How Home Health Occupational Therapy Can Help

How Home Health Occupational Therapy Can Help. GettyImages

In the end, it is function that matters.  Below you will hear about a real life scenario of how home health occupational therapy helped one individual function with more meaning after coming home following a stroke.

Names any other identifying details have been changed to reflect privacy.

Meet Jeanie and her prior life. 

Jeanie is an 87-year-old woman who came home after having a stroke. She lived with her daughter before the stroke, but her daughter was gone for at least three months out of the year.

Jeanie was able to take care of herself without needing her daughter’s help before the stroke. She was able to cook, shop, take care of her medications, dress, and shower on her own, drive, and do her own laundry.

Meet Jeanie immediately after coming home from the hospital.

When Jeanie returned home from the hospital and rehab, she was admitted to home health.  At that point, Jeanie was having difficulty with swallowing her pills and needed help with setting up her medications, remembering to take her medication, making meals, shopping, laundry, and showering. The only thing Jeanie was doing on her own was getting her clothes on and off, brushing her teeth, washing her face and going to the bathroom.  She was also walking with a cane now.

Note: As part of home health services, other services besides occupational therapy were requested by the doctor. These other services included nursing, physical therapy, and speech therapy.

Learn how occupational therapy helped Jeanie.

Occupational therapy was able to work with Jeanie and her daughter (who was home and available during occupational therapy sessions).  After working with occupational therapy, Jeanie is now able to:

  • take her medications
  • set up her pill box
  • make her meals 
  • swallow her evening medications
  • do her own laundry
  • take showers alone
  • more confidently manage her anxiety  

Here’s a bit of how it worked.  Occupational therapy first worked with Jeanie and her daughter to listen for and identify the areas of concern.  After setting specific goals to address the areas of concern, occupational therapy began teaching Jeanie and her daughter new strategies. 

Strategies taught by occupational therapy.

  • Swallowing: One session focused on instructing Jeanie to use a 10 lb lap pad (or bag of rice) to help with swallowing. Some people struggle with anxiety that can impact swallowing and has been attributed to sensory integration issues.  In Jeanie’s case, deep pressure from a 10 lb bag of rice helped calm her system which allowed her to swallow easier.
  • Laundry: Another session focused on helping Jeanie face her anxiety about doing laundry by providing supervision and verbal instructions step by step.  Teaching focused on helping her problem solve areas of concern including where to hang the clothes to dry.  Jeanie had initially hung the clothes in a very high place; this caused her anxiety and was a fall risk. Occupational therapy taught the strategy of using a portable garment rack allow her to more easily hang laundry.  
  • Driving: Another session identified that Jeanie wanted to return to driving but that her cognition, reaction time, and fatigue were limiting. OT made a referral to a local driving specialist for further testing. 
  • Medication Management: Another session focused on instructing her daughter in supervision strategies that would help Jeanie gain her independence back during medication management. This meant teaching her daughter how not to jump in and help too much.  It also meant helping both of them to know how to begin making small changes from having the daughter always tell Jeanie when to take her medications to having Jeanie be responsible for remembering.  Teaching emphasized to the daughter that if 30 minutes had passed by (from when Jeanie needed to take her medications) and Jeanie had not taken her medications then it was time to tell her to take them.  Teaching emphasized caregiver training as well as practical strategies for Jeanie to do daily.
  • Fatigue Management: Another session focused on teaching Jeanie strategies to better manage her fatigue including use of aromatherapy which the patient already owned, having her medications re-checked by her doctors, breaking tasks into mini tasks and doing heavy tasks at the time of day when personal energy levels are highest (such as showering).
  • Strengthening: A separate session focused on teaching exercises she could do to strengthen her arms, which would support overall health and engagement.
  • Meals: A later session keyed in on providing instruction to help her initiate and follow thru on making her own meals again. Instruction emphasized encouragement, promoting for problem-solving and tips for energy conservation.
  • Showering: Another session instructed Jeanie and her daughter in the safest shower set up.  Jeanie declined to have OT present to practice showering, so the daughter was trained in strategies to help her mom become more independent and safe.

Occupational therapy was able to help by offering instructions that focused on changing the way Jeanie was doing activities, changing the environment, and changing Jeanie’s strength and outlook (i.e., anxiety).  With the guidance of occupational therapy, Jeanie was able to be guided back into a more meaningful and independent life. 

Continue Reading