Home' Australian Ageing Agenda : AAA Nov-Dec 2013 Contents WHAT DO OTS BRING TO THIS
SPECIALISED AREA OF WORK?
Danielle McIntosh: OTs start by looking at the roles that the
person has (or has had in the past) to gain an understanding of
the person's life and how this is influencing their current state of
wellbeing, the tasks that they need to be able to perform to fulfil
these roles and the environments in which they need to perform
them. As part of a detailed assessment they look at the impact
that the social, cultural and physical environment can have on
the person's functional performance, to understand how a person
can be supported to engage in life.
SO WHAT IS GOOD SUPPORT?
We know that great outcomes can be achieved for a person
with dementia if we can support and/or compensate for their
disabilities. An OT can assess and modify the environment,
modify or simplify tasks or develop retraining
and rehabilitative programs to improve skill
development -- all strategies that we know can
enable a person with dementia.
WHY DO YOU WORK IN
I have worked as an OT in the area of dementia
care for 10 years. Not only do I find working in
this area rewarding, but I find that it utilises all
my skills as a therapist and provides me with an
immense amount of professional challenge that
surpasses my previous work in an acute tertiary
referral hospital. I also get to work with and
support a wide and diverse group of people who
bring to dementia care their own experiences and
skills, including families, care staff, medical staff,
architects and engineers.
WHAT ARE THE CHALLENGES
YOU FACE AS AN OT?
Not being a nurse -- working in a nurse dominated
field can be daunting. But with so many opportunities to have
a real and valuable impact, you need to adopt the mindset of
confidence from the outset and demonstrate the substantial role
and benefit you can bring to the lives of people with dementia.
CAN YOU SHARE AN EXAMPLE OF
Joan had advanced Alzheimer's type dementia. She required
full assistance from staff to attend to self-care. Her attention
span was limited, she found it difficult to communicate
in words and her ability to mobilise independently was
deteriorating. Staff were finding it hard to engage her in the
group activity program and she was losing weight. I undertook
a detailed observational assessment, including spending time
sitting and walking with Joan, interacting and listening at
her pace, speaking with care staff and Joan's husband. Joan's
husband was concerned that Joan was not
eating well and losing weight. This issue was
identified as the highest priority.
Joan had been the one responsible for
cooking all the family's meals. There was
nothing that she could not cook and she
loved being in the kitchen. We saw this as a
vehicle to addressing her weight loss. Joan
was supported to butter the bread for the
sandwiches by modifying the environment so
she could see the white bread on the chopping
board and could sit down to complete the
task. A built-up handle was applied to the
knife so it was easier for her to hold. Joan
was also asked by staff to "taste and critique"
the egg mixture, which would involve Joan
having at least two spoonfuls. Staff would tell
the residents that Joan made the sandwiches,
which brought a big smile to her face. She
would sit with staff and eat the sandwiches
that she was involved in making. Staff noticed
that when Joan was involved in the preparation of the
meal, she would eat most of it. The sensory stimulation, the
fulfilment of a long-standing role and the self esteem derived
from being engaged in meal preparation provided Joan with
the necessary cues to stimulate her appetite and encourage
her to eat. Joan's weight stabilised but more importantly she
seemed more content.
WHAT DO YOU THINK OT'S NEED TO
DO TO DEVELOP THEIR PROMINENCE
IN THIS FIELD?
We need to continue learning about dementia by reading journal
articles, websites and workshops and join OT aged care interest
groups/forums. I especially encourage OTs to develop their
knowledge and role in design as we are already very skilled at
assessing and modifying the environment. n
A valuable impact
Occupational therapists (OT) bring special skills and
make a diverse contribution to dementia care. Here, Colm
Cunningham discusses this with Danielle McIntosh,
occupational therapist and senior consultant at HammondCare.
Danielle McIntosh, senior
"I have worked as an OT in
the area of dementia care for
10 years. Not only do
I find working in this area
rewarding, but I find that it
utilises all my skills
as a therapist."
50 | NOVEMBER -- DECEMBER 2013 | AAA
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