Hospice and Home Care: Occupational therapy improves quality of life

Posted: Friday, April 27, 2007

If you or a member of your family suffer a stroke, or are recovering from serious illness or surgery such as a hip replacement, you may be referred to receive occupational therapy. That means, not that you will be trained for an "occupation," or to go back to work, but that you will get help in becoming able to take care of yourself and resume activities that are important to you. Juneau occupational therapist Jo Boehme says, "Occupational therapy restores skills for the job of living. It means being able to get back to personal care, homemaking, hobbies, and community activities-to rebuild what you had before, despite medical challenges."

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Physical therapy, which may also be part of a comprehensive recovery program, might, for example, prescribe specific exercises to help you strengthen your legs or increase flexibility so you can walk independently again. Occupational therapy would use those skills to practice daily activities with you, helping to develop ways you could better manage to cook for yourself, or resume bathing on your own, or put on a leg brace if you've lost dexterity in one hand.

In Juneau, most people receive occupational therapy at Bartlett Hospital or outpatient clinics. But if you or a person you are caring for need skilled nursing care and are "homebound" - that is, physically or medically unable to get out of the house-your physician can refer you to receive occupational therapy services through Hospice and Home Care of Juneau, just one of the health and wellness agencies that operate under the umbrella of Catholic Community Service. And if that happens, you can look forward to a bright and encouraging visit from Boehme.

"One of the best things about home care is seeing people in their own home environment," Boehme said. "That gives me a strong idea of what's important to them, whether it's cooking, or continuing a hobby such as woodworking, or resuming being able to get together with friends and family in the community. Our goal is seeing that people are able to manage temporary or permanent disabilities with more confidence and less stress. Occupational therapy definitely makes a difference in the quality of a person's life."

One older woman who received occupational therapy services through Hospice and Home Care of Juneau was able to stay in her own home for three years longer than would otherwise have been possible because Boehme was able to help her figure out how to cook for herself and make her way safely to the coin-operated laundry in her building-even though she needed a walker. "That really helped her sense of independence and self-esteem," Boehme said. "And it also relieved the burden on her daughter, who worked full-time, because she knew her mom could take care of herself safely for much of the day."

Occupational therapists often train family members and caregivers as well as patients, Boehme said. "We might suggest ways to rearrange a room so that caring for a patient will take less energy, or so the patient will be able to do more for himself. We might advise that safety grab rails or a raised toilet seat be installed in the bathroom so a patient can be bathed and cared for more easily and safely. Or we might train a family member to help a patient exercise, or to use special equipment. Boehme works in tandem with other professional caregivers as well. Recently, for example, she consulted with staff at The Bridge, the adult day program operated by Southeast Senior Services. Among other things, she suggested ways to approach patients with dementia, and how to gracefully help patients with the one-sided weakness typical following a stroke.

"We also try to help people age at home," Boehme said. "As we age, we need to adapt our homes to fit our changing mobility." Because they're trained to look for them, occupational therapists may see safety hazards most of us would not notice-and they will suggest changes to help prevent falls, or ways to reduce the strength or energy needed to accomplish some part of personal care or homemaking. They might suggest rearranging furniture, or devise equipment to overcome specific physical limitations.

Besides working with homebound patients through Hospice and Home Care, Boehme also works at Bartlett Regional Hospital. "For me, this is one of the neat things about Juneau," she said. "Sometimes I see people through the whole cycle. I might see them in Bartlett after they have had a hip fracture. If they are slow to recover, I might help with a month of home care. Then perhaps they progress to outpatient therapy at a clinic or the hospital. Then next thing I know, I run into them at the grocery store, or the mall, or the theater. That's wonderfully satisfying for me."

Boehme said at Hospice and Home Care she works as part of a team, which might include the patient, a nurse, family members or hired caregivers, a certified nursing assistant or social worker, and the primary physician. Eligibility for home care services varies, depending on the source of payment and other qualifications, but many homebound patients are referred to Hospice and Home Care of Juneau by their primary physician.

•Hospice & Home Care of Juneau is a division of Catholic Community Service. CCS assists all persons regardless of their faith.

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