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The Expert Care Experience: Parkinson’s and Meaningful Occupations

The Expert Care Experience: Occupational Therapy

This blog is the second in a series detailing the roles of each member of a comprehensive care team. Read the first post on social work hereLearn more about the healthcare professionals that are part of a comprehensive care team and how you can put your care team together today.

What occupies you?

Occupation is defined as the activity that occupies your time. This doesn’t necessarily mean your job; it includes all the activities that make up your day, from getting dressed and preparing meals to gardening or playing cards with friends. The goal of occupational therapy is to help people achieve independence, meaning and satisfaction in all aspects of their lives. Continued participation in meaningful occupations (work, leisure, and self-care) keeps your well-being balanced.

Occupational therapists (OT) use occupation to rehabilitate and create independence in their clients. The OT collaborates with doctors and nurses, physical therapists, speech therapists, social workers, case managers and employers, as well as the client and caregiver, to have a multi-disciplinary, inter-professional approach to care based on where the therapy is taking place (in-patient vs. out-patient setting, etc.).

Achieving independence, meaning and satisfaction
An OT completes an individual evaluation, considering your participation in daily occupational activities (life), and then creates an intervention plan tailored to your needs and specific occupations. Each client is unique, and the OT addresses the client’s and caregiver’s goals collaboratively. The occupational therapist will look at the client holistically by addressing the sensory-motor (movement and sensation), cognitive and psychosocial aspects of the individual, examining each person for any impairment he or she might have from Parkinson’s disease (PD).

The OT addresses what is important to the individual by establishing an intervention plan that will help with the issues at hand. The most basic of the evaluation areas are activities of daily living (ADLs). These include bathing, dressing, cooking, cleaning and hygiene. Work and leisure are also addressed. An OT can employ a variety of means to assist someone in these activities: for example, we help your body restore lost function and/or adapt to new ways of doing things.

OTs can address the symptoms (tremor, bradykinesia and rigidity) associated with PD and offer ways to alleviate and address them with the goal of helping you achieve independence. Many of the compensations and adaptations are simple, such as a built-up handle on a utensil or a grab bar in the bathroom. The OT addresses both the gross motor and fine motor movements as they relate to the individual’s activities; for example, writing a check, playing sports and caring for children require different types of movements. We address issues of money management, community integration and mobility. There are also OTs that address driving and are Certified Rehabilitation Driving Specialists (CRDS).

There are numerous adaptive devices that can be used to achieve independence. This is not an exhaustive list, but examples include the following:

  • A book stand for reading or a built-up weighted handle for writing
  • A shower seat for safety when bathing
  • A weight on the wrist for shaving to decrease tremor
  • An aid to button shirts with small buttons that are difficult to grasp

Strength and endurance are two other factors that influence whether you feel able to do daily activities independently. OTs can educate both you and your caregivers on how to simplify work and conserve energy. This can help you recognize when you should do things and when not to, as well as how to adapt activities for maximum participation.

Self-image and quality of life
People often experience issues relating to the psychological aspect of PD. For example, people with PD may not participate in social activities because they are embarrassed by the symptoms. Sometimes you and your caregiver might not even realize the impact Parkinson’s has on you. The OT will address the impact of PD on social activities and help clients develop a healthy self-image to create a better quality of life moving forward. Through education and interventions, you can overcome any negative feelings and continue to participate in activities with family and friends.

Finally, many people do not realize that bradykinesia (slowness in movement) can sometimes affect cognition, resulting in slowness answering and processing questions. OTs can provide strategies and coping mechanisms to assist with cognitive issues and visual perceptual symptoms that may affect your meaningful occupations.

A holistic approach
Occupational therapy can provide education and techniques for an individual with PD to continue living a meaningful and productive life, from the increased time to the adaptive equipment needed for some activities. The OT’s holistic approach allows them to view the client in all aspects of their performance and hone in on the best ways to both engage you and help you reclaim independent living.

About Nathan B. Herz, OTD, MBA, OTR/L, CEAS
Dr. Ben Herz is the founding Director of the Murphy Deming College of Health Sciences Occupational Therapy Doctoral program in Staunton, VA. He is involved with Parkinson’s disease as both a lecturer, researcher and clinician for over the last 16 years.