Occupational therapy and arthritis

occupational therapy and arthritis

What is in this leaflet?

This leaflet is written for anyone who has arthritis and is having difficulty managing everyday activities. It provides information about the occupational therapy service and includes advice about coping with arthritis and details of specialist equipment that may be helpful to you.

Where do I see an occupational therapist?

Occupational therapists (or OTs as they are known) are usually based in hospitals or social services offices. You will see a hospital-based OT after you have been given a referral from a consultant rheumatologist. The OT will usually see you in the occupational therapy department, on the ward or in the out-patient clinic – although a home visit can be made. Social services OTs see you at home. Your GP can refer you or you can approach social services yourself. Some areas have community care group occupational therapists (CCG OTs) where referral is usually through your GP. However, a hospital OT can also make arrangements for you to see the CCG OT if necessary.

How do I prepare for an OT appointment?

When you see an OT you will be asked about any problems you may be having. It may help to write them down before you go. Think about activities such as washing and dressing, preparing meals, getting around your home, turning on taps or using electrical appliances. Be sure also to mention any difficulties you may have doing your job, your hobbies, or driving your car. Make a note of any questions you want to ask. When you see the OT, she or he will make an assessment of your condition, including which joints are affected, where there is pain and so on.

Having discovered which activities are important to you and highlighted particular problems the OT will explore possible solutions with you. If necessary, this might involve the use of a splint or advice on how best to protect the joints affected by your condition (see later). You may need to make another visit or visits to complete the treatment.

How can an occupational therapist help?

1. By giving practical advice on how you can overcome everyday problems

For example, you may need to rethink the way you do things:

If the problem is:Try this:
Standing to iron, garden, cookSit on a high stool in the house or greenhouse
Carrying thingsUse a shoulder bag or a trolley
Unsteady on your feetRemove loose mats and clutter, keep walkways clear
Reaching up to cupboardsUse lower cupboards, keep the things you use most on the bottom shelves or on the work surface
Draining vegetablesUse a sieve spoon or chip basket in the saucepan, microwave vegetables in light-weight containers

You may need to use special equipment to get the job done. The OT will help you choose which equipment suits your needs. Some items are easily available such as a wide-handled vegetable peeler to improve grip or a lightweight vacuum cleaner. (See arc booklet ‘Your Home and Arthritis’.)

Something like a kettle tipper to help you pour, or a bath lift, come from more specialist sources (see section ‘How do I get the equipment I need?’).

If you need a lot of help with personal care from another person, you may be entitled to claim the Disability Living Allowance.

2. By discussing your condition, how it affects you and what you can do to help yourself

If you have rheumatoid arthritis you need to know how to look after vulnerable joints. If you feel tired you can learn to make the most of your energy. You may also have other practical difficulties and questions about dealing with your condition on a daily basis. You can discuss these with your GP.

3. By making you splints to rest or support painful or damaged joints

After assessment, a variety of splints may be provided or made to help you in your activities or to ease your discomfort. Splints are removable and should be comfortable. They can be reviewed as your needs change.

4. By teaching you activities to help improve strength or movement

This may involve you coming for treatment as an outpatient, usually combined with physiotherapy. The aim is to improve the function of your joints. It may mean discussing activities you can do to help yourself at home. (See arc leaflet ‘Physiotherapy and Arthritis’.)

5. By teaching techniques to help you cope with pain

These may be very simple ideas which you can use at home, for instance placing a bag of frozen peas on a hot joint or wrapping a warm towel around a stiff joint. You may also be taught relaxation methods.

How do I get the equipment I need?

Try out equipment during your consultation. If the item you are interested in is not available, ask if there is a Disabled Living Centre in your area which has it. The OT will tell you how to get equipment and whether it is available on loan from the hospital or social services. Some people are eligible for financial assistance to buy equipment or to have their home adapted. For example, you may be entitled to a Disabled Facilities Grant to pay for a stairlift to be installed.

When you are buying equipment, shop around because prices vary. Try the hospital shop, chemists, general purpose stores and specialist shops. Some hospital OT departments sell equipment. There are also mail-order catalogues – the disadvantage of these is that you cannot try before you buy. Testing equipment is very important – try dials or buttons on electrical appliances and take a tin when you go to buy a tin-opener. You may be eligible to get some items free of VAT (Value-Added Tax).

How can I make getting out and about easier?

Where possible, plan ahead. For example, if you want to go shopping find out where you can park, use a toilet, and sit down to rest. The Blue Badge parking scheme, available from your local County or Metropolitan District council, enables people with difficulty in walking to park nearer the shops. Sometimes an Blue Badge can be difficult to get hold of. If so, enquire at your local Health Information Centre or Citizens Advice Bureau about local Access Groups. They may have negotiated parking areas in your town or city. Access Groups may also be listed in the Yellow Pages. Some towns have a shop mobility scheme where you can hire wheelchairs or scooters to go shopping.

An automatic car and power steering may be all you need to keep you driving. If turning your head is difficult, an interior mirror with a wide ‘panoramic’ view may help. These are stocked by some car accessory shops. If your disability is more complex, have an assessment at a Mobility Centre if there is one in your area. The OT can give you advice about wheelchairs and scooters. (See arc booklet ‘Driving and Arthritis’.)

What if my child has arthritis?

An OT can visit your child at school. She or he can advise on adaptations to improve access and facilities on the premises. An OT may recommend equipment such as a special chair or computer and talk with teachers about, for example, the posture of your child while she or he writes. Home adaptations can be arranged to improve your child’s ability to manage the toilet, stairs or taps. Splints can be made to rest joints, reduce the deforming effects of arthritis, and support joints such as the wrist while writing. The OT can help your child achieve independence in personal care and domestic tasks ready for the day she or he leaves home. (See arc booklet ‘When Your Child Has Arthritis’.)

How can an OT help younger adults with arthritis?

The OT can help you plan for the future, and give advice if you are a parent with arthritis on how to lift and dress your baby when your wrists are painful. S/he can provide ideas on playing with your children when they are full of energy and you’re not! The OT can counsel and give advice on sexual problems – for example, finding positions when making love which reduce pain in inflamed joints. (See arc booklet ‘Sexuality and Arthritis’.)

How can an OT help older adults with arthritis?

After retirement, if hobbies become difficult because of arthritis, the OT can help you to discover others. If you lose a partner who did a lot for you, there may be help to enable you to remain in your own home. (See arc booklet ‘Stairlifts and Homelifts’.)

What about employment?

If you are having difficulties at work it is important to seek advice before giving up your job since it may be possible to make adaptations. The OT can recommend specialist seating and positioning of your work-station to reduce back pain. A splint can support your wrist or finger to enable you to type. You may be eligible for financial assistance through the Access to Work scheme or the Disabled Person’s Tax Credit.

What about leisure activities?

The OT can help you with hobbies and interests. For example, you could use a book stand, card or dominoes holder or have your paintbrush adapted so you can hold it. Gardening tools can also be adapted. (See arc booklet ‘Gardening and Arthritis’.)

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