OT services

Occupational Therapy Services in Malta

Definition of Occupational Therapy (W.F.O.T. 2004)

Occupational therapy is a profession concerned with promoting health and well being through occupation. The primary goal of occupational therapy is to enable people to participate in the activities of everyday life. Occupational therapists achieve this outcome by enabling people to do things that will enhance their ability to participate or by modifying the environment to better support participation.

Occupational therapists have a broad education that equips them with skills and knowledge to work collaboratively with individuals or groups of people who have an impairment of body structure or function due to a health condition, and who experience barriers to participation.

Occupational therapists believe that participation can be supported or restricted by physical, social attitudinal and legislative environments. Therefore, occupational therapy practice may be directed to changing aspects of the environment to enhance participation.

Occupational therapy is practiced in a wide range of settings, including hospitals, health centres, homes, workplaces, schools, reform institutions and housing for seniors. Clients are actively involved in the therapeutic process, and outcomes of occupational therapy are diverse, client-driven and measured in terms of participation or satisfaction derived from participation.

Definizzjoni bil-Malti (M.A.O.T. 2005)

L- “Occupational Therapy” hija professjoni paramedika li toffri rjabilitazzjoni lill-persuni b'dizabilita' fizika u/jew mentali ta’ kull eta'. L-ghan ewlieni huwa li dawn il-persuni jergghu isiru indipendenti kemm jista’ jkun sabiex jergaw jintegraw fis-socjeta’. Dan jista' jintlahaq permezz ta' tahrig fl-attivitajiet ta' kuljum. Dan jinkludi tahrig fl-attivitajiet personali sabiex il-persuna tkun tista' tiehu hsieb taghha nnifisha billi tkun kapaci tinhasel, tilbes u tiekol. L-individwu jinghata’ tahrig ukoll sabiex ikun kapaci jippartecipa f’ attivitajiet domestici li jinkludu t-tindif tad-dar, hasil tal-hwejjeg, tisjir u manutenzjoni bazika tad-dar. F’ certu okkazzjonijiet ikun hemm bzonn ta’ pariri u uzu ta’ apparat specjali biex il-persuna tilhaq dan l-ghan. Isir ukoll tahrig specifiku sabiex il-persuna tkun kapaci tissocjalizza ma l-ohrajn.

Attivitajiet ohra li jinghataw attenzjoni jinkludu kif il-persuna tqatta’ il-hin liberu taghha, kif ukoll biex terga’ tintegra ruha fil-dinja tax-xoghol. L-“Occupational Therapist” tahdem kemm fl-isptarijiet, kif ukoll fil-komunita’.

Sabiex jilhaq l-ghan imsemmi l-“Occupational Therapist” tfassal programm ta' tahrig fuq bazi individwali. Fejn jehtieg, il-familja ta’ l-individu jinghataw tahrig ta’ kif ghandhom jiehdu hsieb il-pazjent u jkomplu il-programm terapewtiku. Fejn ikun hemm bzonn, jinghataw rekommandazzjonijiet sabiex issir il-bidliet necessarji fl-ambjent fejn tghix il-persuna koncernata.

In a Long-Term Residential Care

St. Vincent de Paul Residence (SVPR) is a long term care facility for older persons who cannot continue to live unassisted in their homes. The mission statement at SVPR is to promote and improve the quality of life of the elderly through various activities thus adding life to years not years to life. Residents are encouraged to participate in therapeutic activities organised as part of the occupational therapy treatment. These activities aim to maintain a physical, cognitive, social and spiritual well being. Diversional activities such as cane, woodwork, knitting, rug work and various other hand crafts. Most importantly activities that are meaningful to the residents are carried out at the occupational therapy department by a number of technical aids. Occupational Therapists assess all older persons admitted at SVPR to identify any areas where rehabilitation is required and retrain residents to continue or improve their level of performance in personal activities of daily living such as self-care. Moreover, occupational therapists apart from working with residents in the wards also carry out treatment sessions on an outpatient basis to prevent unnecessary institutionalization. Community services include home visits, governmental homes for the Elderly, lectures to groups of older persons at Day Centres and parish groups. Furthermore, the occupational therapy department also extends its services to the Housing Authority by carrying out a number of home visits as part of the Scheme 7.

Above: Woodwork activity Below: Cane activity	Above: Rug Work Below: Knitting

In Geriatric Rehabilitation

The occupational therapist's primary objective is to achieve the client's maximal independence in daily living tasks using various techniques to overcome difficulties. Some equipment such as long-handled aids, grooming aids and toileting equipment are recommended to maximize function. Clothing adaptations may also be advised.

Above: Pre-dressing skills includes buttoning, lacing etc	Above: Lacing shoes from a sitting position.	Above: Grooming - Shaving in front of a mirror despite being a wheelchair user.
Leisure activities by the occupational therapists are used as a therapeutic medium or as a form of creative therapy whereby the individual can express him/herself in various ways and means. Leisure activities may be carried out individually or within a group setting. Group therapy encourages the client to socialise and share experiences.

Above: Individual cane session	Above: Pottery session within a group	Above: Gardening session
Whether in a hospital setting or in your own home, the occupational therapists can advise you about different ways and techniques to manage various domestic tasks. These may include cooking, cleaning the house, washing of clothes, and ironing. In some Geriatric Departments, the occupational therapists carries out an instrumental home visit following discharge. This is done to encourage integration within the community, help the older person to adjust to his environment, practice activities of daily living tasks, assess/retrain in the use of equipment, give advice regard environmental structuring and to monitor the patient at risk.

Above: Domestic session in the Occupational Therapy kitchen.	Above: Client is washing plates in standing position during an OT session to improve standing tolerance.	Above: Client is being taught how to iron clothes again in a standing position.

Above: Client is being taught how to hang her clothes from a wheelchair.	Above: Client is practicing how to get in and out of the bath using a bath board.	Above: Client is being encouraged to do her bed during an instrumental home visit.
The occupational therapists can also help you improve your writing skills and abilities as well as your cognitive and perceptual difficulties through an individual programme. These can be performed individual or group sessions. Special groups are also organised in some rehabilitation facilities to cater for the needs of patients with specific needs e.g. dementia, Parkinson's Disease, stroke, arthritis, etc. The aim is to educate and retrain a group of patients and their carers having the same diagnosis. Here sessions may include providing information about the disease/ condition, practical ways of managing the older person, provision of handouts/ leaflets, sharing of experiences and providing support.

Above: Writing skills are being encouraged during OT treatment session.	Above: Treading and matching of beads will improve cognitive/ perceptual abilities and fine motor skills.	Above: Group activity is being conducted by an OT aide to stimulate and improve mental abilities.
The occupational therapist also aims at advising you on the best possible equipment available on the market which will make your life and home environment safer and friendly to your needs. Recommendations during a home visit might include alterations to improve access, structural home alterations, practical changes in the home layout, furniture adaptations, safety advice, bathroom/ kitchen equipment and personal devices.	The occupational therapist treats each individual holistically. Attention is also given to the relatives/carers. Family training sessions (F.T.S.) are organised by a team in preparation for discharge. Training and advice on handling, positioning and use of equipment is also provided. ADL techniques, safety and environmental issues, stress management and care of the carers are other areas incorporated during sessions.	The occupational therapists works within a multi-disciplinary team.

Above: Advice is being given by the occupational therapist on seating equipment.	Above: Picture taken during a F.T.S. showing the client, his family members and the team.	Above: Picture taken during one of the Ward Conferences of St. Mary's Ward at Zammit Clapp Hospital.