April is Occupational Therapy Month! For those of you who know me, I’m a Certified Occupational Therapy Assistant (COTA). Usually the only people who are familiar with OT are doctors, nurses, and people who have been on therapy. So since this is OT month, I thought I’d take a moment for a little public education.
Most commonly, Occupational Therapists & Occupational Therapy Assistants work with people with disabilities to enable them to maximize their skills and abilities. Occupational therapy gives people the "skills for the job of living" necessary for living meaningful and satisfying lives. In the US, OT began as a profession in 1917 with the belief in the curative properties of human occupation (or everyday purposeful activity). It was found that when people were able to actively participate in a meaningful activity, they were more likely to improve not only their mental health, but their physical health as well. OT had a prominent role in the moral treatment movement within the large state supported institutions for mental illness that were found across the country in the early 1900's; and was also commonly found in rehabilitation facilities for wounded veterans. If you look at what is most important in our lives, it is the ability to care for ourselves independently and to interact with our world. When you read about OT, you’ll always find references to “activities of daily living” or ADL’s. These are the things that give meaning and purpose to our lives. The basic ADL’s include dressing, bathing, feeding ourselves, going to the bathroom, transferring (such as getting out of bed). Beyond that, our instrumental ADL’s are activities related to independent living and include preparing meals, managing money, shopping for groceries or personal items, performing light or heavy housework, using a telephone, participating in hobbies or other activities, etc.
Today occupational therapy is found in a wide variety of settings including, but not limited to, education, nursing homes, inpatient and outpatient rehabilitation, mental institutions, and home health care. I work in a long term care/skilled nursing facility in the rehabilitation department. Our residents generally range in age from 65-95, but we are starting to see more that are my age (mid-50’s). This is always disturbing to me because it shows how very important it is that we take good care of ourselves. If you weigh over 300 pounds, get sick, and wind up in a nursing home for rehab, the odds on you being able to go back home are pretty slim. Think about how difficult it is for a “healthy” obese person to get around, then imagine what happens after they’ve been flat on their back in the hospital for a few weeks with a medical problem. It takes a huge amount of strength and endurance to be able to move that much weight. In the 3+ years that I’ve been doing this, I’ve never seen a morbidly obese person over 65 return home independently. Even the people who are highly motivated and able reach a point of being able to get from bed to chair after months of work, just aren’t able to take care of themselves alone at home. This is the really sad part of our job. Nobody wants to live in a nursing home, and especially someone who potentially has many years left to live. The cost is so astronomical, that most people have to share a room with someone that they don’t know and may not necessarily get along with. What are the most precious things in your house that you can fit into a dresser, a small closet, or put up on one wall? And everything is regimented to be able to provide and care for everyone. Everybody that requires assistance gets up early to go to breakfast at a scheduled time, you get a bath on schedule, you attend scheduled activities, you go to bed at a certain time. It’s no wonder that there is so much depression in the elderly!
But then there are the days when you can see the effect that you have on people’s lives, the hugs from the ones that love you, the smiles and reminiscences. When a blind lady tells you she remembers you because you’re the one with the kind hands. When a person is able to feed themselves independently. When someone actually gets to go home, whether it’s alone or with family. The first time someone gets dressed and goes to the bathroom safely by themselves. When that head injured patient that couldn’t speak tells you, “see you later alligator”. Those fleeting moments are what keep us going to work day after day, despite the long hours and the never-ending medicare paperwork, having to beg and plead with the ones who need us the most to give us the opportunity to help, and the ridiculous productivity goals we are expected to meet.
So celebrate OT Month by taking care of yourself and doing something that is meaningful and fun for you! I'll be knitting, spinning, learning the cello, doing yoga, working out, and making more time for friends.
If you'd like to learn more about Occupational Therapy, here are some links:
The American Occupational Therapy Association
United States Department of Labor
National Board for Certification in Occupational Therapy (NBCOT)