Occupational therapists help people live life to the fullest despite illness, injury, or disability. In this article, we cover common questions about OT's including what they do, where they work, and how they are different from physical therapists (PT's).

What is Occupational Therapy?

Consider yourself lucky if you happen to know one of the 125,000 occupational
therapists (OTs) or occupational therapy assistants currently working in the
United States. These rehabilitation professionals dedicate their careers to
helping others live life to the fullest despite illness, injury, or disability.
When they're not busy finding ways to maximize patient participation at work,
OTs are quick to help friends and family brainstorm solutions to everyday
problems related to activity engagement or home and community safety.

For those unfamiliar, the term "occupation" can be hard to decode at first
glance. In acknowledgement of Occupational Therapy Month
[https://www.aota.org/Conference-Events/OTMonth.aspx] this April, this article
covers common questions about OT to raise awareness of the valuable helping
profession.

A pediatric outpatient OT addresses social and motor skill development through a
group game.
Your OT Questions Answered:
 * What is occupational therapy?
 * Where do occupational therapists work?
 * What do occupational therapists do?
 * What is the difference between occupational and physical therapy?


A hospital-based OT teaches a back surgery patient how to dress using
long-handled adaptive equipment.What is Occupational Therapy?
Occupation is a broad concept that can be simplified into the activities and
roles that occupy one's time. Occupations are not the same for everyone, as the
things that people want and need to do will differ based upon their age,
relationships to others, and inherent capabilities. 

Activities of daily living (ADLs) are a key component of occupation. ADLs can be
classified from the simple things people do to manage their basic needs to more
complex activities that relate to interacting with the environment and
community. Here are some examples:

Basic Activities of Daily Living (ADLs):

 * Eating
 * Grooming
 * Dressing
 * Bathing
 * Using the toilet

Instrumental Activities of Daily Living (IADLs):

 * Going to school
 * Working
 * Taking care of others
 * Managing a household
 * Driving
 * Participating in religion
 * Participating in leisure

If a person's occupations are affected by a medical event, an occupational
therapist can help them get back to performing their necessary and preferred
activities of daily living to the best of their abilities.

An certified hand therapist OT creates a splint for a stroke survivor to
maximize functional hand use.Where do occupational therapists work?
Occupational therapists work across the healthcare continuum
[http://blog.eoscu.com/blog/what-is-the-continuum-of-care], at all levels of
care within the healthcare system with people of all ages. You can find an
occupational therapist working in the following areas:

Hospital Settings
OTs work with people who are unable to participate in their preferred activities
due to a medical event. In an acute or inpatient rehabilitation hospital
setting, patients get daily occupational therapy prioritizing basic ADL
function. The goal of this setting is to ensure that the patient can resume
their necessary daily tasks like eating, dressing, and using the bathroom upon
discharge, teaching them how to use new strategies or medical equipment to
participate fully as needed.

Home and Outpatient Settings
Occupational therapists also work with people who live at home. Home health OTs
go to the patient's home to provide treatment, whereas outpatient OTs work at an
external facility that receives patients. Patients of these settings get therapy
treatment less frequently than in the hospital, usually a few hours per week or
month. Home health and outpatient therapies balance basic ADL skills alongside
the IADL tasks the patient encounters as they navigate life in their home and
community. 

Long-Term Care Settings
OTs also work with people who live in residential facilities that provide
support for self-care tasks. There are varied levels of support within the
long-term care model. Some some facilities assist residents with incidental
tasks like cooking and cleaning, while others provide constant, basic self-care
assistance in addition to bigger-picture tasks. Even if a long-term care patient
is not expected to live on their own, an OT may still provide treatment to
promote maximal participation in daily routines for improved quality of life.

A home health OT advises about office accessibility for a person with a spinal
cord injury.What do occupational therapists do?
A physician writes a referral for occupational therapy services if he or she
identifies that a patient cannot participate in their daily activities
optimally. From here, the OT process is divided into the following three
components:

Evaluation
During the initial evaluation, an OT will review the patient's medical history
and conduct an interview with the patient or their family to clarify perceived
performance limitations. The OT will also conduct assessments of domains
including strength, balance, upper extremity function, cognitive function, or
visual function to gather objective data related to the patient's complaint. 

The OT compiles evaluation information into a formal document and determines if
follow-up treatment is warranted. If ongoing OT is necessary, the therapist will
write a plan of care including short-term and long-term goals that they expect
the patient to achieve within a set timeframe.

Intervention
The intervention component of OT treatment may span a few weeks to a few months
depending on the patient's diagnosis, degree of impairment, and the treatment
setting. During the intervention phase, the OT provides ongoing treatment
targeted to the patient's deficit areas. 

Treatment may involve practicing affected daily living activities fully, or
performing preparatory exercises or tasks that form the building blocks of
affected skills. The OT will adjust intervention difficulty over time and
according to patient progress to provide the just-right challenge
[http://www.lindasdailylivingskills.com/2010/11/just-right-challenge.html] to
maintain engagement.

Outcome Measurement
Throughout the treatment course, the occupational therapist continues to perform
assessments to verify whether a patient is making progress. Therapists often
revisit the same assessments from the evaluation portion at set intervals;
however, they are able to add or change assessments to the therapy plan as
needed. 

When it is determined that a patient will discharge from occupational therapy
services, the OT will perform a final round of assessments and write a summary
of patient progress over time.

A school-based OT promotes a child's age-appropriate pencil grasp for improved
writing skills.What is the difference between occupational and physical therapy?
OTs and PTs often work together with the shared goal of improving patient
function and quality of life. Both professions perform assessment and treatment
and provide patients with education and equipment recommendations. However, the
means by which they promote improved performance differs.

Physical therapists are mobility experts. PTs treat physical impairments
including musculoskeletal and neurological dysfunction with the end goals of
reducing pain, restoring movement, and preventing disability. A physical
therapist working with a post-knee replacement patient would promote strength
and flexibility of their operative leg as well as mobility skills including
getting out of bed, climbing stairs, and walking with an assistive device.

Occupational therapists are ADL experts. OTs work with patients with physical or
mental health diagnoses that impact daily task performance. Because patients
rely upon mobility skills to accomplish their routines, some aspects of OT and
PT appear similar. However, OT will always frame treatment around functional
task performance. An OT working with the same knee replacement patient would
ensure they are able to dress their lower body, get into their bathtub, and
manage cooking with a new rolling walker.



“Occupational Employment and Wages, May 2020.” Occupational Employment and Wage
Statistics, U.S. Bureau of Labor Statistics, 31 Mar. 2021,
www.bls.gov/oes/current/oes291122.htm#(1).