Introduction
Occupational therapy is one of healthcare’s most significant therapeutic interventions, especially for individuals with physical, cognitive, or sensory problems. Occupational therapists mainly provide activities or occupations that improve the physical and mental health of patients with serious psychic problems. Occupational therapists play a critical role in the healthcare system as they meet with patients and create treatment intervention plans. Such plans include initiating therapeutic processes to improve patients’ ability to perform basic activities that are important in everyday life (Reitzz and Scaffa, 2020). The intervention selected for a particular patient is based on the evaluation of their condition. The therapy choice aims to enable the patient to meet identified specific needs and consider individual characteristics. In addition, the assessment also includes their home and work environment to ensure that the intervention selected and recommended can improve the patient’s independence and ability to meet their needs. This factor distinguishes the area of responsibility of this kind of specialist. Occupational therapists utilize numerous interventions for different patients since they recommend different habits (Kaelin et al., 2019). Environmental adaptation is among the most useful interventions as it enables patients to reduce the barriers in their homes or workplaces that hinder them from living independently.
Occupational Therapy Background Information
Choosing a therapeutic intervention is one of the occupational therapists’ most technical aspects when developing a therapeutic plan. Occupational therapists always pre-assess the patient’s condition for the main determinants that negatively affect health (McGuire et al., 2019). The ultimate goal of occupational therapists is to enhance patients’ well-being and ensure that the domain selected to undertake occupational therapy meets their needs (Amini and Furniss, 2018, p.7). Such domains ensure that the patient has the best conditions for recovery. Occupational therapy focuses on developing interventions to ensure patients develop the best skills and strategies to maintain a normal life. Occupational therapy focuses on five main domains which provide the best skills for patients with various needs. The domains range from occupations, performance patterns, skills, environmental context, and client factors (Read et al., 2020, p.649). The domain selection is based on the main needs and intentions of the patient and what they need to achieve after the therapy. In addition, the domain is selected to equip patients with critical skills that enable them to become resourceful and independent.
Why Do Occupational Therapists Use Environmental Adaptation
Environmental adaptation is the only intervention dealing with external factors hindering a patient’s recovery. The intervention involves manipulating the aspects of an environment that hinders an individual from effectively undertaking routine activities. Occupational therapists mostly focus on developing physical skills that enable patients to undertake daily activities (Boop et al., 2020, p.12; Gray, 2018, p. 16). These interventions involve continuous engagement exercises that make the patient become operationally fit. Occupation interventions involve bathing, dressing, and toileting and where the patient is taught how to undertake routine activities independently (Toledano-González et al., 2018, p. 1414; Chow and Pickens, 2020, p. 2). Performance patterns involve practicing developing habits that require reinforcements. These patterns mean that the activity introduced into the patient’s life is first repeated in interventions, and then becomes a ritual, role or habit that benefits health. Such interventions reinforce the development of life roles that enable the patient to live comfortably without having to depend on another. Performance skills include interventions to enhance the patient’s motor skills (Pentland et al., 2018, p. 14). This domain includes inflammatory and proprioceptive neuromuscular disorders that cause intense functional impairment and encourage the development of the affected body segments within the practice (Merz et al., 2020). Client factors are special interventions that enhance the patient’s dealing with unique conditions like mental, sensory, cardiovascular, and movement needs.
The most frequent places for patients to adapt are the home and workplace, where they spend most of their time. This type of therapy is aimed primarily at these locations since they are easier to work with, they have more familiar connections with the patient, and they themselves are often sources of problems (Rivard and Brown, 2019). Therefore, environmental adaptation is an occupational therapy intervention that enables patients to adapt to home or workplace environments. The intervention assists individuals with disabilities or any other form of health condition in being able to remain independently at home or to be able to work comfortably at work without causing more health issues (Wagman et al., 2020, p.17; Schell and Schell, 2018, p.125). The intervention may include activities like rearranging the objects in the patient’s home, removing them, and adding special equipment or adaptive tools. Such changes are based on the needs of the patients and the impacts that the objects have on the operations of the patient daily. Environmental adaptation depends on the patient’s health condition and how they perceive the objects in their surroundings (Morris and Jenkins, 2018, p. 393). The intervention focuses on altering the kind of information that the patient obtains when looking at objects within their surroundings or the physical objects that obstruct them from physical movement. In addition, the condition within the surrounding that may have negative impacts on the patient are also considered. Therefore, critical evaluation is important when adopting an environment for occupational therapy.
Occupational therapists use environmental adaptation for numerous reasons and for individuals with different health conditions. In most cases, the intervention is applied to individuals with physical impairments and patients with mental health conditions. The environment in which a patient stays, or works plays a critical role in how an individual recovers from a mental health condition (Gray, 2018, p. 17; Curtin and Egan, 2017, p.259). A specific environment may trigger numerous memories that may either enhance or affect the mental condition of a patient. Occupational therapists adopt a particular environment to enhance the patient’s mental well-being and to ensure that their condition is stabilized. Such environments may be modified to make the patient feel comfortable and relaxed when working or undertaking different routine activities, improving their performance (Clemson et al., 2019). Environments with maladaptive features are termed inhibitors of various mental conditions as they reinforce the chronicity of the condition, making it challenging for the patients to recover (Chow and Pickens, 2020, p. 3; Curtin and Egan, 2017, p.259). In this case, therapy is responsible for conducting thorough research to identify the main triggers of the mental condition. With such information, the therapist can adapt environmental aspects to make the patient recover effectively.
An ergo therapist can consider these concomitant factors that do not reflect the specialist’s direct functionality but contribute to the patient’s adaptation and recovery, for example, cool therapy. A cool environment is a great recovery tool for patients since it leads to developing conditions for a comfortable pastime with a beneficial effect on the body. A direct impact on the environment is possible through home visits and the introduction of other professional adaptations into the patient’s rituals that contribute to the restructuring of the established routine (Lockwood et al., 2020). This approach takes into account the subjective and individual goals of the patient, and professional modification as one of the intervention methods of the occupational therapist. As a rule, more individual approaches lead to better results since professional adaptation is still a point of contention among experts in the field of occupational therapy (Walder et al., 2021). In addition, methods of preventing and controlling the patient’s disease work much better during visits if the treatment is carried out mainly remotely.
How Occupational Therapists Use Environment Adaptation
Environmental adaptation is also applied to individuals with special needs to enable them to live comfortably at home. The intervention is flexible as it involves modifying the immediate environment to meet the needs of the patients. For example, adjusting the amount of lighting in a room by either dimming or brightening the lights to create a conducive environment for children with visual impairment or autism (Grandisson et al., 2020, p. 34). Such features are developed to ensure that the patients can undertake their routine activities without being affected by their surroundings. In addition, aspects like adjustable chairs can be used to enable children with physical disabilities to ensure that they can be able to sit well and undertake numerous physical activities that would enable them to interact freely with other students (Mayasich, O. and Tyce, 2019). For the physically disabled, the occupational therapist may opt to adjust the location of items that create a barrier to the individual or install objects like railings that enable them to navigate freely and comfortably (Derakhshanrad and Piven, 2020, p. 163; Nicholson et al., 2020). Environmental adaptation entails adjusting the physical and social aspects to accommodate the patient’s needs.
The intervention is also adopted for the aged since they have special needs. As individuals age, they tend to have numerous health issues, which span from reduced physical and cognitive abilities like movement, sight, hearing impairment, and memory loss, making them need special attention and care (Lin and Fisher, 2020, p 4; Schell and Schell, 2018, p.125). The elderly also opt to have a specific place where they would spend their last days, which needs to be made special to have a comfortable life as they age. Occupational therapists consider such needs and restructure their immediate environment to ensure they feel comfortable around the place (Micklewright and Farquhar, 2022, p. 4). For example, supplying the patient environment with useful devices that make brushing teeth easier or furniture that contributes to a more comfortable environment and the ability to relax in different parts of the room. Moreover, changing the environment that promotes better sleep is proven by research to be correlated with positive outcomes of therapy (Ho and Siu, 2018). Since the elderly have locomotive challenges, the therapist may reduce the physical objects in the house to provide more space for movement. The room should be furnished with the things the individual likes to ensure they have the best memories of their lives and prevent them from being stressed or depressed. The patient should also live close to their family members for company.
Research shows that these interventions have a positive impact on older people. First, although it is not always possible to achieve relief from fear and anxiety, the improvement in cognitive performance has been proven by many studies (Cuevas-Lara et al., 2019). Second, modest benefits are indicated physically, with a variety of interventions ranging from the opportunity to exercise in a given setting to interventions in changes in the home environment that encourage movement (Liu, Chang and Chang, 2018). However, the approach must remain comprehensive and take into account many individual aspects.
Sustainable Intervention Planning
Sustainability in making a decision, in this case, should rely on advanced medical research, specialist experience, evidentiary base practice and consideration of the patient’s individual characteristics. The environment, in this case, acts as an occupational therapist’s tool, the use of which can bring a positive effect along with other interventions. Interventions directed directly at patients provide an opportunity to involve them in physical or mental activity while working with the environment is in the nature of external determinants that affect the patient’s health. By implementing this integrated approach, occupational therapists can achieve better results than if they focus solely on direct interventions, like in sleep research (Ho and Siu, 2018). In fact, the zone of influence of specialists is becoming larger and, accordingly, they must keep more aspects under control.
To attain the best outcomes of an environmental adaptation, a cost assessment must be undertaken to ensure that the adaptation does not increase the financial burden on the patient’s family. The assessment report should ensure that the basic things that enhance their long-term treatment plan are catered for and effectively considered (Smith et al., 2020, p. 137; Bolt et al., 2019, p 2). The assessment ensures that only the basic things are considered before other minor things. The therapist should also categorize the specialized equipment as a basic item in the classification of critical things to ensure that the patient’s healing process is hastened and their well-being enhanced (Epley et al., 2021, p.271). In addition, the various items obtained are then installed in places where they will be suitable for the patients. For example, patients who are unable to move independently should be given equipment like wheelchairs and paths cleared for them to navigate through the place and access basic resources within the room. Moreover, the lighting should be adjusted for patients with sight challenges to give them a conducive vision. Such changes can often be promoted in public places as inclusive environmental improvement programs. For sustainable planning of proactive and reactive measures in this vein, one can rely on the experience of these infrastructural changes to bring this equipment or support elements into the home.
Sustainability has another point of view that needs to be accessed to ensure that the adaptations made do not compromise the environment for future generations. This aspect ensures that the adaptations are aligned with the healthcare quality and requirements. Sustainability is a critical aspect to consider when developing an environmentally friendly adaptation that does not compromise the needs of future generations (Nicholson et al., 2020, p. 9; Bolt et al., 2019, p. 20). This means that the changes should not adversely impact the environment and that the resources used are environmentally friendly and easy to dispose of when they are no longer needed. For example, materials used in producing certain medical devices must be disposed of appropriately, such as plastic and medicine packaging (Ye et al., 2022). Research shows that some forms of environmental adaptation enable environmental conservation as it may involve using plants that may enhance the physical appearance and the conditions of the surroundings (Bolt et al., 2019, p 20; Schell and Schell, 2018, p.125). In this case, the process may involve the modification of the physical environment and significantly impact the environment and climate change. The therapists should consider the impact that the adaptation not only meets the patient’s needs but also consider its impact on the environment. Therefore, sustainability should be emphasized in all aspects of the adjustment process.
Conclusion
In conclusion, environmental adaptation is a process that enables occupational therapists to think out of the box and develop surroundings that enhance the health and well-being of the patient. The therapist should assess the patient’s needs and develop strategies that would enable the patient to heal quickly. Unlike other domains in occupational therapy, which focus on the patient’s condition, environmental adaptations focus on the external aspects that influence the patient’s healing process. The assessment ensures the patient gets the best environment to enhance the healing process or the client’s well-being. An occupational therapist should plan effectively to ensure that the adaptations do not burden the family or cause unnecessary stress to the patient’s family. In addition, the therapist should ensure that the adjustment process is sustainable and in line with healthcare standards. The process should not impact the environment because it compromises the future generation.
Reference List
Amini, D., and Furniss, J. (2018) ‘The occupational therapy practice framework: a foundation for documentation’, Occupational Therapy Practice, pp.1-8. Web.
Bolt, M. et al. (2019). ‘Scoping review: occupational therapy interventions in primary care’, Primary Health Care Research & Development, 20(1), pp.1-6. doi:10.1017/S146342361800049X
Boop, C. et al. (2020) ‘Occupational therapy practice framework: domain and process fourth edition’, American Journal of Occupational Therapy, 74(S2), pp.1-85. doi:10.5014/ajot.2020.74S2001
Brown, T. et al. (2020) ‘Occupational therapy interventions to support aging in place: a rapid Systematic Review’, pp.1-40.
Chow, J.K. and Pickens, N.D. (2020) ‘Measuring the efficacy of occupational therapy in end-of-life care: a scoping review’. The American Journal of Occupational Therapy, 74(1), pp.1-14. doi: 10.5014/ajot.2020.033340
Derakhshanrad, S.A. and Piven, E. (2020) ‘Modification of the training environment to improve functional performance using blacklight conditions: a case study of a child with autism’, International Journal of Developmental Disabilities, 66(2), pp.160-168. doi: 10.1080/20473869.2019.1642640
Epley, E., et al. (2021) ‘Habits and Health Promotion in Occupational Therapy: a Scoping Review’, Annals of International Occupational Therapy, 4(4), pp.e269-e277.doi: 10.3928/24761222-20210921-04
Grandisson, M. et al. (2020) ‘Autism spectrum disorder: How can occupational therapists support schools?’ Canadian Journal of Occupational Therapy, 87(1), pp.30-41. doi:10.1177/0008417419838904
Gray, E., (2020) Mental Health Literacy for Adolescents with Special Needs: a Pilot Occupational Therapy Curriculum in a Middle School. Phd St. Catherine University.
Gray, E. (2018) ‘Occupational Adaptation in a Stroke Self-management Program: a Mixed Methods Study’, Texas Woman’s University.
Lin, T.T. and Fisher, G. (2020) ‘Applying the model of human occupation during the stay-at-home pandemic order’, The Open Journal of Occupational Therapy, 8(4), pp.1-7. doi:10.15453/ 2168-6408.1770
Micklewright, K. and Farquhar, M. 2022 ‘Occupational therapy interventions for adult informal carers and implications for intervention design, delivery and evaluation: a systematic review’, British Journal of Occupational Therapy, pp.1-11. doi:10.1177/03080226221079240
Morris, D.M. and Jenkins, G.R. (2018) ‘Preparing physical and occupational therapists to be health promotion practitioners: a call for action’, International journal of environmental research and public health, 15(2), pp.1-12. doi: 10.3390/ijerph15020392
Nicholson, C.,et al. (2020) ‘Occupational therapy consensus recommendations for functional neurological disorder’, Journal of Neurology, Neurosurgery & Psychiatry, 91(10), pp.1-9. doi: 10.1136/jnnp-2019-322281
Norin, L., Slang, B., Haak, M. and Iwarsson, S. (2021). ‘Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury’, British Journal of Occupational Therapy, 84(12), pp.1-10.doi: 10.1177/0308022620979516
Pentland, D. et al. (2018) Occupational therapy and complexity: defining and describing the practice. London: Royal College of Occupational Therapists.
Read, J. et al. 2020. ‘Remote Home Visit: Exploring the feasibility, acceptability and potential benefits of using digital technology to undertake occupational therapy home assessments’, British Journal of Occupational Therapy, 83(10), pp.1-11. doi:10.1177/0308022620921111
Reitz, S.M. and Scaffa, M.E. (2020) ‘Occupational Therapy in the Promotion of Health and Well-Being’, AJOT: American Journal of Occupational Therapy, 74(3), 1-14.
Schell, B.A.B. and Schell, J.W. eds. (2018) Clinical and professional reasoning in occupational therapy. Lippincott Williams & Wilkins.
Smith, D.L. et al. (2020) ‘Occupational therapy and environmental sustainability: a scoping review ’, Annals of International Occupational Therapy, 3(3), pp.1-16. doi: 10.3928/24761222-20200116-02
Toledano-González, et al. (2018) ‘Occupational therapy, self-efficacy, well-being in older adults living in residential care facilities: a randomized clinical trial’, Frontiers in Psychology, 9, p.1-8. doi:10.3389/fpsyg.2018.01414
Tyrer, P. (2019) ‘Nidotherapy: a cost‐effective systematic environmental intervention’, World Psychiatry, 18(2), pp.144-145. doi: 10.1002/wps.20622
Wagman, P. et al. (2020) ‘Making sustainability in occupational therapy visible by relating to the Agenda 2030 goals–A case description of a Swedish university’, World Federation of Occupational Therapists Bulletin, 76(1), pp.7-14. doi:10.1080/14473828.2020.1718266
Kaelin, V.C. et al. (2019) ‘Occupational therapy practice in mainstream schools: results from an online survey in Switzerland’, Occupational Therapy International, 2019. pp 1-10 doi: 10.1155/2019/3647397
Clemson, L, et al. (2019) ‘Environmental interventions for preventing falls in older people living in the community’, The Cochrane Database of Systematic Reviews, 2019(2), pp. 1-21. doi: 10.1002/14651858.CD013258
Curtin, M., Adams, J. and Egan, M. eds. (2017). Occupational Therapy for People Experiencing Illness, Injury or Impairment E-Book (previously entitled Occupational Therapy and Physical Dysfunction): promoting occupation and Participation. Elsevier Health Sciences.
McGuire, M., et al. (2019) ‘Adapted dance improves motor abilities and participation in children with Down syndrome: a pilot study’, Pediatric Physical Therapy, 31(1), pp.76-82. doi:10.1016/bs.irrdd.2019.06.007
Mayasich, O. and Tyce, A. (2019) ‘Using Leisure as a therapeutic activity to enhance health, well-being, and quality of life among long-term care residents, pp. 1-153.
Merz, J. A., et al. (2020) ‘Occupational therapy group programming for adolescents with developmental and learning disabilities: A retrospective documentation review’, The Open Journal of Occupational Therapy, 8(3), pp. 1-18.
Rivard, A. M., and Brown, C. A. (2019) ‘Moral distress and resilience in the occupational therapy workplace’, Safety, 5(1), p. 10.
Lockwood, K. J., et al. (2020) ‘Home visits by occupational therapists improve adherence to recommendations: process evaluation of a randomized controlled trial’, Australian Occupational Therapy Journal, 67(4), pp. 287-296.
Walder, K., et al. (2021) ‘Occupational adaptation–analyzing the maturity and understanding of the concept through concept analysis’, Scandinavian Journal of Occupational Therapy, 28(1), pp. 26-40.
Ho, E., and Siu, A. M. (2018) ‘Occupational therapy practice in sleep management: A review of conceptual models and research evidence’, Occupational Therapy International, 2018.
Cuevas-Lara, C., et al. (2019) ‘Effectiveness of occupational therapy interventions in acute geriatric wards: a systematic review’, Maturitas, 127, pp. 43-50.
Liu, C. J., Chang, W. P., and Chang, M. C. (2018) ‘Occupational therapy interventions to improve activities of daily living for community-dwelling older adults: A systematic review’, The American Journal of Occupational Therapy, 72(4), pp. 1-11.
Ye, J., et al. (2022) ‘Assessment of medical waste generation, associated environmental impact, and management issues after the outbreak of COVID-19: A case study of the Hubei Province in China’, PloS One, 17(1), p. e0259207.