As Parkinson’s progresses you may find tasks or hobbies become more difficult or take more time, for example doing up buttons, using a computer, writing, eating and drinking. The occupational therapist will first assess your daily routines and often your home, work and leisure activities. He or she will then recommend different ways of doing difficult tasks, or advise about use of appropriate gadgets or technical aids to help.
An occupational therapist can also advise how to adapt your home or workplace to improve easy movement or safety, for example by arranging the installation of extra hand rails by steps, stairs and perhaps in bathrooms. He or she may also advise on how to prevent some potential problems before they arise.
Ideally, you should be referred to an occupational therapy service as soon as you start to find everyday tasks difficult. Because your symptoms will gradually change you will probably need to be referred back to an experienced therapist from time to time so that you can learn new strategies.
Activities at home: an occupational therapist can teach methods that will make everyday tasks easier. For example, to help you dress more easily they may suggest that you plan, gather and organise the sequence of garments in advance, then sit down to dress and use simple methods to help your concentration and flow of movements during the task.
Equipment and gadgets: there are many special gadgets and types of equipment that can help you – the range is vast, from simple gadgets that make cooking, eating or washing easier to electronic devices to open your front door from elsewhere in your home. An occupational therapist can suggest the best equipment for your needs. He or she may also suggest that you relocate furniture so you can move around at home more safely and easily, or they may recommend hand rails, stair lifts and items to help get in and out of bed.
Organising your medication so that you remember to take it on time and as prescribed can be difficult. An occupational therapist will be able to suggest timers, organisers or reminders to help you.
Movement difficulties: if you have movement difficulties, both an occupational therapist and a physiotherapist can suggest helpful strategies. Which therapist you are referred to will depend on where you live. Difficulties include problems in starting to walk (start hesitation), the feet suddenly stopping as if stuck to the ground (freezing), and balance problems which can lead to falls.
Communication: there are numerous gadgets to help with communication, for example telephones with large buttons, specially adapted computer keyboard and mouse, voice amplifiers and pen grips to assist with writing.
Tiredness and emotional problems: if you are finding tasks more difficult to perform, you may also get more tired. This can lead to emotional problems such as lower mood and distress. An occupational therapist will therefore look at your daily routine, helping you to prioritise the most important tasks as well as plan and pace yourself. He or she will also be able to suggest ways to help you relax and revitalise yourself.
Coping strategies: an occupational therapist will be able to suggest coping strategies in order to overcome everyday difficulties you encounter, for example with movement, communication, fatigue and emotional problems. By discussing difficulties with your therapist they will be able to suggest different things you can try to make life easier and so improve your quality of life.
Occupational therapy and carers
Occupational therapists can advise your carer and family how to help you stay independent. They can also advise on ways to look after their own health.
It is important that your family and carers are also involved in, and understand, any changes the occupational therapist recommends to your usual routines. Getting help and advice from an experienced therapist can reduce the amount of help you need from your family or carer and so alleviate any pressure they may feel.
You may meet your occupational therapist in a variety of places, including in your own home, a hospital, a Parkinson's clinic, a rehabilitation unit, an outpatient clinic, or in a residential or nursing home. In some countries it is possible to meet an occupational therapist at a Parkinson's support association office.
Appointments usually last between 30 and 60 minutes, and therapists may recommend a short course of occupational therapy – usually once a week, for a month or two.
At the first appointment, an occupational therapist will ask about your daily activities, in particular how you look after yourself, your work and your leisure interests. For example you may have problems preparing meals, dressing, shopping, walking in crowded places, doing a leisure activity, using a computer, or reading.
Collaboration is essential to successful treatment therefore you need to tell your occupational therapist about your situation, how you cope on a daily basis and problems you experience. Then together you will be able to discuss goals for both you and your family and how you achieve them.
Referral procedures depend on where you live and treatment may or may not be accessible through your country’s national health system.
In some countries occupational therapy is prescribed by medical doctors but in others people with Parkinson’s can contact an occupational therapist direct without going through their doctor.
Training and accreditation varies throughout Europe so it is best to check the experience of anyone you consult. It is helpful to be seen by someone who has experience of Parkinson’s, and always ask for references and the likely costs before treatment commences.
Best Practice Guidelines are available online for occupational therapists working with people who have Parkinson’s.
Your national Parkinson’s organisation may be able to provide information based on members’ experiences. See also, Other Parkinson’s organisations.