Occupational Therapy: Elder Care’s Best-Kept Secret

Don’t let the word “occupational” fool you: The true goal of occupational therapists is not to keep you in a job, but to keep you actively involved in the work of life.

Advanced age often produces changes and losses you cannot control. Occupational therapy (OT) can bridge the gap between ability and what age has diminished—preserving your independence for as long as possible. Meet the four experienced occupational therapists (OTs) who will let us in on a few of the “secrets” of geriatric OT:

• Monica Heltemes is an OTR/L (Master’s of Occupational Therapy, registered/licensed) and owner of MindStart, a company which offers products and education to help people living with dementia and their caregivers.

• Mandy Chamberlain is an MOTR/L who works with older adults in skilled nursing facilities and is the founder of SeniorsFlourish, a resource site for geriatric OTs.

• Alison Emerick, MS, OTR/L, started Ease Living to compile the best therapist approved products to provide customers with independence, safety and dignity.

• Sarah Lyon, MOTR/L, has worked with adult clients in a variety of settings, writes about OT for VeryWell.com, and hosts a website with resources for fellow OTs, otpotential.com.

Occupational Therapy: All About Aging in Place

Maybe you never considered occupational therapy because you didn’t know enough about it, or believed it to be reserved for those with greater health needs. But Monica Heltemes says occupational therapists look at everything, and that’s what gives them such a unique perspective. “They look at all aspects of a person’s physical, cognitive, and mental health, along with outside factors like the home setting and access to assistance, to develop a picture of how the person is functioning in their day to day life,” she says. “From there, the OT and the patient (and family caregiver, if one is involved) can develop goals to address the struggles the person is having and ways to meet the goals.”

Because of this broad vantage point, the solution is typically a multifold one. “The treatment may involve a combination of approaches to help the person get better AND compensations to implement when a particular struggle is one that cannot be changed (for instance, poor vision due to macular degeneration),” says Heltemes.

For Mandy Chamberlain, occupational therapy is focused on one key outcome: “People want to stay in their homes and live meaningful lives—and our job is to help them achieve this goal.”

Returning, and Retaining, Independence Through OT

Alzheimer’s. Joint replacement surgery. Stroke. They do not always rob an individual of all self-care abilities upon diagnosis or occurrence, but they can limit performance over time.

That’s where OTs come in—and they start with the individual’s wishes. “If severe arthritis is limiting your ability to perform grooming, cooking, or some other essential tasks, an OT can help you maximize the use of your hand through exercise or perhaps a supportive splint,” says Sarah Lyon.

In the case of common home hazards—like bathroom falls or medication mismanagement—OTs have solutions: “An OT might recommend a bath chair to allow safe showering, a medication box to aid memory in taking pills appropriately, strategies to minimize incontinence, and an appropriate magnifying glass to aid vision,” says Heltemes.

Occupational therapists consider another important element of home independence: the caregiver. “We provide a lot of caregiver education, so they can help their loved ones stay at home and succeed at home, such as tips to bathe someone that has Alzheimer’s or recommendations to set up the kitchen so the patient can cook independently,” Chamberlain says.

Besides the daily basics, OTs help you get back to the things that make life meaningful, like returning to work or picking up a treasured hobby an injury may have interrupted. “An occupational therapist will help you get there,” says Alison Emerick.

The Best Tech Tools for Independence

From high-tech apps to low-tech aids, there are a number of options for adapting to changes in health.

Heltemes recommends the Wunderlist app for setting up to-do lists and reminders. “It can also be shared with family members, so if the person adds items to the grocery list, the adult child can also see the list and get the groceries the next time at the store,” she says. Heltemes also suggests the Headspace app, which walks you through 10-minute mindfulness meditations. “Mindfulness is being proven as an effective tool to manage anxiety, pain, and can even help mild memory loss,” she says. “Mindfulness is also helpful for caregivers who might be stressed from all their day to day duties.”

Chamberlain has found the Amazon Echo automation tool, better known as “Alexa,” to be a helpful one. “Not only can it read an ebook to you or tell you what the weather forecast is going to be, it can also control things like turning off lights that may be hard to reach in your wheelchair or adjusting your thermostat,” she says. “It can also be integrated with the website IFTTT.com, which lets you set up triggers that ‘if this happens, then that happens.’ For example, if someone with Alzheimer’s wanders too far (using a GPS app), it will notify a caregiver (via text).”

Transfer benches for getting in and out of the tub safely, adjustable silverware to compensate for limited range of motion in a person’s arm, and swivel cushions to ease transfers in and out of cars are all on Chamberlain’s low-tech list.

Home health technology is an exciting and rapidly growing sector of health science, per Emerick, and runs the gamut from simple battery operated or electronic devices, like alarming pill dispensers that assist in following a medication schedule, or talking alarm clocks that dispense personalized reminders.

Getting Started With OT

“Many seniors come to occupational therapy when they are admitted to the hospital for an injury or illness,” says Emerick. Be it a planned knee replacement or an unplanned event like pneumonia, the hospital typically sends an occupational therapist to assess whether the older adult can return home safely. “If it is determined that returning home is not the best plan, the OT will recommend next steps,” she says.

Still, the most traditional method for securing the services of an OT is through your physician. “If there is a particular clinic or OT specialist in your area, you can also reach out to them directly,” Lyon says. If you or an older adult seeking OT resides in senior living, ask the staff: they may have connections with OTs who regularly serve that community, adds Lyon.

Once you get clearance or a referral from your physician, Heltemes suggests checking your insurance plan to understand the coverage criteria and benefits for OT services. These services are typically provided in an outpatient setting—such as a private clinic or hospital—though per Chamberlain, some may qualify for at-home services.

Tell us: What tools and tips help you stay independent at home?