Veterans Health Administration

Karen Duddy, Occupational Therapy Supervisor, and Veterans Bill Armstrong (left) and Olester “Mac” McNary participate in “Doc Talk”- a game in which Veterans learn to better communicate with health care providers.

When we are healthy, it is easier to accomplish what we set out to do, such as going to work, traveling, meeting up with friends, and taking care of our personal needs. Having chronic health conditions makes it more difficult to manage needs due to fatigue and illness. Often people with these conditions end up giving up on socializing and other enjoyable activities. This is problematic because giving up activities results in poorer health, and quality of life.

Occupational therapy has joined with primary care to help Veterans improve their health and well-being by being able to do what they need and want to do in their everyday lives. Occupational therapy can assist Veterans in continuing to take care of their health needs while still doing the activities they enjoy, simply by adapting or doing things differently. Occupational therapy helps Veterans prevent health declines by managing their daily health needs and showing them how to continue to participate in activities that are important to them.

“Occupation” refers to everything that people do during the course of everyday. We work with people throughout their lives to maintain their current level of activities (prevention) or restore function after an injury or illness (rehabilitation). The focus of our work with primary care is to help Veterans who are at risk for declines in health to stay active and take care of their everyday needs.

Improving the Quality of Life

Taking care of ourselves and being able to do what we enjoy keeps us healthier and improves the quality of our lives. Occupational therapy does this by helping Veterans discover solutions to their identified issues.

For example, occupational therapy can help prevent falls at night by recommending better lighting, or identifying trip hazards or where grab bars can be useful. When a Veteran has to give up driving, occupational therapy can help the Veteran use other modes of transportation so they can get to the store and see friends.

Occupational therapy also helps Veterans in their homes after being in the hospital by making sure they can take care of themselves, get groceries, cook meals, take care of their pets, and manage their VA appointments. During a primary care visit, the provider can have an occupational therapist join the visit and problem-solve together when there are concerns about the Veteran’s self-care or safety.

April is Occupational Therapy Month.

Recently a primary care provider called us to talk with a Veteran about self-care for diabetes. The Veteran had just lost his wife, and he needed help to live a healthier lifestyle. He was more concerned about how to be an example for his 10-year-old daughter so she wouldn’t end up unhealthy like him.

We worked together with him and his daughter to develop a plan that made sense for them as a family so they could take walks, shop, prepare food and eat together. This also helped them during this time of sadness over the loss of a mother and wife.

Occupational therapy helps people figure out what is important to them and discover their interests and capabilities. This includes helping Veterans develop plans and take steps to reach their goals. Some Veterans want to organize their lives and take care of personal business, while others want to get back into a more healthy routine. Some Veterans want to feel useful again and give back to their community or fellow Veterans. Then together we explore volunteer opportunities.

Helping Veterans Do What is Important to Them

Occupational therapy and primary care are about health promotion and disease prevention by enabling Veterans do what is important to them, regardless of their limitations, throughout their lives.

The intent is to enable the Veteran to engage in his or her usual occupations, because occupation influences health. If you want to change the human being, you have to change the human doing.

Occupational therapists Thomas Tousignant and Dorene Doi consult with Veteran Ralph Guillen (right) to create timelines for a healthy future.

Optimizing the Quality of Life for Veterans

Karen Duddy is supervisor of the occupational therapy department at VA Long Beach. She is currently pursuing a doctor of occupational therapy degree from Boston University.

Duddy developed an “Everyday Matters” workshop, a 6-week health promotion program for patients at risk for lifestyle-related declines in health and function resulting from chronic conditions.

Emphasis of the “Everyday Matters” program is on clarifying the health, wellness and performance goals of the individual, and identifying and resolving barriers to everyday activities. Veterans begin to understand ways they can adapt so they can fully participate in those things that are most meaningful to them. Seeing oneself as a resource or expert in their own lives helps the Veteran to self-advocate and participate in care decisions with their provider.

VA Long Beach occupational therapists Thomas Tousignant and Dorene Doi participate in primary care visits directly with providers, perform evaluations of how Veterans function in their homes, complete telehealth and in-person visits, and participate in inter-professional group education through the primary care program.

Tousignant and Doi participated in the design of the program and successfully implemented the workshop to a pilot group. They are currently in the process of submitting a proposal for outcomes research with Dr. Anthony Vo, Chief of Primary Care, as principal investigator.

The goal is to obtain outcomes and disseminate the “Everyday Matters” program throughout VA and continue developing innovative ways occupational therapy and primary care can partner to optimize function and quality of life for various at-risk Veteran populations.