Occupational Therapy for Rheumatology
With more of a spotlight on physical therapy, Dr. Hausmann said, there may not always be a clear understanding of what happens in occupational therapy. Although there is some overlap with physical therapy, occupational therapy has many other components.
“I like to rename us life skills therapists,” Ms. Crow said. “Occupational therapists help people who are having difficulty functioning in their daily life,” for examples, she mentioned having difficulty cooking or performing their jobs, “whether that [difficulty stems] from a mental health condition, [such as] schizophrenia …, or if it’s from arthritis or another physical disability.”
Occupational therapy considers the person as a whole with a focus on how they interact with their environment vs. focusing on just one body part, such as the hands—although some occupational therapists are hand specialists.
When meeting with patients for the first time, an occupational therapist typically asks, “Walk me through a day in your life. What’s going well, and what’s not going well?
“We are very detail oriented, so we will make a goal that is ridiculously specific,” Ms. Crow said. One example: A patient may mention they can’t turn a page in a child’s book while reading to them. An occupational therapist will drill down to determine if it’s a physical impediment and if it’s something the person can or cannot control. Next, they will look at solutions, such as improving hand strength or implementing adaptations or life hacks, such as holding the book differently, getting a bigger book or switching to an e-reader.
Another example: Ms. Crow described the goal of a female patient with RA who wanted to independently use wrist splints as needed to participate in activities of daily living, identify adaptive equipment and strategies to use during childcare, and create a schedule to set the pace and priorities for household and childcare activities.
“We are really life skills detectives and help people with the minutiae of their life,” she says.
Referrals to Occupational Therapy
When should a rheumatology patient be referred to occupational therapy? Ms. Crow said the answer is simple: Refer if a patient is having difficulty functioning in their daily life and performing their required activities. These activities include the basic activities of daily living, such as using the bathroom, cooking or self-care. They also include the more complex activities of daily living, such as health management and maintenance, which includes tracking symptoms, making healthy lifestyle choices and managing the job of being a patient with chronic illness.
