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  • Jen Brueton

Occupational Therapy in the time of COVID

Updated: Feb 10




The COVID-19 pandemic has had a profound impact on the lives, health and wellbeing of individuals, families and communities worldwide.


This is evident in the way people access and undertake their occupations as a result of the pandemic. These include: accessing resources, activities of daily living, communication, mobility, social isolation, displacement, mental health and wellbeing. Occupational therapists understand the vital need to access and use infection control measures combined with the need to sustain good psychological, mental health and stamina in order to stay safe and healthy.


Occupational therapists fill a vital role in working with people affected by COVID-19 to develop strategies to facilitate continued access to their occupations which include individual, family, community, social and environmental adaptation, mental health, assistive technology and telehealth.


In the acute setting, Occupational Therapists are a valuable part of the multidisciplinary team involved in treating people with severe symptoms of COVID-19 infection in ICU or High Care. The following areas of intervention are considered depending upon individual needs and the severity of each client.

• Positioning for maximizing respiratory functioning

• Bed Mobility

• Pulmonary rehab

• Early Mobilization

• Communication management to increase social participation, especially if they are ventilated

• Promote family engagement with the use of technology to connect people using social media like WhatsApp, Skype, Mobile etc

• *Cognition training and re-orientation (prevention of delirium)

• Sensory stimulation

• Energy conservation

• Mental wellness (decreasing anxiety and depression symptoms, counselling and education)

*40% of people with severe COVID-19 experience neurological complications including confusion, delirium, higher risk of stroke, other brain-related complications a new study from Wuhan, China published in JAMA Neurology has suggested.



Occupational Therapy has shown to improve patient outcomes by providing meaningful and task-orientated participation in daily activities while on the ward (getting dressed, showering, toileting, communication with family members, functional mobility), improving general strength and endurance to facilitate active participation in basic activities of daily living and assisting the client in overcoming emotional difficulties through the use of counselling, education, relaxation and mindfulness techniques. We know that clients who have been severely affected by COVID-19 and spent time on a ventilator will present with significantly reduced muscle strength and poor exercise tolerance as a result. This can continue long after the client has tested negative, also known as Long Covid, and the client has returned home which makes reintegrating back into the family and work spheres more difficult.


According to the WHO, most people with COVID-19 experience mild symptoms or moderate illness.

• Approximately 10-15% of cases progress to severe disease, and about 5% become

critically ill.

• Typically people recover from COVID-19 after 2 to 6 weeks.

• For some people, some symptoms may linger or recur for weeks or months following

initial recovery. This can also happen in people with mild disease. People are not

infectious to others during this time.

• Some patients develop medical complications that may have lasting health effects to their body systems and organs.

• Heart

 Damage to heart muscle, heart failure

• Lungs

 Damage to lung tissue and restrictive lung failure

• Brain and the nervous system

 Loss of sense of smell (anosmia)

 Consequences of thromboembolic events such as

pulmonary embolism, heart attack, stroke

 Cognitive impairment (e.g. memory and

concentration)

• Mental health

 Anxiety, depression, post-traumatic stress disorder

and sleep disturbance

• Musculoskeletal and others

 Pain in joints and muscles

 Fatigue


Occupational therapists can provide therapeutic and rehabilitation to people suffering from longer-term effects of Covid once they have been discharged from hospital to improve their independence and functioning in their daily occupations either at an outpatient rehab centre or at home.


To find an Occupational Therapist to assist you or a loved affected by Covid click here https://membership.instopp.co.za/public/Index#/ or get in touch with us.


References:

  1. https://www.who.int/docs/default-source/coronaviruse/risk-comms-updates/update-36-long-term-symptoms.pdf?sfvrsn=5d3789a6_2

  2. https://www.wfot.org/assets/resources/occupational-therpy-intervention-in-COVID19_Final.pdf

  3. https://www.wfot.org/about/public-statement-occupational-therapy-response-to-the-covid-19-pandemic


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