The Contribution of Occupational Therapy: A Profession in Support
12.5 The Scope of Occupational Therapy Assessment and Intervention
The elderly client learns strategies and techniques to lighten the load of occupations (meaningful activities) during the day and is taught ergonomics applicable to them to avoid pain and overload and to prevent falls. They are also taught (or re-taught) how to complete everyday tasks that they need and want to do, as well as being taught how to promote and/or maintain cognitive functions (memory, attention, con- centration, problem-solving, etc.). The resumption of leisure activities is encour- aged, such as participating in hobbies and physical activities that were once of interest to the elderly client, as well as generating new interests that better suit their current realties. Expressive, creative activities may be suggested as well with the goal of finding and communicating a personal sense of being, so that confidence and self-esteem may grow [9].
M. Ardia et al.
109
As can be seen, finding the right balance between the person, their environment and occupations are essential to promote the well-being of elderly clients during typical, everyday situations. This is true across all care settings, from acute care to being discharged home or to a long-term care facility. In summary, the Person- Environment- Occupation (PEO) theoretical model by Dr. Mary Law [12] and col- leagues follows the holistic view of helping the client, along with their family and friends, to engage in an active therapeutic process.
The occupational therapist demonstrates clinical reasoning by taking into account the scientific literature in the geriatric field. The knowledge translation (KT) of sci- entific information is a multistage process that includes the collection, evaluation, summary, and sharing of scientific knowledge on a specific topic to the end user.
Best practice is sought to inspire the professional practice to provide material to be discussed with the person and to determine together the application of the best prac- tice techniques that are presented in the literature. In fact, the Canadian Institutes of Health Research defines knowledge translation as a dynamic and iterative process to include “… the exchange, synthesis and ethically-sound application of knowledge - within a complex system of interactions among researchers and users - to accelerate the capture of the benefits of research … through improved health, more effective services and products, and a strengthened health-care system” [9].
KT has always been a principle that is naturally integrated into the objectives of OT clinical practice via the consistent interaction with their clients and families [13].
According to the broad and solid scientific basis, the importance of having an occupational therapist within each rehabilitation team is clearly evidenced. Their specific knowledge can contribute and enrich the team by implementing the human aspect and interdisciplinary nature of the care plan. By including OT in the thera- peutic and diagnostic treatment plan, their specific professional competences will favor the continuity of care throughout the network of services, supporting the elderly and their family during strenuous periods of adaptations and changes in routines that are necessary due to a disease or illness.
For these reasons, OT will provide a sound assessment practice, with the aim of identifying a truly individualized therapeutic project adapted to every level of dif- ficulty of each client.
Conclusion
OT, therefore, is a powerful therapeutic discipline: preventing occupational deprivation (complete loss of participating in activity, with a gradual and inexo- rable social isolation) and the subsequent sensory deprivation. The profession seeks to avoid/reduce the client’s dependency on social assistance and therefore the economic costs associated with it.
OT uses rigorous conceptual models from the scientific point of view, but with flexibility from the practical point of view. The therapeutic process begins with a discussion centered on the narrative of the client’s own personal and occupational history, and then, through clinical reasoning, it will proceed to the core of OT:
12 The Contribution of Occupational Therapy: A Profession in Support of the Elderly
110
going from assessment to occupational rehabilitation. This is explicit in the recov- ery and reinforcement of “a group of activities that have a personal meaning, that are culturally important and support the person to participate in a given social context” [14]. “Occupation is always evaluated and interpreted within a given context” [14]. This statement leads us to emphasize, in conclusion, one of the themes that is the cornerstone of OT: occupation does not have meaning when it is placed out of context, in an artificial or contrived way, but must always be incor- porated simultaneously into various types of environments [14].
OT will not only become an explorer of the person’s abilities but will support, to the fullest potential, the personal search inside each client for their own per- sonal resources and capabilities to reinvent themselves. This allows the elderly person to find and/or recover the needed energy for the resolution of problems related to their occupations.
References
1. Polatajko H (2015) Occupation-based practice, client centered practice: an occupational ther- apy imperative. Giornale Italiano di Terapia Occupazionale 15:8
2. Regione Toscana (2013) La fragilità nell’anziano: Linea Guida. Accessed online on 21/06/2016 from: http://www.snlg-iss.it/cms/files/LG_Fragilita_anziano_2013.pdf
3. Richard L, Barthélémy L, Tremblay MC, Pin S, Gauvin L (2013) Interventions de prévention et promotion de la santé pour les aînés: modèle écologique. Guide d’aide à l’action franco- québécois. Inpes, coll. Santé en action, Saint-Denis, France, p 112
4. Simonelli I, Simonelli F (2010) Atlante concettuale della salutogenesi (modelli e teorie di riferimento per generare salute). Franco Angeli, Milan, Italy
5. Pozzi C, Bertholom Y (2015) Migliorare la pratica. Giornale Italiano di Terapia Occupazionale, n° 13
6. Benkirane R (2002) La teoria della complessità. Bollati Boringhieri, Torino, Italy
7. Boyce B (2011) The healing power of mindfulness. Accessed online 21/06/2016 from: http://
www.mindful.org/the-healing-power-of-mindfulness/
8. Latini CM (2015) II bisogno occupazionale nel fine della vita. Quando un terapista occupazio- nale diventa palliativista. Giornale Italiano di Terapia Occupazionale, n° 15
9. Ardia M, Boffelli L, Caiata-Olgiati G, Capra B, Di Serio C, Ferrari F, Kunz O, Stock- Bernasconi K, Vukic T, Wangler K (2016) Ergoterapia e oncologia/oncoreha Dal to cure al to care: Affrontare i problemi quotidiani, accrescere l’autonomia e la voglia di vivere, accompa- gnare nei bisogni, desideri, mantenere i ruoli, adattare il luogo di vita. Poster presented at the
“Lega Contro il Cancro” Event, Ticino, Switzerland
10. World Federation of Occupational Therapists (WFOT) (2004) Code of ethics. Accessed online on 22/06/2016 from: http://www.wfot.org/ResourceCentre.aspx
11. Interprofessional Education Collaborative Expert Panel (2011) Core competencies for inter- professional collaborative practice: report of an expert panel. Interprofessional Education Collaborative, Washington, DC
12. Law M, Cooper B, Strong SS, Rigby P, Letts L (1996) The person-environment-occupation model: a Transactive approach to occupational performance. Can J Occup Ther 63(1):9–23 13. Cramm H, White C (2011) KT and OT: a context for knowledge translation for occupational
therapy. OT Now 13(6):24–26
14. Whiteford GE (2010) Occupation in context. In: Turner A et al (eds) Occupational therapy and physical dysfunction- enabling occupation. Churchill Livingstone – Elsevier, Stratford, United Kingdom, pp 135–147
M. Ardia et al.
111
Sitography
Associazione Italiana dei Terapisti Occupazionali (AITO): www.aito.it
Società Tecnico/Scientifica Italiana di Terapia Occupazionale (SITO): www.aito.it/sito World Federation of Occupational Therapists (WFOT): www.wfot.org
Council of Occupational Therapists for the European Countries (COTEC): www.cotec-europe.org European Network of Occupational Therapy in Higher Education (ENOTHE): www.enothe.hva.nl Mary Ardia is an OT at the “Centro Competenze Anziani” in Manno, Switzerland, and is a lec- turer for the Department of Business Economics, Health, and Social Care at the “Scuola Universitaria Professionale della Svizzera Italiana” (SUSPI). She specializes in palliative care and also works in private practice.
Yann Bertholom is an OT at the rehabilitation center of “Il Paese di Oz - ANFFAS” in Trento, Italy, and is the president of the Italian Scientific Society of Occupational Therapy (SITO). He is a lecturer for the Undergraduate Occupational Therapy program at the “University of Modena and Reggio Emilia” (UNIMORE).
Giovanna Caiata-Olgiati is an OT at the “Centro Competenze Anziani” in Manno, Switzerland, and is a lecturer for the Department of Business Economics, Health, and Social Care at the “Scuola Universitaria Professionale della Svizzera Italiana” (SUSPI). She also works at the “Caribù Center” of Occupational Therapy in Biasca, Switzerland.
Christian Pozzi is an OT at the “Ancelle” Rehabilitation Hospital in Cremona, Italy, and works with the Geriatric Research Group in Brescia, Italy. He teaches at the “Sacro Cuore” Catholic University in Rome, Italy.
Heather L. Hammond is an OT at the “Centro di Terapia Occupazionale” in Bologna, Italy. She is a lecturer for the Undergraduate Occupational Therapy programs at the “University of Modena and Reggio Emilia” (UNIMORE) and at the “Claudiana Scuola Provinciale Superiore di Sanità”
in Bolzano, Italy. She is also a board member of the Italian Scientific Society of Occupational Therapy (SITO).
12 The Contribution of Occupational Therapy: A Profession in Support of the Elderly
© Springer International Publishing AG 2018 113
S. Masiero, U. Carraro (eds.), Rehabilitation Medicine for Elderly Patients, Practical Issues in Geriatrics, DOI 10.1007/978-3-319-57406-6_13 F. Romagnoli (*) • S. Tocco
Centro Riabilitativo “Dalla Mano e Arto Superiore” Srl - CRIMAS, Parma, Italy e-mail: [email protected]; [email protected]