As an OT you help a person live the most independent life they can possibly live.  But what “occupation” you are impacting depends on your patient.  When someone asks me what I do, I love to tell this story about one of the more unique patient requests I encountered as an OT.

Enjoy!
Cheryl Hall, OT
Author and Illustrator, The Occupational Therapy Toolkit

I met my new patient “Jack” after a surgery that left him with just his thumbs and ½ of his dominate index finger.  Suffering from severe and uncontrolled diabetes, prior surgeries had taken their toll.   Jack had seen OTs throughout his battle with diabetes and gamely demonstrated his capacity to do what he could to feed himself, and complete some upper extremity dressingand grooming tasks.

I helped him adjust some strategies to compensate for the most recent surgery, and then asked if there was anything else that I could help him with.  He hesitated and confessed there was one thing he could no longer do since the surgery, but he was embarrassed to ask.  I gently encouraged him to confide in me, and he said, “The most recent surgery took my nose-picking finger, one of my few pleasures”

This was one occupation that I had never been asked to help with before, but I appreciated his desire to stay independent in this one seemingly small, but valued activity.  I started with an assessment of the sensation, skin integrity and circulation in his residual finger and consulted both his nurse and doctor. I then asked Jack a series of questions about how he performed that occupation – what did the finger look like, what did the finger nail look like, and how was the activity performed?

Using splinting material, I constructed a tapered device that spiraled loosely around his residual index finger and anchored it around his hand with Velcro and splint straps.  With some adjustment, the device successfully substituted for the missing finger and Jack regained control over one of his valued occupations.

To keep occupation front and center in your practice, keep these three strategies in mind:

Live and breathe occupation. What does it mean to you? What activities would you miss most? Observe your family and friends – what occupations would they want help with?

Listen, listen and listen some more. Patients know what is important to them.  By practicing good listening strategies, you will learn more about your patient’s most important “occupation”.

Connect with your peers.  OT is a wonderful, sharing profession.  Talk through challenges with other OTs.  Ask them who their “Jack” has been.  One day you too will have a Jack, and you will be ready to help them too.