As Occupational Therapists
we are often asked is it ‘safe’ for an older person to return home from
hospital; what are the ‘risks’? Generally, this is referring to physical safety
risks- will the person fall? Is there a steep stair-case with no rails? Might
they set the kitchen on fire by forgetting a pan left on?
There is always a push to
get patients home and free up beds, and of course hospital is not a good place
for an older person to be. There is not the luxury of unlimited time to spend
following up on someone who has recently got home from hospital. All these
factors can mean that in planning for an older person’s return home, the
emphasis on ‘safety’ means requiring them to not engage in certain occupations or use certain parts of
their home, to become dependent instead of independent. There is a balance to
be struck, and sometimes the person feels it is time to let go of previous
occupations themselves, but there is a danger of discouraging valued
occupations that contribute to an individual’s sense of self-efficacy and
well-being.
In my J post, I looked at a
paper by Jackson (in Zemke & Clark 1996- see books tab at top of page)
called “Living a Meaningful Existence in Old Age’. One of the factors that she
identified as contributing to a meaningful life was the chance to take ‘risks’.
This did not mean doing dangerous or foolhardy things, but that people still
wanted the opportunity to try new things, to learn new skills, to succeed or
fail, to experience new things, to have challenge and excitement. It could also
mean choosing to continue to engage in an activity that is personally
meaningful. When an individual becomes disabled, they are often deprived of
these opportunities.
As OTs our job is to enable
individuals to participate in their chosen occupations as safely as possible,
not to stop them! I’d be very interested to hear people’s thoughts on this.
