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What is Occupational Therapy?
Occupational therapy is a health profession that employs a wide range of interventions to empower clients to overcome barriers and do the activities that they find meaningful.
Occupational therapy is a vibrant and valued component of Ontario’s healthcare system. Approximately 6,000 occupational therapists (OTs) work in Ontario where they provide direct services, education, consultation, research activity, sales, or administrative services. Occupational therapists work in a variety of settings across Ontario’s health care system.
Occupational Therapists Make the Everyday Possible
Older adults can experience major life transitions that impact their everyday lives. They may need to adapt to changes including retirement from paid employment, changes in residence, and loss of friends and loved ones. Each of these transitions and the corresponding circumstances under which they occur are unique. These events are considered significant because of the profound changes they can present to roles, routines, responsibilities, relationships, and, ultimately, sense of self.
Transitions at this later life stage often come when older adults may also be coping with other health and/or social difficulties. Without adequate preparation and coping abilities, there may be serious consequences on mental health including social isolation, depression, apathy, addiction, increased rates of morbidity and mortality, and even suicide. Supporting older adults through these transitions can help them to overcome challenges and enable them to live more full and functional lives.
Occupational therapists incorporate clients’ goals with evidence-based processes to enhance participation in valued and meaningful activities. This holistic approach is particularly useful in the areas of wellness, health promotion, and prevention.
OTs work with people to identify and address difficulties with everyday activities.
Together, clients and occupational therapists find solutions to enable active participation in life.
Caregiving
“The stress of suddenly becoming a caregiver yet still being a loving wife was overwhelming.”
Occupational therapy can help!
Spirituality
Spirituality is of considerable importance for seniors’ physical wellness and quality of life.
Occupational therapy can help!
Social Isolation
“Of all the things in life, I was least prepared to deal with the loss of friends and family. In the past year alone, seven friends have passed away.”
Occupational therapy can help!
Ageing in Place
Over 85% of seniors would prefer to “age in place” in their homes and communities, however many homes and communities lack the structural features and support services to make this a safe, realistic option (Lantz & Fenn 2017).
Occupational therapy can help!
Older Workers
An increasing number of older Canadians have remained in, or returned to, the labour force in recent decades (Statistics Canada, 2019). These seniors face unique challenges in the workplace.
Occupational therapy can help!
Senior Citizenship
“After the death of my husband, I started to look for means to stay occupied. I want to make a lasting positive impact, but I am worried about continuing this work as I get older.”
Occupational therapy can help!
Chronic Illness and Disability
Many people over 50 years of age are living with multiple chronic conditions.
Occupational therapy can help!
End of Life
People want to die pain-free, with dignity, and at home (Arnup, 2018)
Occupational therapy can help!
Driving
“One day, I decided to take my car for a ride. It took me a half-hour just to back up and park. It was one of the scariest experiences in my life. It made me question whether I should be driving altogether.”
Occupational therapy can help!
Retirement
“After retirement, I am struggling to find a reason to get out of bed and use the things I’ve learned. ”
Occupational therapy can help!
Return on Investment in Occupational Therapy
Occupational therapy interventions are cost-effective and clinically proven to contribute to positive health and well-being outcomes.
Occupational therapy is the only spending category where additional spending has a statistically significant association with lower admission rates for heart failure, pneumonia, and acute myocardial infarction (Rogers et al., 2016). As occupational therapists focus on a person’s functional and social needs, they are uniquely situated to prevent readmissions. The study suggests that investing more money in occupational therapy has the potential to considerably improve both care quality and client outcomes.
Additionally, occupational therapy interventions have the potential to postpone entry into residential care, saving up to $48,000 per year per person (Laing & Buisson, 2008).
Who pays for occupational therapy services?
In Ontario, occupational therapy services are covered, in whole or in part, by both public and private health care systems.
Ontario Health Insurance Plan (OHIP)
OHIP covers occupational therapy when provided through:
- hospitals and rehabilitation centres,
- Family Health Teams,
- Assertive Community Treatment Teams,
- Community Health Centres,
- Home and Community Care Programs that provide access to OT for eligible clients in their homes, schools, or long-term care facilities.
Automobile insurance
- In Ontario, people hurt in motor vehicle accidents may access occupational therapy funded by auto insurance policies.
Extended health insurance
- Some extended health insurance plans pay for occupational therapy, usually up to a maximum amount.
Workplace Safety and Insurance Board
- Workers injured on the job or impacted by a work-related illness may be covered for occupational therapy.
Veteran Affairs Canada
- Canadians who have served in the Canadian Forces, navy, army, or air force may be eligible for funding of occupational therapy.
Fee for Service
- Clients may choose to pay out of pocket for occupational therapy not covered by a public or private plan.
Gaps in Access Require Political Attention
Occupational therapists’ work can support the health system by both minimizing care support needs and preventing hospital readmissions. However, investment in therapy services including occupational therapy falls short of the resources needed to meet the needs of Ontarians.
Although the number of occupational therapists is increasing, demand for services largely outweighs availability. While waitlists increase, job security for occupational therapists in the community falters, sending many into more stable jobs that do not allow them to use their broad scope of knowledge. The growing number of rehabilitation providers is not matched with overall population growth, and occupational therapy students are unable to consistently find placements as providers are too busy. This may mean fewer occupational therapists to meet the needs of people in their communities, leading to greater strain on hospitals.
Even when rehabilitation services are available, strict eligibility requirements mean that not everyone in need is able to access the services they need.
Most occupational therapy services are not universally accessible because of unequal access and the lack of coverage in many extended health benefits plans.
- Those without the means to pay for rehabilitation services, including seniors or Canadians with chronic illnesses, often face excessive wait times for any publicly funded rehabilitation or go without essential treatment. This has the potential to create a greater burden on the health care system further along the continuum of care, or may lead to increased dependence on pharmaceutical interventions which may not necessarily address the individual’s primary need.
- Doctors and other health professionals may not refer their patients to occupational therapy knowing that there may be financial implications. According to the 2013 National Physicians Survey by the College of Family Physicians, Canadian Medical Association and the Royal College of Physicians and Surgeons, 70% of physicians were unhappy about their difficulties in securing publicly funded occupational therapists for their patients.
- In rural areas, the lack of services may converge with stigma and discrimination to create situations where people with episodic disabilities have complex needs and few health supports.