By Shea Wright 

For older adults, acute care and outpatient occupational therapy (OT) play crucial roles in helping them regain independence after surgery or injury.  

Research estimates 90% of adults over age 65 are more likely to experience one or more chronic condition and will need specific treatments and medical care, including occupational therapy.  

Outpatient occupational therapy focuses on helping individuals who live at home but need therapy to recover from an injury, surgery, or condition affecting their daily activities. This differs from acute care occupational therapy, which is provided in the hospital immediately after a serious illness or surgery and focuses on short-term recovery and discharge planning 

“Occupations are any activities that occupy your time — daily tasks like bathing and dressing, as well as hobbies such as cooking or gardening,” said Kaitlyn Lynch, OTD, OTR/L, an CMH acute care occupational therapist at VCU Health Community Memorial Hospital (CMH). “Therapies, such as activity simulation, modification, and adaptive equipment training, help patients regain their ability to perform these activities independently.”  

“A common misconception is that any [occupational therapy] is painful, but the phrase “No Pain, No Gain” isn’t true. Pain is the body's way of signaling a problem that should not be ignored,” said Laurie LaFeldt, OTR/L, an occupational therapist and outpatient supervisor at CMH. “Our priority whether you are seeing one of our therapists for acute or outpatient treatment are to address pain and ensure that therapy is a comfortable, effective experience.” 
 
VCU Health News spoke with LaFeldt and Lynch to better understand how both acute care occupational therapy and outpatient occupational therapy can help you get back on your feet and when it’s time to get a referral. 

Left to right: Kaitlyn Lynch, OTD, OTR/L, is an acute care occupational therapist, and Laurie LaFeldt, OTR/L, is an occupational therapist and the outpatient supervisor at VCU Health Community Memorial Hospital.(Shea Wright, Enterprise Marketing and Communications)

What are the most common conditions and injuries treated by occupational therapists? 

LaFeldt: Many of our patients in our outpatient client have orthopedic injuries such as rotator cuff injuries, fractures in the arms or hands, and post-surgical rehabilitation. We also treat individuals recovering from a stroke. 

Lynch: Acute care occupational therapists also work with patients recovering from strokes, orthopedic surgeries, or critical illnesses to assess their ability to safely perform basic daily tasks. We also help them determine the next steps for their care. 

Upper body injuries are frequently treated in occupational therapy. What are some of the leading causes of these injuries, and how does your team approach treatment? 

LaFeldt: Common causes of upper body injuries include falls, overuse, and muscle imbalance. If a patient has a recent injury, their doctor may refer them to occupational therapy to explore non-surgical solutions for pain, stiffness, and weakness.  

Many times, occupational therapy can help patients avoid surgery altogether. We use modalities such as ultrasound, heat and cold therapy, as well as stretching and strengthening exercises, to restore function. 

For stroke patients or older adults with mobility challenges, how does occupational therapy support their recovery and daily function? 

LaFeldt: For stroke patients specifically, our goal is to rehabilitate daily functions as much as possible. Recovery varies depending on factors like spasticity (tightness) and coordination in areas like arms and legs. We develop targeted exercises and activities to help patients regain function. Home exercises and patient follow-through are essential for optimal recovery. 

When should someone consider seeing an occupational therapist after a serious injury?  

Lynch: Someone should consider seeing an occupational therapist when they experience a decline in their ability to perform daily activities independently. You will need a referral from a physician, physician assistant, or nurse practitioner. 

What can patients expect during their first appointment? 

Lynch: Your first appointment may include an initial assessment to discuss concerns, medical history and an observation to identify current strengths and areas of opportunity. In the acute care setting, patients can expect to see an occupational therapist after surgery such as a hip or knee replacement, an accident or an illness. The patient can expect the occupational therapist to help them with getting out of bed and completing daily activities, such as bathing or oral care while also completing functional mobility such as walking to the bathroom.  

During an illness or after surgery, an acute care occupational therapist plays a crucial role in the early mobility of the patient. Early mobility leads to lower readmission rates and faster recovery rates. Lying in bed for multiple days can decrease muscle mass and decrease respiratory function.  

LaFeldt: Outpatient occupational therapy patients can expect to be asked about their ability to complete daily activities safely. Can they bathe themselves? What prevents them from doing tasks like taking out the trash or caring for pets? Factors such as fatigue, illness, arthritis, or injury can all impact independence, and occupational therapy helps patients develop strategies to overcome these challenges. 

Meet our team of occupational therapists at VCU Health Community Memorial Hospital

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