Aging In Place Directory

#45 - The Role of Occupational Therapists in Aging in Place

• Esther C Kane CAPS, C.D.S. • Episode 45

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Occupational therapists serve as vital healthcare professionals in helping individuals achieve meaningful, purposeful, and safe lives as they age in place. Their comprehensive approach encompasses everything from cognitive and perceptual assessments to physical evaluations and environmental modifications.

• OTs evaluate whether patients can safely return home by assessing cognitive, visual, perceptual, and physical abilities
• Home assessments include checking for mobility issues, tripping hazards, furniture safety, and accessibility of essential items
• Modern homes are increasingly becoming therapeutic spaces as hospital stays shorten dramatically
• OTs excel at working as team players with contractors, designers, electricians and other aging in place professionals
• Prevention is crucial—modifying homes before accidents happen helps seniors maintain independence longer
• Most seniors are unaware of how OTs can help them remain safely in their homes
• OTs often serve as the missing puzzle piece in the aging in place journey

Check out the Aging in Place Directory to find OTs and other aging in place professionals in your area. Subscribe to our podcast for weekly episodes about aging safely and independently at home.


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Speaker 1:

Hello everyone and welcome to the Aging in Place Directory podcast. I'm Esther Kane. I am a retired occupational therapist and a certified Aging in Place specialist and a retired internet marketer, although I think, with all the work that I'm doing with Aging in Place Directory and our other websites and podcasting and social media, I think I'm still definitely still in the world of internet marketing, which is good, it's good, it's always good to learn. Today's topic is going to be about of an OT in aging in place aging in place niche. Now, unless you don't know what an OT is I assume you do since you're at this podcast. But just in case, an OT, an occupational therapist is a health care professional, normally works alongside a speech therapist and a physical therapist. The main goal of an OT is to help an individual, no matter what age, to have a purposeful, meaningful, safe life, and that means you know. That could mean you know, helping them to be able to do a job, helping them to do daily tasks around the house, around the yard, helping them to enjoy their leisure activities, their hobbies, even driving. There are OTs who specialize in driving, driving training. There are OTs that specialize in visual, perceptual. There are OTs that specialize in all kinds of different aspects. The one thing that I love about being an OT is that it encompasses so many different factors. I mean OTs can work with individuals who were born with a disability and they help them to perform tasks that you know makes their life meaningful and purposeful and fun and engaging and still safe. So that involves everything from cognition to visual perception, to physical to adaptive equipment, to adapting the environment. You know, it involves everything. All to get psychological even, it involves all different aspects of that. It's a jack-of-all-trades kind of thing, because it takes a jack-of-all-trades to perform a lot of tasks. But if someone has a stroke or suffers a brain aneurysm or has a chronic illness that is depleting them of their mobility or you know whatever, and they just need to do a few things around the house, then the OT is the one who can help to get them back to doing as much of what they were doing before this happened. So of course, modifying a home is simply part of that process, along with everything else cognition and psychological and visual, perceptual and adaptive equipment and then it's everything from fine motor to it's everything. So that's why it makes it so difficult to even describe what an OT does, because it's different for each and every single patient or client, so it isn't necessarily about a lot of people. You know I would say, hi, I'm an OT. They'll say, oh, oh, you find people jobs. No, not exactly occupational therapy. Occupational just means whatever your life entails. It could be playing golf and then playing bridge at night and making dinner, you know for yourself, that could be your occupation, but it could also be a job, of course, anything at all, all right.

Speaker 1:

So what is the role of OT in the niche of aging in place? So an OT goal, my goal when I was in a rehab, in rehab hospitals. It was my role, my I had the strongest voice in that room to decide whether or not the patient was going to go home. So that meant that I had to assess the patient cognitively, visually, perceptually and physically, if they can maneuver in their home. That also meant that I had to assess the home itself as well, and what we often did is we would take the patient with us to the home. We would go to the house and we would see how they would move through the home. You know, did the walker or wheelchair or cane or whatever they have any trouble moving around? Were there items on the floor that they could trip over? Or was there enough room around the furniture? That was often the largest issue. Was the furniture even safe? Glass coffee tables were, you know, dangerous Square coffee tables and dining room tables and anything square with a sharp edge was also not a great idea. Could they reach the pots and pans and plates? And you know, and you know, was the refrigerator accommodating enough that they could reach items in the refrigerator? There were a lot of different issues that we needed to address, depending on where the person lived, what the person was able to do, but I was the one to determine that.

Speaker 1:

I have a very good story for you, because one of the physicians that was in one of the team meetings said that Mrs Smith I forget her name, but we'll call her Mrs Smith was able to go home, that he felt she was independent to go home and she was certainly ambulating quite well. She was able to feed herself. She had trouble following one, two, three steps, that was true, so making a sandwich was not always the easiest thing for her, but he felt that family members could certainly help her with those issues by having food delivered, that kind of thing. But my concern was the fact that she wasn't able to really comprehend her medications. And he said no, no, no, she read the pill bottle for me, so she knows what to do. And I said no. So I took him by the hand out of the meeting and over to Mrs Smith's room. We walked in there and I said hi, mrs Smith, how are you doing today? And she was pleasant as usual. Oh, I'm doing fine. I said that's great.

Speaker 1:

You know, we're talking about you going home and now I know you're taking some medication. Can you, can you read that bottle of medication? That's that's by you? I mean, do you know what it is? She goes oh, yes, these are the blue pills that I have to take. I said that's great. Can you read what it says? And she read you know, one pill before a meal in the morning. And then she, you know, put the bottle down. I said that's great.

Speaker 1:

And I looked at the doctor. I said now, what I'm not sure about is, you know, retention and comprehension. That's really the issue. That's what I said. And I turned around and went to Mrs Smith and said Mrs Smith, do you know what medication it is that you have to take? She goes yes, I have to take the blue pill. I said that's right. When do you take that? She said I'm not sure. I think I take it in the evening. And I said, okay, do you have to take it with food? She goes oh no, I can take it with my glass of wine. I looked at the doctor. I don't know that this is necessarily a safe thing. So he said, all right, well, maybe she can go home with you know some adaptations, something to remind her or something to tell her or signs or something like that. So we obviously needed to work with her a little bit longer instead of sending her home. I mean, he was ready to send her home that afternoon. So obviously there's these little issues, just these little things to make the everyday things not only plausible. You know that she could do them, but safe, she had to be safe. Having the medication with wine was not necessarily a good idea Actually it wasn't and she needed to take that in the morning with food. So, yeah, and this was just like a minute after she read it. So anyway, so that was.

Speaker 1:

That is basically the role of an ot and home health ots would do the same thing. Most ots do the same thing that work in geriatrics. I never worked in pediatrics except for my rotations, so I don't have much information on pediatrics, but I definitely worked in geriatrics for 12 years, all right. So the home these days is becoming more and more a therapeutic space. A therapeutic space. You know the days of Dr Welby and Dr Kildare, if you are old enough to remember those, when somebody would go into a hospital and spend time there for a week or two or whatever, before they went home. Those days are gone Now. You get into the hospital, you get treated and even if you have surgery, depending on the surgery, you go home that day. So the home environment is becoming more and more the therapeutic space to recover.

Speaker 1:

But that means that the space itself must be safe for the person. You know, let's say, they had some kind of surgery that affected their mobility. Well, now can they maneuver into the bathroom? Can they take care of themselves in the bathroom? You know, if you have shoulder surgery of some kind, it may be difficult to wipe yourself, to clean yourself, you know to to shower, to put on clothing, to do almost anything.

Speaker 1:

I fractured my wrist ten years ago from a very bad fall. I have six pins and two plates in there. Now that'll be there till the day I go. But that kept me immobile for a very long time. And I remember the first time I tried to open a can of soup with a can opener. I didn't have an electric can opener, which I needed to get one, but I didn't have one and I just couldn't hold the can because I had no strength in my hand and I had to use my arm and I just started crying. I mean, it's very difficult to do things when you're used to doing them in a different way, on top of all the emotional and pain that goes on when you have an injury like that.

Speaker 1:

So the home itself has to be, or should be, made therapeutically safe for the patient returning home. So that really should be part of the conversation you have when you go in for a surgery, especially if you are living alone or have somebody just come in every now and then, and it may be that you need somebody to come in and stay with you for a while. That may be. But the changes in the house could involve every. It could be as simple as an electric can opener or, you know, increasing the lighting throughout the house, or it could be much more, like you know, adding grab bars and replacing the toilet with a higher one, or getting a tall adaptation on the toilet to make it taller. It could be changing the shower to a walk-in shower with non-slip flooring and zero threshold. Stair lifts or stair treads, non-slip treads it could be so many different things. Ramps, everything. It could be a lot of different things depending on the person that is coming home and the condition of the home, and that is where the OT excels. The training for OT is almost entirely on that, taking into account everything again the psychological, the physical, the visual, perceptual, the cognitive. All of that is involved in the assessment and in how the OT sees not only the individual but how the OT sees the environment as well. You're changing. At some point you can't change the individual anymore, so then you have to change the environment to accommodate the individual. That was the mantra I was taught in school, day in and day out. So but the magic with ots is that they're very good team players. They're very good at working with other members of the aging in place team.

Speaker 1:

We all know everybody working in aging in place knows that it is not a one-man shop, it is not a one-man project there's. It's impossible, I think I mean. Prove me wrong, tell me in the comments. You know, let me know. Um, but honestly, you could use so many different professionals in an aging in place project. It could be a designer, a contractor, you know a handyman, electrician, a plumber. You know tile people for showers, you know glass installers or not, you know floor installers and then, of course, adaptive equipment. You know all the new modern home. You know what am I talking? A safe home, not safe home, smart home, smart home devices all of that can be integrated into, you know, all these people into one team to create the safe home for the person, whatever it is that they need. It could be anything. You know low vision, dementia, a stroke, you know anything. And all of those fields, all of those specialties, work together with the OT. You know the OT can determine what is needed, what may be best, but it's the other providers that can actually provide it, other providers that can actually provide it and they may have insight into a new product or a project that they have done for someone else with a similar injury or home that you know the OT can learn from as well.

Speaker 1:

Certainly, no one knows everything in Aging in Place. We are all constantly learning, but as OTs, we were always taught to work as a team with other members. You have to, especially in an aging in place. So the role that I think aging in place professionals really should push or not the role it's the idea that aging in place professionals should push is prevention. You want to stay independent in your home. You want to live in your home for as long as possible. Let me help you do that, and the way we do that is by modifying the home to make it as safe as possible. You know, even if you did have an injury and you you know, be it a fall or a chronic illness or whatever, making the home safer can help you to recover better in the home versus causing another accident.

Speaker 1:

I was at a conference not too long ago, several months ago in Kansas City, where this oncologist was giving a presentation on aging in place app that he had developed, called dwell safe. Check it out, it looks really cool and, anyway, what he was saying was that what he saw as an oncologist is that he would be treating his patients and then he would send them home, only to find out a month or so later that they were back in the hospital because of an injury that they had at home. Because obviously, when you're going through chemo and or radiation, you become very weak and if you become weak you tend to fall bump into things. And if your home isn't modified to cushion those incidences, to help you from having those, well, they're not going to help you. You are going to be weak, most likely from the chemo and radiation. But then how can you not injure yourself? How can you not fall through that square glass coffee table? Or even if you do hit the coffee table, that it doesn't break into glass, that you don't have to scoot through a small narrow doorway? You know, widen it to make it easier. The whole idea is to make it safer. So he felt that the home was really going to be the future hospital, the future treatment center for recovery for patients, and he saw that homes were not necessarily safe for older adults and that's why he wanted to develop this Dwell Safe app. So take it from the mouth of people who are actually doing the work and seeing the results of what they're doing and kudos to him being an oncologist and seeing the significance of aging in place. You know, prevention, really.

Speaker 1:

So if you're not an OT, if you're a contractor or designer, interior decorator or handyman, or you know, plumber, electrician, moving, you know, moving company for seniors, chefs for seniors I mean, there's so many services for seniors. If you're any one of those, how can you work with an OT? The way to start is one to reach out to a local OT, a group Association. Invite them into your project planning. You know, do presentations there, they do home assessments, they can provide universal design input and they can help you to meet your clients needs. And that ends up giving making you a more well-rounded provider for your clients. Not only are you coming in to prepare a meal for them or coming in to put in a new toilet excuse me for them, you are coming in with other skills, with another professional to help even more. You're the full rounded everything. And what is that going to do? That's going to put your name in their little rolodex mental or physical rolodex and they're going to call you the next time they need something because you are the source of services for them, even though that may not be your main stick, but that is what you can do.

Speaker 1:

If you're a caregiver, obviously talk to your loved one's physician for a referral for OT services or connect with one privately. You can contact a home health agency and see if they can help you, but you can also look online and see if there are any private OTs working in your area. It's a wonderful opportunity to really get a full picture of all the things that could be done to make the home safer. Not that you have to do everything. I mean they may recommend a residential elevator, but you may not have the funds at the moment for a residential elevator or you may not feel it's necessary at the moment. But have the discussion with the ot, see what they have to say and, of course, with the person installing the residential elevator see what they have to say. It doesn't cost anything to have somebody come out and take a look.

Speaker 1:

All right, ots, in my opinion, are often the missing puzzle in the entire Aging in Place journey. Most seniors I'm 67 and most of my friends are seniors and they all are not as aware of OTs before they met me, before they knew me. Now they know, because it's mostly what I talk about so well, amongst other things, but they are now aware of the role that an OT can help them to stay in their home. There isn't anyone that I know in my age group or older that wants to leave their home, even though the home may be 5,000 square feet and they are the only person living in there. I can talk to them till I'm blue in the face and they are not going to downsize. They simply don't want to downsize. Okay, nothing wrong with that. But now let's make the house safer so you can stay in it as long as possible. So that's the, that's the, that's the job. That's why I'm always calling out the rugs. Get rid of those rugs.

Speaker 1:

So if you are interested in occupational therapy services, if you think it's something that is would be useful for you, for your aging parents, for your business, I urge you to get in contact with OTs in your area. Look at the directory Aging in Place directory. I'm working very hard to get as many Aging in Place professionals in that directory as possible so that you can find people in your local area to connect with, not only to work with, but to refer and to use if you need them yourself or you know, or for an aging parent. So that's my take on occupational therapy in the Aging in Place niche. I think it's a perfect fit niche. I think it's a perfect fit. It's why I went into this niche and started doing this podcast and created the Aging in Place directory. I also have seniorsafetyadvicecom and several other websites all focused on aging, because that was my specialty for many, many years. So combining that with everything I learned in internet marketing just made it a very simple decision to do that as my soft retirement.

Speaker 1:

Okay, so don't forget to give us your comments, let us know what you think of this podcast, subscribe and we put out a podcast each and every week. We may start doing them a little more often, I'm not sure yet we have to look at our schedules. Um, we both are extremely busy with all our sites and social media and videos and everything else, but we do so enjoy doing the podcasts and I am looking forward to giving you more and more and even some wonderful interviews. I have some lined up that'll be coming up very soon. All right, take care. Thank you so much for listening and we'll see you next time.

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Esther C. Kane, CAPS, C.D.S.

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