What is an Occupational Therapist?
Occupational therapists (OTs) help people improve their ability to perform tasks in their daily living and working environments. They will provide you with aids and adaptations, for example, changes required to bathrooms and kitchens.
They work with individuals who have conditions that are mentally, physically, developmentally, or emotionally disabling. They also help them to develop, recover, or maintain daily living and work skills. Their goal is to help clients lead independent, productive, and satisfying lives.
Examples of the range of people with whom OTs work are: people with learning disabilities, those who have had a stroke or an accident, people with Alzheimer's Disease and young people with autism.
An OT will work with a wide range of people, including the carer, to develop a lifestyle programme that meets the needs of the person who is ill or disabled and design a programme of treatment based on the individual’s unique lifestyle, environment and preferences.
Some OTs have additional training in 'moving and handling' – an issue of crucial importance for carers who are putting their own health at risk by moving the person they care for in an unsafe way. You should check with your OT if you haven't already been trained in how best to perform such physical tasks.
Patients coming out of hospital may have an OT assessment as part of a hospital discharge plan. This assessment could lead to you and the one you're caring for being eligible for additional services that could lighten your caring load, so it's well worth enquiring about such assessments when they come out of hospital.
OTs can work in any health or social care setting. We are most familiar with them in the social services teams, helping people in the community, and as part of NHS Primary Care Trusts, perhaps working out of GP practices.
OTs may be employed by NHS Trusts for Learning Disability or Mental Health and in a variety of clinics. They may give advice in Disabled Living Centres or equipment companies, or provide a service in care homes. They may be employed by industrial and commercial organisations as part of the occupational health service to help personnel back to work.
OTs are also an integral part of the joint Community Rehabilitation Teams that are being set up by some local NHS Primary Care Trusts and social services.
Finally, some OTs work in private practices, and some families prefer to pay for a consultation and advice.
Firstly, a decision needs to be made about what possible kind of help is needed. Help with everyday tasks and getting around may be obvious, but have you considered the stress and emotional problems associated with the one you're caring for no longer being able to do familiar activities? It might be an idea to think about, or write down, all the things you would like the OT to help with before you get in contact.
Potential contacts for OTs include your GP practice, your care manager (if you have one), a day centre manager, or the hospital clinic. If you are managing at home without any of these contacts, then approach your local social services office.
A word of warning
Limited funding and the shortage of occupational therapists nationally means that carers and the person they care for may struggle to get enough advice and help at the time that it is needed and in the manner that supports and encourages rehabilitation.
You may have found that health and social care staff are as stressed as you, because they are limited in the time and resources that are available to do a good job. We have heard from many carers about the difficult situations that they have encountered with simple requests like getting equipment, let alone requests for entire programmes for independent living.
You may have to be persistent in asking for an assessment of your needs and subsequent support. But it may be helpful if you get all the information you can, from your local Carers' Centre or via the internet, about what is available for you locally.
A Carer's Assessment should enable you to identify your needs and the risk to your health if you don't get equipment or training to help you in your tasks.
Once you have had your needs assessed, you may want to buy the equipment yourself, or some of it if the wait is very long.
If you do struggle to get any help, you could keep a record of your conversations and telephone calls, so that you can be accurate in reporting what has happened if, for example, you need to make a complaint. Each local authority should have a complaints procedure, which could culminate in approaching the local government ombudsman. Your local Citizens Advice Bureau should be able to help with this.
Many carers will have experienced difficulties with the supply and return of equipment. Some equipment and aids for the home come from social services and some from the hospital service. In March 2000, the audit commission's report 'Fully Equipped' highlighted some of these services' shortcomings throughout the country, and the government pledged to improve them. A national drive to develop community equipment services, with full integration across health and social care is ongoing.
The development of local community equipment services is supported by the Integration of Community Equipment Service (ICES) Team. The package of reform includes:
Finally, whether your equipment is provided by social services or from the private sector, if you get faulty equipment or it breaks down – report it at once, don’t try to mend it yourself, or you may find that your OT or supplier disclaims any responsibility, and you are left with a large repair bill.