Fairfield County Edition

Occupational Therapy as a Means of Empowerment

Empowerment defined is the ability to control and manage your life in a way that yields the most opportunity, satisfaction and joy. A sense of independence and determination and pursuit of meaningful activities underlie this drive. What happens if an illness, accident, injury or diagnosis changes the direction of your life and causes you to question everything you thought you knew about your life path?

It’s important to never feel like you are alone and that, indeed, “it takes a village”—plus a lot of patience and compassion. Occupational therapy can support that journey.

Basics of Occupational Therapy

Occupational Therapy (OT) is the holistic approach to increasing function following an injury, illness, developmental delay or diagnosis. It is a holistic approach to wellness and living and performing to the best of ability due to any physical, mental or cognitive differences for a person of any age. The term “occupation” means roles and is focused on the person’s interests, preferences and task demands and performance abilities. OT personnel are specifically state licensed and board registered and are certified Occupational Therapists and Certified Occupational Therapy Assistants, requiring different educational requirements and responsibilities.

There are multiple areas for this profession to address with a focus on personal routines, abilities and individual goals. The term ADL, or activities of daily living, is focused on the ability to care for oneself and entails dressing, washing, toileting, grooming and feeding—basically, everything you do to care for and maintain your body to survive. Other tasks can be considered the IADL, or instrumental activities of daily living, which can include: shopping, driving, laundry, household management and cooking.

Imagine that you are effortlessly going through your routine without becoming overly focused on it because it’s already established and you have the physical strength, coordination, visual, attention and mental abilities to sequence and problem solve tasks. You can complete getting up with or without an alarm clock, shower, get dressed, feed pets and make breakfast using whatever appropriate appliance. You can even motivate any children or partners in the house to get up and go about their routine, pack lunch, eat breakfast, check emails, brush teeth and get out of the house to begin the day, which may include driving or walking to your destination.

Now, imagine that you had a cerebrovascular accident or stroke that impacted your ability to use your dominant hand to prepare breakfast or impacted your ability to walk. How would your life and routines change? Could you dress yourself? Eat? Speak? Do the same job? Care for your family in the way you want?

What about the child who has sensory
sensitivity and is impacted by the brightness of the sun or the smell of coffee and hides when he hears his sibling’s alarm clock go off? How might this child’s and his caregiver’s routine need to be altered so everyone can complete their morning routine? If the child goes to school, how is the classroom organized and experienced by the child, and how is he or she able to learn?

What about an older adult with the onset of cognitive changes, worried that she may have the beginning of dementia? She has visual changes, falls often because she can’t see the steps and cannot prepare food using the stove—therefore stops eating properly and doesn’t call family or friends for support because she “doesn’t want to be a burden”.

What about a young woman who recently had both legs amputated due to complications from infection following surgery? How is she going to get into the tub to take a shower and navigate the halls in her school?

How can OT help?

Occupational Therapists work with individuals directly one-on-one or in a group setting to address the impact of an illness, injury or condition to empower individuals to develop new ways of participating in their routines and being able to achieve either the previous level of independence or maximize their ability to complete desired tasks. 

When someone encounters a catastrophic or life changing event, or has a developmental delay that will impact their learning and interaction with others and the environment, their world is forever changed. What they were able to do before may not be possible any time soon after the event—or may never be possible. An occupational therapist supports that individual during the rehabilitation and recovery process by teaching them new skills to recover, adapt or compensate abilities.

It is important to grieve the loss of function or what once was normal and to acknowledge it honestly and openly. There is no need to sugarcoat things or pretend to ignore how life may be different. True empowerment begins when there is a personal commitment to healing and rehabilitation or recovery. It’s the recognition that a person didn’t ask for, want or even imagine the circumstances that occurred, but nevertheless, there will be a “new normal”. There’s still a lot of value to their life and personal goals can be realized.

Occupational Therapists work in a variety of settings such as schools, hospitals, skilled nursing facilities, independent and assisted living communities, behavioral health centers, community centers and programs, rehabilitation centers, pediatric and adult outpatient centers and private homes.

Getting Started with OT

In the state of Connecticut, a physician’s order is required to order a medically indicated OT evaluation before a plan of care can be developed. At the time of meeting with an Occupational Therapist, an evaluation or assessment is completed exploring appropriate areas of concern and a person’s physical, cognitive and functional performance in various areas. There is a lot of exploratory questioning, standardized testing to develop baseline scores and plan of care development, in which the frequency and proposed duration of therapy is discussed before proceeding. There is always collaboration between the Occupational Therapist and other members of the medical team, as appropriate. The most critical feature is that the plan of care is designed based on collaboration with the patient, who is expressing his or her goals, preferences, what areas of function are challenging and which areas of life are most important to address.

In a school setting, there is a process of identification of possible barriers to learning and a referral to an Occupational Therapist who is usually on site to evaluate the child with parent’s permission. Results and recommendations are discussed with the student’s parents or guardians to discuss an educational program.

An initial brief screening can take place before a full evaluation is ordered and completed to note any challenges that may be appropriate for further evaluation.

You can begin your conversation with a doctor or student’s teacher and discuss areas of concern. A local membership organization called the Connecticut Occupational Therapist Association and a national advocacy organization, the American Occupational Therapy Association, can provide different resources for patients and clinicians.

Jennifer C. Hirschberg-Wise is the founder of Radiant Journey LLC, Occupational Therapy & Integrative Wellness and is committed to working with you or your loved one to reclaim your life and function after injury, illness or diagnosis. She has experience working with people across the lifespan with a variety of orthopedic, neurological and physical abilities. Connect at 860-916-9742, Jennifer@RadiantJourneyLLC.com or RadiantJourneyLLC.com.

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