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Who are occupational therapists and how can they help our family?

Many of us meet occupational therapists for the first time when we have an older relative preparing to leave hospital. It’s not a job title that gives much away but occupational therapists are there to help people carry on their lives as well as possible. So who are they and what do they do?

Occupational therapists are fully trained professionals who focus on enabling people to get back on their feet after illness or injury. Their aim is to help people retain their independence as much as possible and to continue with the activities they need to do or enjoy, like hobbies and social activities.

When we meet occupational therapists in hospital it’s often because they’re helping to prepare a family member for discharge, but they are also employed throughout the health service, by local authorities and in care homes. Many specialise in areas such as mental health, including dementia, and strokes.

Leaving hospital

An occupational therapist will get involved with your relative as they’re preparing to leave hospital. They’ll assess how your relative is and may make a home visit. The aim is to help your relative carry on with their day-to-day occupations as well as they can. Most people would like to wash, dress and cook for themselves, and get out of the house, as a minimum. Many will be looking after partners as well as themselves.

So the occupational therapist will look at the person’s strengths and skills as well as any support that’s available to them, and then make suggestions on making life easier. That could be anything from a simple reorganisation in the kitchen to fitting a shower downstairs. It’s all about what the person wants to achieve and how they can be helped to do that.

Once your relative is home, they may need intense support for a short period of time. Reablement or Intermediate Care teams work with people usually up to six weeks on setting goals, such as getting up the stairs to sleep every night or preparing lunch, and working to achieve those goals.

Home or care home?

If the person has the capacity to understand and make their own decisions, then they’ll be able to talk with the occupational therapist about what they feel their needs are. The discussion will be about making changes to build on their strengths and support while minimising risks. If the person still wishes to go home then a risk plan will be agreed with the team outlining the risks and what is in place to minimise them. The person can then return home but with support in place to review how they are managing.

It’s a different situation if it’s judged that the person doesn’t have the capacity to make decisions for example, when someone has advanced dementia. A meeting will be convened to agree what would be in their best interest. This is likely to involve next of kin – who may hold power of attorney, the GP, and other health or social care staff involved in their care. The point of the meeting is to determine what actions are in the best interests of the person. Only when all community support has been exhausted will a decision be made to move them to a care home.

Occupational therapists in care homes

Some care homes employ occupational therapists and other occupational therapists provide in reach support to residents in care homes. Occupational therapists can advise on ideas, changes to the environment and equipment to help residents take part in the daily life of the home. As an example, someone might benefit from specialist seating and the occupational therapist will not only suggest which seating but show the carers how to position the resident to be most comfortable.

Importantly, they can watch how a resident manages eating and drinking and advise if they’re having difficulties. An occupational therapist can also pick up on other issues such as depression that might be causing a loss of appetite.

Occupational therapist and dementia

Dementia is a rapidly growing concern for families. You may be naturally worried that a relative living with dementia will come to harm.

An occupational therapist can help in a number of ways. They can show you how to share reminiscences and life stories to bring back happy memories and start new conversations. They’ll advise on home adaptations and alarms to minimise risk while your relative is home alone, and provide advice to carers on providing support and sharing activities.

Occupational therapists can also advise carers on communication and how to support a person with dementia to take part in activities. This can have benefits in reducing symptoms of dementia that can be difficult to cope with such as aggression or restlessness.

As part of the wider health and social care network occupational therapists can also direct you to other useful services.

How you can contact an occupational therapist

If you feel a relative could benefit from help from an occupational therapist while they’re still living at home, the first port of call is their GP or district nurse. You could also contact social services to find help. Many have a social care helpline number found on their local authority web site that you can call for advice.

Some services have criteria for referrals and may direct you to an alternative service and others may have a waiting list.

Alternatively you can contact an independent occupational therapist privately. More information is available at www.cotss-ip.org.uk.

It’s recognised that for many people their needs are long term. In many services a person will be discharged after an episode of care but they can be referred again and the service usually tries to see them quickly and if possible by the same occupational therapist.

Thanks to the British Association of Occupational Therapists and College of Occupational Therapists for help in producing this article.

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