Occupational Therapists (OTs) work either in hospitals or in the community. They help people overcome problems in everyday tasks caused by their rheumatoid arthritis and offer advice on how to protect joints from further damage, aids, equipment and adaptations.
Most people we interviewed had seen an OT either soon after diagnosis, or for specific problems or after surgery. The advice offered by OTs was described as brilliant (see Interview 16 below), really good and quite helpful by most people although two people felt that the OT had been less knowledgeable than they would have liked, particularly about aids for work, and had not fulfilled promises of providing equipment and further information. One woman felt exasperated that she had to explain her ongoing problems to a different OT each time she was referred at the same hospital and that there was little continuity of care.
Hoped that the occupational therapist would have been more helpful and provided items that were…
OTs had supplied various gadgets and equipment (see Personal life and changes to the home). Equipment for the kitchen included kettle tippers, perching stools, bottle top removers, trolleys and non-slip mats (e.g. Dycem). Two people said these were very useful for different tasks such as stopping things slipping on a surface and removing jar tops.
Several people had received aids for personal care and dressing, including bath boards and seats, bottom washers/wipers, raised toilet seats, long-handled hairbrushes, a sock aid and dressing stick. One woman had bought an electric toothbrush which helped; another still hoped to find something that would allow her to shampoo her own hair. People often found taps or showers difficult to turn on and had either been offered special tap turners, which fit over existing taps, or changed to lever taps which made it much easier. An OT visited one womans home before she had surgery and helped with various aids.
Has seen many occupational therapists over the years and been given some useful equipment.
An occupational therapist visited her home and provided some very useful equipment including…
Other useful items included a Helping Hand to pick up things from the floor, large key fobs to make them easier to turn and writing aids. One woman was worried that if she chose to have all the gadgets the OT suggested her home would look like an old persons home.
OTs also provided advice on how to protect joints and gave them splints for various joints. The most common were wrist splints to be worn for specific activities such as household chores, gardening, cycling, pushing pushchairs as well as at rest. People said they offered support when their wrists felt weak, stopped them twisting them and helped when their wrists were painful. However it was difficult to wear them for some tasks. Wrist splints worn at night supported their wrists in a good position and stopped them aching in the morning. One woman was unsure whether wearing them was a good idea as she said it made her wrists very stiff and it took a long time to get them moving.
Wrist splints are usually made of strong elasticated material with a metal bar to keep the correct wrist angle and Velcro straps for fitting. One woman describes how she didnt like the look of those provided by the hospital and had found a company that made more attractive looking ones.
Uses wrist splints for different tasks and has found a company that makes ‘designer’ wrist splints.
Other splints were often specially made by the OTs to fit the individual and included thumb, finger, ankle, knee and leg splints. People said that some of these were good but others found them horrible and chose not to wear them. The leg splints were worn at night to keep knees straight. One woman also had a neck collar, which she wore on car journeys, to stop unexpected jolts. One young woman had been given special gloves to wear at night to reduce the inflammation in her hands which she found helpful.
Several more recently diagnosed respondents were not always willing to listen to the occupational therapist. They felt advice about protecting joints and damage that may restrict them did not apply to them because they felt they were not going to get that bad and they would not need gadgets. Similarly others felt that they had got over the worst part and their symptoms were improving with medication. However having met an OT they felt they could approach one in future for advice if they did have problems. Some people who had lived with RA for many years felt they had little left to learn from further visits to an OT.