Long term conditions
Occupational therapists support people with long term conditions
Occupational therapists are specifically and uniquely trained to emphasise the relationship between occupation, health and wellbeing. Occupational therapists work with service users to help them to regain and maintain a personally satisfying routine of everyday activities – this could include self care, leisure or work activities - that they need or want to do, in order to help people with long term conditions to live life their way.
By using their specialist expertise, occupational therapists can carry out multi factorial assessments to establish the functional implications of service users with long term conditions. After identifying occupation focussed goals, they offer occupational therapy interventions to enable service users to continue with their daily activities helping them get the most from life, and remain independent.
Key facts about occupational therapy and long term conditions
Occupational therapists work in a large range of areas where their contribution to the safe management of long term conditions has significantly reduced the need for further health and social care interventions; enabling service users to have an increased independence and quality of life. (AHPF 2005)
Allied Health Professionals, including occupational therapists can work in specialist neurology centers that include orthotists, speech and language therapists, physiotherapists, psychologists, dietitians and nurses. Following assessment of the individual’s needs a multi-disciplinary treatment programme is planned. These interventions enable people to manage their conditions and live as independent lives as possible minimising the demands on health and social care services. (AHPF 2005). This is done through:
- Working across the acute and community interface
- Delivering integrated services across health and social care
- Supporting people to manage their own conditions to prevent admission
- Supporting early discharge from hospital
- Provision of equipment and adaptations that promote independence and management of the condition
- Helping those with long term conditions to remain or return to work
Recent research on occupational therapy interventions with people with a traumatic brain injury has shown remarkable success in return to work, without a large increase in health costs. (Phillips et al 2011).
Occupational therapist assist people with Parkinson’s with their mobility, prevention of falling, transfers e.g. in out of bed and on and off a chair, posture and seating, eating and drinking, self-care and fatigue management (Aragon et al 2010).
NICE Guidelines for chronic fatigue syndrome(CFS) /myalgic encephalomyelitis (ME) (NICE 2007) recommend that every person diagnosed with CFS should be offered help with occupational activities, including work and education if appropriate, and that people with severe CFS may need to use community services including nursing, occupational therapy, dietetics, respite care psychology and physiotherapy.
There is increasing evidence that occupational therapists not only support people with multiple sclerosis at a symptomatic management level (Mathiowetz et al 2007) (Matuska et al 2007) (Mathiowetz et al 2005) but can enhance participation through meaningful activities by providing environmental support and reducing social environmental barriers, and by enhancing personal coping strategies (Finlayson et al 2008), (Finlayson et al 2003), (Yorkston et al 2005), (Mosley et al 2003). Evidence is also available on what people with multiple sclerosis want from clinicians (Sweetland 2007)
Cost benefit of occupational therapy and long term conditions
A study that explored the relationship between provision of equipment and reduction on care package costs and residential care found that over an eight week period cost savings to care packages through provision of equipment were over £60,000 (Hill 2006).
Housing adaptations reduce the need for daily visits and reduce or remove costs for home care (savings range from £1,200 to £29,000 a year) (Heywood et al 2007).
Allied Health Professionals Federation (2005) Working differently: the role of allied health professionals in the treatment and management of long-term conditions. London: Allied Health Professionals Federation.
Aragon A, Kings J (2010) Occupational therapy for people with Parkinson’s: best practice guidelines. London: College of Occupational Therapists.
Finlayson M, Garcia J D, Cho C (2008) Occupational therapy service use among people aging with Multiple Sclerosis. American Journal of Occupational Therapy, 62(3), 320-328.
Finlayson M, Van Denend T, Shevil E (2003) Multiple perspectives of the health service need, use, and variability among older adults with multiple sclerosis. Occupational Therapy in Health Care, 17(3/4), 5-25.
Heywood F, Turner, L (2007) Better outcomes, lower costs: implications for health and social care budgets of investment in housing adaptations, improvements and equipment: a review of the evidence. London: Department for Work and Pensions. Accessed on 14.06.11
Hill Susan (2006) Independent living: equipment cost savings. Chelmsford: Essex Learning and Social Care. [Unpublished]
Mathiowetz VG, Finlayson ML, Matuska KM, Chen HY, Luo P (2005) Randomized controlled trial of an energy conservation course for persons with multiple sclerosis. Multiple Sclerosis, 1(5), 592-601.
Mathiowetz VG, Matuska KM, Finlayson ML, Luo P, Chen HY (2007) One-year follow-up to a randomized controlled trial of an energy conservation course for persons with multiple sclerosis. International Journal of Rehabilitation Research, 30(4), p305-313.
Matuska K, Mathiowetz V, Finlayson M (2007) Use and perceived effectiveness of energy conservation strategies for managing multiple sclerosis fatigue. American Journal of Occupational Therapy, 62(1), 62-69.
Mosley LJ, Lee GP, Hughes ML, Chatto C (2003) Analysis of symptoms, functional impairments, and participation in occupational therapy for individuals with multiple sclerosis. Occupational Therapy in Health Care, 17(3/4), 27-43.
National Institute for Health and Clinical Excellence (2007) Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy) Diagnosis and management of CFS/ME in adults and children. (NICE clinical guideline 53) London: NICE. Available at: www.nice.org.uk/nicemedia/pdf/CG53NICEGuideline.pdf Accessed on 14.06.11.
Phillips J, Radford KA, Drummond AE, Sach T (2011) Employment after traumatic brain injury (TBI): Cohort comparison and economic analysis. Clinical Rehabilitation 25; 957-8
Sweetland J et al (2007) Vocational rehabilitation services for people with multiple sclerosis: what patients want from clinicians and employers. Multiple Sclerosis 13(9), 1183-1189.
Yorkston KM, Johnson KL, Klasner ER (2005) Taking part in life: enhancing participation in multiple sclerosis. Physical Medicine and Rehabilitation Clinics of North America, 16(2), 583-594.