Occupational therapy should be used a lot more often to empower senior citizens to more fully participate in and enjoy their lives, according to an industry organization promoting Occupational Therapy Month, celebrated each April.
Healthcare professionals supervising treatment of senior citizens who could benefit from occupational therapy sometimes fail to include it in a healthcare plan, according to Varleisha D. Gibbs, PhD, OTD, OTR/L, vice president of Practice Engagement and Capacity Building at the American Occupational Therapy Association. AOTA represents more than 230,000 occupational therapists, occupational therapist assistants and occupational therapy students.
“Occupational therapy can’t be excluded,” she says. “We’re really good collaborators, but we’re not always invited to the table. For example, with patients who have suffered strokes, often their providers will think of physical therapy, but not occupational therapy.”
Gibbs says family members should ask for occupational therapy, even if providers don’t call for it. “I had to ask for it for my mother and my grandmother,” she says. “I got it. But I had to ask.”
PT versus OT
Physical therapy helps patients cope with pain, increase range of motion, improve endurance and develop gross motor skills. On the other hand, occupational therapy helps patients improve fine motor skills and hand-eye coordination, and learn or re-learn daily tasks. This includes bathing, dressing, eating and even managing emotions.
Occupational therapy treats patients who are recovering from physical, developmental, mental or emotional challenges, which impact the person’s ability to perform daily activities, according to AOTA.
The association is working to raise awareness of the value of occupational therapy during Occupational Therapy Month. This year’s theme is “Occupational Therapy Brings Possibilities to Life.”
“Occupational therapy is a science-driven, evidence-based profession that enables people of all ages to participate in daily living or live better with injury, illness or disability,” according to the association. “This is accomplished through designing strategies for everyday living and customizing environments to develop and maximize potential. Occupational therapy services are provided for habilitation, rehabilitation, and promotion of health and wellness for clients with disability and non-disability-related needs.”
How it all works
In some cases, occupational therapy — which entails using exercises, specialized equipment, modifications to homes and other strategies — can enable seniors to stay in their homes, rather than having to move to assisted living facilities.
The practice helps people do what they need to do and what they want to do, says Gibbs. This may involve regaining the ability to do the kind of work they did prior to an injury or ailment, or learning new tasks.
“Just because people are getting older doesn’t mean they can’t learn new things,” Gibbs says.
Occupational therapists also help people drive and navigate public transportation, when possible, she says.
Occupational therapists start by developing a comprehensive profile of their patients; their home environments; and their physical, psychological and emotional needs and desires. Therapists then custom-tailor treatment plans for each patient and offer advice on using insurance to cover costs, Gibbs says.
On the home front
Some occupational therapy patients need help with the most fundamental tasks. For example, stroke patients need help with getting out of bed, bathing, dressing, preparing meals, eating, combing their hair and other daily activities.
Home modifications that may help patients include brighter lighting, larger utensils, plates that stay put, higher toilet seats, handles on commodes and rugs that don’t slide on floors. Sitting on secure kitchen stools makes it easier for some patients to prepare food. Some patients need help working on balance.
The therapists also educate caregivers about needed changes, such as keeping toiletries on top of sinks, instead of in medicine cabinets that may now be too high for seniors to reach. They can also help seniors learn how to best get in and out of vehicles.
Regarding patients with dementia, occupational therapists can help create home modifications while collaborating with any family members who live with the patient.
For example, Gibbs says that stoves can be equipped with knobs that are hard to turn or with a type of lock that shuts off gas or electric stoves if a fire is detected. The lock has a 30-second delay, which is enough time to clear any smoke if someone has accidentally burned food, but still fast enough to stop a fire from getting worse if they’ve left the stove on and left the home.
Meanwhile, masking doorways with murals or wallpaper may help prevent seniors with dementia from wandering out of their homes, says Gibbs, although she notes it’s not a fool-proof plan.
Occupational therapists typically check patients’ blood pressure and, when needed, respiration rates during and after activities.
For patients who have collapsed or fallen, therapists first address the cause and then develop a treatment plan. “I’d be thinking, is there an awareness issue, is there a neurological component, is there dementia, is there a problem with blood pressure, is there something in the environment that needs to change?” Gibbs says.
For example, something as simple as hanging a bell around a pet’s neck can help prevent a patient from tripping over the pet, says Gibbs.
In some cases, occupational therapists will have their patients use repetitive exercises to perform physical tasks. “But we try to make the exercises as organic and natural as possible,” Gibbs says. “We problem solve as much as we can and use a lot of encouragement.”
Medicare and Medicare Advantage cover occupational therapy, she says. Medicaid recognizes occupational therapy as a covered service, although it’s optional for states to include this benefit. Private insurers and sometimes Medicaid cover occupational therapy for those younger than 65.
With private insurers, coverage “would require approval like any healthcare coverage,” Gibbs says. “The medical provider and the insurer will determine if the service is covered and frequency and duration.”
Denise DiStephan is an award-winning, veteran journalist and communications professional based in New Jersey.