Occupational therapy in the community Margaret Brockett, BSR(OT), OT(C) ccupational therapy is the use of adapted activity to promote health, develop skills, restore function and maintain ability. Oct. 21, 1991, marks the beginning of National Occupational Therapy Week. This is the fifth annual event promoted by the Canadian Association of Occupational Therapists (CAOT) and the last with the theme "Occupational therapy: when daily living becomes a challenge." This year the focus is on the community. An increasing number of occupational therapists are choosing to work in the community, a setting for which they are ideally suited. A greater emphasis on treating patients in their homes means that physicians need to know the role of occupational therapists in accomplishing this. Hospital consultants must be assured that the patients they discharge back to the community can not only manage but also enjoy some quality of life. The Canadian model of occupational therapy is client-centred and based on occupational performance. In this model, clients identify the activities self in three areas of occupational performance are leisure that care, productivity (work) and can well they decide how important to them; they perform the activites and how satisfied they are with their performance. Occupational therapists work directly with clients in their immediate environment to analyse the difficulties being experienced and to offer solutions or alternative ways of attaining the desired result. Occupational therapists also work indirectly to modify and adapt the systems and the physical environment that affect their clients' ability to lead a life that has quality and purpose. My father has a much younger friend who experienced a number of misfortunes in a short time. Within a year after taking early retirement he was widowed and suffered a stroke. He can no longer get upstairs in his home; there is no one to help him up and down the five steps at the front door, and O

walking soon becomes an effort. His home is now a prison, and he is isolated, lonely and depressed. Arrangements were made for home help and "meals on wheels," but what is he to do all day? The windows are dirty, and the garden outside once so is a wilderness. He cannot reach the neat and tidy book that the well-meaning helper tidied away. His cardigan is stained and missing a button, but dressing is a problem. The familiar garments are easier to manage, but who is there to see him anyway? His daughter does what she can, but she is a single parent with an autistic teenager, who is increasingly difficult to manage. An occupational therapist would work with this man to make it possible for him to reach the book and to get help from the community with cleaning the windows and taking charge of the garden once again. When he is ready to take more care of his appearance there would be help in finding better ways of managing his dressing and personal care. A hand rail installed down the front steps might make outings easier. An occupational therapist could help the daughter by reviewing her circumstances and ensuring that she has the practical help and support needed to manage her son. As well, the daughter's fears about her son's outbursts and her father's safety when they are together could be reviewed and a program of carefully structured family events planned. Father, daughter and grandson are members of a family that is currently dysfunctional but that could, with the help of an occupational therapist, become a supportive unit nurturing interdependence. The person who can benefit from occupational therapy is not necessarily sick or disabled. My father, who at 85 is physically fit and mentally alert, is the life and soul of the group home in which he has chosen to live since my mother died 2 years ago. Yet each day has become a challenge, even for one so -

Ms. Brockett is a former executive director of the Canadian Association of Occupational Therapists, Toronto, Ont.

Reprint requests to: Margaret Brockett, 45 Belgravia Ave., Toronto, ON M6E 2M4 -

For prescribing information see page 1045

CAN MED ASSOC J 1991; 145 (8)


healthy and active. Although my father has travelled widely and adapted to many different living situations he finds today's highly automated society more than he can handle. Not for him the instant teller he prefers the friendly bank clerk. Touch-tone telephones try his patience, and answering machines get no response. To resolve problems with his increasingly illegible handwriting he has taught himself to type on a manual typewriter, since even an electronic keyboard is too fast for him! The microwave oven and the compact disc player have been mastered but not the videocassette recorder. He prefers an outing to the movies, but even that is a trial: the sidewalks are uneven and ready to trip up the unwary, and the bus driver demands the exact change or tokens, which slip so easily from fingers made clumsy by arthritis. Growing old in this mechanized age is a challenge. The CAOT has recently received funding from the Seniors' Independence Program, Department of National Health and Welfare, to mount a project entitled "Responding to the challenge of an aging population." One of the objectives of the project is to work with older people in identifying how occupa-

Conferences continued from page 925 Nov. 1-2, 1991: Pediatric AIDS Conference (sponsored by the Sunny Hill Hospital for Children, Vancouver, and the Division of Continuing Education in the Health Sciences, University of British Columbia) Coast Plaza Hotel at Stanley Park, Vancouver Pediatric AIDS Conference, Continuing Education in the Health Sciences, 105-2194 Health Sciences Mall, Vancouver, BC V6T 1Z3; (604) 822-2626, fax (604) 822-4835 Nov. 1-2, 1991: Women, Food and Weight - New Perspectives 519 Church Street Community Centre, Toronto National Eating Disorder Information Centre, 200 Elizabeth St., Ste. CWI-328, Toronto, ON M5G 2C4; (416) 340-4156 Nov. 1-3, 1991: Canadian Foundation for the Study of Infant Deaths 7th Annual Baby's Breath Conference

Charlottetown Canadian Foundation for the Study of Infant Deaths, PO Box 190, Stn. R, Toronto, ON M4G 3Z9; (416) 488-3260, fax (416) 488-3864 Nov. 4-5, 1991: Symposium: Transgenic Animal Models in Biomedical Research National Institutes of Health, Bethesda, Md. Dr. George Migaki, Registry of Comparative Pathology, Armed Forces Institute of Pathology, Washington, DC 20306; (202) 576-2452, fax (202) 576-2164 930

CAN MED ASSOC J 1991; 145 (8)

tional therapists can assist them in overcoming just the sort of difficulties my father is encountering. Two demonstration projects are well under way in Winnipeg and St. John's, where occupational therapists are working with established seniors' organizations. Nationally, CAOT is establishing firm links with national seniors' associations and developing resources and a network for occupational therapists to consult with groups of healthy elderly people in the community. All of us who live into old age will know from personal experience the challenges of remaining in familiar surroundings; those of us with disabled family members already know. Occupational therapists can help make a difference. During National Occupational Therapy Week we invite you to find out how occupational therapists can assist your patients. Call the CAOT at (416) 487-5404 for the number of your provincial occupational therapy organization and the name of a contact person.u

[In 1919 Dr. J.L. Biggar stated: "The cost





rehabilitation is considerably less than the cost of idleness" (see this issue's Encore, which begins on page 981). - Ed.] Nov. 4-6, 1991: NIH Consensus Development Conference - Diagnosis and Treatment of Depression in Late Life Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, Md. Conference Registrar, Prospect Associates, 500-1801 Rockville Pike, Rockville, MD 20852; (301) 468-MEET, fax (301) 770-5164 Nov. 5, 1991: 11th Annual Rehabilitation Education Day: "What Can I Say?" - Responding to Disability, Loss and Life Changes Ottawa Civic Hospital Agnes Friesen, Rehabilitation Services, Ottawa Civic Hospital, 1053 Carling Ave., Ottawa, ON K1Y 4E9; (613) 761-4722

Nov. 6-7, 1991: National Conference on Childhood Injury Prevention - Working Together for a Safer World Ottawa Canadian Institute of Child Health, 55 Parkdale Ave., 3rd Floor, Ottawa, ON K1Y lE5; (613) 729-3206, fax (613) 722-4829 Nov. 7, 1991: Mental Illness in the Family: Life Cycle Perspectives Clarke Institute of Psychiatry, Toronto Patti Pettit, Education Department, Clarke Institute of Psychiatry, 250 College St., Toronto, ON M5T I R8; (416) 979-6852, fax (416) 599-5728

continued on page 933 LE 15 OCT^OBRE 1991

Occupational therapy in the community.

EDITORIAL * EDITORIAL Occupational therapy in the community Margaret Brockett, BSR(OT), OT(C) ccupational therapy is the use of adapted activity to p...
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