The role of the occupational therapist in cognitive stimulation and rehabilitation

The role of the occupational therapist in cognitive stimulation and rehabilitation

An occupational therapist, better known as an OT, is a professional who studied in the university in order to get a degree that certified them as a qualified person to perform these activities.

Usually can get a bachelor degree in occupational therapy in a university or can study a post grad course that is approved by the HCPC, which is the Health and Care Professions Council.

Also a person can be an occupational therapist by working as a support staff of another OT on the job.

The occupational therapist is considered an allied in the health field, even though is not a doctor they can be very helpful and useful for any type of patient who requires assistance for improving their motor skills that were damaged by some disease or accident.

These motor skills that everyone performs as a daily basis can be a real struggle to the people who are no longer capable to do them anymore so easily.

When somebody has to live with an illness, injury or disability can be very depressing to not being able to perform daily tasks, especially if before the sickness episode they were capable to do them.

This is the moment when the occupational therapist can be very useful for them, because the goal of the therapy is to promote health and well being to the person affected.

What does an occupational therapist do?

An OT is a health professional who is focused and centered in their client’s needs, with the aim of promoting their participation in the activities of daily life.

The occupational therapy is designed to help people of all ages, from babies to elders, to acquire or regain the motor skills that allow them to get more involved in life by performing activities or occupations.

These daily activities can be so easy for the rest of the people, but for the patient are very hard to achieve.

Activities like eating alone, going to the bathroom alone or getting dressed alone can be very challenging for the patient, but the OT can help them to dominate these tasks.

Since every patient is different and each one can have a different disease, illness or disability, the OT has to be very well trained to design and apply the best strategy to help the patient to recover and to try to have a normal life.

Even though it might seem like a minor thing, it is a huge study field, and every day is growing more and more in order to develop new methods and techniques that can be applied to the patients and get successful results.

Actually, it is a very diverse career that involves several knowledge in different areas that are needed to help a patient, like a baby who has developmental delays, or like an elderly person who needs end-of-life care.

Every occupational therapist is oriented to a specific field of study, since it is not advisable that everyone do everything, it is better if each professional is well trained in just one field, this way they can become the best specialists and can help more people, because they have more knowledge that can be applied to the patient.

There are wide ranges of health problems and the occupational therapists work with patients who are suffering one of these issues.

What are the strategies used by the occupational therapist?

A person has three occupations in life, and those are the self care, leisure, and work. If there is any type of inconvenient that is affecting one of these occupations then the occupational therapist has to help the patient by using different methods and techniques withthem.

First of all, the occupational therapist has to carry out a diagnose that allows them to identify what are the disabilities of their patient. They need to evaluate the patient in order to get to know them better, and with a proper diagnose they can create a better strategy.

By all the knowledge that the OT obtain in the courses or in the university they are well prepared to design the best technique that addresses the problem and solve it.

They teach their patient to execute a series of activities, exercises, practices, and any other task that can be helpful for the patient’s recovery process.

These tasks can be done at home, at work, in school, when practicing a sport and even when the patient is performing another activity, like driving.

If the occupational therapist teaches the patients to be more independent, then the patients can feel more confident and their self-esteem can increase considerably, which are both very good for the patients’ improvement and their inclusion in the daily life.

When a sick person can realize that they can start doing the activities that were so hard for them to do it is a very special moment that has to be celebrated, because that is a huge progress in life.

In fact, the occupational therapist is a professional very much needed by the patient who has any type of disability, since they don’t have to pay for a nurse to take care of them and their relatives can feel also relieved if they see the progress.

Sometimes there will be some days that are more difficult than other, and the patient might feel like they are not making any progress at all, but what it’s more important is that they don’t quit to the therapy, because even if they don’t feel like progressing, they are still being persevering and constant, and those two are the most important ingredients for the full recovery of a person’s health.

How the occupational therapist can help the patient?

As we mentioned before, the occupational therapist can design several strategies to help the patient to perform different tasks according to their level of difficulty regarding motor skills.

If for a determinate patient it’s very difficult to tie their shoelaces the occupational therapist has to design the activities that can help them to accomplish this task.

The therapy is indicated for anybody who is struggling to perform any activity that is required to do on a daily basis.

After the therapy is completed the person can be capable to be independent and to overcome the problems regarding motor skills that were caused by any disease or illness.

The main goal of the occupational therapist is to help the patients to reach their goals that hold meaning for them; because what might seem like something less important to most people, for a person who’s got motor skills problems it can be a great achievement.

These goals can vary according to the patient and to their health problem, but more commonly are daily tasks that will make them feel more independent and more confident in themselves.

Maybe for a patient it might be a great progress to cook a delicious dinner without hurting themselves or making any mistakes; and for another patient their great goal could be to return to college and get good grades in their courses.

For every person the goal is different, but the meaning of each goal is the same: the possibility to return to have a normal life, by overcoming the obstacles and difficulties regarding the motor skills.

Where can an occupational therapist work?

The occupational therapist is a professional who can work in any place where they need and allied in the health field.

They can work in a company with the purpose of supervise how the workers perform certain activities and determine if these are affecting their health in some way.

For example, a company may have workers whose scope of work is to lift heavy objects; that is when the occupational therapist has to instruct them how to lift the weight in the correct way in order to not get hurt and to avoid injuries that may lead to a worse disease, that ends up disabling them.

And if they are not doing the lifting properly, the OT has to correct them and monitor the situation, so they can start implementing the instruction the OT has given to them.

Sometimes the workers don’t pay attention on how they do the activity they are assigned to, but this is the beginning of something worse.

Every person who is doing a task like lifting heavy weight has to be instructed correctly in how to do it so they cannot get hurt by any physical stress caused in their back.

If the worker insist on continuing doing the task in the wrong way it might develop a serious disease that may affect the lower or upper back, and if they don’t take the necessary actions to prevent this problem they might up end unable to work.

This is when they would need an occupational therapist to help them do the rehabilitation necessary to eliminate the pain they feel on their back, and to continue living the life without any disability.

Another place where the occupational therapist can work is the hospital, where they can help the patients there to recover from a recent accident or a stroke, and even a brain injury, and these types of patients usually spent more time in therapy.

Also they can work in a private practice, where the attention to the patient is a little bit more exclusive and they can follow up better the evolution of the patient.

The nursing homes are also a well suited place for an occupational therapist to do their job, and there are many patients they can help, from elder people to people with a life-limiting illness.

Other workplaces for the occupational therapist that perhaps are not very commonly hired in are the schools and companies, where they are requested to teach every kid and staff member how to perform the needed tasks, and then they supervise that everything is being done correctly and without representing any harm to the health.

The occupational therapist also offer their professional services for home health care, which is one of the most requested jobs since they can be with the patient exclusively and help them to be more independent and assist them with the activities they need help.

This type of home health care is very beneficial for the patient, because they feel well attended and like they are being taken seriously, because the therapist really wants to help them to reach their goals.

In the case of the babies and toddlers the most recommended is that the OT can provide them home-based therapy.

The occupational therapists are always busy going from one place to another to visit their different patients and to check their progress and how do they feel.

They are very interested into help their patients to develop the fine and gross motor skills, that’s why they tend to keep in touch with their patients even though the therapy sessions have ended, because they feel happy for them and because they’re succeeding in their goals of regaining the control of their lives.

If the occupational therapist has enough experience and is well trained in their field of study; they can be very helpful for other colleagues who are interested in learning.

This way they can organize some conferences or therapeutic groups of study, where they can teach everything they have learned to other colleagues that want to work in that specific field of study.

They can become the advisors for other occupational therapists and also help them with their patients, in order to design the best strategies that will work well with them.

And of course they can also support each other when the bad days come, because some days they might feel depressed or overwhelmed by the amount of work or because a patient doesn’t want to continue with the therapy and so on.

But even though there might be sad days, the good days are so much more, where they can see how their patient evolves and how they start taking control of their lives.

How does an occupational therapist feel about their job?

The most important thing about where the occupational therapist can work is not about the place itself but the passion that they feel about their job.

If they feel convinced and dedicated for what they are doing, then any place is good, because the purpose is to help the patient with their problem or difficulty.

Usually the occupational therapists are always very passionate about their jobs and they really want their patients to get better and start seeing the progress in their lives.

Sometimes there are patients whose purpose is not to get better but not to get worse, for instance the patients who need end-of-life care, since they have a disease that is limiting their lives, and here is where the occupational therapist has to focus on promoting self-management of the patient.

The patient and their loved ones are encouraged to take control and to learn how to live well with their diagnosed disease.

Basically, the occupational therapist just wants the patient to feel comfortable with being different, and to try to have a normal life by being as more independent as they can.

How the occupational therapist can help with rehabilitation?

Since there are many health issues that can affect a person, causing them to suffer from illness, disease or an injury that is also causing some disability or inability to do a determinate task, the occupational therapist must know how to address correctly the strategy in order to help the patient to rehabilitate and try to get back to normal.

Overall, the main goal of the rehabilitation is to help the patient regardless their condition so they can get back to participate in daily activities that they want to do, and to take care of themselves as well as to do the occupations of life.

One of the major focuses of the occupational therapy is the rehabilitation, and actually is the core of this discipline.

Since there are many parts of the body that might be affected for a health issue, the occupational therapy is divided for the upper and lower body, being the target of the upper body rehabilitation the extremities like the elbow, forearm, wrist, hand, and so on.

The rehabilitation aims to promote the patient’s ability to perform everyday tasks and activities that they can’t longer do due to the health issue.

The occupational therapist attempts to help the patient to get the most of their life.

In order that the patient can evolve faster and better with their rehabilitation it is advisable that they include their therapy program into work and leisure.

The patient can do the work rehabilitation by returning to work, or start working, and in this area the OT can help them by assessing them in their role at work, in their ability to complete the tasks assigned and providing training to the patient on how they can do what they’ve been assigned.

As for the leisure rehabilitation this can cover all the fun activities that the patient wants to do, like a hobby.

If the patient is participating in leisure activities they would stop feeling isolated, which can improve their self-esteem and their quality of life, which are both very important for their recovery of the health problem.

The occupational therapist can assist the patient and give them indications on what they can do for fun and how they can do it.

For example, if the patient likes gardening but it is a difficult activity for them, the occupational therapist will prepare a strategy with easier ways to do these tasks by implementing techniques and special tools.

What is the cognitive stimulation?

One of the fields of study for the occupational therapist is the cognitive stimulation, which is the treatment designed to help the people who suffer from dementia in a certain grade.

The term “dementia” includes several types of illness, and the two main types that are most common are vascular dementia and Alzheimer.

There are enough evidence that shows that the occupational therapy can be beneficial for the patients who suffer dementia, since there were many studies carried out in several countries like India, Spain, United States, Holland and Italy where they helped patients with dementia by applying occupational therapy and the results were very encouraging.

In a study carried out by Kumar P. et al in India in 2014 they helped the patients with 10 sessions of occupational therapy of 70 minutes each during 5 weeks, where the main focus of the sessions was to do relaxation exercises, physical activity, daily based activities, cognitive stimulation and recreational activities.

The results for this particular study showed that the patients with dementia improved their quality of life, since they were able to have a better psychological and physical health control.

Also it is important to mention that for some studies the intervention target was the patient with dementia and for other was the caregiver and the patient.

One of the results obtained in the studies where the intervention target was the patient with dementia was that they decreased considerably the consumption of psychotropic drugs, and also they were showing a reduction of physical containment.

In the cases were the target was the family caregiver, along with the patient with dementia, the results were very optimistic for improving life not only for the patient but also to the person who is always taking care of them.

For the caregiver they were able to perceive that the stress for taking care of the patient was decreasing as well as a reduction of the symptoms of depression, since they were able to see an evolution in the patient’s independence and control of their life.

They also showed more self-confidence in their caregiver role as they felt more prepared to face the challenge of taking care of a person with this type of disease.

For the patient, the results were also hopeful, since they also had a decrease of the symptoms of depression.

As for the patient´s independence; they improved their participation in daily activities and also their control on these activities and tasks.

When is the best time to refer a patient with dementia to occupational therapy?

Since the occupational therapy for cognitive stimulation for patients with dementia is showing such good results, it is wise to implement it in home care and day care centers, to improve the patient’s life.

When the patient starts to show the following symptoms it is advisable to refer them to occupational therapy:

  • Psychological and behavioral symptoms that can be detrimental to their life and the people around them
  • The relatives and the caregiver don’t know how to deal with a person with dementia and don’t have the necessary tools to help them to have a better life.
  • There are risks for the patient’s safety due to their inability to perform certain activities.

The recommended amount of sessions for experiencing the good results is from 8 to 12 sessions divided into programs and carried out cyclically.

How an occupational therapist can help a person with sensory proceeding issues?

Another of the fields of study for the occupational therapist is the patients with sensory proceeding issues.

All humans have five senses: sight, touch, taste, hearing and smell, and also we all have two senses that are considered “internal”, which are the movement and the proprioception, also known as body awareness.

These two internal senses work together to help the body to have motor control and posture, as well as to know where the body is in space, which means to have balance and coordination.

A person with sensory proceeding issue is someone who can’t synthesize all the information that the body is receiving from these seven senses, which leads them to suffering one of the three types of problems caused by this issue.

One of these problems is hypersensitivity which is described as over-sensitivity, the other one is hyposensitivity, which is under-sensitivity, and the other is the combination of these two in an overwhelming degree.

The people who are hypersensitive tend to feel overwhelmed by the crowded places, fluorescent lights, and loud noises and so on. They usually exclude themselves from the places they don’t feel comfortable and try to be alone.

And the ones who suffer from hyposentivity on the other hand tend to try to be the center of attention wherever they are.

They like to keep in movement, touching things, feeling everything, and this issue is usually mistaken as an AHDH, which in some cases the patient may have it or not.

When a person is diagnosed with sensory proceeding issues, the occupational therapist can be a great help for these types of patients.

For a person with hypersensitivity they recommend a strategy based on diminishing the sensory overload, and this can be achieved by practicing activities like special seating and testing in a separate room.

The goal is to help the hypersensitive patient to regulate the sensitivity and to reach a normal level of it.

For these type of patients exists something called the sensory gyms, which are designed to practice activities that involve a lot of movement, like swinging or jumping.

Also they practice to help the person to sit for a moment and focus in a determinate activity, which is very helpful for learning how to control themselves.

There is even one practice that it is done in order to get the patient to get to focus on somebody and to have eye contact, for instance the case of a child attended by the OT Lindsay Biel who was continuously in motion and he couldn’t communicate with the people, so she applied one technique consisting in brushing of his skin, which had great results since the child was able to establish eye contact with the therapist during the whole session.

Since there are many practices, methods and techniques that the occupational therapist can apply to the patients with sensory proceeding issues, it is still advisable that the OT can design the best strategy according to the patients needs and also considering their ages.

Because for a child some methods might not be as effective as for an adult, so it is better to get to know the patient, what are their needs, how do they feel the world that is around them and how do they develop in it.

How the occupational therapist can help with gross motor skills?

In some cases there are patients, mostly children, who are not capable of developing correctly or properly the gross and fine motor skills.

The gross motor skills are related with the major muscle groups, where the person struggles to get balance, strength and coordination, to name a few, and these type of things are related with activities such as walking, running, jumping and so on.

When a person doesn’t know how to control their gross motor skills they might feel embarrassed, which can affect their social life and self-esteem.

This type of gross motor skill problems can be caused by an accident, an injury, or any other episode that affected the person physically and they are trying to recover in order to get back to normal as they were before.

And for children this might be caused due to they never learned how to control their gross motor skills, even though this can be easy for some children, there are others who don’t know how to develop this.

The occupational therapist can help people to dominate their gross motor skills by practicing some activities that helps them gain coordination and balance, as well as endurance and strength which are both very important to control the body movements.

Usually when a patient needs to develop their gross motor skills, the occupational therapist tends to work with a physical therapist too, since both have almost the same goal for the patient.

Additionally, the occupational therapist will recommend the patient to do a series of exercises that will help them to increase the muscle tone and strength in the core, since the muscles need to be strong in order to support the body and to do the several activities they want.

How the occupational therapist can help with fine motor skills?

The fine motor skills are related with the small muscles that are located in the hands. Even though they are small muscles they still can cause a big problem if the person doesn’t know how to handle them correctly.

When the fine motor skills are under-develop the person can have a significant decrease on independence, self-confidence and performance at work or school.

Just like the gross motor skills can be developed correctly by some children, for others is very difficult to learn how to dominate these small muscles.

And for adults this type of problem with fine motor skills can be caused by a stroke or an injury which compromised their coordination in the hands and fingers.

This is when the patient might need rehabilitation in order to recover from the problem that led them to live this situation.

When the occupational therapist is dedicated to help a person with fine motor skills problems they basically are trying to rewire the brain, since these skills involve not only the muscular system, but the skeletal and neurological systems too.

The better approach for this issue is to motivate the person to get involved in a specific activity from four to six hours that is interesting for them.

There are many activities that are good for this issue, and each activity or task can be very beneficial for the several movements that we can do with our hands.

The occupational therapists aim to improve the coordination that the patient can do with their hands, like the ones following:

  • Finger isolation: the ability to move one finger at a time
  • Pincer grasp: grasping and object between the index finger and the thumb, like for planting seeds.
  • Thumb opposition: improve the strength of the web space between the index finger and the thumb, as well as the cooperation of the rest of the fingers for this task.
  • Tripod grasp: the ability to grasp and object with the index finger and the thumb, with the help of the middle finger, like when holding a pencil.
  • Bilateral coordination: the ability to use both hands together.

All these movements are necessary for the person in order to have a normal life and to interact better with the world around them.

For children these types of therapies can be beneficial, since they can practice their fine motor skills in several sessions at their home or at school, and even at both places, which can be very helpful because the therapy is being done throughout the child’s day, and this way they can evolve much faster.

The occupational therapist not only works with the child but also with their family, they provide the parents some good advises to help their child and they explain better this condition and how they can overcome it and have a better life.

Some occupational therapist offer also a fine motor skills group during the weekends and during holidays; this way the patient can work on the tasks that will help them to develop fine motor skills whenever they decide to do it.

What are the key components of the occupational therapy?

Every occupational therapist has to know the goals they are trying to achieve together with their patients, and how is the approach they need to give.

The first key component of the occupational therapy is that it has only one focus, which is the patient’s occupation.

As we mentioned before, the occupations are the basic tasks of life that we do to take care of others and ourselves, to be social and have fun and to work because we are part of a society and we need to contribute with it.

The second key component is that the occupational therapist are well educated and trained to understand that there might be times in a person’s life where their whole world can change due to a disability, injury or illness that can create them a challenging life.

These events affect the daily activities that the person does and that are important to them, meaning that if they return to do these activities they can feel pleased and happy.

The occupational therapists are professionals who know how to apply their expertise and know how to asses all the different health conditions that may cause the affection of a person’s abilities; this is the third key component.

They will have to implement certain strategies and activities that help the patient to overcome or learn how to live with the health condition or difficulty they might have that is affecting the performance of their daily activities.

The fourth key component is that the occupational therapy has it focus on the person’s strength and not on their weaknesses, because the purpose is to take advantage of what they still can do to help them perform the tasks they are still not able to do.

Of course the patient’s preferences are always the priority, and the program will be designed according to their needs, and when the patient is a baby or a child, according to their parent’s need.

And the last key component of the occupational therapy is that the program has to responds to the patient’s needs regarding their situation.

The occupational therapist is dedicated to help the patient to live their lives in a meaningful and satisfactory way for them, so they can star enjoying life regardless the difficulties they might have.

Since the occupational therapists are educated in a holistic way, by integrating knowledge of the social, psychological, health and occupational fields they can provide good solutions for their patients regarding their motor skills issues.

This career is suitable to the people who are passionate about helping others and who like to solve problems and design strategies, since it is a very regarding and interesting field of study for them.

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4 thoughts on “The role of the occupational therapist in cognitive stimulation and rehabilitation

  1. Anna Thursday June 15th, 2017 at 09:05 AM

    Very Nice post…

  2. NeuronUP Thursday June 15th, 2017 at 09:18 AM

    Thank you Anna! We are glad you like it!

  3. Jelena Friday June 16th, 2017 at 10:08 AM

    With the advent of static life and work styles, the importance of an occupational therapist will only go up. Good read! Thank you!

    • NeuronUP Wednesday July 19th, 2017 at 11:18 AM

      Thanks for your comment Jelena! A very interesting reflection!

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