Can Occupational Therapy Help People With Chronic Illness?

More and more I’m seeing people talk about how an Occupational Therapist can be of benefit to people living with chronic illness, but it’s something that I honestly don’t know that much about.

The only somewhat relevant experience I’ve ever has been with Occupational Health (which is different) in a work environment, and to be honest, they weren’t always the best experiences. I found a lot of the time things were being pushed on me that I knew I’d never use – like voice recognition software. I understand why it was offered, but I also know how I work and that I’d just never use it (I literally need to write!). I didn’t want anyone to waste money and resources. But I did get foot rests and back rests that have definitely been helpful to me.

Because I don’t really know all that much about Occupational Therapy and how it can be of benefit to people in situations like mine, I reached out to one of my lovely Instagram followers, Maike Van Wezel, who works at Ten Boom in the Netherlands, to learn more. And honestly, when I read her answers to my questions, I could absolutely see how much benefit OT would have been to me when I was younger (and probably even now!) and if I can find one here, I’d love to create some more content about my experience.

I hope you find this post helpful and answers some questions you may have about Occupational Therapy.

Ok, so let’s start with the simple stuff! What actually is Occupational Therapy?

Occupational therapy focusses on maintaining the ability (or regaining the ability) to perform meaningful daily activities.

Who is Occupational Therapy for?

It is a very broad kind of therapy. It is for anyone who  experiences difficulties doing an activity that’s meaningful to them.

This could be anything from attending a party while coping  with sensory processing issues to finding the right mobility aid to be able to go to school or work.

You might really want to do your own grocery shopping while your friend who deals with the same health issues doesn’t care about her groceries but is very excited to vacuum her living room.

Every patient is different and it’s an OT’s job to help you figure out what meaningful activities are important to you.

What does your job as an Occupational Therapist entail?

I specialise in paediatric care. I focus on sensory processing disorder but recently started seeing more and more children and teenagers with chronic illness.

We work in a team of 9 OT’s (some for children and some for adults) and see each other pretty often. I mostly do house visits but every so often I go to schools or daycare centres. This allows me to understand my patients better and when they have practical questions we can get to work immediately!

I own the practice together with 4 other OT’s. My days consist of seeing patients, meeting with colleagues, working on our PR and website and a lot of driving from one place to another.

There’s quite a lot of paperwork, as well as the opportunity to come up with innovative projects!

Ooh can you tell me what kind of projects?!

I’m working with my colleague Trix to create a photography course for disabled people.

We want to teach the basics of photography, as well as focus on ways to adapt your hobby to your disability.

I also want to create a multidisciplinary rehab team for children/teens who don’t qualify for rehab in a clinic.

Can you tell me a little bit about your background? What was your training and why did you decide to become an OT?

I think my mom was the first who pointed out OT. I was still in high school at the time. I asked a local OT if i could follow her around for a day and immediately fell in love with the occupation.

In the Netherlands the training takes 4 years. OT is a paramedical occupation so we learn a lot about the human anatomy and physiology and illnesses as well as human behaviour.

My internships consisted of half a year at a rehabilitation clinic for children and half a year in a small practice with the therapist who introduced me to OT.

What I love most about OT (and the reason why I wanted to become one) is that we focus on the patient’s abilities instead of the disabilities. I love showing people ways to makes their lives easier or more enjoyable.

Also there’s a lot of opportunities to be creative since every question, patient and situation is different.

You work in the Netherlands – is there a difference between OT in different countries?

Honestly, I had to call my colleague to be able to answer this question haha.

The foundation of OT and the things we do is the same internationally.

The setting we work in is different. In The Netherlands we have a lot of small practices patients can turn to without a referral. The care that is given is payed for by health insurance.

In other countries you might need to turn to a clinic. But the care in general will be the same.

The accessibility of OT also depends on whether you need a referral from your doctor and the societal and cultural beliefs around (chronic) illness.

What kind of things can an OT help with?

All kinds of things, as long as it is important to you. I’ll write down some things that come to mind when I think about OT and chronic illness.

• Pacing and finding a balance between how much your body can handle and how much you actually do during the day
• Coping with cognitive difficulties, teaching strategies
• Driving lessons to learn how to drive your wheelchair/scooter/walking frame safely
• Household chores and practical things such as cleaning, cooking, grocery shopping
• Personal care such as showering and getting dressed
• Re-integration to work or preventing that you have to stop working
• Finding (new) hobbies that fit your abilities
• Finding the right mobility aid

What can people expect when they get a referral to an OT?

The first session is about your OT getting to know you and the questions you have.

The OT might ask if it’s okay to observe you while you perform a (for you meaningful) task. This way we get a sense of the things that prevent you from performing it the way you’d like to.

Often instruments are used to  document your progress. For example, the OT might ask you to rate how happy you are with the way you perform the specific task right now or how important the task is to you.

It’s our version of the pain scale that’s dreaded by the chronic community. I think ours is more fun!

Can Occupational Therapists do home visits?

In the Netherlands, we mostly do home visits. I believe it’s key to successful OT treatment.

In the Netherlands the qualifier is that your question has to be specific to your home-situation. For example; you want to (re-)learn how to make coffee by yourself in the easiest way possible.

You come to your OT’s office and practice making coffee. The two of you figure out the best way for you to perform this task. You return home, excited to give it a try…only to realise that you practiced with a K-cup while you use a drip coffeemaker at home.

This is a very basic example and you’d probably have realised this while practicing. But there are so many factors around ones home that should be taken in account while adapting activities or choosing (mobility) aids.

What’s the best way to talk about mobility aids with an OT?

Start the conversation with an open mind, and try not to focus too much on a specific mobility aid.

It’s absolutely okay if you have an idea of what you’d like. But your OT might know many more options that could turn out to be even better than you imagined.

If you find it hard to ask your OT about mobility aids, you can always start the conversation by asking a question about your mobility.

Think of the things you’d like to do but are out of range for you right now. For example, you’d like to go shopping in a nearby city or you need to go to a work event.

You can start by telling your OT about your desire to do these things. Try to also sketch a clear picture of your abilities. How far or long can you walk for on average, how long can you stand for? These things will help you and your OT to find the right mobility aid for you.

What recommendations would you have for people who find it intimidating to seek help from an OT?

Remember that we are also just people. We need you as an experience expert on your own situation as much as you need us for our expertise. OT takes teamwork 🙂

If you find it intimidating, you could allow yourself to go to an OT with a fairly simple question you don’t feel too nervous about. This will give you the chance to experience the way we work and to see if you have ‘a match’ with your OT. When you feel confident about it you can ask your other question(s) during a later appointment.

What is the difference between an Occupational Therapist, a physiotherapist and a personal trainer?

I think physiotherapists and personal trainers focus on gaining ability. Gaining strength, getting in shape, bettering your lung/heart capacity. And while these things are very important, it’s also nice to meanwhile live your life to the fullest.

That why OT’s focus on meaningful activities and working with the abilities you already have.

What should people look for in a good OT?

I think the most important thing is that the OT listens to what you have to tell/ask. OT takes teamwork between the therapist and the patient so I think it’s also important that you ‘click’.

How can people go about finding the right OT for them?

I think every country has websites where OT’s are listed. If you’re looking for an OT with a specific specialisation or experience treating patients with specific condition your best bet is to ask around on patient support groups. A forum or Facebook group is a good place to start.

What kind of things could an OT suggest when working with patients with conditions like ME and EDS?

It depends on the questions you have. Most of the time it’s about pacing, finding ways to balance your abilities with your daily activities and finding ‘hacks’ to save energy.

These hacks can be anything from getting your groceries delivered to easy meals to cook by yourself, use of mobility aids, or finding the right tin opener for your sore hands.

What advice would you give to someone who wants to become an OT?

I love this question! I could talk for days about OT, but I’ll try to keep this short.

The best thing to do is to do a small internship. Just for a day or two. This will help you figure out if you want to be an OT.

You should also think about what way you learn best. Some people think that OT is very ‘practical’ so the studying must be that way as well.

It’s partially true, the last year is all about internships. But the 3 years before that are about books, literature and a lot of fictional patients.

I really liked the studies, but after three years of theory I was oh-so ready to meet some real life patients haha.

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A huge thank you to Maike for taking the time to answer these questions – and an equally huge thanks to everyone on Instagram who shared with me what they wanted to know! Header image credit to @thisthingtheycallrecovery.

You can join the conversation on this topic on the accompanying Instagram post here.

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