Image source: NoSystem images / Getty.

Occupational therapists (OTs) have been in the spotlight this month after the National Disability Insurance Agency (NDIA) froze NDIS payments for these services at $193.99 per hour for the sixth year.

The NDIA also cut travel payments for OTs who visit people in their home and community by 50%.

Health Minister Mark Bulter says it’s important people on the NDIS aren’t paying more for therapy and support than they would pay in the health or aged care system.

But OTs are concerned this could affect therapists’ viability, including their ability to support people with disability in their homes and communities.

But what can OTs actually do? And why is it often better to do this in a person’s home and community?

Who might see an OT?​

Imagine trying to get back to your daily life after a major health setback, such as a car accident or stroke, or an episode of a long-term condition or disability, such as depression or arthritis. The things you used to do with ease can become difficult and exhausting.

After such a setback, your home or community can also feel like an obstacle course. Maybe you can’t carry the laundry basket out to the line anymore, or you’re struggling to keep up with your children.

This is where occupational therapy can make a real difference. OTs are health professionals that enable people to do the things they need, want and love to do in daily life, from getting dressed to cooking dinner, gardening to driving.

Occupational therapists work with people of all ages. They overcome barriers by changing the environments and objects we use, teaching new skills, rehabilitating old ones and tweaking the way we tackle tasks.

What can OTs do in the home and community?​

Seeing people in their own homes and communities allows the therapist to get a more accurate picture of a person’s strengths and abilities, which can be difficult to understand in a clinic.

OTs use their skills and creativity to provide personalised care, tailored to individual needs and circumstances.

An older person with dementia might, for example, cause alarm by putting a plastic kettle on the stove of a hospital kitchen. But they could make their cup of tea perfectly safely at home with their stove top kettle.

OTs can support home and community mobility, such as checking a wheelchair passes smoothly through doorways and can manoeuvre in tight spaces such as bathrooms.

But they can also advise on kitchen aids and seating to save energy for people with conditions such as multiple sclerosis, to support them continuing to cook family meals.

In their work with neurodivergent people of different ages, an OT might help an autistic teen develop sensory strategies to deal with their busy and noisy school day.

For other people, OT support might help them navigate their local public transport system. Learning and practising skills where they’re used makes it easier to carry them over into everyday life.

What does the research say?​

Research shows home and community OT can lead to better activity and participation than clinic-based therapy. It’s also cost-effective.

For stroke survivors, OT makes everyday tasks like showering or getting dressed easier.

OT at home eases burden and stress for the parents of children with cerebral palsy and carers of people with dementia.

OT at home helps older people with ongoing health issues to be more actively involved in their communities.

Community OT is also effective in supporting recovery for people with mental health problems, enabling them to enjoy community and leisure activities, seek and maintain employment and enhance physical activity.

OT focuses on helping you do the things that keep you well and independent, which means fewer trips back to the hospital. OTs can spot and solve trip hazards within homes, for example, before a frail person has a fall.

People who get OT at home soon after leaving hospital are less likely to be readmitted. Emerging research also suggests OT can work jointly with paramedics when someone falls at home by visiting and offering immediate treatment that prevent avoidable hospital stays.

There are some downsides, such as limited access in disadvantaged communities. While telehealth can address some barriers, it is not suitable in every case.

How do Australians access OTs?​

There are many pathways to access OT services, but the complexity of the health-care system means the process is challenging to navigate.

OT services can also be costly, due to severely limited funding, equipment and transport costs.

OT is available as part of Home Care Packages and the Commonwealth Home Support Programme for older people.

OT has also played a key role in supporting NDIS participants since the scheme’s inception. However, waiting lists often stretch for many months and not everyone knows about what OT can offer.

You can also access community OT through Medicare Chronic Disease Management plans, local community health centres and councils and through private health insurance rebates.

Source: @ConversationEDU / X.

Thanks to Lana O’Neil (Occupational Therapist at Western Health in Victoria) and Sarah McCann (Senior Occupational Therapist at Western Health) for sharing their clinical expertise for this article.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

 

[Rotty]

My son has a head injury disability. After months of rehabilitation he is able to live on his own.
He lives in a Park Home at a caravan Park, where there are people around. I have been visiting him weekly to make sure he has his medication etc. His main disability is memory loss. He cannot drive so needs to use public transport if possible. But so often forgets where he is going or why. For a time he had a friend in the Park who took my son to the shops or to the bank etc. But he no longer lives there. This is one reason above many others that I am trying to get him on the NDIS program, also for some company . To do shopping, banking, getting to the local "Food Bank" - who are wonderful people - and to doctors, etc. I am lucky to have retired but I do not live very close so I travel a lot to do these things. Having help would take the stain off me as I am getting on (76) and would like to have this in place if anything happened to me. BUT the amount of paper work, and information is very overwhelming. I have had a meeting with the NDIS, and have started to process. I hope that there will be light at the end of the tunnel. NDIS is a wonderful community service and I just hope I can get through all the paper work so my son is not left without help.

 

[jsan]

Hi Rotty I wish you all the best in your journey I found that my experience was very quick from approval to funding was less than a month but I have read that some people have been waiting for 12 to 18 months to get funding I think it all depends on how you are able to look after yourself in my case i am on a high need and so is my wife as she is terminal

 

[natalielocket]

Having worked in Age Care, (Community) Having an OT visit Clients to access their mobile ability, is so important. So many have a wheelie walker, bought by Family, but they walker is too low for them. They are not aware that the handles can be lengthened. Plus the OT also accesses the Client for how they can handle every day cutlery. There are special types out there who have arthritis in their hands, Also if a Podiatrist is needed for special types of shoes. Certainly Not Open Toed Shoes. Volunteering in the Hospital system I see so many Seniors wearing flip flops etc, with a wheelie Walker, too low for them, and even walking sticks the same.