Ageing can be seen as a triumph of development, whereby people are living longer because of better nutrition, sanitation, health care, education and economic well-being. However, it can pose a set of social and economic challenges, especially if older individuals are struck by chronic diseases. SPD’s senior occupational therapist Janet Pua shares how occupational therapy can play a part in improving the lives of older adults with chronic diseases.

Globally, nations are entering a millennium with ageing populations. Older adults, defined as individuals who are 65 years old and above (Department of Statistics Singapore, 2013), face many health-related issues of which chronic diseases are prevalent in this population [World Health Organization (WHO), 2011].

The common chronic conditions in older adults are cardiovascular diseases, cerebrovascular diseases, chronic obstructive pulmonary diseases, osteoarthritis and rheumatoid arthritis (WHO, 2008). Chronic conditions are often associated with multiple long-term health implications and functional difficulties (WHO, 2008; Hand, Law, & McColl, 2011). Holistic health care services are therefore required to address the different needs of this client group (Hand et al., 2011; Liu, & Richardson, 2012).

Occupational therapists have the potential and ability to be valuable team members in chronic disease management. Evidence is emerging to support the effectiveness of occupational therapy programmes for older adults with chronic diseases.

Occupations refer to the activities of everyday life and commonly refer to areas of self-care, productivity and leisure (Turpin & Iwama, 2011). Occupation-based intervention focuses on an individual’s occupational needs and is aimed at enabling a person to participate in meaningful activities of daily living (Turpin & Iwama, 2011). Depending on the nature and cause of the specific conditions, occupational therapy intervention may include the following:

• Retraining in daily self-care and home management tasks (e.g. eating, bathing, dressing, transferring, toileting and moving around)
• Education on energy conservation and task/environment simplification techniques to cope with physical demands and reduce the fatigue associated with many chronic conditions
• Recommendation of assistive devices to reduce difficulties in performing daily living tasks (e.g. recommending a rocking knife to clients with rheumatoid arthritis to enable them to cut food with less strength and more dexterity)
• Coaching of clients to incorporate health management tasks into their daily routines (e.g. strategies on medication routine
• Conducting home assessments to minimise potential fall risks and education on fall recovery technique
• Self-management believes that individuals are experts of their own health and can be internally motivated for active management towards their own health conditions. An occupational therapist can help to equip clients with the knowledge and skills to manage their symptoms, physical and psychosocial impact associated with chronic conditions.

Studies have shown that occupation-based interventions are beneficial in helping older adults with chronic conditions

A study reported occupational therapy and physical therapy home intervention can be effective in helping older adults reduces functional difficulties in basic and instrumental activities of daily living , fear of falling and home hazard despite suffering from chronic conditions(Gitlin et al., 2006).

Another study has also showed that older adults significantly improved in activity participation, self-perceptions of activity performance and satisfaction after having participated in an occupation therapy and community based chronic disease management programme (Dugow and Connolly, 2011).

These studies provide evidence that occupational therapists’ unique knowledge and skills on occupation-based intervention is able to help older adults to achieve greater occupational performance, health and quality of life despite chronic diseases.

References
Department of Statistics Singapore. (2013). Population trends 2013. Retrieved December 24, 2013.

Dugow, H., & Connolly, D.,(2011). Exploring impact of independent living programme on activity participation of elderly people with chronic conditions. International Journal of Therapy and Rehabilitation, 19(3), 154-162.

Gitlin, L. N., Winter, L., Dennis, M. P., Corcoran, M., Schinfeld, S., & Hauck, W. W., (2006). A randomized trial of a multicomponent home intervention to reduce functional difficulties in older adults. Journal of American Geriatrics Society, 54(5), 809-816.

Hand, C., Law, M., & McColl, M. A. (2011). Occupational therapy interventions for chronic diseases: A scoping review. The American Journal of Occupational Therapy, 65(4), 428-436.

Liu, J. L., & Richardson, P. K. (2012). Successful aging in older adults with disability. Occupation, Participation and Health, 32(4), 126-134.

Turpin, M., & Iwama, M. K. (2011). Using occupational therapy models in practice: A field guide. China: Elsevier Ktd.

World Health Organization. (2008). Global burden of disease: 2004 update. Retrieved December 20, 2013.

World Health Organization. (2011). Global status report on noncommunicable diseases 2010. Retrieved December 24, 2013.