Occupational therapists to the rescue

To mark Occupational Therapy Week employees from The Children’s Trust spent a day with restricted use of their arms, legs or voice and shared their experiences.

Occupational Therapy (OT) aims to allow people to better perform everyday activities, some of which they may have lost the ability to do because of an injury, and to give them more independence. The project aimed to increase understanding of occupational therapy (OT). The Children’s Trust is the UK's leading charity for children and young people with brain injury offering both residential and community-based rehabilitation services. After several hours of the challenge, the participants met with occupational therapists (OTs) to discuss what they were finding difficult and the OTs explained the support they’d offer in a real-life situation to enable independence.

Loss of voice

Two employees were unable to talk for the day. Speaking about the experience Jamie said: “It’s really isolating. I feel I’m being rude to people and I’ve found people are miming or whispering to us even though they can talk!”  Tracey added: “I’ve been using written communications, such as email, but you wouldn’t always have that. It feels quite lonely.” Suggestions from the OT’s included using ID cards that explain what the problem is; Yes and No signs to point at look at; and paper or electronic communication devices. Mandie Geddes, Occupational Therapy and Equipment Technician, said: “There’s a lot of assisted technology around. Communications folders allow someone to point to something they want – this could be a paper version or on an ipad. You can put a voice to the ipad version and personalise to different situations.”

Unable to walk

Kate spent the morning in a manual wheelchair and found it harder than expected, unable to do even the things she had thought she’d be able to. A lack of upper body strength was a physical challenge but Kate’s biggest challenge was feeling she was completely dependent on other people. “I need to ask for everything – drinks to be made due to the surface height, doors to be opened, someone to heat up my lunch. Everything feels quite intimidating.” Kate added: “I feel I’m standing out and people are looking away as they don’t know what to say. Or it feels like they don’t want to make a point of acknowledging me just because I’m in a wheelchair. “Everyone has been walking behind me so I feel left out. It’s been really eye-opening.” When she met with the OTs at lunchtime Kate’s wheelchair was changed from manual to electric. Mandie explained other support to Kate: “We’d look into other seating options such as a suitable office chair for work and a comfy chair or hi-lo chair at home and we’d practice transfers with you for the different options of seating throughout your day including the toilet with the use of a transfer board. ”We’d help you build up your upper arm strength. “There would be lots of new techniques to learn and some would be cognitive – helping you through new learning.” “You’re home and work environment would be adapted to accommodate for the wheelchair, and objects re-located in a reachable place such as tea, coffee and sugar.” The electric wheelchair made Kate’s life a lot easier in the afternoon although she switched back to manual controls indoor as it was tricky to manoeuvre around desks in an office.

No use of dominant or non-dominant arm

Two of the employees were unable to use one of their arms. Jo said: “Everything’s taking longer. Some things have been fine but this morning I chose the shampoo with the flip top lid and the toothpaste with a pump! “I’ve used my knees and teeth when I need to grip something - and when I was holding something in my functioning hand I used my elbow to close doors and switch off the light.” Stephen took the same challenge restricting his dominant hand. He found the challenge harder than he expected, especially as he already uses his non-dominant hand for eating and brushing his teeth. “Using the mouse on the computer is hard and I’ve been using my nose to lock my computer (ctrl, alt, delete)! This challenge is not easy and I’ve been looking online to try and find solutions.” The occupational therapists suggested strengthening exercises and specialist equipment, such as a chopping board with spikes to keep food stable and zip extenders to make the zip bigger to grab onto. Mairi Kennedy, Occupational Therapist, said: “There are lots of compensatory techniques that we teach children. They find things frustrating as they could do these things before – so we find children might say “Come on hand”. We have to push through that frustration and help them to learn quickly.”

Reflecting on the challenge

All the participants felt they benefitted from their experience in Occupational Therapy Week (6-12 November) and the therapists also found it insightful. Mandie gave more information about occupational therapy saying: “It’s not just about physical disabilities. We also focus on people’s mental wellbeing, which can often come alongside having a disability such as feeling isolated and not feeling motivated to engage with others. “As OTs it’s not just about issuing a piece of equipment or modelling a new technique. It also involves motivating and encouraging the child or young adult to participate in trying them out too.”

Referrals to occupational therapy

While the challenge was carried out by the OT team at The Children’s Trust, GPs and paediatricians can make referrals to OT services UK-wide. Some NHS services even have an open referral system, which means other people such as health professionals or pre-school/school staff can make referrals. Mairi said: “To find out this information for your local service, I’d recommend going onto your local NHS trust’s website and trying to locate the children’s therapies section. In this section, they should include information about who the service can receive their referrals from. “Sometimes it is a little complicated to find who your local NHS children’s therapies are so I’d recommend having a discussion with the GP or Paediatrician about your wishes to have a referral made.”
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