With a team of specialists to put the body back together, wheelchair users can be mobile and healthy. But it’s the humble occupational therapist who assists spinal cord injury (SCI) patients to live a fulfilling life.
An SCI is a catastrophic life-changing event that impacts on every facet of daily living. Doctors put us together again; physiotherapists and biokineticists strengthen our muscles and mobilise our joints; dieticians adjust and adapt our diets and fluid intake and, where needed, speech therapists teach us to swallow again.
When our minds flip out, there are psychologists who hook us up again. Yet, all of this, however effective, still leaves us stranded. How do we return to productive lives? How do we rediscover our potential? How do we reintegrate into society? How do we cope with the routine tasks of ordinary daily life?
Occupational therapists (OTs) are the reintegration wizards who can guide, retrain and figure out solutions with us. According to the American Occupational Therapy Association (AOTA), the tenet that every individual has the desire and right to engage in meaningful activities is fundamental to the practice of occupational therapy.
OTs have the education, training and skills that enable them to figure out the best solutions to meet our needs. Where they are not able to help us, they connect us with people who can.
What exactly is occupational therapy?
According to the Canadian Association of Occupational Therapists (CAOT), life is made up of meaningful everyday activities such as walking the dog, gardening, preparing a meal, doing the laundry and playing games. Occupations are a part of life. They describe who we are and how we feel about ourselves.
Occupations bring meaning to life. When we cannot participate in in these daily activities any more, due to an SCI, we turn to OTs for help. Together with psychologists, they give us the methods and tools to sort out our emotions and minds.
Together with physiotherapists and biokineticists, they tease the maximum functionality out of our bodies. Physios first teach us to do a movement and then the OT teaches us to use the movement.
But OTs go far beyond this. They assess the limits of our abilities and the demands placed on us by the realities of our daily circumstances; then they bridge the gap between the two with innovative solutions. Where they are not able to innovate, they facilitate. They find experts who can explain the situation, describe the needs and meet the challenge to find solutions.
OTs also guide our caregivers and family on how best to support us, recommending special techniques, do’s and don’ts and practical advice, including assistance with home training programmes. OTs “walk alongside” us during the period of picking up the pieces of a shattered life and help us put our lives back together again.
So far, so good, but what precisely do OTs do?
OTs teach us techniques to perform basic activities such as washing and dressing, toilet routines, eating and drinking. They introduce adaptations such as writing aids and adapted utensils for eating and drinking where needed. They expose us to equipment and techniques to help us in the bedroom, bathroom and kitchen. Where we are not able to get by on our own, they train our caregivers and family.
A wheelchair is not an off-the-shelf monstrosity that we buy at the local chemist. We spend our lives in them, so they must be designed to serve us optimally in all our seating, posture and mobility situations. Large wheelchair manufacturers and retailers have OT seating specialists who help us to select the chair that is best suited to our needs.
They specifically look at posture management and provide the required back and other supports to minimise the onset of postural deformities. OTs are key players in getting us mobile beyond our wheelchairs. They are critical role-players when we look into assistive devices for motor vehicles. They understand our abilities and how best to adapt the steering, brake and accelerator to ensure safe driving as well as transfers between car and chair.
At work they help with adaptive devices for the use of a computer keyboard and telephone or cellphone. They even advise employers on our needs and how to best accommodate us so we can be maximally productive. For those at school or university, OTs can also advise educators on how to support and accommodate us. In leisure, sport and hobbies they help with equipment and adaptations that help us to enjoy, compete or just have fun.
These are just a few facets of expertise of an OT. We get to know them during rehabilitation, but we must not forget them when we are discharged. They care for our wellbeing and they can be life changers if we make use of them. One reminder, though: as in all professions, there are specialities within the profession of OT.
So, shop around for the right OT for your specific need. In your search, start with your local rehab hospital. If they cannot help, they will point you in the right direction. We all dream of a fulfilled life that has meaning and contributes to society. OTs can help us to fulfil that dream, we just need to invite them to do so.
The Occupational Therapy Association of South Africa (OTASA) can guide people in finding the right therapist. The OTASA can be contacted via telephone at 012 362 5457, fax at 086 651 5438 or email at firstname.lastname@example.org. Visit the OTASA website for more information at www.otasa.org.za.
Ida’s Corner is a regular column by George Louw, who qualified as a medical doctor, but, due to a progressing spastic paralysis, he chose a career in health administration. The column is named after Ida Hlongwa, who worked as caregiver for Ari Seirlis for 20 years. Her charm, smile, commitment, quality care and sacrifice set the bar incredibly high for the caregiving fraternity.