this could be through:

Breaking the task down into smaller, more manageable steps and then gradually putting them together
Working on the different steps involved in the task, e.g. chopping vegetables, could include exercises that increase hand dexterity, fine motor skills, and sensation, strengthening jobs for the hand and arm, posture and balance, and practising chopping vegetables.
Adapting the task or the environment, e.g. chopping vegetables, could include using an adapted knife, using an adapted chopping board, or completing the job in different postures, e.g. perching, sitting on a stool, or standing.
Work on the physical and cognitive demands of the task, e.g., completing the job with focus and quiet surroundings, talking, or having the radio on to increase cognitive needs.
reducing the amount of support or assistance needed ((e.g. physical assistance, to supervision, to independent)

With your OT, thinking about all aspects of your life where you may want to focus your rehabilitation is essential. It may help to think about these areas:

Self-care – washing, dressing, eating, drinking, hair, make-up
Domestic tasks – cooking, meal preparation, household tasks
Community tasks – shopping, restaurants, public transport
Work – volunteering, paid work, other caring roles
Leisure tasks – hobbies and sports

OT has such a wide and varied remit – if a task is important to you, it’s important to us! Here are a few top tips to support your OT intervention; remember TARA:

Time – most changes don’t happen overnight; they will be small and build up over time; it can be hard to see how much you are changing. Take videos so you can watch back and see the changes!
Activities – practice, practice, practice! Keep activities fun and varied; mix it up!
Rest - Fatigue is very common, so listen to your body and pace yourself. Take rests when you need and don’t feel negative about needing to rest – your body is still recovering.
Ambition and motivation – keep going; you are your biggest champion. Believe in yourself and what you want to achieve. Your OT will be right beside you, cheering you on!