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Exemplars of Practice

OCCUPATIONAL THERAPISTS WORKING WITHIN THE PRIMARY HEALTH CARE MODEL: EXEMPLARS OF PRACTICE

NOVEMBER 1995

CONTENT CONTRIBUTORS

  • Jeanette Edwards
  • Marcia Finlayson
  • Barb Kowalski
  • Candace Plouffe
  • Gayle Restall
  • Laurie Ringaert
  • Dorothy Schwab
  • Rick Sapacz
  • Marlene Stern
  • Anne Strock
  • Theresa Sullivan

Occupational Therapy in Primary Health Care: An Overview

Occupational Therapists define occupation as "everything people do to occupy themselves." From this broad and encompassing perspective, occupation is what people do to look after themselves (self care), enjoy life (leisure), and contribute socially and economically to their communities (productivity) (CAOT, 1994).

It is this theoretical base that distinguishes Occupational Therapy from other disciplines. Occupational Therapy and Primary Health Care: A Practice Paper (MSOT, Feb. 1995) outlines the diverse and integrative approach of the Occupational Therapist. The integration of individuals with families, families with communities and communities with the larger social context is a fundamental component of Occupational Therapy philosophy, intervention and research.

Occupational Therapy understands that this integration further necessitates not only an integrated health system, but also the integration of that health system with other sectors, such as education, housing, transportation, employment and recreation-leisure. Furthermore, processes such as health promotion and community development must also involve these sectors.

The following examples demonstrate how many Occupational Therapists in Manitoba apply their professional expertise to ‘occupation’ in its broadest sense. These exemplars of practice are presented to illustrate the application of Occupational Therapy in integrated service systems, both in the private and public sector.

Occupational Therapy in Education

  • A primary occupation for children is one of being a student. Children with special learning needs often require assistance in accessing and participating in the school system. Manitoba schools have employed Occupational Therapists to review the child’s needs, assess the educational environment(s) and provide recommendations in strategies, resources and materials to facilitate the child’s participation in school and hence integration within the school system
  • Policies and procedures related to the provision of health care services in schools are currently being developed by the provincial government and local school divisions. Occupational Therapists participate in planning committees bringing unique skills in understanding health and community, ensuring that policies developed allow for the successful integration of the health and educational systems.

Occupational Therapy in Housing

  • Ten Ten Sinclair is a community living situation for adults with disabilities, which is designed to assess the environmental needs and functional abilities of tenants. In addition, staff and tenants work jointly in advocating and securing appropriate housing options for the disabled. Occupational Therapists have played a critical role in attainment of this mandate and have continued to play a primary role in advocating for the development of housing and support services that are community responsive, cost effective and consumer directed.

Occupational Therapy in Transportation

  • The Driving, Assessment and Management Program in Manitoba assesses the skills of drivers with disabilities and designs programs which facilitate the attainment of skills necessary for safe driving independence. Occupational Therapists work within this program aimed to decrease the dependence of drivers with disabilities on caregivers and social programs.
  • The Access Advisory Committee for the City of Winnipeg ensures accessibility for citizens with various disabilities. An Occupational Therapist participates in this committee and through the consideration of both physical environments and policy issues, is able to advocate for the elimination of physical and attitudinal barriers to promote independent living in Winnipeg.

Occupational Therapy in Employment

  • The Mental Health Worker Training Project facilitated the successful shift of clients with mental health disabilities to the role of participating citizens through the provision of specific vocational programs. Occupational Therapists provided consultation to this program. One year following the graduation of the first 16 persons, 14 remained gainfully employed.

Occupational Therapy in Recreation-Leisure

  • Leisure is an occupation which is essential to one’s quality of life and sense of well being. A horseback riding program for the disabled offers children with an opportunity for a community leisure experience and the opportunity to actively develop gross motor skills. Occupational Therapists regularly volunteer with this program, assisting children in developing the skills to become as independent in riding as possible.

Occupational Therapy in Health Promotion and Injury Prevention

  • CN Rail contracts an Occupational Therapist to implement a health promotion and injury prevention program. Preventative strategies such as education and ergonomic interventions as well as injury management strategies such as work hardening assist in reducing work place injuries such as repetitive strain and back injuries.
  • Manitoba Health recognized the need for an orientation and teaching tool to ensure safe lifting, home safety and healthy attitudes towards older adults for their provincial home care staff . An Occupational Therapist, in responding to this need, created an interactional card game. This game is now being sold to numerous employers and other interested parties across North America.

Occupational Therapy in Community Development

  • A successful community development strategy implemented in the inner city of Winnipeg is the creation of a seniors council. This council is directed by the community and aims at ensuring that seniors and other persons in need are provided access to support services which assist in the maintenance of independent living. An Occupational Therapist, through her role in a community based health care facility and her understanding of primary health care and community development, facilitated the creation of this council.
  • Self help and Advocacy organizations, such as the Multiple Sclerosis Society and the Canadian Mental Health Association, focus their efforts on fundraising to provide individual and family services and to promote research. Through volunteerism, several Occupational Therapists provide their expertise and share their philosophical framework , which lends itself well to the community development strategies and positive application of primary health care principles carried out by these organizations.