Occupational Therapist

What does an Occupational Therapist do?

The Occupational Therapist (or OT) works very closely with the other members of ward staff to make sure that you will be able to look after yourself when you go home. This might involve various assessments to see if you are able to do everyday things like washing and dressing,cooking and managing housework and shopping.They will also help make sure that you have all the help you need when you get there. This might include things like arranging for you to have various pieces of equipment to help you manage at home. The Occupational Therapist can also organise community rehabilitation or organise packages of care as needed.

Why might I need to see an Occupational Therapist after Intensive Care?

Spending time in Intensive Care can result in things like muscle wasting, weakness, tiredness, stiff joints and problems getting around. This can sometimes lead, in the short term, to difficulties with everyday things like washing and dressing yourself, getting up and down stairs and being able to cook and clean up after yourself. Some people get back to normal quicker than others and you may also want to talk about any concerns you have about getting back to work or leisure activities.The OT can give advice on conserving your energy (patients are often very tired for several months after Intensive Care), coping with anxiety (which is also common) and advice on relaxation.

When should I expect to see an Occupational Therapist?

The Occupational Therapist tends to see patients only after they've been discharged to the general wards.They can be referred for assessment by any member of the ward team, although they work most closely with the nurses and physiotherapists.

What is involved in the various assessments?

The Occupational Therapist’s visit will generally start by having a chat with you about how you managed everyday activities before you became unwell, how well you are currently able to do these things by yourself, and worries you might have about getting back to normal and the kinds of help you might need after you get home. There are a number of assessments that she or he might carry out. These include:

• Personal care (e.g. washing and dressing yourself):With your permission, the OT will assess how well you manage with washing/showering and dressing. This will include assessment of your balance when sitting or standing still (static balance) and during activity (dynamic balance). In order to help you maintain your independence, the OT may prescribe equipment or can help you practice these activities.
• Transfers (e.g. being able to get out of bed and into a chair or onto the toilet):The OT will ask to watch how you move when getting out of bed or a chair. Transfering into and out of bed will also look at how you move around to change your position.When assessing how able you are to stand up from a sitting position, the OT will also look at how well you are able to maintain your balance when adjusting your clothes. 
• Mobility (how well you are able to get around):Mobility is generally assessed by the physiotherapist. However, the OT may also want to assess how safely you move around during everyday activities eg when carrying or moving things.
• Kitchen assessments: In a kitchen assessment, the OT will ask you to prepare a hot drink and a light snack. She or he will assess you for a number of things including exercise tolerance (how tired you get), safety, balance and cognition (how you think through the task at hand).
• Cognitive assessments: This is normally a very specialised form of assessment eg for patients who have had a stroke or brain injury. More routine cognitive assessments will assess short and long term memory.  
• Environmental visits:These are carried out  if large pieces of equipment eg hospital beds or hoists are required for hospital discharge
• Home assessments

What kind of help can I get after I've gone home?

There are a number of organisations and services that the OT can refer you to before you get home. These include:

• Intermediate care: This is community based rehabilitation service to help support patients (and families) immediately after hospital discharge.
• Reablement teams: These are community based teams that can provide personal care and help with everyday living activities, usually for up to six weeks after hospital discharge. Their aim is to help patients regain the confidence and skills to maintain their independence.

• Telecare services:Telecare involves the use of personal devices and monitoring services (support staff) to help people to remain safe and independent in their own homes. The most common device is a personal alarm or "pendant" that people can use to summon help if they need it. There are a great many available devices and pieces of equipment (some of which you may have to pay for yourself) that you can be assessed for. 

• Vocational Rehabilitation

Who can I contact if I find that I need more help than I thought I would?

Sometimes, patients who are discharged home without being seen by an Occupational Therapist can struggle more than they thought they would. You can contact one of the following organisations and ask to be assessed for support.

Social care direct (Edinburgh):                       0131 200 23 24

Midlothian Social Work Access Team:          0131 271 3900

East Lothian Access team:                             01620 820 174

Who can I contact if my equipment hasn't arrived?

Some equipment is considered "essential" for hospital discharge (eg raised toilet seats), meaning that it must already in place before you go home.Despite our best efforts, it is not always possible to make sure that any non essential equipment or adaptations you might need are in place for when you get home. You can contact the Joint Equipment store on  (0131) 529 6300 to find out more about when you can expect it.