Occupational Therapists
Assess functional limitations of people resulting from injuries, illnesses and disabilities and provide therapy to enable people to perform their daily activities and occupations.
Home visits on a busy morning
You are an occupational therapist making home visits for a community health service, with three people to see before lunch. It is 8:30am. Your car is packed with measuring tools and sample equipment. Each home is different, and every family has their own idea of what you are there to do.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
Dad should not be living alone. Please just take out the rugs, install rails everywhere and get a commode. I do not want a phone call at midnight again. Whatever you recommend, I will back it.
Agree to recommend a full set of changes, because she knows him best and wants him safe
The house starts to look like a hospital. Her father feels managed and refuses to use half the equipment, so the money and the effort are wasted.
Acknowledge her fear, then start by seeing what her father does and wants each day
She nods, relieved that someone has taken her worry seriously. You spend time with her father, and the plan that emerges is smaller and better targeted.
Tell her that decisions about the home are up to her father, not her, and leave it there
The principle is right, but Sofia feels dismissed and becomes defensive. She starts to see you as one more barrier between her and her father.
I don't need any help, thanks. I've lived in this house for forty years. They sent you because my family worry too much. You can have a cup of tea and then go.
Accept the tea, chat about the house, and ask him to show you what a normal day is like
He relaxes and shows you around, mentioning that the shower is hard to step into. You are glad you listened, though he may take a couple of visits to trust you.
Tell him you are only there to make sure he is safe and he should let you do your job
He goes quiet and shows you nothing. You leave with a half-finished assessment, and he says he does not want you back.
Ask what he wants to keep doing at home, then look at what stands in the way of that
He wants to keep making his own breakfast and walking to the corner shop. You work with those goals, and he agrees to try one small change.
We have a long waiting list. I know you wanted another hour with Mrs Yilmaz, but I need you to wrap up quickly and move to the next person. Can you finish her visit in twenty minutes?
Cut the visit short and give a brief summary, then follow up by phone later in the week
You manage the time, but Mrs Yilmaz doesn't feel heard and the phone follow-up is rushed. A key detail about her bathroom is missed.
Say what is still needed, finish the essentials today and book a second visit
You finish the safety check and book a short second visit. Bryony adjusts the schedule. Mrs Yilmaz is not rushed, and the waiting list moves a little more slowly than hoped.
Keep going until you are finished, ignoring the schedule
Mrs Yilmaz is well looked after, but two other clients wait a long time, one of them in pain. A good job for one person can become an unfair one for others.
How it went
By the afternoon you have seen three people, written three plans and spent a long time in the car. Occupational therapy is about helping people do what matters to them, by changing the task, the tools or the place. Which part of that sounds the most interesting?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: Keeping the armchair
A fictional case set in a community health service that visits people in their own homes.
The situation
Mei Ling was an occupational therapist visiting Mr Costa, aged eighty-two, after he had a fall at home. His daughter Sofia had already looked into moving a hospital bed into the lounge room, adding rails everywhere and getting rid of the rug. Mr Costa sat in his favourite armchair with his arms folded and said he wanted none of it. He wanted to garden and to sit in the chair where he had always sat. Sofia was frightened for him, and Mr Costa was determined not to be treated like a patient.
What they did
Mei Ling asked Mr Costa to show her his day, from waking to bed. She noticed that the fall had happened near the back step on the way to the garden. She talked with Sofia in the kitchen about her fears, and with Mr Costa about what mattered to him. Instead of a bed in the lounge, she suggested a rail at the step, a firmer cushion for the armchair so it was easier to stand from, and a small change to the garden path. She wrote up the plan and let him choose which parts to try first.
How it turned out
Mr Costa accepted the rail and the cushion, and ignored one suggestion entirely, which Mei Ling accepted. Sofia relaxed once the risky spots were dealt with. At the review visit he showed Mei Ling his tomatoes. She said the best result was that he was still in charge of his own home.
What would you do?
- Why did Mei Ling begin by asking about his day?
- How would you balance safety and independence for someone you loved?
- What would you do if a client refused a suggestion you thought was important?