Occupational Therapy is much broader than people think – could you tell us what it is?
We sat down with Dr Kirstin James, Programme Lead for Occupational Therapy at Edinburgh Napier University and chatted about how you'll find Occupational Therapists where you may not think and how she helped an artist participate in the thing she enjoyed the most again.
There are lots of official definitions but the one I use is that occupational therapists help people do the things they want to do. Which sounds simple, but underneath it is quite complex.
Your occupations are the things that you do; they define you, but you also define yourself by them. I think everyone knows that when you go somewhere people will ask “what do you do?” and you wouldn’t say, “What do I do? Well sometimes I go walking.” You say “I’m a [insert job here].” But your occupations are more than your job, they’re all the things that you do.
Can you give some examples of simple interventions that help people in their day-to-day lives?
At the moment I also work at an A&E department. When I started my career I would have thought “what is an occupational therapist doing in A&E?” But when someone comes into A&E having had a fall, say, the fall can get treated – they can get an x-ray, see whether or not the ankle is broken or not. But the questions is, can they cope at home on their own?
So we’ll have a conversation and I’ll ask them where they live, who they see every day, how they get about. And I’ll ask, now that you have this pain in your ankle, are those things still possible? Are there things that you can adapt so that you can go home short term? Or do we need to now think of you having some kind of emergency care package? The goal is that the person will be supported to leave A&E and go home.
Because if it’s not something that’s an illness or an injury, actually coming into hospital doesn’t always have the best outcome. People lose their routine, they lose their structure. So my job is to very quickly assess someone’s daily occupations, understand what the interruption is, and then figure out how we can support them with the challenging parts so that they can return as quickly as possible to their usual circumstance.
And maybe it’s not possible to return to what the person was doing, but let’s look at what their future looks like doing things differently. There’s a lot of research that says people can have a lot of grief around occupations that they’ve lost through an injury or an event. And if there’s a lot of focus on “before” then the “after” can be very daunting.
So it’s simple but also complicated.
Can you share one of your most rewarding experiences as an occupational therapist?
I worked in Chicago for six years there is one person who sticks in my mind. She’d had a stroke and had quite restricted movement in her right hand. She was an artist; she liked to paint. She was able to use adaptive ways to get dressed, to go out, to move around, to cook, to do things at home, but her love in her life was painting. Her goal was to regain enough movement in her right arm so that she could participate in the thing that she enjoyed most.
I was able to work with her really quite intensively. She started off doing movements on the table, and then she could write on a table. I remember she wrote her shopping list and gave it to her daughter to see if it was legible – that was a major breakthrough. The next step was to creep her hand up a wall, and then was able to keep it there, and then she was able to hold something in her hand, and then she was eventually able to hold a paintbrush and paint. And it was amazing.
It’s not often you get the opportunity to really work with someone on one particular thing. Sometimes there are things that are essentials – yes I like to paint but I have to be able to drive my car, get on the bus, go to work. So to be able to work with someone so intensively on something that was their passion – it was amazing to do that with her. I can still picture her standing: we put lots of big tear-out sheets on the wall for her to practice on, and I remember her laughing and smiling and she was so happy.
Do you think the sector has changed much since you did your original training? Has technology changed the field?
If you were to go into a care environment now, the complexity of the needs that people have who need support has just changed out of sight. And that’s really the success of the NHS – that’s people living later into life with multiple medical morbidities and conditions that in the past they wouldn’t have survived.
What are you excited about with the new course?
It’s exciting that it’s something we can design from the start, rather than trying to change something or fix something – that’s what’s really exciting. We’ve had the opportunity to really think about what is needed in health and social care. Not just now – we’re forecasting a bit. So in the near future, what is it the health and social care needs from its graduates?
It is a really interesting course. I’m really excited about getting the course started in January, having our first cohort, seeing the students’ work. I’m just looking forward to the students having success.