Occupational Therapy: Your Life by Design

The role of an occupational therapist is often not fully understood, or is confused with the role of a physical therapist. What’s the differentiator? Cue the “your life by design” approach.

Occupational therapy concerns an individual’s specific needs and functions which are necessary to live their chosen life. Since the role of an occupational therapist and the process of occupational therapy are unique, cultivating an understanding of how an occupational therapist works to restore functions can help us realize that tasks which may seem so minor can have a huge impact on our daily lives.

So, what is occupational therapy and what is its purpose during rehabilitation?

Occupational therapy is the practice of working to restore functions of daily living. Occupational therapists work to understand their patients’ lifestyles, environments and skills to assess current and former functionality and mobility, and which goals are needed to help them gain independence or adapt to a new way of living. Top daily functions that occupational therapists work to restore include bathing, dressing, eating and leisure activities.

The role of an occupational therapist varies from patient to patient because all therapy should be customized for each specific case. By taking a “your life by design” approach, an occupational therapist’s work is unique to each patient and his or her condition(s).

When are the services of an occupational therapist needed?

Anyone who is unable to perform a certain function essential to their lifestyle is a candidate to receive services from an occupational therapist. Commonly, occupational therapists see patients who have suffered a traumatic injury or are living with or recovering from a neurological or orthopedic condition.

Evaluating the Patient

One of the most important parts of occupational therapy is the evaluation process. When an occupational therapist begins to work with a new patient, they must first determine a thorough understanding of the situation with the patient and, oftentimes, their family or caregiver.

Establishing this initial situation analysis helps an occupational therapist gauge the needs and wants of each patient. As part of the evaluation process, an occupational therapist works with the patient and his or her loved ones to set goals that will work to get the patient back to their optimal level of independence.

After goals are established, therapy begins by assessing the patient’s current level of function, as well as inquiring about the patient’s previous levels of function. Additionally, an occupational therapist must understand the patient’s home and social environments. Because the goal of occupational therapy is to ultimately help the patient regain or adapt their lifestyle towards some level of independence, having a specific understanding of the physical layout of their living quarters and frequented establishments is essential.

An occupational therapist may conduct an at-home screening, taking into account the different parts of their patient’s home that may need to be included in the development of their overall therapy strategy, things such as a lot of stairs, high kitchen cabinets, bathroom layout, etc. The physical layout of the house will have a significant impact on the types of functions that will be worked to restore.

The evaluation process also entails developing an understanding of the patient’s lifestyle. An occupational therapist may ask questions like, “Where do you typically go during the day?” or “What kind of activities do you enjoy doing?”

For example, if the patient enjoys going to church, it would be important for an occupational therapist to know what obstacles the patient might face during this particular outing, e.g. gravel parking lots, old wooden railings, tile floors and low bench seats.

Overall, an occupational therapist wants to gauge what the patient will be dealing with on a daily basis when they are out of medical care. If a full reclaim of independence is unlikely, an occupational therapist will take steps to evaluate the patient’s environment and lifestyle, and determine the ways in which he or she can work to adapt to it for the highest level of independence and functionality.

Your Most Important Daily Functions

Since the goal of an occupational therapist is to get patients home and back to day-to-day activities, there is a focus on basic daily functions like bathing, getting dressed, cooking, doing laundry and other daily chores.

Additionally, occupational therapists can restore other functions that are priorities to each individual patient, such as gardening, dancing or playing Scrabble.  The relationship between the therapist and the patient is important as the therapist connects with the patient and helps motivate to achieve these tasks.

Think about all of the small functions each individual completes at home on a daily basis. Every task, from getting out of bed in the morning to putting on pajamas at night, needs to be taken into account for successful occupational therapy rehabilitation.

It’s a Process

What makes occupational therapy such a unique and inclusive practice is the “your life by design” premise. The process of therapy differs with each patient because each patient presents different needs, wants, challenges and environmental elements.

What does typical occupational therapy look like? It is common for an occupational therapist to work with a stroke patient during their recovery. First and as mentioned previously, an occupational therapist will evaluate the patient and determine the functions that they wish to restore.

In the case of stroke rehabilitation, an occupational therapist will analyze the patient’s upper extremity for any deficiencies, including abnormalities in range of motion, and will also evaluate cognitive function (reasoning) and check for field cuts in vision, evidence of neglect and self-care. After this initial evaluation, an occupational therapist will work with the stroke patient to set individualized goals.

A major component of the recovery process is education. The occupational therapist will re-teach, or introduce, a certain function. In many cases, recovery comes with practice, repetition or required use of a particular function. It is important to not just adapt the patient’s unaffected side, but to also challenge the patient to use his or her affected side. It’s easy for a therapist to say a patient has reached his or her full potential; however, the best therapists see plateaus as opportunities to continue growing in a skill, not as final destinations.

Technology plays a major role in recovery, as mobility and adaptation technology are often utilized in the recovery process. Much of a patient’s therapy may take place in a therapy gym, which can offer different robotics, electrical stimulation, orthotics, harness systems and other tools to assist a patient in reaching his or her goals.

These technology-based recovery tools help patients learn different functions such as walking, carrying laundry or throwing a ball, all while additional safety measures are in place, and can offer an interface for visual and auditory feedback.

Next Step

Once a patient has either reached or made progress towards their goals and can safely return home, independently or with the assistance of their family, the inpatient therapy process will come to a close. Oftentimes, however, independence means something different for each patient and a continuum of care is required.  Outpatient therapy or home health services may be needed.

Occupational therapy is the complex field of helping someone return to normalcy. Although the challenge comes from the unique case of each individual, a safe and successful return home is the ultimate goal for all.