"It
is important to remember that each person experiences disability in a
completely personal way."- S. Brooks
Tick tock...Tick tock...Tick
tock- children don't even realize that 24 hours have lapsed as their day is
dominated by Play. Adolescents on the other hand, wish they could go back to
their childhood as they are too stressed about passing their grades and being
up to date. Adults are drowning in their vocational demands and the elderly
often have nothing but leisure. Journeying through our lives, we all
engage in our own occupations on a daily basis. We do what we each personally
want to do along with what is expected of us socially and culturally.
Hence we see, that for every age group,
engagement in occupation is different. Putting on my thinking cap and delving
deeper, participating in every day tasks for INDIVIDUALS is unique because no
one-person is the same as the other. Essentially, we all sleep, do self-care,
walk and talk, but each in their distinctive manners. Hence, the foundation of
OT is enabling the client to do what is meaningful to
them. It means looking at them holistically-considering them psychologically,
physically, spiritually, culturally and contextually- and centering treatment
around their habits, routines, roles and rituals. It means putting aside
conventional methods of conducting tasks and focusing intervention on enabling
them to do what is most valuable to them.
A practical example of this would be my
treatment planning and implementation for my patient this week. Agreed that
occupation has therapeutic potential. However, if occupation is used
irrelevantly, it is inefficacious. It would have been futile if my treatment
sessions entailed making food on a stove top, with food processors and all
sorts of fancy adaptive cutlery and boards. Although she would eventually be
able to independently cook and clean in that setup, the question remains- Have
I enabled her to function independently? and the answer is a stark No, because
back in her rural settlement, she does not have access to all these urban tools
and technological advancements. Her family cooks on open fire, uses basic
cutlery and does everything manually. Hence my session would have been
pointless as the patient would be inefficient in her environment. Likewise, I
would not work towards regaining her dressing abilities in pants and a blouse
as she only wears skirts and a loose top.
That is why adopting a
client-centered approach is VITAL, because instead of me "presuming" what is
beneficial for the client, I have to reposition my thinking to entail in my
treatment sessions what the client will
eventually do when she is home. Hence, since my aim at the moment is
balance retraining, my treatment was focused around achieving good static and
dynamic balance for her. This was done by involving her in leisure and home
management tasks in sitting with the necessary structural adaptations to
achieve my goals for her. Since she was a machinist premorbid, her leisure
activity involved sewing. If I chose board games as leisure then it would have
been pointless as firstly, it is not relevant to her context and secondly she
would not choose to participate in that thereby defeating the purpose of the
activity. Because, what is the point of teaching her something she will not be
executing at home. Furthermore, I got in touch with the social worker to
contact her family and schedule caregiver training specific to her environment.
In all honesty, being so accustomed to
an urban lifestyle whilst practicing in a rural setting, it is sometimes
tempting to lose sight of the fact that we are all unique individuals with
personal goals and aspirations. Hence engraining a client-centered approach in
my foundational learning is vital because as an Occupational Therapist on
the Rehabilitation team, my ultimate role is to enable patients to regain
function so they can live as independently, productively and meaningfully in
the future as possible.
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