The role of the Occupational Therapist in Nursing Homes
Occupational therapy is a health care profession that aims to help people do the everyday things that they want and need to do when faced with injury, illness, disability or challenging life events (WFOT, 2012). It is a client-centred profession, focusing on achieving the individuals own goals.
Occupational therapists work with babies, children, adults, and older adults in a variety of different environments such as at home, in the school, a nursing home or a clinic.
Although it may contradict the typical view of a nursing home, they can be engaging and filled with activity. Through occupational therapy, residents can develop function, as well as an increased sense of competency and personal happiness.
An occupational therapist can help a short-term resident who may be in convalescence, to regain the skills they need to return home. They can also work with long-term residents to provide meaningful occupations in their lives and maintain a level of independence.
For many older adults, they will be seated for most part of the day and therefore it is important that they are sitting in a comfortable, safe, functional seat, that also meets their physical needs such as postural support, and also improves digestion and breathing (Engstrom, 2002).
An occupational therapist can provide a comprehensive seating assessment to residents in a nursing home for armchairs, wheelchairs or other specialised seating. The assessment takes into consideration a personâ€™s functional ability, postural analysis and environmental factors. Having the correct seating for an individual also helps to reduce the risk of pressure sores.
Pressure sores are a severe, yet usually preventable, common problem amongst older adults. An occupational therapist can assess residents of a nursing home to ensure that their mattress and armchair is meeting their needs and can provide pressure relieving equipment such as cushions or air-mattresses to those who may be at risk of developing a pressure sore (Macens, Rose, & Mackenzie, 2011).
They can also consult with other members of staff on the importance of moving an individualâ€™s position if they are bedbound or have limited mobility to help prevent sores.
There are many different aids and appliances that when introduced into a personâ€™s life, can make things a little bit easier and allow them to reengage in their daily activities. An occupational therapist can recommend equipment for a resident such as shower stools, easy-grip cutlery or a raised toilet seat to assist a person in their everyday lives. These assistive devices can help maintain a personâ€™s independence and participation in their daily activities.
Leisure and Productivity:
Leisure is an important part of our lives and should be part of a person in a nursing homes life. An occupational therapist can work with other staff members of a nursing home to ensure that all residents have the opportunity to engage in meaningful activities and to socialise with one another. Occupational therapy is a client-centred profession that aims to meet the goals of the individual by collaborating with them. An occupational therapist can develop an activity schedule to be run within the nursing home, taking into consideration the residents interests. This would encourage the residents to participate in activities, increasing their activity levels and enjoyment, and is shown to reduce depression in older adults (Fine, 2001). Community outings can also be facilitated by an occupational therapist and other staff members.
An occupational therapist can advise staff of any environmental adaptations that could be made to ensure a safe and functional environment for individuals. This could include ensuring that there is adequate lighting in all the rooms of the nursing home, removing any potential fall/trip hazards such as rugs, ensuring that bedrooms and common areas are free from clutter and easily accessible for all residents, and the environment supports a personâ€™s ability to participate in activities.
For short-term residents, a home visit could be provided by an occupational therapist to ensure that the environment that they are returning to is safe and meets their needs. This could include moving a bedroom downstairs to ensure the individual does not have to use the stairs, remove any possible fall/trip hazards and assist the family with arranging security and safety measures such as a house alarm or emergency button system for the individual.
Memory and Dementia:
Dementia is a condition that can severely impact on a personâ€™s function in everyday life and ability to participate in activities that are meaningful to them. An occupational therapist can work with the individual (if in the early stages of the disease), family members and other staff members about dementia and its functional implications (Schaber, & Lieberman, 2010). The occupational therapist will look at an individualâ€™s capabilities, impairments and any areas requiring intervention, as highlighted by the individual, family members or members of staff. While there is no cure for this disease, an occupational therapist can help the individual to maintain a level of function through compensation or making adaptations. The occupational therapist can also ensure that the person is safe and happy within the nursing home.
The occupational therapist can also run reminiscence groups with residents to keep their minds active and these groups are also enjoyable for members. Reminiscence groups give members an opportunity to share stories of when they were younger, look at pictures of famous people of their youth and also listen to old songs. An occupational therapist can also work with residents to overcome memory difficulties, related to general aging.
Engstorm, B. (2002). Ergonomic Seating A True Challenge Wheelchair Seating and Mobility Principles.
Sweden: Posturalis Books.
Fine, Jonathan (2001). The Effect of Leisure Activity on Depression in the Elderly: Implications for the Field of Occupational Therapy. Occupational Therapy in Health Care, 13(1), 45-59.
Macens, K., Rose, A., & Mackenzie, L. (2011). Pressure care practice and occupational therapy: findings of an exploratory study. Australian Occupational Therapy Journal, 58(5), 346-54.
Schaber, P., & Lieberman, D. (2010). Occupational therapy practice guidelines for adults with Alzheimerâ€™s disease and related disorders. Bethesda, MD: AOTA.
World Federation of Occupational Therapists (2012). Definition of Occupational Therapy. Retrieved April 30,2014, from: www.wfot.org/AboutUs/AboutOccupationalTherapy/DefinitionofOccupationalTherapy.aspx