Occupational Therapy

Medical ward Occupational Therapists cover a range of specialities which include respiratory, rheumatology, endocrinology, gastroenterology, cardiology and renal. These wards give OTs the experience of a variety of specific long-term conditions and how they impact on a patient’s everyday living.Many patients on medical wards will have chronic conditions which may have flared up suddenly or which may have progressed gradually, leaving the patient no longer able to cope at home. Initially, OTs work closely with doctors and nurses in planning for a patient’s rehabilitation, and staying in close contact with local community services to begin preparing for the patient’s return home. With physiotherapy colleagues and other staff, OTs will to help patients to get up for the first time and recommend specific exercises for their condition and ability so they can regain independence.

The role of the medical ward Occupational Therapists can be broad, and may include use of activities to help settle a disorientated patient with dementia, assessment for splints to support joints, or potentially completion of access visits to assess the home environment and potential needs for equipment.

Surgical occupational therapy covers many different areas, including abdominal surgery, ear nose and throat, urology and trauma-based injuries. Surgical Occupational Therapists see planned or elective surgery patients, as well as emergency surgery patients, and treat a wide variety of age groups from 18 years upwards. The Occupational Therapist in surgery will assess function and look at how a person managed previously and whether this current condition or injury will affect them temporarily, or permanently. In surgery, Occupational Therapists will also see patients who may have a long-standing illness such as cancer, Parkinson’s, dementia or stroke, and will consider this in interventions to best maintain that person’s independence in everyday activities. Surgical Occupational Therapists may refer patients for voluntary-based assistance at home as well as further rehabilitation and care, when appropriate. We can also look at equipment provision if necessary, for a person to return home safely and independently.

Surgical Occupational Therapists also assist with new surgical interventions, such as stoma management or long term indwelling catheters. This helps patients and families to learn about using and looking after their device, as well as where to find help when necessary.

Orthopaedic Occupational Therapists see patients of all ages, for both planned and emergency surgery involving bones and muscles. While the Occupational Therapists see emergency patients after surgery, for patients with planned operations, occupational therapy is often involved before surgery. This enables the Occupational Therapist to complete an initial assessment, discuss concerns, answer questions and give advice on appropriate equipment or modifications of existing furniture in order to prepare the patient for their recovery and rehabilitation.

Orthopaedic Occupational Therapists assess function, address pain management and its effect on function, recommend alternative strategies for patients to continue to perform their everyday activities, provide rehabilitation and advise as to best practice. Orthopaedic Occupational Therapists will also consider the home environment to ensure that is suitable for the patient to complete their everyday activities when they return home following surgery. Where necessary, the Occupational Therapist may complete an access visit if they have concerns about the patient managing within the home environment.

Occupational therapy in neuro-rehabilitation (usually called ‘neuro-rehab’) and acute stroke care can help patients find practical solutions to overcome some of the problems that have been caused by brain injury and stroke. This involves helping patients find practical solutions to carrying out their everyday tasks and activities, which are important for independence and quality of life. This can includes bathing, dressing, toileting and preparing food.

After a brain injury or stroke, patients may experience physical, cognitive (understanding) or emotional difficulties which affect how everyday tasks are completed. Neuro-rehab Occupational Therapists will further explore cognition and thinking skills, and how patients perceive the world around them and aim to offer new ways on how to do things.

In addition to providing treatment, neuro-rehab Occupational Therapists are able to provide equipment or make recommendations to make tasks easier at home as well as accessing community services and / or returning to work.

Occupational Therapists in Elderly Care treat patients over the age of 65, usually with a variety of medical conditions. All elderly care patients are assessed by an Occupational Therapist in order to identify any needs or difficulties patients may be having with performing their everyday activities, such as washing and dressing, toileting or functional tasks in the kitchen. Intervention and rehabilitation is then tailored to the patients’ needs to increase their independence and functioning in their everyday activities in order to prepare them for when they leave the hospital. Elderly care Occupational Therapists are involved in patient discharge, and ensure that patients will be returning to an appropriate environment that will help keep them as independent and safe as possible.

Within Elderly Care, the Emmer Green Hip Fracture Unit treats patients with hip fractures. On this unit there is an emphasis on rehabilitation, and therapists see patients within a day of their surgery to get them on their feet and moving, in line with national recommendations. Occupational Therapists assess and practice functional skills, provide appropriate equipment where required, refer and provide information about services in the community and may refer for reablement care (CRT) where appropriate.

Occupational therapy in rheumatology is both an inpatient and outpatient service, working with individuals with rheumatological conditions such as arthritis and chronic pain. The Occupational Therapist in rheumatology will assess how patients are managing their everyday activities and responsibilities, and provide treatment to help patients manage pain, fatigue and functional difficulties. The aim, as with all occupational therapy, is to promote and support the patient’s independence.

Occupational therapy treatment addresses both physical and mental health and wellbeing, recognising the impact of physical symptoms on mental health. It can involve supplying pre-fabricated splints or custom fitting of splints to support painful and inflamed joints, oedema and swelling management, recommendation of strengthening exercises and provision of equipment or aids to maintain independence. Rheumatology Occupational Therapists can also help with self-management techniques including pain management, sleep hygiene, energy conservation, fatigue management, pacing and joint protection strategies.

In the Emergency Department, the Acute Medical Unit and the Short Stay Unit are both short stay units that attempt to prevent patients being admitted to a ward, unless it is absolutely necessary. The A&E Occupational Therapists work together with other members of the multidisciplinary team (MDT) to provide timely, patient-focused assessments and treatment for people who are elderly, frail, or who have had a change in function. A&E Occupational Therapists will assess a patient’s functioning to ensure that they are safe to manage at home, and can potentially provide equipment or link patients with community services to support them at home to avoid hospital admission, where appropriate.

The A&E Occupational Therapist has a key role in reducing the length of stay for patients who do not require an inpatient hospital stay – this is made possible through collaboration with the patient, their family/friends and community/voluntary services.