Helping to provide skills for ‘the job of living’

Duane Hicks

Whether they’re helping a person re-adjust to their every-day life after a stroke or aiding a young child with a physical disability, occupational therapists see a wide range of clients and help them in many different ways.
But what exactly is occupational therapy?
With October being Occupational Therapy Month, local occupational therapist Sheryl Barkley and occupational therapy assistant Heidi Heyens at La Verendrye Hospital, as well as occupational therapist Darcy Friesen of the Northwest Community Care Access Centre, helped shed some light on a form of therapy that isn’t always well understood.
Defined by the American Occupational Therapy Association as giving people “the skills for the job of living” necessary for “living life to its fullest,” occupational therapy provides treatment programs based on purposeful activity that helps lead people back into useful, self-sufficient lives after physical injury or illness, or development, social, or emotional problems.
Occupational therapy also helps the elderly remain active in their daily lives at home.
“How we’re a little different from other professions is that we look at every-day basic activities that an individual has to do,” explained Barkley, adding that because the occupational therapy department is tied to the hospital, their aim is to ensure hospital patients are able to go home and function in their daily lives.
“What we are looking at a lot here with our patients is can they get in and out of the bathtub safely, are they are able to walk safely, do they need a walker or wheelchair to get around, are they able to get themselves dressed, are they going to need some kind of aid to help them put their socks or shoes on?
“Those really basic things that might be taken for granted.
“What are their roles and responsibilities in a typical day, and are they able to meet those roles and responsibilities?” Barkley added. “If not, where are they getting stuck?
“From there, we come up with a game plan and see what we can do to change that . . . whether it might be changing the environment, changing the way they do the task, or giving them some kind of aid to help them do the task,” she explained.
Barkley and Heyens said they see a wide range of patients, and every day is different.
“We see all ages here,” Barkley said. “Right now, our oldest patient is 97 and my youngest patient would be a one-year-old.
“It’s kind of across the spectrum.
“Most of the patients we see are elderly and in-patients in the hospital,” she noted. “A lot of people come back after they have a hip replacement—that’s a big one. People that have strokes.
“We see a lot of people who have dementia and are no longer able to function in their home environment.
“The younger kids, we see a variety. A lot of developmental delay, cerebral palsy, Down Syndrome,” she remarked.
“We also see people that have hand injuries, and need splinting. They need to use their hand and protect their hand while it’s healing, so we do a fair amount of splinting.”
When it comes to how she and Heyens help patients, Barkley said it varies greatly given occupational therapy is “client-centered” and handled on a person-by-person basis.
“What is the person’s goals? What do they want to be able to do? That’s where we start from,” she explained.
In addition to doing assessments for wheelchairs and other mobility aids, the occupational therapy department at La Verendrye provides training with adaptive devices for the home, such as grab bars for the bathroom, raised toilet and bath seats, and aids for the kitchen, and also can help clients improve hand activities such as using keys, telephones, and faucets.
In the case of a child who needs to work on their fine motor skills, for example, they may have the child play with Play-Doh, then use tongs to pick up an item—eventually moving up to using scissors or holding a pencil properly.
The department also has devices like a “light board,” which can be used to exercise a patient’s balance or hand-eye co-ordination, as well as leisure activities, like games, for clients.
“That’s one thing that I have certainly noticed over the years that I have worked here—leisure becomes that thing that folks can’t participate in,” said Barkley.
“They used to golf, or they used to fish or they used to hunt, and we’ve found that people often have to give up that leisure because of some kind of reason.
“It’s not always physical—sometimes it’s forgetfulness and they are not safe to do it anymore.
“That’s a hard one to try and help people with,” Barkley admitted. “Sometimes we have to direct people and introduce them to new hobbies.”
“Some of the people live their whole life, and now because of arthritis they can’t do what they want,” echoed Heyens.
“I mean, there’s not really another way to knit.”
“As people age, they could keep that it mind. What are they interested in and how they can adapt it down the road,” said Barkley.
“I know, no one has a crystal ball and know they’ll end up with poor vision, but they can keep their options open as far as leisure.
“And keep involved in leisure,” she stressed. “That’s important, too.
“A huge indicator of happiness is if you’re able to continue your leisure pursuits.”
Heyens said the department has a Nintendo Wii to let clients participate in “virtual” forms of some activities they no longer can do.
“Some of them used to bowl 50 years ago, and are now able to do that from a wheelchair,” she noted. “They’re quite excited about that.
“Most of the older folks have slowly warmed up to it,” she smiled.
Barkley said it’s even important for those with memory issues to engage in activities.
“Even if tomorrow, they may not remember that they had that card game or participated in that Bingo, they still will get that good feeling of participating afterwards, and that can carry into the next day where they still feel good about themselves,” she reasoned.
Barkley also said that keeping active despite a change in one’s physical or mental capabilities is an area friends and relatives also can help out with.
“I had one lady just last week tell me she plays bridge,” Barkley recalled. “Her eyesight is gone, but she still goes over and plays with the same group of ladies.
“They call out the numbers and it doesn’t affect play because they’ve gotten into that routine with her. They help her out.
“There’s commitments that other people have to the leisure you’re involved in, as well,” Barkley added. “There’s a lot of help and support out there.”
OT on the road
Friesen, meanwhile, does not work out an office but spends his time visiting homes and schools across Rainy River District—everywhere from Fort Frances to Rainy River and up to Morson and Nestor Falls.
While Barkley and Heyens have clients referred by doctors, most of Friesen’s are self-referrals or families that come to him.
“I do a lot of wheelchair assessments. I do home assessments, where I look at home safety issues, especially for the elderly,” he explained.
“And I also cover the school system, so I see children with fine motor handwriting issues.
“I guess those would be the three big ones that I do,” Friesen said. “I get other stuff mixed in there, but those are the big ones.”
He added he spends a fair amount of time helping people decide what they could use in their homes to make their lives easier, such as railings, grab bars, bathroom equipment, and modifications.
Those clients then can get in contact with a business to supply them with the equipment and do installations.
Friesen conceded there’s often confusion between occupational therapy and other kinds of therapy, such as physiotherapy.
“That does come up quite a bit,” he remarked. “I go to see [clients] and when I get there, they’re, ‘Oh, the physiotherapist is here.’
“It’s not as well understood as physiotherapy,” he noted.
Friesen said the highlight of the job is “helping people do the things they need to do on a daily basis.”