Occupational therapy PDF

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Occupational therapy What is Occupational therapy? (Definitions) Occupational therapy is the art and science of helping people do the day to day actuates that are important and meaningful to their health and wellbeing through engagement in valued occupations. It is a skill. Occupational therapy is the art and science of enabling engagement in everyday living, through occupation; of enabling people to perform the occupations that foster health and wellbeing and of enabling a inclusive society so that all people may participate to their potential in their daily life Occupational therapy is a client centred health profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the actives everyday life. Occupational therapists achieve this outcome by working with people and communities to enhance their ability to engage in the occupations they want to do or are expected to do or by modifying the occupation or the environment to better support their occupation engagement. Client centred is do what the client wants. Occupational therapy is the use of assessment and treatment to develop, recover or maintain the daily living and work skills of people with a physical mental or cognitive disorder. Occupational therapists focus much of their work on identifying and eliminating environmental barriers to independence and participation in daily activities.Occupational therapists work with clients of all ages, ranging from infants to the elderly. Occupational therapy interventions focus on adapting the environment, modifying the task, teaching the skill, and educating the client/family in order to increase participation in and performance of daily activities, particularly those that are meaningful to the client. Occupational therapy is a profession that promotes health and well being through occupation. Occupational therapy focuses on enabling people to take part in their hobbies and activities despite illness, disability, mental health or emotional difficulties. People are motivated and inspired by the things that we want to do, this is what gets us out of bed in the morning! When you have barriers to achieving your goals an occupational therapist can support you as an individual to accomplish what is important to you, by building on your skills and adapting your activities and environment. Occupation is different for everybody and work intensively with client and work with family, and support workers.when we work with ot, we work with a wide variety of people.

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Occupational therapists need to know about the occupations each person does. and use occupation as their therapeutic medium which means we look like how they wash and dress, work, cooking, leisure tasks. …OTs use a multitude of other therapeutic interventions e.g. biomechanical approaches motor learning neurodevelopmental approaches cognitive-perceptual techniques splinting and orthotics counselling skills rehabilitative approach adaptive equipment physical modalities …and a million other techniques to solve occupational performance problems, modify the environment and ultimately assist people to participate in the occupations and occupational roles that want to be able to do. OT manipulates environment.

What makes Occupational therapy unique. attributes of effective occupational therapists. -curious about people -go inside people’s lives- in their homes, work and communities. ( to get a grasp of who they are and their occupation) -we enable people to participate in occupations -ask lots of questions -excellent at listening by asking questions of what they say and make eye contact and reconfirm what they say -be confident and assertive communicate -we see people’s strengths and potential -we work with anyone. OTS are strong despite people’s grief, loss, trauma, poor hygiene, disability. - empower the people we work with, occupational therapists work along side people - “No other health profession focusses on occupation to the same extent as occupational therapy, nor appreciates its complexity and relationship to health and well-being”

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“The unique core skills of occupational therapists are largely hidden. They are the reasoning skills used to apply the understanding of occupation and its impact on health to the meaningful activities and occupations of service users. Visible practice skills are diverse and some may be shared with other professions. While some activities can appear mundane, forming the rationale for their use is the unique core skill of occupational therapists.” Occupations define who we are as individuals, as families, as groups, as communities and as countries “Occupation refers to groups of activities and tasks of everyday life, named organised and given value and meaning by individuals and a culture. Occupation is everything people do to occupy themselves including: looking after themselves (self-care) enjoying life (leisure) contributing to the social and economic fabric of their communities (productivity)” (Canadian Association of Occupational Therapists, 2002, p. 34) “An occupation is a specific individual’s personally constructed, non-repeatable experience. That is, an occupation is a subjective event in perceived temporal, spatial, and sociocultural conditions that are unique to that one-time occurrence. An occupation has a shape, a pace, a beginning and an ending, a shared or solitary aspect, a cultural meaning to the person, and an infinite number of other perceived contextual qualities. A person interprets his or her occupations before, during, and after they happen. Although an occupation can be observed, interpretation of the meaning or emotional content of an occupation by anyone other than the person experiencing it is necessarily inexact”. (Pierce, 2001, p. 139)

Activity “An activity is a culturally defined and general class of actions The common sense meanings of activities, such as play or cooking, enable us to communicate about generalised categories of occupational experiences in a broad, accessible way. An activity is not experienced by a specific person; is not observable as an occurrence; and is not located in a fully existent temporal, spatial, and sociocultural context.”

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Occupation of eating

make or buy food put on plate sit down grab it put in mouth chew swallow

Food is stressful likes eating donuts knows that apples are the best

Domains of practice: person, environment and occupation

Activities of Daily Living i.e. ADLs Instrumental Activities of Daily Living Rest and Sleep Education Work Play Social Participation How to help a client STEP 1: Assess STEP 2: Analyse the problems and set occupation based goals STEP 3: Devise an intervention plan that will overcome each of the problems so they can achieve their goals ex: STEP 1: What are the occupations and occupational roles that are important to Casey, today and in the future? STEP 2: What PERSON factors are impacting Casey? His strengths? Barriers, problems, needs, issues? What ENVIRONMENT factors are impacting Casey? His strengths? Barriers, problems, needs, issues?

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as an OT, you have to understand every person as an individual…… -their occupations -their occupational roles -their environment eg home, work -their dreams -their hope -their issues and problems and challenges observe where OT works, what OT do, who OT work with an occupational therapist is a skilled professional that helps us carry out activities we need or want to do if we have a disability or because we are getting older. and OT can help us find other ways to live the life we want to. OT help people reach their goals where do they work? hospitals, clinic, client’s homes, age care, schools, workplaces, mine sites — people perform their occupations there who do they work with? everyone across lifespan and anyone who has difficulty doing something that will affect their quality of life/health and wellbeing what do they do? they help people live independently, changing environment, trying to make the difficulties in life seem not so difficult by doing task analysis by breaking occupations down in bite size chunks for people, modifying the environment, Difference between occupation and activity occupation refers to groups of actives and tasks of everyday life, named organised and given value and meaning by individuals and a culture, occupation is everything people do to occupy themselves including -looking after themselves ( self care) -enjoying life (leisure) -contributing to the social and economic fabric of their communities (productivity) OTs need to understand the specific occupants and occupational roles that are meaningful to each specific person and what benefits each person gains from these occupations if people are participating in occupations they love, then they will be motivated to participate in their recovery/rehab program

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1. an occupational therapist aims to improve the quality of life for their clients through understanding their needs and their occupation which is what they enjoy to do. 2. an occupational therapist is unique compared to other health professions as no other health profession appreciates human complexity and relationship to health and wellbeing. They aim to improve the quality of life whereas other health profession aim to improve the health and wellbeing of patients/clients. OT is very creative. A lot more personal- trust and building relationship

Week 2 Occupation and activity - meaningful occupation: the meaning that each person associates with occupations is highly influenced by past experiences and the contexts in which we have been immersed including: - -culture - -personal interests - -values desires ex value safety and being in environment where you feel protected - -geographical location - -spirituality - -parents - -peers and their beliefs - -socioeconomic factor - -government policy - -self efficacy- belief that we can achieve our goals and belief in ourselves - -current and future goals and many more factors

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occupational performance: it is how you do your occupation and is used everywhere occupational and activity analysis occupation based goals occupation as a therapeutic medium: how to be an effective listener and using ourselves to acknowledge and listen our clients client centred practice therapeutic use of self: listening and finding out what is important to client and how to get client engaged in their occupations modification of Person Occupation and Environment enhance occupation performance

Meaningful occupations: occupational therapists are focussed on the meaning that each person gains from participating in a specific occupation. Occupational therapists focuses their interventions so that each person can participate in previous or new occupations and occupational roles that are meaningful to them

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occupations have different meaning to different people: every occupation that you do has meaning to you -you might love it or be ambivalent or hate it - Some occupations we have to do We hate, despise or are disgusted by some occupations we do Some we choose to do We are drawn to occupations that have positive meaning or benefit to us but sometimes we choose occupations that have negative impact on our health and well-being Flow: is the full immersion in occupations and secret to happiness “In positive psychology, flow, also known as ‘being in the zone’, is the mental state of operation in which a person performing an activity is fully immersed in a feeling of energized focus, full involvement, and enjoyment in the process of the activity. In essence, flow is characterized by complete absorption in what one does, and a resulting loss in one's sense of space and time”. (Csikszentmihalyi, 2001, p.2) In order for a flow state to occur, you must see the activity as: voluntary enjoyable intrinsically motivating it must require skill and be challenging (but not too challenging) with clear goals towards success you should feel as though you have control and receive immediate feedback with room for growth. Evidence indicates that flow is highly correlated with: happiness subjective and psychological well-being People who experience a lot of flow in their daily lives develop positive traits, such as high concentration, high self-esteem, and greater health. (Cziksentmihalyi, 1997)

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OTs always set occupation based goals e.g. SELF-CARE: Yan will dress his upper body independently and lower with minimal assistance whilst sitting by 3 July LEISURE: Bindi will play chess and engage in conversation with friends for 30 minutes a few times per week by July PRODUCTIVITY: Belinda will gain 20 hours/week of work in retail or sales by October and maintain the job for at least 6 months

OTs NEVER set impairment based goals e.g. Yan will increase the strength of his right biceps muscle to 5/5 on the MAS Bindi will be able to remember 5 objects presented to her – 5 minutes later OTs ALWAYS set occupation based goals People who set goals achieve better outcomes than those who do not Setting goals focusses the person’s attention and drives performance Setting challenging goals, that are realistic and achievable, leads to greater effort Goals are much more motivational than verbal encouragement e.g. “Keep trying harder” and “You are doing so well”. Goals allow recognition of achievement and progress towards toward the goal is measurable “Client-centred practice is an approach to providing occupational therapy, which embraces a philosophy of respect for, and partnership with, people receiving services. Client-centred practice recognises the autonomy of individuals, the need for client choice in making decisions about occupational needs, the strengths clients bring to a therapy encounter, the benefits of client-therapist partnership and the need to ensure that services are accessible and fit the context in which a client lives.” “Client-centred occupational therapy is a partnership between the client and the therapist that empowers the client to engage in functional performance and fulfill his or her occupational roles in a variety of environments. The client participates actively in negotiating goals which are given priority and are at the centre of assessment, intervention and evaluation. Throughout the process the therapist listens to and respects the clients’ values, adapts the interventions to meet the client’s needs and enables the client to make informed decisions.”

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Modification of person, environment and occupation ex: bethany the surfer person: balance, coordination occupation: steps involved environment: what does the environment look like? ocean, water, waves www.independentlearningcentre. com Key goal is to how to get people back to doing what they want to do

Occupation vs activity : occupation has meaning why do we categories task? Ots use categories when asking questions-especially during initial interview categories are checklist that OTS use to ensure we are asking about the full array of occupations a person does categories remind OTS to ask a lot of questions OTs ask questions to identify occupations where people might be having difficulties then… OTs observe or assess the person’s performance during some of these occupations where they are having difficult i.e: OTS observe and assess PADLS, IADLS, rest and sleep , education, work, play, leisure and social participation eg, we observe a person cooking or showering or dressing or working or doing a leisure occupation OTS observe people doing occupations so we can determine why they are having problems completing the occupation OTs can assess a person’s performance in one occupation Then make inferences about how they might perform doing another occupation eg. we observe the problems a person has dressing and can make inferences about how they might go cooking or working or driving Doing meaningful occupation impacts on your health and wellbeing every occupation has a different meaning and benefit to each individual the meaning we derive from occupations can and does change

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week 3 "Aids like wheelchairs and computers can play an important role in overcoming physical deficiencies, but the right mental attitude is even more important. It is no use complaining about the public's attitude about the disabled. It is up to disabled people to change people's awareness in the same way that blacks and women have changed public perceptions.“ - Stephen Hawking If an OT is using occupation only as a distraction or diversion- then we are not being occupational therapists Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity Disability fact Over a billion people live with some form of disability i.e. about 15% of the world's population Rates of disability are increasing due to ageing and an increase in chronic health conditions Disability is more common among women, older people, and children and adults who are poor. Half of disabled people cannot afford health care, compared to a third of non-disabled people. People with disabilities have: poorer health outcomes lower education achievements less economic participation higher rates of poverty than people without disabilities. Disability according to the medical model Medical model: disability is a feature of the person caused by the disease, trauma. or health condition. Medical care is provided in the form of individual treatment by professionals. Disability: according to the social model Social model: disability is a socially crated problem- not an attribute of the individual and disability is thus not a health problem. it is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives. Overcoming the difficulties faced by people with disabilities requires interventions to remove environmental and social barriers

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Disability: according to the social model A person who has a disability (e.g. they have had an accident and become a paraplegic using a manual wheelchair) gets offered a job in an office doing accounts doing computer work and attending meetings and talking on the phone. An optimal environment would have ramps to get in/out of the building Lifts to get between floors Height adjustable desks and computer monitor THUS - the environment is assisting the person do their productive occupation A poor environment, might have a ramp that is very steep thus the person is fatigued when they arrive at work a fixed height desk meaning the person is in an awkward posture all day THUS, the environment makes it difficult for the person to do their productive occupation Disability is not fixed, the level of impairment experienced by the person is highly dependent on the environment. Occupation perspective of ‘health’ 1.Participation in occupation promotes health in individuals, families, groups, communities, and populations 2.People have the right to participate in occupations relevant to their community/culture 3.People have the right to choose occupations relevant to their community/culture 4.People need to participate in a balanced range of purposeful occupations for their health and well being Occupational balance: “the individual’s perception of having the right amount of occupations and the right variations between occupations in relation to .. -occupational areas -occupations with different characteristics -time use Occupational balance: “a satisfying pattern of daily activity that is healthful, meaningful and sustainable to the individual within the context of his or her current life circumstances” Includes 4 dimensions that promote… 1. health eg exercise, rest, meals 2. relationships ie. occupations done with others 3. challenge - a feeling of engagement and competence 4. identify- creates a positive personal identity

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