What an occupational therapist does

If you only get one clinician into the house, this is often the one to get.

An occupational therapist is not interested in your diagnosis so much as in your Tuesday: whether you can get out of that bed, into that shower, and make lunch in that kitchen. Then they change the task, the equipment or the building until you can.

This is general information, not advice. Equipment and modifications that carry risk should be prescribed by a clinician who has seen the person and the house.

What the visit involves

Expect an hour or more, and expect to be asked to actually do things rather than describe them.

They will watch you get out of a chair and off the bed. Walk your hallway with you. Go into the bathroom and look at the shower recess, the toilet height and what there is to hold. Look at the kitchen, the bench height, the cupboards you can and cannot reach, the kettle. Walk the path from the bed to the toilet, which is where night falls happen. Look at the back step, the front step and the letterbox.

Then they write a specification. Not “she needs a rail”, but which wall, what length, what height, what type, and whether the wall behind it will hold. That specificity is the entire value, and it is what separates equipment that gets used from equipment that gets funded and ignored.

What they can change

Equipment. Shower stools, rails, bed levers, chair raisers, reachers, jar openers, sock aids, long-handled shoehorns, dressing sticks. Most of it cheap and most of it more effective than people expect. Our equipment and assistive technology list works through the categories.

The building. Rails, lever taps, a level-entry shower, a ramp, widening a doorway, step edging, lighting. Covered in home modifications for ageing in place.

The method. Often the cheapest fix of all. Sitting to dress instead of standing. Showering at a different time of day. Keeping the things you use daily between hip and shoulder height so nothing needs a stool. Doing the hard task first while energy is highest.

Pressure care and seating, where someone is sitting or lying for long periods and skin is at risk.

Cognitive and memory supports, including how a kitchen is set up for someone with dementia so that habit can do the remembering. That sits alongside keeping routines that work when someone has dementia.

When to ask for one

• After a fall, or after a hospital stay that changed what someone can do
• When showering or dressing has become the sticking point
• Before spending money on equipment or building work
• When a new diagnosis will change what the house needs
• When someone is managing but you can see how thin the margin is
• When a carer is doing tasks that equipment could do instead

That last one is underrated. A daughter lifting her father in and out of a chair twice a day is a problem with an equipment answer, and it is her back that will end the arrangement.

Getting the most out of it

Do not tidy up for the visit, and do not perform. The instinct is to present the house at its best and to manage the task better than usual because someone is watching. Both make the assessment useless. Let them see the real thing.

Say what you have stopped doing. People report what they struggle with and forget to mention what they have quietly given up. The abandoned tasks are the most useful information in the visit.

Have the person who will use the equipment present and deciding. Equipment chosen for someone rather than with them is the equipment that does not get used.

Ask what is free or cheap and can happen this week. There is almost always something: moving furniture, changing a height, taking up a rug, a five dollar tap turner.

Ask about the review. Needs change, and a specification written eight months ago may be wrong now.

How it gets paid for

Occupational therapy can be funded through aged care arrangements, and the equipment and modifications an OT specifies sit under a separate funding pool from your ongoing services, which is explained in what the AT-HM scheme pays for. Some people also access OT through Medicare arrangements set up by a GP, or through DVA if they are eligible.

Because the rules depend on your assessment and change over time, ask your GP and your provider what applies to you rather than assuming. Current information is at myagedcare.gov.au.

If you want an OT assessment arranged and the recommendations then followed through day to day, that is part of what we coordinate. Ring us and a person will answer.