occupational therapy intervention

[mishtomo]

Hi to all,

I'm interested in your thoughts about the role of occupational therapy for people with Alzheimer's disease and their carers, I'm presently studying Occupational Therapy at university and due to family experiences of AD I have become interested in the role that Occupational Therapists can offer.

Have any of you had positive or negative experiences of Occupational Therapy interventions that you would be willing to share ? or any thoughts on what you would have expected from professionals?

Any comments will be gratfully received and thanks for taking thetime to read this post.

mishtomo

 

[Lila13]

My mother saw two OT's in hosp last year, as they moved her from one ward to another, the first seemed quite useful but then after they transferred her the second one hadn't even heard of the first one.

Main function of OT as far as I could tell, to re-teach her basic skills as far as she was able to re-learn, (washing, dressing, making a cup of tea).

Would have been useful if the intermediate care team mentioned by the first OT had ever appeared!

 

[mishtomo]

Occupational Therapy

thanks for your reply,
the role of OT can vary so much thrught the country and finding a model that seems to be beneficial to most people is proving difficult, the role of OT seems to be more focused on assessment in the community than rehabilitation or ongoing care, my personal experiences of OT intervention could also be more positive, the role for OT has so much to offer but the potential hasn't yet been reached and services seem to be diminishing not expanding to cope with the growing population with AD.

thanks

 

[Lynne]

OT has so much to offer but the potential hasn't yet been reached and services seem to be diminishing, not expanding, to cope with the growing population with AD.
thanks

Thanks for confirming what we, the families of dementia sufferers, have all known for some considerable time!
I wish a few more health professionals would shout this loud & clear, where it matters.
Apologies for the scratchy, cynical tone - I hope you understand.

 

[Lila13]

During the second half of my mother's stay in hospital last year, it seemed to be the OT's who were responsible for deciding when she could go home, as the doctors said there was nothing medically wrong with her.

The 2nd OT was obsessed with us finding a dossett box, not realising my mother wouldn't be able to use it, (and anyway a few days later her GP said "no more medication").

 

[Tender Face]

Well done, Mishtomo

But I'm afraid my personal experience of OT 'in the community' is different to the theory you are being taught......

Several times over the last few years I have witnessed my mum in hospital after surgery barely round from the anaesthetic when an OT (or two) have presented at her bedside on a 'mission' to get her discharged and 'home' as quickly as possible...

Now she has dementia and has been referred for OT assessment in her home we are advised to expect a 12 month wait ....

It was very different some years back when dad was diagnosed with terminal illness....... (but no dementia issues) ......

Sorry, that all seemed very negative.... when what I really wanted to do was applaud you for your thinking ..... absolutely every success wished for you - including influencing the services provided ... it seems almost criminal that someone with the training, knowledge and understanding to promote a better quality of life for dementia sufferers (and their carers) might not be supported and funded to meet needs......

Let's hope you might be the one to help make the changes needed....

Bset of luck with your studies ... and please keep in touch ....

Karen

 

[mishtomo]

thankyou for your replies.

thanks to you all for the taking the time to reply to me, I am determined to influence my own practice and hopefully then the practice of others. I'm not naiive and I realise that the long standing practices of professionals may not be easily challenged but at least if I can influence my own then the people I become involved will hopefully recieve the best care that I am able to provide within any local constraints.

My interests also lies with carers, I am interested in the level of support carers recieve from other professionals and OT's and what services do carers feel they are not receiving that would assist them in the caring role and hopefully influence their own well-being and other commitments.

thank you all for your kind words and support,
mishtomo

 

[DeborahBlythe]

Almost anything that you bring to the table about OT's and dementia will, very likely, be a bonus, since so little seems to be available at present. Since my mother was diagnosed in 2004, no professional has ever seen a link between her needs and OTs. She has been seen by slews of NHS professional but I cannot recall any input by OTs. If it was there, it was fleeting and despite many hours/days/weeks and more of close involvement with my mum's care, I have never come face to face with an OT! They must be very rare birds.

I did ask, before my mother was admitted to hospital in March, for her to be able to access an intermediate care package: a package of care that is designed to prevent hospital admission, or help rehabilitation afterwards. I was told at the time that intermediate care packages were not available for people with dementia because the point of them is lost on people with memory problems. They cannot retain the information and skills which are one of the main points of these care packages. Had she been offered one, I expect that OT input would have been made available. ( Sorry, my writing skills are going a bit crummy at this hour.)

Good luck with your studies. Deborah

 

[mishtomo]

O.t.

Hi again to you all,

I have been researching Occupational Therapy involvment in day centres for people with AD and I have been suprised by the lack of input from OT's in this setting as we have been taught that a crucial role of OT is running/coordinating groups and especially reminiscene groups for people with AD and other dementias.

I understand that budgets / PCT's local authorities etc have an influential say in what happens but theory around the effectiveness of these groups in this area is vast and I feel as a profession OT can be effective in the care of people with Alzheimers disease.

what do others think?

thanks again, I hope you all have the christmas you wish for.

mishtomo.

 

[eiggam]

Hello, OT.

Have you, or can you be hired to go to a Home for private therapy, what are your skills with an Alz patient? Have you seen any help for the patient after you have been with a patient?
Has a Home have you sign any forms, for visiting a patient.
Many Thanks, This should be a service every sibling can offered a parent in a confining space,
There have been many studies where 'Stroking' is very beneficial for the elderly, in fact for everyone. Is it not a basic Human need to stroke and be stroked.
You are needed, keep pushing.

 

[Nutty Nan]

I have only just picked up on this thread.
Thank you for your interest, Mishtomo!

It seems to me that, like any time-and-motion study versus real-life practicalities, the theory of OT and reality, especially for AD sufferers, is many miles apart.
There ARE all sorts of things that could be offered, but ...... it may be that the more obvious demands on OTs from patients who are being rehabilitated after surgery etc. take up all the time and funding available?

I am an untrained carer (for my husband), and what I find frustrating is the frequent sentence from professionals (Consultant, Social Services, CPN, Carer's Assessment Team etc) "Just give us a call if there is anything you need". Problem is: I am making it up as I go along, no experience other than that picked up along the way and from others on TP (!), so how can I ask for things I don't know exist?? I have recently come across a catalogue (Winslow), which contains many things that would/could have helped us a great deal several years ago ..... now we are too far into AD to introduce games etc. A clued-up OT might have been able to point us in the right direction.
In fairness, we did have a visit from the OT department some 12 months ago, and they fitted handrails and lent us a raised toilet seat - helpful, but not exactly a comprehensive service.

Good luck with your forward-thinking approach, Mishtomo, we need professionals like you!!

 

[nbdrea]

OT's role with Alzheimers Patients

I am an Occupational Therapist and recently took a position as the Director of Rehab. for an Alzheimer and related dementia facility. It has been a tremendously positive experience thus far. I believe as professionals it is our job to develop our role in this specific area. We def. have a lot to offer to this population because of the unique way we are trained to assess patients. What I think we need to remember is to try to address not only the physical needs, but the emotional, and pshyco. social needs of the patients and of their families.

 

[lesmisralbles]

Walk a mile in our shoes

Live with a person with Alzheimers and the person that looks after them for 24 hours. Thats all you need to do. You will learn more from that than anything else.
As I said, walk a mile our my shoes
Barb

 

[Nell]

I have worked with OTs in a variety of situations (educational) and found them to be incredibly valuable in many ways.

As for dementia, may I agree with the person who said personal experience is the best teacher? I'm sure many OTs do a great job without having had personal experience, but it certainly is a bonus.

Things I consider to be important:

Talk first to the patient, not the Carer - unless it is totally clear that the patient cannot respond. It shows very little respect for the patient if the Carer is asked about the patient, in the patient's presence.

Talk to the Carer AWAY from the patient so you can understand the Carer's issues , as well as the patient's. Many patients will insist they are "fine" or that they take care of them-selves, when their Carers can tell you that is patently untrue!

ASK the Carers what they need - which areas of caring are difficult and what would make a positive difference. Many people are unaware of the help available and you might discover you can make the world of difference by just asking what the Carer needs for the patient.

Tell the Carers what they can expect in the way of support. Many TPers have only discovered things from being on TP - it is almost as if there is a "conspiracy of silence" to keep information from Carers in case they start asking for too much!

Remember that even when patients are in Care Homes, the family members (or friends) remain Carers. Altho' they no longer have primary responsibility for the patient, they are still very involved in the patient's care. Also, because their focus is on one person, rather than a ward full of people, they are much more aware of the individual needs of the patient, in most cases.

Carers are sufferers too. Caring is very hard work, physically and emotionally. It tears people (and families) apart. It is a HUGE stress. Please DON'T make people "fight, argue, scream" for help that is their right. We are tired and worn out from caring - we need support, not another battle to get the help our patient is entitled to.

More on the above: if you can't help, explain clearly "why" and give a realistic time frame of when you can help. Don't fob people off with "I'll get back to you" and fail to do so.

Realise that the patient will NOT be able to learn new things. You might have all sorts of wonderful equipment, ideas, etc. but unless the person was using these before dementia, s/he will be unable to use them now.

More on the above: so you need to address the Carer's issues as much as the patient's problems.

I realise I have laid a great deal of stress on the caring side. I hope you will understand why and not feel I'm being one-sided.

As for the dementia sufferer, there are two things that I believe really guide "best practice":

1 Learn as much as you can about the disease - not only from a medical perspective but also from a social one (TP forums are very useful for this).

2 "Do unto others as you would have them do unto you". I know the Golden Rule is a cliche, but it is still our best guide. Ask yourself: if this was ME that had dementia, would I like the way I was being treated by my OT? If it was my parent or spouse that was the patient, would I be happy with the way this OT is treating him/ her? If you can honestly answer "yes", you are doing a good job!

Every best wish for a satisfying future in your chosen field.

 

[timo]

New kid on tbe block

Hi everyone. I am a carer in an EMI home who is also very interested OT. From what I have read I can see just how far into the patients background the roots extend. The family liaison on top of direct patient contact for twenty residents on 20 hours a week is unachievable. But thats just my experience at the home where I work,or is it the profession as a whole?

 

[BeckyJan]

Hello timo:
You may not realise but you have posted on a fairly old Thread. It is still relevant but you may wish to start a new Thread of your own. If so go to the main Support area and see 'New Thread' on top left.

Best wishes

 

[joherb]

the forgotten few

I was once an occupational therapy student who worked mainly within mental health. NOw I am working as a carer/support worker for health care agency and part of my placements are in older people in EMI/day centre with dementia etc.

Working in a care home I think people with dementia etc are 'the forgotten few' with healthcare professionals such as physio and occupational therapy and even doctors not showing an interest or the individual is put on an ever increasing long list of ...waiting or the professional not knowing their client.

OT's are concerned about 'behaviour' - dementia suffers are ever increasing changing behaviour - medication changes coinside with individual personality changes etc

Carers whether family or in care home are a combination of physio and occupational therapists who bear the brunt of continuing care package (when i say brunt - not meaning in a brutal way).

Working with people with dementia is stressful, rewarding, frustrating, caring, loving, demoralising, aggressive, humourous, all sorts of different words relate to an individual and far more can describe the state of relationshop between carer and caree.

After only finishing within 1st year of OT I am left feeling - is there anything else i can do, is this it, is there anything more within a care home that i can do..

 

[Sue J]

Forgotten many

Hi Joherb

I agree with you except that I don't believe dementia sufferers are the 'forgotten few' but the 'forgotten many' - if you check out this site and realize how many dementia sufferers are undiagnosed and suffering without support.

I think in the early stages OT would be extremly valuable. All those useful things people have learnt by trial and error e.g. all the threads on here about useful items, clocks, memo boards, routine etc. etc. if families had OT input early they could be helped so much.

Don't know if you're aware of it but there is a care home, I think in Wiltshire who have reconstructed a room with old artefacts i.e. phones, furniture , till registers etc. resident spend time in there and it helps them, and it has drastically reduced there use of anti psychotics , if I remember right by 70% is what the manager said when she was interviewed. Maybe there is more you can do although it sounds like you're doing a lot already - even by asking the question on here - from small things!