Not Just a Cup: Utilizing Household Items to Enhance Treatment

By Crystal Mulligan, MS, OTR/L
Occupational Therapist

Transitioning to treating in the home can be a little daunting for some clinicians. One of the reasons is because of the lack of traditional equipment. Whether you are a seasoned clinician or a new graduate, you may find yourself thinking “I wish I had XYZ as we do in the clinic” or, “If I were doing this in the hospital, I would be able to use ABC“. Having to think outside the therapy gym and being creative is one of my favorite things about treating in the home, and I challenge you to allow it to become one of yours!

It may feel like we have no equipment to work with and in the traditional sense, that is true. I’d like you to reframe that idea, and when walking into a patient’s home, look around at all the “equipment” you do have. Our “office” is their living room, kitchen, or bathroom, and is there truly any better way to ensure carryover and understanding than by already being in their own home? We don’t have to simulate the transfer into the bathtub and hope they do it the same way at home. We don’t need to show them examples of how to utilize a calendar to recall appointments—we can take their own calendar off the wall and begin the process with them. Trying to have your patient accurately recall how many steps there are in the home? Not for us! In many ways, I find this makes House Calls the best setting in which to deliver care.

Why Everyday Items are Important For Treatment

Personally, I bring a blood pressure cuff/stethoscope, pulse oximeter, my laptop, and of course hand sanitizer and sanitizing wipes when I go to treat patients. Typically, that’s it. Let’s talk about why I try to treat this way. Well, first off sanitary conditions and time constraints. Especially now with the fear of COVID-19, less is more. With fewer items coming out of one home and into another, you’re decreasing the risk of transmitting anything. Sharing is caring—but in this case, everyone can keep their own germs to themselves.

Second, let’s talk about time! There are things you are going to have to share between patients, like your pulse oximeter or blood pressure cuff, so you have to clean and sanitize these in between each patient. The more things you have to sanitize, the more time it takes, the longer your day is, and the longer your day is, the more burnt out you feel. The more burnt out you feel, the more your treatment may begin to suffer….well, you get the idea.

Now let’s talk about you, your back, and your shoulders. Both the AOTA and APTA offer information about lightening the load in a student’s backpack, warning signs that your backpack is too heavy and how to better carry the load. I find that I often say to myself “practice what you preach!” Think about how heavy the bag you are carrying around is. Is it digging into your shoulders? Leaving red marks? Causing pain? We put enough strain on our bodies through the nature of our work, we don’t need carrying around cones and dumbbells adding to that.

Lastly, my favorite part of using items around the home for treatments is the carryover opportunities. When you are using things that are already there patients can easily implement them into their home exercise program. They become familiar and learned habits for your patients. If the items are already there for them to use you don’t need to consider financial cost and you take away the “it hasn’t come yet” or “I didn’t get to the store” excuse. It also makes each of your treatments patient-centered and personalized.

How to Utilize Everyday Items in the Home

My favorite way? Being creative. My process is to come up with a treatment idea and then just look around for what I can use to make that idea a reality. Of course, I always ask permission to use something before we do, and I recommend you do the same. Involve your patient, “I’m looking to do XYZ. What do you have in your home we can practice doing this with?” They may have ideas of things you can’t see or just wouldn’t have thought to use. I find this to be a good exercise to keep up my creativity and uniqueness in my treatment. I do get stuck sometimes, feel bored in my treatment ideas, or need a fresh idea. My first source of inspiration is my colleagues and clinician friends. We each come with our own different experiences and backgrounds and can offer each other lots of help and ideas. There are also communities on Facebook for clinicians who treat in the home which offer lots of ideas and opportunities for collaboration. Lastly, Pinterest is a lifesaver when you’re stuck in a rut.

What Items Can You Use When Treating in the Home?

Remember your equipment can be anything, don’t overcomplicate it. Let’s look at a simple cup. I guarantee most homes will have some sort of cup. What can we do with it?

• Working on dual-task and balance? Let’s carry the cup from room to room, grading the activity by how much liquid is in the cup.
• Working on cognition and sequencing? Let’s make a mug cake in our cup with simple ingredients likely to be found in the home.
• Upper extremity strengthening and range of motion? Place the cup on various heights having the patient retrieve it.
• Grip strength? Sustained grasp around the cup with or without items added inside.
• Obstacle navigation? Let’s put that cup on the floor and get around it safely.
• A Bonus challenge for the client could be having them place the cup on the floor or pick it up. The options are endless and that is just for a cup!

Some of the more interesting things I’ve used have included: K-cups, dogs and dog toys, brooms or mops, pillows, cans, individually wrapped candy, books, playing cards, and game pieces from grandchildren’s toys.

Treating in the home can be an intimidating experience, but it doesn’t have to be. Practice makes progress—implement this into your practice and you will see your patients progress.