I have been working as an occupational therapist for over 17 years and have grown to love my profession more and more. An occupational therapist (OT) seeks to help people regain or maintain their ability to carry out day to day activities and do what they love. We do this by looking at what motivates each individual; what their own goals are in life and finding equipment to help them achieve their potential.
We OTs work with people from all walks of life, from children to older people, in hospitals, in prisons or at home.
During my time in this profession, I have seen many changes – some for the better and some definitely for the worse. I have mainly worked in NHS hospitals and funding has always been an issue. However, looking back, we were once able to issue our patients with much more equipment free of charge than we can now. For example, 10 years ago, our OT department, based in a busy general medical hospital, was able to provide patients with long handled shoe horns, long handled ‘grabbers’, plate guards, long handled sponges – should they demonstrate a need for them. Now, these items are rarely provided (unless, in some cases, you’ve had a hip replacement) and OTs have to direct people to where they can buy these items themselves.
We would often be able to carry out home visits with a patient who was soon to be discharged home, to make sure they will be able manage around the house, before they were sent home. This would allow us to see if there were any safety issues, or extra equipment or care needed for the person to be safe once home. Sadly, in a lot of hospitals now, home visits are not so freely made, unless essential. This is mainly down to fewer staff and cuts to funding. The consequences of this could mean that we would have to refer to the community teams to assess the patient once home, which delays discharge.
In some areas I have worked, the referral rate to OTs has increased whilst the staff numbers have decreased, placing much more demand on the department and often creating waiting lists.
There have been some improvements. OTs often have to order equipment daily for the people they work with. This used to be done on long-winded forms, which had to be faxed over to the equipment stores. Now, most community equipment stores have an online system, similar to shopping on Amazon. This makes the whole process much speedier.
Something that hasn’t changed, unfortunately, is the vast difference of equipment provision across the different counties. Some counties’ NHS and social services will provide certain pieces of frequently needed equipment for free, whilst others refuse to do so. This is not only unfair for the person in need of such equipment; but it also makes it difficult for the OT – especially working in a specialist hospital, where there are many patients from different parts of the country. It then takes a lot of time and resources to source what equipment is available to each patient in their county.
There are, I am pleased to say, many positive things that I have noticed in this time period too. There is more choice of equipment for people and the quality has improved in a lot of cases. Telecare has come on leaps and bounds and can really help people to remain in their own homes for longer. This is an umbrella term for many different pieces of equipment or devices which can provide continuous, remote monitoring to alert someone that there is a problem. An example could be a pendant alarm or sensor mat on the floor by the bed to detect someone falling.
For the profession itself, there are more and more areas where you might find an OT – for example assessing for Blue Badges, homeless day centres and hostels, with refugees and in care homes and job centres.
I think today, more than ever, due to the increasing pressure on the NHS and social services, OTs have a very important role to play in people’s lives. We can help speed up hospital discharges and help to avoid some unnecessary hospital admissions by helping people to carry out their daily tasks as independently as possible, without having to rely on other people/services as much. It is more challenging in these times due to funding cuts and more is asked of us, however, I firmly believe that occupational therapy is something worth investing in; I’ve seen how important it is and the difference it can make.
By Nicola McMullen-Klein