Many people can’t wait for retirement age, to kick it back, relax and enjoy life, but what most people don’t think about is the fact that your job keeps you busy, giving you a sense of purpose and meaning and when that sense of purpose gets taken away from you, you feel as though your life has no purpose or meaning, leading to depression.
As people age, they become frail and less agile, they become childlike again, which for many, is heart breaking to see, so we try to make their lives easier by helping them to get dressed so that it gets done quicker, we feed them so that they don’t mess but what we don’t realize is that we are promoting “learned helplessness” by doing so. One of the most important roles of OT’s is to promote independence and self-reliance. Examples of this include education (diabetes, high blood pressure, cholesterol etc.), exercise and rehab techniques – encouraging the relearning of skills as well as coping with a permanent loss of function. OT’s help to simplify activities and provide sensory stimulation as well as offer tips on home / work environment safety, in order to improve a person’s functional ability.
OT is often mistaken for something to do with career counselling, however, in the OT world, an ‘occupation’ refers to the everyday activities that people do as individuals, in families and within communities to occupy their time that brings meaning and purpose to their life. It includes things they need to, want to, and are expected to do.
The role of an OT
Occupational therapists help patients recover or develop skills needed for their activities of daily living (ADL’s), which include self-care, leisure, independent living, school and work careers. Occupational therapists work in schools, hospitals, nursing homes and with patients in their own homes. The OT scope of practice is very broad, and people who could benefit from OT include those who have had strokes, those born with developmental disorders, people recovering from surgery, people suffering with anxiety and depression as well as addictions and psychiatric illnesses.
Within the nursing home environment, the OT works towards achieving social inclusion and participation in group activities as a means to eliminate leisure boredom. The aging process is often accompanied by a decline in physical and cognitive skills – hence the maintenance of cognitive health being of vital importance in the quality of life and well-being of older adults. These groups include; physical exercise groups, cognitive stimulation and leisure activities (puzzles, board games, general knowledge quizzes, dancing and crossword puzzles), which according to the British Medical Journal stimulates the brain and reduces the risk of dementia and progression thereof.
Occupational therapy is client specific, centred around what the individual enjoys doing, rather than what the OT enjoys or wants the client to do, so at Brenthurst, if residents do not want to join in on group sessions, they are not forced to do so, but rather encouraged to engage in their preferred activities. Although we cannot expect cognitive skills of those with dementia to be improved, range of motion, strength and endurance skills can be improved or maintained for as long as possible, even with the backdrop of dementia.
Examples below give an indication of the potential OT and team intervention for residents with dementia
|Problem area||OT and Team Intervention|
|Resident forgets what season it is when choosing clothing||Set up limited clothing selection to fit the season whilst addressing residents self-control and self-efficacy|
|Repetitive non-productive behaviour||Provide opportunities to engage in tasks that fulfil their needs to be productive and support relationships with others|
|Disorientation and wandering around||Setting up the environment to enhance daily activity – mobility within safe confines, e.g. having stop signs at the gates to keep residents oriented to that particular area only|
|Personality changes||Teaching carers the concept of caring, non-defensive responding and working on the underlying factor that may have triggered the behavioural change|
When an individual is having difficulty with higher-level executive skills, they can be referred to an OT for driving, work and a home safety evaluation and intervention. In middle stages of dementia, the focus is mostly on keeping the individual engaged in tasks that are meaningful to them, personally. When they start having difficulty with basic activities of daily living (ADL’s) , the focus then shifts to decreasing the burden of the caregiver and enhancing the individuals basic care by implementing safe transfers, protecting the skin from developing skin flaps, maintaining their passive range of motion to reduce the risk of developing contractures and providing sensory stimulation to suit the individuals needs/wants.
Ultimately, the aim is to allow those with dementia to enjoy life by promoting relationships and social participation so as not to become isolated, and to promote and focus on their strengths as opposed to their weaknesses.
- Alzheimer’s Association. (n.d.).What is dementia? Retrieved from http://www.alz.org/alzheimers_disease_what_is_dementia.asp
- American Occupational Therapy Association. (2008). Occupational therapy practice framework: Domain and process (2nd). American Journal of Occupational Therapy, 62, 625–683. doi: 10.5014/ajot62.6.625
- Schaber, P., & Lieberman, D. (2010).Occupational therapy practice guidelines for adults with Alzheimer’s disease and related disorders. Bethesda, MD: AOTA Press.
Developed by Regula H. Robnett, PhD, OTR/L, for the American Occupational Therapy Association. Copyright © 2012 by the American Occupational Therapy Association.