Occupational therapy has very little to do with the kind of work a person does but has everything to do with helping a person restore and maintain the skills they need to have a good quality of life.
“My role is to help you with your activities of daily living (ADLs),” says Kathleen Olejniczak, MS, one of the five full-time and one part-time occupational therapists at Roswell Park Comprehensive Cancer Center. “For a patient, that might include basic things — bathing, dressing, being able to use the restroom — but it might also involve higher-level things, maybe simple meal prep. Our whole role is making sure you are able to do things in the reality of your self-care to go home safely.”
Occupational therapy might make people think about returning to work, but that name is “kind of a misnomer,” says therapist Eileen Rogers, MS. “It’s a matter of how you occupy your day. How do you occupy your life? You get up, you make breakfast, you get dressed. What are the things you do during the day? That’s what we focus on.”
Treatment for cancer doesn’t just affect the tumor and the area of the person’s body where their cancer is found; it can change the whole person and their ability to live their lives in what was their previous normal way. Occupational therapists are available to Roswell Park patients at any point in their course of treatment, working mostly at the bedside but with the opportunity to help outpatients maintain or restore their fine motor skills, balance, dexterity or any other ability.
Goals vary by patient
The goal is for patients to be allowed to return to their homes and, as much as possible, the things they did before treatment. “If you have support at home, that changes the aspect of our care a little,” says therapist Kim Treanor, MS. “If you have someone who can help you do things, you don’t have to be fully independent to go home. We might help you be as independent as you need or want to be. We can also make recommendations for adaptive equipment,” including stability bars for installation in the bathroom or special tools to help put on socks or shoes.
“After surgeries, chemotherapy, your overall physical abilities can be limited. Physical therapy works with bed mobility and the ability to get up and walk around. We think about things like, once you’re home and using the bathroom, how do you care for yourself. How do you safely and effectively manage those things,” adds therapist Sean Moran, MS. “Some patients might need to go to a rehabilitation facility before they can go home. We make appropriate discharge recommendations for patients based on that.”
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Some patients might expect they’ll have to reach a certain benchmark before they can be released home, like being able to walk a certain distance around their floor, or to be able to complete a certain number of laps on a wing. With occupational therapy, the question is more along the lines of can the patient put on their socks unassisted, or can they resume a favorite hobby.
“We ask a lot of questions when we evaluate a patient,” Treanor says. “I think sometimes they’re a little surprised by that. We also ask a lot of very specific questions, which guide where we need to go and the work we’ll do. We don’t ask to be nosy!”
Occupational therapists work closely with physical therapists to help patients do what they need, and desire, independently.
Independence is key but means different things to patients
“Some people will only have energy for a certain amount of time per day. Are they going to spend that time taking a shower and getting dressed but then they’ll have no energy for anything else? Or is it a conversation we can have with them where they are willing to accept help for some of those tasks,” says therapist Jennifer Sickels, MS. “They need to focus on what’s important to them.”
Even if a patient’s cancer isn’t directly related to a mobility issue, a majority of patients could benefit from working with an occupational therapist. “Roswell Park talks a lot about survivorship and quality of life after care. You can’t have a survivorship program without an occupational therapy program to help and work with patients,” Treanor says. “Some people may not need to see us very often or for a long period of time. Sometimes it’s just giving people the tools they need to do what they want on their own.”
Helping patients regain the ability to do what matters to them is a gratifying role to play, the team says. “There are things we can do to help people be happy, and that makes us happy,” Sickels says. “It’s meaningful work.”