Cardiovascular Disease and Occupational Therapy
Cardiovascular disease (CVD) can have a major impact on an individual's quality of life, as it can lead to discomfort or chronic pain, limitations in activities, disability and unemployment (CAOT, 2014). CVD requires lifestyle changes to prevent progression of the disease, further cardiac events and activity restrictions (CAOT, 2014).
Occupational Therapy Role
The role of an occupational therapist varies within different settings, especially working with persons at risk for or suffering from CVD. Along with other interdisciplinary team members, OTs help persons affected by CVD to determine what activities can be performed safely, and how to modify activities to decrease the amount of energy required to maximize activity results when exercise capacity is limited (CAOT, 2014).
Persons with CVD are often seen at acute care institutions in Canada, when individuals are at the point of requiring surgery, such as coronary artery bypass grafts (CABG) or pacemaker insertion. Due to the nature of the current healthcare system, OT interventions generally occur post-surgery, and involve assessment/ evaluation and recommendations for discharge planning (assess for safety and OT follow up at home).
Different programs may be offered by different members of the interdisciplinary health care team, depending on the human and financial resources that exist. The team may be composed of occupational therapists, physiotherapists, vocational rehabilitation therapists, advanced practitioner nurses, speech language pathologists, dietitians, social workers, and more.
Ultimately, the role of the occupational therapist in any setting focuses on restoring and enabling clients' function and independence in meaningful activities within their environment.
Enabling occupation: the process of facilitating, guiding, coaching, educating, prompting, listening, reflecting, encouraging, or otherwise collaborating with people so that they may choose, organize, and perform those tasks and activities of everyday life which they find useful and meaningful in their environment (CAOT, 1997).
Opportunities for OT Interventions
There are a variety of possible OT interventions that may be implemented with clients who have cardiovascular issues, such as those listed below. Greater detail regarding some of the interventions is provided within the website as well.
Occupational Therapy Role
The role of an occupational therapist varies within different settings, especially working with persons at risk for or suffering from CVD. Along with other interdisciplinary team members, OTs help persons affected by CVD to determine what activities can be performed safely, and how to modify activities to decrease the amount of energy required to maximize activity results when exercise capacity is limited (CAOT, 2014).
Persons with CVD are often seen at acute care institutions in Canada, when individuals are at the point of requiring surgery, such as coronary artery bypass grafts (CABG) or pacemaker insertion. Due to the nature of the current healthcare system, OT interventions generally occur post-surgery, and involve assessment/ evaluation and recommendations for discharge planning (assess for safety and OT follow up at home).
Different programs may be offered by different members of the interdisciplinary health care team, depending on the human and financial resources that exist. The team may be composed of occupational therapists, physiotherapists, vocational rehabilitation therapists, advanced practitioner nurses, speech language pathologists, dietitians, social workers, and more.
Ultimately, the role of the occupational therapist in any setting focuses on restoring and enabling clients' function and independence in meaningful activities within their environment.
Enabling occupation: the process of facilitating, guiding, coaching, educating, prompting, listening, reflecting, encouraging, or otherwise collaborating with people so that they may choose, organize, and perform those tasks and activities of everyday life which they find useful and meaningful in their environment (CAOT, 1997).
Opportunities for OT Interventions
There are a variety of possible OT interventions that may be implemented with clients who have cardiovascular issues, such as those listed below. Greater detail regarding some of the interventions is provided within the website as well.
- Cognitive assessment and treatment for safety in completion of activities of daily living (ADLs) and instrumental activities of daily living (I-ADLs) at home and in the community
- Physical assessment and treatment for safety in completion of ADLs and IADLs at home and in the community (e.g. transfers)
- Stress management
- Cardiovascular rehabilitation
- Energy conservation education (pacing, scheduling)
- Smoking cessation
- Discharge planning, including home safety, patient placement needs and caregiver education,
- Provision of seating and positioning equipment, as well as equipment for pressure relief/ positioning
- Upper extremity assessment and exercise programs to assist in regaining strength and independence post-surgery
- Provision of adaptive aids (e.g. feeding tools, reachers, etc.)
- Improve range of motion, strength, coordination and mobility
OT Intervention Strategies
The Canadian Association of Occupational Therapists (CAOT) suggests the following OT strategies regarding CVD interventions: (CAOT, 2014)
1. Body mechanics: Use smooth, rhythmic and repetitive motions, which are easier on your heart. Being mindful of regular breathing, avoid overexertion when lifting heavy objects, and slide objects or use a cart if available. Some tasks can be completed sitting to save energy, such as folding laundry or meal preparation. Frequently changing positions activates different muscles, increases circulation and prevents fatigue (CAOT, 2014).
2. Simplify tasks: Breakdown activities into small steps, taking frequent small breaks throughout (versus fewer long rest periods). Adjust work heights and areas to fit you and your needs (i.e., place frequently used items between waist and chest heights The most frequently used items should be located between waist and chest heights, and avoid working with arms above shoulder level.
3. Get fit!: Follow a regular cardiovascular exercise program as approved by your physician. Be creative (i.e., get off one bus stop early and walk), and do activities you enjoy (i.e., join an exercise class with a friend).
4. Recognize emotions: Be aware of things that causes stressful, heart-rate increasing emotions (e.g. anger, anxiety, and frustration), how you handle these events, and strategies to alleviate stressors, such as prioritizing and scheduling. Being well-rested and eating healthy, along with working off tension appropriately are also important factors.
Lifestyle
An OT can assist in goal setting and making necessary lifestyle changes to create a healthy balance between work, home and leisure roles.
It is important to reflect on what activities and which occupations (work, self-care, rest/sleep and leisure) are important for NOW?
i.e., what is good, real, beautiful, special, and WHY?
THEN it becomes possible to recognize what is important and help to:
- Re-balance work, self-care, rest and sleep, and leisure domains of activities.
- Some usual activities will not seem that important anymore.
- Some others were never important and now became first priority. (CAOT, 2014)
References
CAOT (2014). How does occupational therapy help? Retrieved from http://www.caot.ca/default.asp?pageid=3703