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These are the patterns that make up our lives, from what may perceive as mundane such getting dressed in the morning and having a shower, to celebrating a loved one’s birthday or going for a bike ride in the countryside, all of these hold meaning for us in some way, these are the occupations that make up who we are, and to the client/person these hold special meaning (Kramer, 2003). Furthermore, when as a result of an illness of a disruption that a client/person is unable to participate in those ‘meaningful occupations’ this can have a direct impact on their health and wellbeing.

The significance of this, is that within Occupational Therapy is the perception of ourselves as ‘Occupational beings’, and through this an empathy with our client group, the impact on health/wellbeing if for some reason we were unable to participate effectively in those occupations/activities in our everyday lives that we take for granted such as shopping, socialising with friends, and being unable to dress/wash ourselves without the assistance of others (Wilson & Wilcock, 2005), (Kielhofner, 2009). For a client this may be loss of role, but also where they have for instance, a reintroduction of new roles/commitments, that may be if a client was in hospital for a long time/accommodation where for instance food preparation/shopping, housework was done for them, then the role of the Occupational Therapist would be re-introduce these occupations for the client to assert this imbalance due to restricted participation in occupations.

Example 1 (Physical)

For a patient returning home from hospital following a hip replacement, there may be a time of recuperation, if in employment prior to being admitted it may be a case that they have to stay at home or a reduced amount of hours, or possibly a change of career, the implications of this could be:

  • Financial, this may affect their leisure/socialising opportunities of which the client may no longer be able to participate due to reduced disposable income.
  • Diet, food and drink in the same respect with reduced financial means that a client/family may not have the same luxuries they had before e.g. drink and cigarettes could be effected if the client smokes affecting their wellbeing.
  • Loss of role, if previously the client was the ‘bread winner’, and now another member of the family is the main financial provider.
  • Daily routine/energy management, with a physical impairment the client may take longer to do those occupations as getting dressed in the morning, and shopping, may they have a reduced amount of time restricting those occupations they can fit in, but also a reduced level of energy.
  • Low self esteem/self image, the client may not want to participate in those previous occupation due being perceived as being ill or having to use such adaptations as a walking, or if difficulties going to the toilet they may feel the need to stay near, or due to lack of confidence if in hospital a long time, the outside world may feel like a scary place.

Example 2 (Mental health)

In a mental health setting with a client returning home following a stay in hospital, whilst there may be very similarities with the ‘physical example’, it also mean that after a long stay in hospital that the client is not returning to their home due to many reason or rehabilitation in the community which may be a very big transition.

  • Financial/obligations to manage budget this may affect their leisure/socialising opportunities, but also that the client may have to manage there budget which could be problematic/challenge to do these again.
  • Diet, food and drink/having to cook again. In the same respect with reduced financial means that a client/family may not have the same luxuries they had before, but also this may mean having to cook for themselves again, and having to adjust to doing things like going to the supermarket again.
  • Loss of role/new roles to undertake, if previously the client was the ‘bread winner’, but also if the client roles have been restricted, then being re-introduce to those new roles that facilitates supported/independent living.
  • Daily routine/energy management, this may building a routine again to engage in those occupations of everyday life, managing energy in relation to medication, and getting used to sleeping at regular times.
  • Low self esteem/self image, the client may not want to participate in those previous occupation due being perceived as being ill, or due to lack of confidence if in hospital a long time, the outside world may feel like a scary place.

In conclusion, through considering the occupations a client/person participates in a holistic way, we understand that ‘everything is connected’ and that for us as an Occupational Therapist’s is to seek to address this ‘Occupational imbalance’ when an illness/disruption occurs by devising strategies/interventions with the client to address this, believing that people are ‘occupational beings’ and when they are unable to participate in meaningful occupations this can have a serious impact on their health and wellbeing.

References

Creek (2011) Occupational Therapy and Mental Health. Elsevier Health Sciences

Kielhofner, G (2009) The Kind of Knowledge Needed to Support Practice in Conceptual Foundations of Occupational Therapy Practice. F. A. Davis Company: Philadelphia, USA

Kramer, P (2003) Perspectives in Human Occupation: Participation in Life Lippincott Williams & Wilkins

Punwar, A. J. (2000) Occupational Therapy: Principles and Practice. Philadelphia: Lippincott Williams & Wilkins

Wilson & Wilcock, (2005) Occupational Therapy and Physical Dysfunction: Enabling Occupation. Elsevier Health Sciences

Useful related terms

  • Occupational deprivation: where for some reason a client is unable to participate in an occupation over a long period. (Creek, 2011)
  • Occupational Alienation: which is where a client feels the occupations they engage in hold no meaning to them. (Punwar, 2000)