Occupational Therapy’s Impact On Aging In Place

By Patty Hoffman, OD, OTR, BCG
Occupational Therapist

Having worked as an occupational therapist in numerous settings, I thought I had reaped the rewards, seen the benefits, and shared in the enjoyments of my patients’ successes in every way. I had worked in rehabilitation hospitals, subacute rehabs, acute care, outpatient clinics, skilled nursing facilities, and day programs. I enjoyed my work and recognized that I was blessed to possess such a rewarding career.

It was February of 2007. My kids were getting older and more independent, and I decided it would be a good time to try “home care” and pick up a few per diem hours. As I sat in my interview with FOX, I quickly began to recognize the benefit of assisting the frailest of the frail. The proactive approach and the philosophy of intolerance of ageism at FOX were something I had not experienced before. FOX was not a practice that simply accepted “old age” as the reason for a person’s decline. Identifying and addressing issues before they became problems was a refreshing take on the therapy that I had been experiencing for two decades.

One of my first patients, Rebeca, was a woman with severe COPD. Her husband had recently passed away. Her son, who lived in Oregon, was planning on bringing her out to live on the west coast with him. She had lived in her home for over 50 years, and her parents had lived there before passing it on to her. She was heartbroken, depressed, and unmotivated, and felt that she had no options. As a FOX clinician, I had been trained to recognize the signs and symptoms of depression, and rather than write her off as non-compliant or unmotivated, I knew that with time, there was a good chance I could make a change.

With gentle encouragement and collaboration with her son, Rebeca and I began to evaluate the potential obstacles, and prioritize the issues that caused her son to feel Rebeca was at risk. Because FOX provides services under Medicare Part B, I was not limited by the shorter duration and home-bound status typically experienced when working under Medicare Part A. This provided the opportunity to develop trust and rapport and provide treatment related to quality-of-life issues so often put on the back burner due to lack of time and resources.

We looked at everything: safety of the entryway, furniture placement, positioning during activities of daily living for energy conservation, lighting, community resources, and emergency alert systems. After a few weeks, Rebeca began to show an increase in her self-confidence and belief in her ability to maintain her quality of life in her own home with the numerous changes we were making. After two months, Rebeca’s son was convinced as well and agreed that the move out west was no longer necessary. The change in Rebeca was remarkable. I was left with such a feeling of joy and satisfaction that I could have such an impact on someone’s quality of life in this way.

Aging in place is not always so remarkable. Sometimes, it’s the little things that carry great meaning. My patient, Felicia, who had also recently lost her husband, was referred to me following a wrist fracture. Her primary goal was to be able to open a bottle of wine, as she and her husband shared a glass every night and she wished to continue this tradition in his memory. After 12 weeks of therapy, Felicia and I shared a glass of wine from a bottle opened by her, and watched a beautiful sunset on her back deck.

I have been performing geriatric house calls for nearly 11 years. Providing patients with the opportunity to age in place – be it physically remaining in their own home, or allowing them the opportunity to engage in activities that make the house a home – has been the most rewarding experience one can imagine as an occupational therapist.

While a FOX patient and clinician, the people featured in this photo are not in the article.