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.
It is no secret that there are physical, mental and emotional consequences of stress. Access to money is a basic human need as food, shelter, and emotional security are all impacted by our ability to provide for ourselves and our family. As such, the stress created from a lack of money, or drastic and sudden loss of income, is significant. In the economic crisis of 2008, there was mounting evidence that financial issues were causing a whole host of associated health problems including a rise in reports of headaches, backaches, ulcers, increased blood pressure, depression and anxiety (http://www.frbsf.org/community-development/files/choi.pdf). Therefore, it is no secret that financial security is a determinant of health.
I can say that 100% of my clients suffer from financial problems after their traumatic event. How could you not? If you think your income is “insured” against illness or disability, check again. If you are fortunate you have private disability or health coverage. Or, you might have a good short or long term disability plan at work and in that case, you might get 80% of your income covered at the time of claim. However, this usually only lasts for two years before the “test” changes and most people find their income loss benefits end. In the world of auto insurance, without other coverage, the maximum income replacement is $400 / week, regardless of what you made before (unless you “bought up” which no one does). And just think – three years ago the Financial Services Commission of Ontario wanted to lower this to $300 / week to put more money back in the pockets of insurers. Could you live on $1200 / month? I digress…
So, you are in an accident, suffer an illness or can no longer work. How will you manage? How will you be able to afford the medications you are now required to take (these aren’t covered 100% either folks), the equipment you need (the government might fund 75% for some items, but when a prosthetic limb is $60,000 that is still a lot out of pocket), the treatment you require (even with extended benefits, $350 in PT won’t get you very far), and your regular expenses that won’t dwindle unless you make major lifestyle changes? The answer is stress, worry, concern, sleepless nights, borrowing, illegal activity, and brutal attempts to unsafely return to work because you “have to”.
Believe it or not, managing your finances is what we call another “occupation”. Working with an occupational therapist, a disabled person can create a new budget around the change in income, get support to make decisions about spending, and gain access to other potential sources of financial support. Perhaps you qualify for the Disability Tax Credit, or the Registered Disability Savings Plan? Maybe you need to apply for the Ontario Disability Support Program, or can access funding for devices through the Assistive Devices Program? Perhaps your home modifications qualify for the new Tax Credit, or you can apply to the March of Dimes under their Home and Vehicle Modification Program? Maybe without other coverage the local Community Care Access Center can provide you with home care, treatment or equipment? Can your medications be covered by Trillium? Are you maximizing the coverage available to you under auto insurance policy or work benefits? Is there a local food bank, or disabled transportation program? These are all things we look at.
Then of course, there is the process of returning to work. What if you cannot manage the demands of your previous job or this is no longer available to you based on a long absence? Perhaps the jobs you are trained for no longer match your abilities? Occupational therapists can help with identifying previous job demands, outlining new job interests, and comparing these to the abilities you have. We can set up structured work programs, gradual re-entry plans, and connect you with people and programs in the community that help people get back into the work force.
Occupation is managing your finances and making sure you can get by. If this is impacted by a disability, Occupational Therapists’ treat that.
Check out previous posts from our “Occupation Is” series.