Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)
Remember: Occupational Therapists define the word “occupation” as the way people “occupy” their time. So, for us, this term actually includes all roles involved in living (again, therapy for living, who knew?). In keeping with my theme for October, in celebration of OT month, I will continue to explore the journey of “occupation” from morning to night, highlighting how OT’s help when things breakdown along the continuum that is living.
So, we have slept, are out of bed, groomed and dressed. Now what? Typically we head to the kitchen to grab something to eat. Admittedly, I am a terrible cook. And on top of this I am leery of ready-made foods, and think the microwave is the root of all cancer. So, let’s just say I struggle with everything that is meal preparation. Many of my clients struggle with this also, but for much more legitimate reasons…
For most of us, breakfast is typically simple. Cereal, toast, maybe eggs, pancakes, granola or fruit. Lunch slightly more complicated, and dinner is an effort. So what if you have a brain injury and have difficulty planning meals? Or, you cannot drive, or can no longer access public transit so you have problems getting items at the store? Maybe you are on a strict budget and can only get food from a food bank. Perhaps you have food in the house, but your appetite is supressed from medication, depression, or some other physiological or mental illness. The dishes might be too heavy to lift if you have upper extremity problems, or you have one hand you can’t use at all which makes cutting, peeling, and carrying heavy pots very difficult. If you have a special diet, or cannot consume foods by mouth, meals take on another form – pureed, soft, smoothies, Ensure, or even through a feeding tube. If the meal is made, perhaps you just can’t carry it to the table as you use a wheelchair, or cane, and the last time you tried the meal ended up on the floor. If you have tremors, shakes or dizziness, walking carrying anything is a challenge. Once you are at the table with your food, an upper extremity or visual problem might make it hard to get the food onto the fork, spoon, or into your mouth. Chewing could be another problem if you have oral-motor difficulties. Then you have to swallow and choking or aspiration are possible.
Occupational therapy treats all that. We provide strategies and supports to enable shopping, and aids that might help get the groceries into the car, into the house, and into the cupboard, fridge or freezer. Or to improve memory we can help to set up systems that enable people to shop efficiently and effectively, including meal planning, creation of lists, mapping out products in isles, and providing strategies on ways to prevent visual and auditory overload common to most stores. When cooking, occupational therapists look at safety around appliances, provide strategies to reduce bending, standing, or reaching, or even aids to reduce bilateral (two-handed) tasks if necessary. If there are dietary concerns, occupational therapy can provide aids and education, and can work with a speech therapist or dietitian to make people are able to manage nutritional needs. If there are negative eating behaviors, we can treat that through cognitive and behavioral therapy, tracking, and helping people access other resources and programs. For consuming food, there are several devices that we can use to address a visual-perceptual neglect, a dominant hand impairment, and train people how to eat with a prosthetic. We can make customized utensils and splints to bridge the gap between a hand and mouth if the two can’t connect.
Spoken quite simply – occupation is everything that is eating: from planning what to eat, getting the food from the store to the house, preparing this safely, and making sure the food meets the mouth, or the stomach. If these things are a challenge for you, occupational therapists treat that.