By: Chrissy Queen, OT
When a patient first arrives at a skilled nursing facility (SNF), they are seen by both a Physical Therapist (PT) and Occupational Therapist (OT). Everyone knows what PT is so the question becomes what exactly is OT? Occupational Therapy focuses on maximizing a patient’s level of independence with daily tasks (ADLs) using compensatory techniques, education on body mechanics and instruction on use of adaptive equipment or strategies as needed to complete a functional task. The goal of OT in a rehab setting is to return the patient to their prior level of independence so they can safely return home.
During their stay at a Skilled Nursing Facility, a patient will undergo many assessments of their ability to complete their bathing, dressing and toileting routines. The therapist will provide explanation and demonstration on use of adaptive equipment and techniques within the parameters of their specific diagnosis/rehab needs. The therapist will complete education on safe strategies for managing home tasks such as light meal preparation and laundry tasks.
Occupational therapists also work to improve strength and range of motion in the upper extremities. This can be an important component to recovery for patients who may need to rely on trunk and upper extremity support when they have an affected lower extremity. They also provide education on walker safety during ADL tasks during home management tasks.
An Occupational Therapist also works to determine the best seating for a patient when in a SNF for rehab. Assessment of width of wheelchairs, types of armrests and leg rests needed and providing specialized cushions when appropriate are all areas an OT will address.
Family education is an important component of Occupational Therapy as well. An OT will provide direct hands on family and staff training on a patient’s ability to complete functional skills and on the level of assistance they will require if returning home.
Finally, prior to a patient returning home to their previous living arrangements, an Occupational Therapist can perform a home safety evaluation. This involves taking the patient to their home and assessing needs for modifications so the patient may safely return home. Recommendations will be made for any equipment needed within the home that will promote independence, safety and decreased risk of falls. Modifications to a patient’s home may include removal of throw rugs to reduce fall risk, installation of grab bars for security and moving of household furniture to prevent tripping hazards.
There are many ways an Occupational Therapist can influence and affect a patient’s rehab stay in a Skilled Nursing Facility. The goal is to return the patient to their prior level of function with daily tasks, prevent falls and optimize patient rate of success when returned home. After all Physical Therapy may get you up and walking but without skills learned in Occupational Therapy, you would be walking around with no clothes on.