Injury, disability, or diseases are among the factors that can affect the ability to carry out activities of daily living (ADLs). Stroke, for example, is the number one cause of disability among American adults. According to the National Stroke Association, about 5.4 million Americans face every day hampered by the effects of stroke, while millions more of their family members are involved in helping them recover.
Occupational therapy is an important part of this rehabilitation process. Occupational therapy practitioners will guide the rehab process, but it is essential for the stroke survivor and family members to be involved. For occupational therapy to be successful, the activities associated with it must be meaningful to the patient, and that meaning becomes most apparent when the family participates.
In occupational therapy, the objective is to enable the patient regain the ability to perform personal tasks (such as household activities) and professional tasks (such as job-related activities). Occupational therapy is primarily concerned about the ADLs because these enable the individual to live independently. The approach to rehab therapy will be individualized, taking into account the personal needs and interests of the patient. The program should be designed to improve motor skills, cognitive and communication capabilities, as well as the ability for social interaction.
Before occupational therapy can begin, there must be a referral for rehabilitation from the patient’s physician. The referral is like a prescription: it contains information on the nature and history of the injury or disease and defines the goals of the therapy.
After a period of observation to find out what the patient needs, the occupational therapist determines routines to promote health and develop the impaired skills. Appropriate exercises are recommended to motivate performance and encourage more active life both in the house and the community.
In some cases, it may be necessary to eliminate, alter or modify items in the daily routine. The patient and the caregiver are trained in efficient and safe techniques of transferring between toilet, chair and other surfaces. Modifications, such as shaving or changing clothes with just one hand, are taught. Ways to prepare food without unnecessary movements may be demonstrated. The therapist may recommend clothing and dressing aids like fasteners to help put on clothes and shoes. To get around memory problems, the patient may be taught how to use drug organizers and to write down things they need to remember.
Suitable means of adapting to work functions and facilitating community activity are taught, such as ways of going to the grocery without driving, using hearing aids in different situations and traveling safely with or without assistive mobility devices like canes. In particular, ways to maneuver a wheelchair in grocery aisles or office corridors need to be learned. Patients may be trained in the use of ergonomic keyboards to reduce physical strain on their arms.
The choice of assistive mobility devices from among various options will be important. Grab bars for use in the bathroom help those with balance problems, while shower chairs are suitable for those unable to stand for any length of time. Difficulty getting in or out of the tub may be solved with bathtub benches, while difficulty eating due to hand tremors may be addressed with weighted or large-handled eating utensils like a swivel spoons.
Assistive mobility devices should be chosen just as carefully. The suitability of walking canes or walkers depends on the strength of the hands and legs, as well as the balance and coordination. The occupational therapist must make sure a wheelchair is properly fitted to the patient’s dimensions; if necessary, upper-extremity amputees need to be trained in its use.
Occupational therapy offers immense benefits to patients. For a stroke sufferer, the likelihood of needing to move to an assisted-care home goes down 40 percent if occupational therapy is provided. Further deterioration is arrested and the individual is more likely to regain independence in performing ADLs. As added benefit, the interventions also result in fewer burdens to family members who provide care to their loved ones.