Conditions Requiring Inpatient Occupational Therapy

Occupational therapists primarily serve in a consultative role in the Intensive Care Units (ICUs). They perform comprehensive initial assessments and monitor and reassess their patient's progress as appropriate. Often they are consulted to manage the positioning of patients' upper extremities, which can include the fabrication and fitting of custom splints.

An occupational therapist is available on a part-time basis to provide consultation to infants and their parents in the Neonatal Intensive Care Unit, a Level III NICU. Their role is to perform Developmental Assessments and to recommend strategies to both nursing staff and parents that will encourage normal infant development. This occupational therapist works closely with a part-time physical therapist as part of the rehabilitation consult team.

Patients admitted to BIDMC's general medicine units may be referred to occupational therapy if they are having difficulty with self-care or it is unsafe for them to perform certain functional activities. Occupational therapists are often asked to perform home safety assessments in preparation for a patient's return to home. Most patients, who at the time of discharge require a greater level of assistance with their mobility than before their hospitalization, can benefit from occupational therapy.

Occupational therapists evaluate and treat patients who have problems with sensory processing, coordination, motor function and cognition, because of a neurological illness or injury. Patients who are admitted with spinal cord injuries are often extremely limited in their ability to move; occupational therapists recommend adapted call bells and other assistive devices that facilitate independence. Patients with brain injuries may require behavioral approaches. Occupational therapists may also teach compensatory strategies to assure that patients are can safely participate in meaningful activities. The goal of therapy is to maximize function to allow the patient to be transferred to an appropriate rehabilitation center for further rehabilitation. Some patients, upon discharge, are able to return home and receive occupational therapy there or as an outpatient at a private facility.

Hand Surgery

Occupational therapists play a key role with patients recovering from hand surgery. Specialists, such as hand surgeons or plastic surgeons, often will refer their patients to occupational therapy for fabrication and fitting of customized splints for the upper extremities. Occupational therapists teach patients how to control swelling following surgery and provide instruction in home exercise programs to ensure patients return to independent functioning. If necessary, occupational therapists teach self-care techniques, such as one-handed techniques to compensate for the inability to use an extremity. They also help plan post-hospital care if further occupational therapy is required.

Joint Replacement and Reconstruction Rehabilitation

Occupational therapists are key members of the orthopedic treatment team for patients undergoing joint replacement and/or joint reconstruction rehabilitation. Following surgery, occupational therapists provide patients with training in activities of daily living such as how to independently put pants and socks on while avoiding certain positions.

Spinal Surgery

Spine surgeons refer patients for occupational therapy following spinal surgery such as back surgery. The occupational therapist's primary role is to teach patients the proper way to bathe and dress themselves. Some patients may have pain or weakness after surgery and need to be instructed in the use of adaptive equipment. The occupational therapist also teaches patients how to put on and take off custom back braces.

Most patients admitted to the inpatient psychiatric unit are referred to occupational therapy for evaluation and treatment. Therapists work closely with the treatment team to help organize and implement treatment occupational therapy groups throughout the day. These groups focus on teaching patients coping strategies they can apply to manage life activities.

Patients recovering from transplant surgery or preparing for surgery are often in the hospital for an extended period of time. Occupational therapists are available on a consultative basis to perform a comprehensive evaluation and establish a plan of care to minimize the effects of the extended hospitalization. Occupational therapists teach patients self-care routines to assure a maximum level of independence. Programs are modified based on the patient's performance and medical condition.

Patient requiring vascular surgery may be limited in bearing weight on their extremities and require training in activities of daily living in order to return to their baseline level of functioning.