Occupational therapy aims to support people so they can continue doing activities that are important to them and maintain independence. It can assist with overcoming difficulties with daily tasks and so improve wellbeing. Although the term suggests that it relates to an occupation or work, occupational therapy can help with a much wider range of activities.
Occupational therapy is available within many healthcare services across Europe and in some countries may be known by another name (for example in Germany, France, and the Netherlands occupational therapy is known as ‘Ergotherapie’ and in Sweden it is called ‘Arbetsterapi’).
An occupational therapist is often a member of the multidisciplinary team, that is, a group of professionals with different areas of expertise, who together will help you manage your Parkinson’s.
How can occupational therapy help me?
As Parkinson’s progresses you may find tasks or hobbies become more difficult or take more time and energy, for example turning in bed, eating and drinking, doing up buttons, using a computer and writing. Your occupational therapist will first assess your daily routines and often your home, work and leisure activities. He or she will then recommend different ways of doing difficult tasks, or advise on the use of appropriate gadgets or technical aids to assist you.
An occupational therapist can also advise how to adapt your home or workplace to improve easy movement or safety, for example by arranging the installation of extra hand rails by steps, stairs and perhaps in bathrooms. He or she may also advise on how to prevent some potential problems before they arise.
It is important to stress that the success of occupational therapy is dependent on your collaboration with your therapist. The advice and recommendations you are given should be a catalyst for you to develop your own routines that enhance quality of life and preserve independence. Occupational therapy cannot overcome daily challenges without your active engagement and cooperation!
Ideally, you should ask to be referred to, or contact directly, an occupational therapy service as soon as you start to find everyday tasks difficult. Because your symptoms will gradually change, you will probably need to contact an experienced therapist from time to time so that you can learn new strategies.
Activities at home: an occupational therapist can teach methods that will make everyday tasks easier. For example, to help you dress more easily they may suggest that you plan, gather and organise the sequence of garments in advance, then sit down to dress and use simple methods to help your concentration and flow of movements during the task.
Equipment and gadgets: there are many special gadgets and types of equipment that can assist you – the range is vast, from simple gadgets that make cooking, eating or washing easier to electronic devices to open your front door from elsewhere in your home. An occupational therapist can suggest the best equipment for your needs. He or she may also recommend that you relocate furniture so you can move around at home more safely and easily, or they may suggest hand rails, stair lifts and items to aid getting in and out of bed.
Organising your medication so that you remember to take it on time and as prescribed can be difficult. An occupational therapist will be able to suggest timers, organisers or reminders to assist with this.
Movement difficulties: if you have movement difficulties, both an occupational therapist and a physiotherapist can suggest helpful strategies. Which therapist you are referred to will depend on where you live. Difficulties include problems in starting to walk (start hesitation), the feet suddenly stopping as if stuck to the ground (freezing), and balance problems which can lead to falls.
Tiredness and emotional problems: if you are finding tasks more difficult to perform, you may also get more tired. This can contribute to emotional problems such as lower mood and distress. An occupational therapist will therefore look at your daily routine, and you can mutually prioritise the most important tasks and agree a plan to pace yourself. He or she will also be able to suggest ways to promote relaxation and revitalise yourself.
Communication: there are numerous gadgets to aid communication, for example telephones with large buttons, specially adapted computer keyboard and mouse, voice amplifiers and pen grips to assist with writing.
Coping strategies: an occupational therapist will be able to propose coping strategies in order to overcome everyday difficulties you encounter, for example with movement, communication, fatigue and emotional problems. By discussing difficulties with your therapist, he or she will be able to suggest different things you can try to make life easier and so improve your quality of life.
Occupational therapy and carers
Occupational therapists can advise your carer and family how to support you in staying independent. They can also advise on ways to look after their own health.
It is important that your family and carers are also involved in, and understand, any changes the occupational therapist recommends to your usual routines. Getting help and advice from an experienced therapist can reduce the amount of help you need from your family or carer and so alleviate any pressure they may feel.
What should I expect at an appointment?
You may meet your occupational therapist in a variety of places, including in your own home, a hospital, a Parkinson's clinic, a rehabilitation unit, an outpatient clinic, or in a residential or nursing home. In some countries it is possible to meet an occupational therapist at a Parkinson's support association office.
Appointments usually last between 30 and 60 minutes, and therapists may recommend a short course of occupational therapy – usually once a week, for a month or two.
At the first appointment, an occupational therapist will ask about your daily activities, in particular how you look after yourself, your work and your leisure interests. For example, you may have problems preparing meals, dressing, shopping, walking in crowded places, doing a leisure activity, using a computer, or reading.
Collaboration is essential to successful treatment. Therefore, you need to tell your occupational therapist about your situation, how you cope on a daily basis and problems you experience. Then together you will be able to discuss goals for both you and your family and how you achieve them.
How do I find an occupational therapist?
Referral procedures depend on where you live and treatment may or may not be accessible through your country’s national health system.
In some countries occupational therapy is prescribed by medical doctors but in others people with Parkinson’s can contact an occupational therapist direct without going through their doctor.
Training and accreditation varies throughout Europe so it is best to check the experience of anyone you consult. It is helpful to be seen by someone who has experience of Parkinson’s, and always ask for references and the likely costs before treatment commences.
Best Practice Guidelines are available online for occupational therapists working with people who have Parkinson’s. ParkinsonNet also provides evidence based guidelines in English.
Your national Parkinson’s organisation may be able to provide information based on members’ experiences. See also, Other Parkinson’s organisations.
