What Do Occupational Therapists Do and When Should You Refer to Them?

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Occupational therapy is difficult to pin down, define, and explain to patients (even doctors struggle from time to time).  So feel no shame about struggling to understand what it is that OTs do. That being said, we’ll start with what they don’t do: OT, despite the name, is not about getting anyone employed. It’s also not just another name for physical therapy- our cousins in the therapy world. So then, what is it that they actually do? And when is it appropriate to refer to them?

                                                             What They Do

1.   Look at a Patient’s Physical Capabilities. They are assessing strength, range of motion, posture, and balance to determine what limitations might exist.
2.   Environment Modifications. They can modify a patient’s environment to support a person’s ability to perform their self-care tasks in order to facilitate safety and independence. This is done with the use of equipment, (shower bench, long handled sponge, sock-aid, weighted silverware) rearrangement of furniture, (raising the height of couches for improved transfer, widening pathways, removing doors, etc.), or simply rearranging a kitchen to make it more accessible by wheelchair or convenient so that a person doesn’t need to do something dangerous just to get a plate.
3.   Assess the Method for Which a Patient Completes a Task. An occupational therapist can change the way the person does a particular task to make it safer or improve their ability to complete the task.

They don’t just look at the patients themselves, they look beyond whatever dysfunctions may exist to help a person overcome the barriers to their engagement in activity. 
                                                           When to Refer
Below is a small sample of the laundry list of issues that should guide you to referring to an OT.

•  Difficulty with buttons/snaps/zippers? Other hand issues? Fine motor control deficits?
• Cognition? Poor safety awareness
• Is pain interfering with completion of normal household or self care tasks? (dressing, bathing, grooming, toileting, transferring, etc.)
• Low tolerance for activity? Fatiguing quickly?
• Do they live alone? If so, are you comfortable with that or does that little voice in your head start causing you to worry?  Are alarm bells going off in your head when you find out they have no caregivers or assistance?
• If they have caregivers, do you feel comfortable with the way they assist your patient for transfers?  Are the caregivers the reason this individual is dressed, bathed, and seated in front of you today?
• Does this patient spend most of their time seated in a wheelchair or lying down in bed?
• Does your patient suffer from a lack of engagement?  
• Is their home environment a barely disguised death trap of clutter, throw rugs, loose hand railings, uneven steps, and slick floors?
•  Do they have any difficulty feeding themselves?  
• Are they cooking and if so, are they safe to do so?
•  Are they able to open containers?
• Are they able to reach overhead and/or below their knees without pain or loss of balance?
• Does their shower or tub require Olympic-like agility to transfer into?  
• How’s their balance while looking around in the kitchen or moving something from one place to another?

If any of these questions give you pause, OR if you’re nodding vigorously to any/each question, then you known who to call--and it ain’t the ghost busters!