What is occupational therapy?
Performing routine and daily tasks can be made difficult by the effects of rheumatoid arthritis, particularly pain and stiffness. Occupational therapy enables those with rheumatoid arthritis to maintain their independence by providing solutions to help with activities of daily living. Your doctor may refer you to an occupational therapist as part of your treatment.
Occupational therapists are an important part of many rheumatology teams. They are responsible for assessing a personÂ’s needs and make recommendations on how to manage difficulties in the home, with transport or work life. In addition, they are experts in knowing which gadgets, tools, and adaptations will make life easier.
Occupational therapy assessment
During your first appointment, the therapist will take a detailed history by asking detailed questions regarding your ability to carry out certain activities – grooming, eating, drinking, dressing, getting out of bed, driving, cleaning, cooking, shopping and working.
The occupational therapist may then carry out a physical examination to test your abilities. This will involve looking at the range of motion in your arms and other limbs. They will also observe if you have physical deformities that might hinder performance.
By gathering all this information, recommendations can be made regarding supports, adaptations in the home or mobility aids that might benefit you.
Adaptations in the home/work may include:
- ergonomic cutlery and appliances to help with cooking
- bath rails and shower trays to make washing yourself easier
- grabbers or reachers to help pick up things
- stair lifts or other adaptations to your home
- corrective footwear or stints to improve walking
- car accessories and cushions to make driving more comfortable
- arm wrists and other computer accessories for work
Energy conservation
An occupational therapist can also advise an individual with rheumatoid arthritis on how to carry activities in the most effective way. It is important that you rest your joints and conserve your energy. The therapist may teach you joint protection techniques to help reduce joint strain, conserve energy and protect further joint damage.
Some principles of joint rest and protection are:
- Maintain good posture
- Conserve energy by balancing work with rest
- Sit rather than stand when working
- Use larger joints (elbows and forearms) where possible
- When lifting, use two hands rather than one
- Slide objects instead of lifting them
- Avoid tight grip or twisting motion of hands
Accessing occupational therapy
Occupational therapists are employed by the Health Services Executive (HSE). You can apply directly to the HSE for the services of an occupational therapist. However, it is more usual for you to be referred by a public health nurse, your GP or the hospital. You can find out more on the citizens advice websitewww.citizensinformation.ie.
Unfortunately, there is a shortage of occupational therapists in Ireland and therefore there are long waiting lists. However, people with disabilities (including rheumatoid arthritis) are given priority.
After the occupational therapist has carried out their assessment, they may arrange for the HSE to supply appropriate aids and appliances or may certify that you are eligible for the disabled person’s grant. This entitles you to a Mobile Aids Grant, which you can use to buy adaptations. For a list of providers of products visitwww.assistireland.ie.
In some cases, the HSE may refer people who urgently need the service to private practitioners. The Association of Occupational Therapists of Ireland (the professional body that regulates the profession in Ireland) has a list of registered occupational therapists in private practice. You can obtain the list by contacting the Association of Occupational Therapists in Ireland www.aoti.ie, 29 Gardiner Place, Dublin 1. Tel: 01 878 0247.