Caitlin Whyte: Most of us are familiar with physical therapy, but what is occupational therapy and can it be delivered in the home? Nicole Federman joins us today to explain how occupational therapy includes helping people regain the life skills they may have lost due to an injury or illness. This is the Inspire Health podcast from Upland Hills Health.

I'm Caitlin Whyte. All right. So start us off here, Nicole, what is occupational therapy?

Nichole Federman: Occupational therapy, when people talk to me about occupational therapy, they always say to me, I don't know why I need you. I don't, especially if they're retired, I don't work anymore. I'm like, no, no, no. Occupational therapy refers to the skills for the job of living. And I'm like, the job of living means any activity we do in our life, anything.

It doesn't matter if you work anymore because we're talking about any job you have. Getting up in the morning and taking a shower, getting dressed, playing golf, mowing your lawn, anything like that. That is the job of living. Anything that you need to do in an everyday setting. So I explain that to help a person I want them to know that I want to help them restore that function so they can pursue those everyday activities that we will often refer to as like the occupations of life.

Host: I love that phrase, occupations of life. Can you just break that concept down a little bit more?

Nichole Federman: Sure. They can be something as basic as a self cares,  like dressing, bathing, as I stated, toileting to, to like an instrumental daily living task, which is more like,   our cleaning, our laundry, our yard work. I mean, school, our work life, leisure and hobbies, like golfing, and I say golfing because I've helped people get back to their golf swing. And we look at those individuals, not only from the physical aspect, but also those psychosocial aspects of life. So we want to help our patients, our clients return, you know, to that prior level of function so that, they can be back to where they want to be. And if they can't be, then I want to help them achieve that at the optimal level so that we can modify that activity for them and reassess and re-teach and train by using specific adaptive devices.

  We provide a lot of different strategies so that we can give alternative ways of doing things so people can be as independent and self-sufficient as possible in their, in their lives.

Host: Gotcha. You know, you mentioned at the top of the episode that people are kind of confused by occupational therapy and what it really does. So who can really benefit from occupational therapy?

Nichole Federman: Well, OT, because it is the job of living, we go back to all ages. So from the beginning of life, we can work with babies, to toddlers, to teenagers, young adults, adults of all ages, of course, and then all the way to the end of life, where we might be in more of a palliative care or hospice setting.

So we focus on really early intervention when it comes to the babies and the toddlers, and with developmental delays.   We work with parents and caregivers in their homes, you know, to, in their early childhood, the school systems, so that we can work on those developmental milestones, we also work in adult day programs.

We can work in hospital settings. I mean, we're kind of all over because life is all over, right? So, both inpatient, outpatient, mental health settings. We are getting people, even into that community integration again. So, we are kind of all over. When I'm talking about hospice and palliative care settings, we're often working on the safety for that caregiver education to reduce the risk of the caregiver getting hurt as well as a patient injury when, when the caregiver is taking care of that person. We want that process to be as comfortable and least stressful as possible. So, keeping a loved one in a person's home at the end of life is often one of the most important things to either that person or that family. Often, and many times, it's to the patient. And if we can keep them in the home and work to attain the goals for both, you know, the patient and the caregiver to be there safely, that's what OT's role is with hospice and palliative care.

Host: Well, that kind of leads me into my next question here, Nicole. How does occupational therapy fit into home health or care that is delivered in the home?

Nichole Federman: Okay, that's a great question because,  home care OTs, we, we most often see patients at home in relation to their rehab when they are getting ready to transition home from like a hospital or an acute rehab program, sometimes long term care settings like skilled nursing facilities. The doctors will refer for an occupational therapy to evaluate in the home to help with that transition. They're ready to be discharged from that acute care or skilled nursing facility, but they still need a little more help to get back home. So we get those referrals from primary care providers or MDs, hospitalists, and then we'll start that referral process. So when we're in the home, we're really working to find the right fit between the individual's abilities and what they need and desire to complete their activities to return to their prior levels of function, you know, so they can live in their home environment and be as safe as possible. It's really important, in the home setting that we really focus on what they need to do and want to do and modify those activities so they can be as safe as possible.

Host: Well, Nicole, this episode is just chock full of information. Thank you so much for sharing and joining us today. You can find more about occupational therapy online at uplandhillshealth.org. And thank you for listening. I'm Caitlin Whyte, and this has been the Inspire Health Podcast from Upland Hills Health.