Occupational Therapy Month: An Expert’s Advocacy Guide for OTs
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“Our focus in OT is how do I help you be independent and how do I help you achieve the goals you want to achieve, be the best you can be, live the life you want to live and have the best quality of life possible. There are so many different things that can figure into that. There are so many different ways we can have an impact.”
Dr. Michael Roberts, Program Director of Regis College’s Occupational Therapy Master’s Degree Program
During the month of April, the U.S. medical community celebrates Occupational Therapy (OT) Month to honor the more than 213,000 occupational therapists, occupational therapy assistants, and students who work to improve the lives of their clients and families.
This year, there is cause for an even bigger celebration of the profession. During the time of the coronavirus, OTs have proven themselves to be an essential part of the rehabilitation process for the many individuals whose lives have been disrupted by the pandemic.
We talked to an expert in the field to learn about how OTs’ skills have benefited Covid-19 patients and get an insider’s perspective on the future of the profession.
Meet the Expert: Dr. Michael Roberts
Dr. Michael Roberts is the program director of Regis College’s Occupational Therapy Master’s Degree Program and the host of the I Love OT Podcast. He graduated from the occupational therapy program at Tufts University in 1994. Since then, he’s worked in short-term rehab, long-term acute care hospitals, inpatient rehab, hospitals, and home care.
Over the years, he has also taught at the University of New England, Lasell College, and held the position of academic fieldwork coordinator at his alma mater from 2008 to 2015. He left that role to start the OT program at Regis College and has been the founding director ever since.
Dr. Roberts’ current research is focused on outcomes in fieldwork performance and the practice of academic fieldwork coordination. His past research was focused on the use of next-generation gaming consoles (Nintendo Wii) for health and wellness purposes.
Occupational Therapists’ Role During the Pandemic
OTs treat patients of all ages that suffer from injuries, illnesses, or disabilities to help them regain the physical and mental skills needed for daily life, whether that is in a school environment, workplace, at home, and even when it comes to play and leisure.
“Our focus in OT is how do I help you be independent and how do I help you achieve the goals you want to achieve, be the best you can be, live the life you want to live, and have the best quality of life possible,” Dr. Roberts said. “There are so many different things that can figure into that. There are so many different ways we can have an impact.”
Patients that have been bed-ridden for multiple weeks or months—such as particularly severe cases of Covid-19—are also candidates for OT care. Many of them suffer a loss of strength, coordination, mobility, and independence. In these situations, OTs have proven to be a beneficial part of the recovery process, helping clients regain their independence and reinstate their daily routines.
“We’re seeing how dangerous it is acutely, but we’re just learning what it means to be a long haul survivor of Covid and what the possible cognitive limitations and physical limitations are,” Dr. Roberts said. “There are so many different ways that it’s affecting people in the long term.”
OTs are trained to help patients who have just suffered from short-term acute conditions, such as heart attacks, organ transplants, or broken bones, but also work with patients for the long haul to help them regain their strength and prevent further damage, which is why OTs can help support all types of individuals affected by the Covid-19 at every stage of their recovery journey, the Royal College of Occupational Therapy said.
Beyond the physical aspects of rehabilitation, recovering coronavirus patients can also be troubled with sleeping difficulties, anxiety, and depression six months after their initial recovery, according to a study conducted on survivors of Covid-19.
OTs may also help clients suffering from the mental aspects of recovery by recommending clients utilize familiar activities as coping mechanisms, such as listening to music, playing cards, writing, doodling, cooking, or cleaning.
“We have a very holistic approach. We do everything from physical to psychosocial to social participation and everything in between. So we are uniquely qualified to help,” Dr. Roberts said.
A New Era for Occupational Therapy: Medicare Home Health Therapy
Thanks to Covid-19, the profession has seen a long-overdue change finally fulfilled. In April 2020, during the onset of the pandemic, OTs were permitted to open Medicare home health cases on a temporary basis, when the Centers for Medicare & Medicaid Services (CMS) issued an emergency rule to reduce regulatory burdens for home health providers.
Then, on December 27, 2020 the “Consolidated Appropriations and Coronavirus Relief Act” was signed into law. The bill included numerous statutory provisions that directly affect healthcare providers, including a hard-fought victory for occupational therapy, following extensive advocacy from various OT organizations, such as the American Occupational Therapy Association (AOTA).
The main takeaway? It will enable them to open Medicare home health therapy cases—an action that in the past, has not been available for OTs.
“Passage of this legislation is a recognition of occupational therapy’s essential role in home health, including identifying home safety issues and establishing routines to maximize a client’s ability to follow his or her plan of care,” the AOTA wrote.
“You know how vampires can’t just come into your house—they have to be invited in? Well, we were the vampires of home care, essentially,” Dr. Roberts explained.
“We couldn’t come into the house unless we’re invited in by someone else. So a doctor can say, this client needs to go home and needs OTPT, speech, nursing, and social work, and a home health aid, but we [OTs] couldn’t be the first ones in the door.”
“So, this is going to just make it that much easier because it’s going to expand the number of visits and the number of times we can actually be in the room with our clients. We can get in earlier and we can have more input into the direction of the whole program.”
Dr. Roberts also thinks that this change will help facilitate growth in the profession.
A Rising Demand for OTs
For a number of years in the early 2000s, demand for OTs plateaued. The Balanced Budget Act (BBA) of 1997 had caused a decline in job availability. Skilled nursing facilities and home health agencies began laying off employees left and right. Simultaneously, there was a dramatic decrease in student enrollments seen by many occupational therapy and occupational therapy assistant programs in the years following.
While the Covid-19 pandemic has caused a temporary boost in demand for OTs, outside of the health crisis, experts expect that demand will continue to rise. In fact, in the 10-year period between 2019 and 2029, the Bureau of Labor Statistics anticipates that the need for OTs will grow by 16 percent—which is much faster than the average projected rate for all occupations in the same decade (4 percent).
So where is this sudden increase in demand coming from?
The Aging Population
Much of the increase in the need for OTs has to do with the aging of the U.S. population of Baby Boomers. As people age, they increasingly want to stay in their own homes, as opposed to living in assisted living facilities or nursing homes.
“As the Boomers get into their 70s and as a greater proportion of the population is over 65, many of whom have already have chronic diseases or chronic diagnoses like diabetes or arthritis or chronic obstructive pulmonary disease or heart disease, those people are going to have more needs in the long term,” Dr. Roberts said.
“So they’re going to be in the community longer, potentially with limitations. And so this aging of our population is going to mean that there are more people with needs that can be addressed through occupational therapy.”
“And I think there’s also a greater emphasis on aging in place. So between telehealth and adaptive equipment and accessibility changes and more resources in the community, more people are able to live longer at home.”
While the aging population is definitely a significant factor, it’s not the only cause.
A Profession Gaining Recognition
Demand for OTs is also up in hospitals due to increased recognition of the role that occupational therapy has in lowering readmission rates.
A 2016 study by Johns Hopkins University researchers found that “occupational therapy was the only spending category that had a statistically significant impact on hospital readmissions” for heart failure, pneumonia and acute myocardial infarction.
“The findings of this important study highlight just one of the many roles occupational therapy practitioners are playing in improving quality and reducing healthcare costs,” said Frederick P. Somers, CEO of the AOTA. “Occupational therapy practitioners are proving to be an essential member of any interprofessional team successfully addressing the changing demands of the healthcare delivery system.”
The Increasing Needs of Youth
As services for students with disabilities expand and the number of children diagnosed with autism spectrum disorders grows, parents are learning more about their children’s rights. As a result, the need for occupational therapy in school systems is likely to increase, according to the AOTA.
“I think there is a greater focus on needs and the required resources for the community of families where someone in the family is on the autism spectrum,” Dr. Roberts added. “As we continue to highlight the needs of that population, and we’ve broadened our understanding of the impact of that diagnosis, especially in school systems. That will help our focus on the quality of life, social participation, and independence function.”
To address the growing need for OTs, master’s degree programs like that at Regis College, which was accredited in 2018 and where Dr. Roberts is the founding director, are beginning to pop up.
“Feel free to go on Monster or Indeed and just check for OT programs in your area. You’re going to see how many OT job listings are up. There are a lot of jobs out there and starting salaries are good, so you can borrow money for school and not worry that you’re never going to use the degree again, or saddle yourself with so much debt and never be able to make it back. The job market is strong enough and salaries are strong enough that it’s a good investment in yourself,” Dr. Roberts said.
Resources for Current & Aspiring Occupational Therapists
If you are interested in a career in Occupational Therapy, the following organizations and links are a great place to start your research and become informed about the current happenings in the field.
- World Federation of Occupational Therapy (WFOT) is the global voice for OT and sets the standard for its practice. Its online resources include manuals and guidelines, policies, online modules, and a wealth of other useful publications for OTs. You can also become a member of WFOT on a student basis.
- The American Occupational Therapy Association (AOTA) advances occupational therapy practice, education, and research through standard-setting and advocacy. You can become a member to take advantage of the organization’s networking opportunities.
- The OT Toolbox provides free activities, resources, and tools for pediatric occupational therapy interventions, as well as handouts, worksheets, and educational materials to support occupational therapy for children.
- Check out Dr. Robert’s podcast, I Love OT, which celebrates what is special, exciting, unique, and rewarding about OT with monthly episodes.
- Also, check out Dr. Roberts’ favorite OT podcasts, which include: OT 4 Lyfe, Occupied, OT & Chill, OT Schoolhouse, Seniors Flourish, OT Uncorked, OT After Dark