April is Occupational Therapy Month and what better time to build an understanding about what an OT (occupational therapist) does and how vital the service is that we provide to older adults. The role of an OT is often confused with that of a PT (physical therapist). Although our functions sometime overlap, and OTs and PTs often work together as a team, there are important differences between the two disciplines.
When I was an intern, my mentor described what we do this way: An OT looks at how individuals occupy their time, their role in their environments and how that role intertwines with their values. For example, an OT might work with a child who has a disability and may be having difficulty at school. Attending class is how the child occupies his or her time and learning is the role where successful outcomes are valued. Through a process of evaluation the OT can develop interventions that help the child compensate for barriers to participate fully in classroom and social activities.
With older adults the focus is on safety, which means evaluating the environment in which an individual lives and making sure he or she is equipped to function as independently as possible. If support is necessary, the OT recommends the appropriate adaptations that allow the patient to engage in what we call purposeful activities like dressing, eating and grooming, also known as activities of daily living (ADLs).
Take for example a senior patient who is in a skilled nursing facility after a hip fracture. Remediation would include evaluating activities that have most value and/or importance in the patient’s life. Again with safety in mind, we want first to evaluate how well the patient gets in and out of bed, is able to dress with or without assistance, and can manage personal hygiene. Once these ADLs are evaluated and interventions put in place as needed, the next step may be to assess a patient in a kitchen setting. Can he or she manage to make a cup of tea? At this point the OT and patient will work together to develop strategies that will help the patient function safely and, in time, with greater independence once he or she returns home.
By contrast, with the same patient, a PT will look at the hip itself, assessing things like muscle strength and gait pattern as it relates to functional mobility. Once again, safety is an important issue and focus is on treatments to strengthen the hip, and improve balance and gait with the goal of restoring the patient’s mobility.
Occupational therapy can be described as a holistic health care discipline. As long as I’ve practiced, I never tire of the sense of gratification I get from helping my patients perform purposeful activities that have meaning to them and make a real difference in the quality of their lives. So if you know someone who is an OT—give him or her a hug and say thanks!
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