An article by Sonia Terrón Pérez,
Occupational Therapist in home care, responsible for in Madrid
The occupational therapy is a socio-sanitary discipline that, through the assessment of the physical, mental, sensory and social capacities and problems of the individual, aims, with adequate treatment, to enable them to achieve the greatest possible degree of independence in their daily lifecontributing to the recovery of his illness and/or facilitating the adaptation to his disability.
It intervenes when said capacity is at risk or is damaged for any reason. It also takes into account the contextual conditions that could affect the person’s participation in their daily life activities, such as architectural barriers, accessibility, to adapt or modify the environment and achieve the greatest possible autonomy.
The main objective of occupational therapy is enable people to participate in activities of daily living, in addition to promoting their health, their autonomy, as well as well-being and social justice, from a person-centered approach. The occupational therapist pursues these objectives through the use of occupation and activity (meaningful and purposeful), adapting and modifying the environment, training and advising in the management of support products, etc., being able to use other complementary treatment techniques.
Among its areas of action ishome care, being the activities of daily living (ADL) a fundamental part of the work of the occupational therapist in homes. Activities of daily living are all those activities that a person carries out daily from the time they get up until they go to bed. They are those that make up the daily activity of the human being, allowing them to establish different habits and routines such as dressing, grooming, eating, etc. In order to carry them out, the correct cognitive, social, motor, psychological functioning and a good sensory integration of the person are necessary.
ADLs can be classified as:
Basic Activities of Daily Living (ABVD)
Activities aimed at caring for oneself. They respond to the basic needs of each individual. They require a small level of organization and are simple. They are carried out daily and automatically. Without autonomy in them, the human being is not capable of surviving by himself. Some examples of basic activities are: dressing, eating, bathing, grooming, toilet training, walking, etc.
Instrumental Activities of Daily Living (IADL)
Activities oriented towards interaction with the environment that imply the ability of the individual to be able to lead an independent life in the community. They vary depending on the environment. They require a higher degree of organization and cognitive and motor complexity than basic activities. Without autonomy in them, the human being is capable of surviving. Some examples of instrumental activities are: housework, shopping, managing medication, using the telephone and public transportation, managing financial affairs, etc.
Advanced Activities of Daily Living (AADL)
Activities that allow people to develop their roles within society and that the subject carries out as part of his recreation and personal fulfillment. They are more complex than the previous ones and are not essential for maintaining independence. You can survive without them although the quality of life decreases. They are related to the lifestyle of each person. Some examples of advanced activities are: work, play, education, social activities, cultural activities, etc.
When there is an injury or illness, it can generate a loss of autonomy in carrying out activities of daily living, affecting the subject’s quality of life. To achieve maximum autonomy, the occupational therapist (OT) assesses, trains, compensates and restores all those motor, cognitive, social and environmental skills that have been compromised. The first step for a good intervention in the activities of daily living is to carry out the evaluation that consists of collecting and analyzing the information necessary to understand the functioning of the person in the activities. Subsequently, periodic evaluations are carried out to compare results, readjust objectives and adapt the treatment to your needs.
The occupational therapist obtains information about the needs, problems and concerns related to the occupations and significant activities of the person, as well as their weaknesses, strengths, of all areas of the individual that can affect their performance. It is understood by occupational performance the different ways in which human beings approach their daily tasks in the fields of self-care, in the instrumental activities of daily life and in the productive, leisure and participation activities.
The occupational therapist identifies which are the affected components and how they are affecting their abilities to carry out their activities of daily living. collect information through various techniques (observation, interviews and questionnaires), tests (standardized measurements such as tests or objective tests) and various sources (reports from other professionals, family members and caregivers). Create a treatment plan according to individualized objectives in accordance with the abilities, needs and interests of the person. The objectives and the intervention plan are agreed with the subject and/or family.
The occupational therapist performs individualized interventions with the patient and their relatives in a real environment. teaches patients to reach their maximum level of autonomy in your own environment. And when the person is not able to adjust to the demands of the environment, he acts in the environment.
Besides, intervenes in the family and caregivers because they are the ones that can most influence the functionality and the degree of autonomy of the activities of daily life. The occupational therapist advises and guides of the changes and adaptations that provide the accessibility and mobility of the person within his environment and of the supporting products that make it easier to carry out daily activities. Therefore, it will intervene by maintaining and recovering functions, promoting the development of skills, compensating for deficits and adapting or modifying the environment.
In conclusion, The purpose of occupational therapy is to achieve the greatest independence of the person to be treated, which presents risk or occupational dysfunction, at any stage of its life cycle. Works with individuals who are limited by injury or physical disability, psychosocial dysfunction, developmental or learning disorders, etc. Use the activity therapeutically to prevent faculties at risk, to maintain or strengthen those that are being lost or to train others in their own environment.
The occupational therapist performs functional assessments, task analysis, environmental assessments, adaptations, and compensates, improves, or maintains people’s functionality. The training and re-education of the activities of daily living (hygiene, nutrition, management of public transport, use of money, etc.), the adaptation and transformation of the environment and the training in handling support products are some of the functions that Works as an occupational therapist at home.
Therefore, andhe occupational therapist is the best prepared and trained professional to address the activities of daily living at home and the home itself is the most appropriate place for intervention, since many of the activities of daily life carried out by the person are carried out at home or in their environment. In addition, by working in a real environment it facilitates or favors the treatment plan is tailored to individual and personal needs of each patient and family.