How occupational therapy can aid small changes that make a big difference to older people

Jo Marshall is Senior Occupational Therapist (OT) in a rehabilitation and falls service in a multidisciplinary community team for the NHS in Nottingham. She works closely with older adults in this role. She has a portfolio career and works as a Teaching Fellow at Coventry University teaching on the postgraduate certificate in frailty and in the Allied Health Professionals (AHP) return to practice team. She is a mentor for two Occupational Therapists returning to the HCPC register. She is a member of the BGS, the Royal College of Occupational Therapists and registered with the Health and Care Professions Council.  She posts on X: @Josephineus

To mark National Allied Health Professions Day, Jo explains why she is supporting the #ChooseGeriatrics campaign.

On AHPs day, I am reflecting on my role in the rehabilitation and falls service. Working with older people is such a rewarding career and I feel as an OT we can really add more life to people’s days.

We complete a holistic assessment when we go and assess older people who have fallen or would like rehabilitation. This contains most of the elements of the comprehensive geriatric assessment, so is very thorough and we can be with them for about two hours discussing how they are and what is important to them. This really gives me the opportunity to get to know the person I am talking to and understand how to personalise their care and support. Our assessment also covers the guide to action if they have fallen, so we can work with the person to try to reduce their risk of falls in the future.

I saw a lady recently in her 90s who had fallen in the same place three times while trying to hang out her washing in the back garden. I have worked with her to look at her goals and discussed with her, her son and the multidisciplinary team ways to try to reduce her risk of falls. I referred her for a galvanised rail outside to try to keep her independent and doing the activities that are meaningful to her, whilst also reducing her falls risk.

I also referred her to one of the physios in my team as she would like to try to improve her strength and balance to stay independent. I provided equipment inside to maintain her independence, which included a kitchen trolley to enable her to continue to carry hot drinks from the kitchen through to the living room for her and her family. I have been to see her at home a number of times and she welcomes me into her home and now offers me a cup of tea! She is such an independent lady and really loves spending time with her family. Hopefully the small changes we have suggested will help her to stay independent at home for longer.

I also see a lot of people for postural seating assessments and complex sleep systems to try to reduce contractures when they are in bed due to many different physical or mental health conditions and co-morbidities. This can also be very rewarding. One lady who had dementia sticks in my mind. I went to assess her with my physio colleague, and she didn’t have sitting balance as she had been in bed a long time due to multiple illnesses. She needed tilt in space and postural supported seating, so she did not slip from the chair or fall to the side. Once I had visited with the seating rep and completed the necessary paperwork to obtain the seating, I returned with a colleague to hoist her out into the chair. The difference in her quality of life being able to sit up and interact with her husband was heartwarming. I completed the moving and handling plan and when I returned the following week after to review her with the carers, she was like a different lady. The frail person I had met in bed initially was sat up in her new chair facing down the back garden and was laughing with her husband. Such small changes can have such a huge impact on an older person’s life. They were both over the moon that she could sit up at the table and they could have their dinner together, which was a meaningful activity for them as they had been married for over 50 years!

I love working as an OT with older adults in the community and feel that there is real difference that can be made by working with them to understand their goals and really trying to bring back life to their days.