Occupational Therapist

Occupational Therapists (OTs) are specialists in occupation, which involves activities you do because have to (e.g. work) or because you enjoy them (e.g. hobbies). OTs provide rehabilitation in and after ICU, to help people regain basic skills to look after themselves, and return to all the things they need or want to do. OTs traditionally provided input for people who spend longer in ICU (which now includes patients with COVID-19), usually as soon as patients become more awake, but it is not yet standard in every ICU.  

What do occupational therapists do in Intensive Care?

OTs aim to understand each patient as an individual, and they will work with you to help you relearn the things that are important to you.Doing so will help ensure your rehabilitation is focused on what is important to you and will help you to become as independent as possible with the everyday activities that you want to be able to do. Your OT will help you to try and overcome issues that prevent you from doing things for yourself e.g. physical issues like weakness or pain, or a non-physical issue like anxiety, delirium (feeling confused or disorientated) or fatigue (tiredness). OTs will also find out about your home and work situation, and what life was like before you came into hospital, in order to work out what you need.

Supporting physical recovery

Many patients experience muscle wasting and joint pain or stiffness during their time on Intensive Care, especially if they have been unwell for some time. Your arms and hands, for example, are really important for completing everyday activities, so your OT may provide you with a positioning plan or provide you with splints to help keep your arms and hands flexible. They can provide similar help with your legs and feet. 

Supporting cognitive recovery (your thinking abilities)

"Cognition" includes things like memory, concentration and planning. Many patients experience delirium (feeling confused or disorientated) and fatigue (tiredness) during their time on Intensive Care, which can interfere with these things. Your OT can help with this, by re-orientating you to your surroundings (usually by asking you lots of questions) or asking you to complete some activities that can help you think about, plan and organise activities during your recovery. 

Keeping you occupied and connected with life outside

Many patients experience boredom during their time on ICU, particularly when they are more awake and starting to feel better.It's important for your recovery to keep occupied and connected with life outside and at home during this time This can be very difficult due to the environment, not being allowed to have family members visit, and limitations in your physical and cognitive (thinking) ability, however OTs can help you find things you can do. Some units can provide access to radio, televisions or technology e.g. iPads.

Setting goals for your rehabilitation 

The OT will set small, achievable goals with you or your family. While on ICU, these may include:

• Personal care e.g. brushing your teeth, combing your hair, shaving, getting washed and dressed 
• Communication: working alongside speech and language therapists, they can provide you with aids or to help you write things down if you can’t speak (e.g. if the breathing tube is still in place), and can help you use technology (e.g. iPads or tablets), so that you can communicate with the ICU staff, or your family at home
• Getting out of bed: the OTs and physiotherapists can help find the right type of chair for you to sit in
• Eating and drinking: if you are able to eat and drink normally, the OT can help find ways for you to feed yourself independently, and can provide you with aids e.g. adapted cutlery 
• Staying in contact with family and friends: this is particularly important for recovery, and your OT can help you find ways to do this e.g. through using technology

Helping to balance activity, rest and sleep

Many patients experience fatigue (tiredness) during and after ICU, and it's very important for your recovery that your day is balanced, and that you get proper rest and sleep. Your OT will work alonside the other ICU staff to help manage rest periods, and help ensure that you get a restful sleep.