What is Occupational Therapy?
Occupational Therapy (OT) Is a client-centred health
profession concerned with promoting health and wellbeing through occupation. It
is the use of treatments to develop, recover, or maintain the daily living and
work skills of people with a physical, mental or developmental condition.
Occupational therapy is a practice that places a premium on
the progress towards the client’s goals.
Occupational therapy interventions focus on adapting the
environment, modifying the task, teaching the skill, and educating the
client/family in order to increase participation in and performance of daily
activities, particularly those that are meaningful to the client.
What does an Occupational Therapist Do?
An
OT creates individual treatment
programmes to help people of all ages – babies, children, adults and
older people to carry out activities they need or want to do, but are prevented
from doing so as a result of physical or mental illness, disability, or the
effects of ageing.
Activities can include the
necessities of daily living such as getting dressed, preparing a meal and going
to work, or simply continuing with a favourite hobby. Occupational therapists
will work with individuals to help them to find alternative ways to carry on
with activities to enable them to live in their way, more
confident, more independent and productive lives.
Over
one-third of occupational therapy practitioners work with older adults, when an
elderly person is affected by illness, accident, injury, disability, or a
mental health condition, providing advice
on how to undertake daily activities such as bathing, dressing, eating and participating
in a favourite hobby, This may incluide education, exercise, and
rehabilitation techniques that encourage relearning of fine motor skills,
improvement of basic motor skills, strength, and dexterity. Assessing and recommending equipment such as mobility
aids, wheelchairs and artificial limbs and, if needed, advise on special
devices to help around the home.
Occupational Therapy in Care at Home?
The role of an Occupational
Therapist and personal assitants is to help service users to maintain
independence in self-care and mobility, enhance their daily routine and enjoy
an active life in their home.
The occupational tharapist provides:
·
Advice on use of space and
equipment, such as seating.
·
Strategies to prevent falls and
manage risk.
·
Help to manage unusual behaviours,
such as restlessness and lack of inhibition.
·
To ensure a person-centred
approach to care and outcomes that result in the improved wellbeing of service
users.
Advice on Daily Activities.
Is important to remember to take a
person-centred approach. This means listening to the service users, respecting
their choices and preferences, and understanding their needs. we will work with
them and their family members to find solutions to help with those everyday
activities that have become difficult.
- Helping to develop a routine that
improves their quality of life.
- Proposing ideas and using equipment
to support service users to carry out activities that they enjoy or want to do.
- Finding solutions to difficulties
service users may have with communication, their memory or the environment.
Equipment and Mobility Aids
The type and amount of equipment needed will vary according to the
specific needs of service users. When
providing equipment, providers should consider:
·
The needs of the individual – helping to maintain, wherever possible,
independence.
·
The safety of the individual and staff.
Using the right, well-maintained equipment operated by trained
staff can help prevent accidents and reduce the personal and financial costs.
Moving and Handling can be defined as any transporting or
supporting of a load, including lifting, putting down, pushing and pulling,
carrying or moving, by hand or bodily force.
It could involve one or more staff, with the service users we
can make use of equipment as:
- Hoists and slings
- Slide Sheets
- Turntables
- Transfer boards
It's essential that you know about safe moving and
handling so you don't hurt yourself or them.
Continence Promotion and Personal Hygiene
Keeping clean is essential for good health. Poor hygiene can
cause skin complaints, unpleasant smells and bacterial or parasitic infections.
Some of the equipment we can use to help service users to have a save and
comfortable personal hygiene are:
- Commodes
- Shower Commodes chair
- Shower seats
- Bath seats
Before
starting make sure that:
·
The floor
is not slippery (dry it if necessary),
·
The room
is a comfortable temperature,
·
The water
is comfortably warm (older people particularly feel the cold, so
bear this in mind when adjusting the temperature),
·
The locks
are removed from the door (the person you care for may want privacy, but in an
emergency you will need to get into the bathroom), and
·
You look
out for your own safety, for example by making sure you can manage if
you have to lift the person in and out of the bath.
For most people, using the toilet and personal hygiene is a
very private activity. When helping someone be
sensitive and help maintain their dignity.
Mobility means different things to
different people. For some people,
mobility is being able to go out when they want to and where they want to. For others is being able to get from one place
to another by any means to maintain their independence.
Some of the mobility aids used are:
- Walking frames
- Walking trolleys
- Walking sticks
- Crutches
- Wheelchairs
Maintaining mobility is vital as
people grow older, it can make the difference between an active old age and one
spent sitting in a chair or shuffling around. It is important that you check
with the service users what mobility means for them.
Maintaining mobility doesn’t have
to means a specially designed exercise programme, just remaining active will
help, moving around the house, preparing a meal with supervison, or taking a
walk are all valid forms of exercises, as a personal care you must to encourage
service users to try to maintain. Maintaining their mobility can also help
people to maintain their independence.
Cushions and Pressure Relief
Pressure ulcers are a
complex health problem arising from many interrelated factors. There are a range of special mattresses and cushions
that can relieve pressure on vulnerable parts of the body.
The care team will discuss the
types of mattresses and cushions most suitable for the service users.
Those thought to be at risk of
developing pressure ulcers, or who have pre-existing grade one or two pressure
ulcers, usually benefit from a specially designed foam mattress, which relieves
the pressure on their body. People with
a grade three or four pressure ulcer will require a more sophisticated mattress
or bed system. For example, there are
mattresses that can be connected to a constant flow of air, which is
automatically regulated to reduce pressure as and when required. These some of
them:
- Cushions
- Pressure relief
- Positioning aids
- Mattresses and mattress overlays
It is important to avoid putting pressure on areas that are
vulnerable to pressure ulcers or where pressure ulcers have already formed. Moving and regularly changing service users
position helps prevent pressure ulcers developing and relieves the pressure on the
ulcers that have developed.
To draw up a "repositioning timetable", which
states how often service users need to be moved helps to avoid putting any
vulnerable areas of skin under pressure whenever possible. For some
people, this may be as often as once every 15 minutes. Others may need to be moved only once every
two hours.
Dealing with Challenging Behaviour
Challenging
behaviour is often seen in people with conditions that affect communication and
the brain, such as learning disabilities or dementia.
A
person’s behaviour can be defined as “challenging” if it puts them or those
around them, (such as their carer), at risk or leads to poorer quality of life.
It can also impact on their ability to
join in everyday activities. Challenging behaviour can include aggression,
self-harm, destructiveness and disruptiveness.
Communication
is the main way we interact and express our needs, likes and dislikes. If communication is a problem then it can be
very frustrating for the person involved and may result in challenging
behaviour. If this behaviour leads to a
desired outcome, it may be repeated again and again.
As
a carer, try to understand why the service user you look after is behaving in
this way. For example, they might feel
anxious or bored, or in pain.
If
you can recognise the early warning signs, you may be able to prevent
behavioural outbursts. For example, if
being in a large group of people makes the service user you care for feel
anxious and makes them become agitated, you could arrange for them to be in a
smaller group or have one-to-one support.
Try
to find out what the person is aiming for in their challenging behaviour. Do they crave one-to-one attention, or do they
want to be removed from a situation they find difficult? Keep a record of the person’s behaviour to see
if there are any patterns. This lets us
know what situations or people trigger the behaviour, what the early warning
signs are, and what happens after the event.
If
a reason for the behaviour can be established then their needs could be met in
an alternative way in order to prevent them resorting to challenging behaviour.
Any
techniques you try must be followed consistently by all those involved in the
care of the person you look after. If everyone does this, it will help the
individual involved to understand what's expected of them.
Maintaining a Safe Work Environment
In
our workplace, we have a responsibility to report any unsafe situation to our
clients and managers. It is important
that you develop an awareness of health and safety risk and that you are always
aware of any risk in any situation you are in. If you get into the habit of
making a mental checklist, you will find that is helps.
An
example of a safety checklist:
|
HAZARDS
|
CHECK
|
|
Environment:
|
|
Floors
|
Are
they dry?
|
|
Carpets
and rugs
|
Are
they worn or curled at the edges?
|
|
Doorways
and corridors
|
Are
they clear of obstacles?
|
|
Electrical
flexes
|
Are
they trailing?
|
|
Equipment:
|
|
Beds
|
Are
the brakes on and are they high enough?
|
|
Electrical
or gas appliances
|
Are
they worn and have they been serviced?
|
|
Lifting
equipment
|
Is
it worn or damaged?
|
|
Mobility
aids
|
Are
they worn or damaged?
|
|
Cleaning
materials & chemicals.
|
Are
they correctly labelled?
|
|
Containers
|
Are
they leaking or damaged?
|
|
Waste
disposal equipment
|
Is
it faulty?
|
|
People:
|
|
Visitors
to the building
|
Should
they be there?
|
|
Handling
procedures
|
Have
they been assessed for risk?
|
|
Intruders
|
Have
police been called?
|
|
Violent
and aggressive behaviour
|
Has
it been dealt with?
|
I
hope you have found this introduction to Occupational Therapy useful. You can find more information from the
British Association of Occupational Therapists HERE.
General
Healthcare Guidance can be found
from the SCSWIS website here HERE
Staff
and service users can contact me for more advice or follow me on the Blog and
Forum.
Johanna Garcia
Team Leader and Professional Advisor – Occupational
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