Community OT

"For many stroke survivors and their families, the real work of recovery begins after formal rehabilitation. One of  the most important tasks of a rehabilitation program is to help those involved to prepare for this stage of recovery" (Gresham et al, 1995, p143).

Ive never recieved therapy of any kind in my own home. And I havent spent any time as a patient in a hospital since I was 4. But if I had to choose between the two I would pick therapy in my own home. Community OT, Ive found as a student is intense. From the outside looking in, it looks simple. Before placement I always read up on what roles to expect and what kind of workload etc. I always go into each placement gearing to just jump in. Entering community therapy was tricky for me. Working relationships are different between client and therapist, theyre closer. Interdisciplinary relationships between colleagues was the norm. I observed far more emotional investment in this context that I did at my hospital placement. I was gobsmacked how my supervisor could turn simple chitchat and a cup of tea into a simple and straightforward home assessment, to then later look at the notes and see details that were incrediably expansive and I remember thinking, "how did she get all that information from what I just saw?"
Observation and interpersonal skills need to be very much honed in this context, among other things. In a qualitative study on the perception of community occupational therapy, participants with hemiplegia rated these things to have a positive affect: convenience, therapeutic environment, social contact and control (Stephenson & Wiles, 2000).

Although most individuals who have had a stroke improve in basic functional abilities such as self cares, activities in the home and walking, a lot still have limitations in getting back their their original social role. Again, from my teeny tiny scope of student experience I found that men were more unhappy with recovery in the home. When I asked them what they wanted I got, "I want to go back to work." Going back to work was a huge motivating factor that can spur both men and women on. As an occupational therapist (soon to be), that doing is integral to human life. It is what makes us - us. Our doing gives us our role, our efficacy, it affects our body both positively and negatively, it affects future generations as well. To some people their job is tied in with their wellbeing. Helping them get there sounds almost cliched yet a wonderful kind of occupational therapy.


References


Gresham, G. E., Duncan, P. E., Stason, W. B., Adams, H. P., Adelman, A. M., Alexander, D. N., Bishop, D. S., Diller, L., Donaldson, N. E. Granger, C. V., Holland, A. L., Kelly-Hayes, M., McDowell, F. H., Myers, L., Phipps, M. A., Roth, E. J., Siebens, H. C., Tarvin, G. A., & Trombly, C. A. (1995). Post stroke rehabilitation. Clinical Practice Guideline 16. (AHCPR Publication 95-0662). Rockville, MD: United States Agency for Health Care Policy and Research. 


Stephenson, S., & Wiles, R. (2000). Advantages and disadvantages of the home setting for therapy: views of patients and therapists. British Journal of Occupational Therapy, 63(2), 59-64.