Occupational Therapy in Assisted Living Facilities: What You Need to Know

Occupational therapy is a way for people to learn or relearn how to perform everyday actions that typically are essential parts of their profession, hobbies, or basic routines. These actions and activities can be things they need to do or simply want to do, according to the American Occupational Therapy Association.^[01]

“Occupational therapy is a partnership between an occupational therapist and our patients and their families,” says Rob Russow OTD, OTR/L, an assistant professor of clinical occupational therapy at the University of Southern California.^[02] “We can help people focus on ways to occupy their time that are meaningful to them. This could be daily tasks like dressing, bathing, and eating — but it could also be activities that they didn’t think they would be able to do again, like painting, cooking, or playing a game.”

Occupational therapy can provide extra support to help older adults maintain their independence as they experience changes related to aging or disease.

In theory, any older adult could benefit from occupational therapy, often abbreviated as OT. People with the following specific conditions or risks factors may be especially great candidates for this type of therapy, as noted by Russow:

• High fall risk
• Poor balance
• Dementia or other cognitive impairments
• Parkinson’s disease
• Multiple sclerosis
• Chronic illnesses or conditions, such as COPD and diabetes
• A “long COVID” diagnosis

While many perceive occupational therapy as being purely about physical abilities, it can also play an important role in supporting a person’s self-worth, passions, and social connections.

“Everyone deserves to live life to the fullest, regardless of age or health status,” says Russow. “Engaging in OT can also allow people to discover a new valued way to engage in the world around them and help families reconnect with their loved ones when they have dementia or other health conditions.”

Is assisted living the right fit?

In an assisted living community with on-site occupational therapy, your loved one will have the convenience of receiving therapy in the actual environment they live in every day.

Typically, an occupational therapist will develop a custom plan to fit your loved one’s unique needs. Each session, Russow explained, will usually start with a check-in to help the occupational therapist understand how the person has been doing since the previous session.

From the check-in, an occupational therapist may work with your loved one on an activity or exercise that helps them perform a basic yet now-difficult action, such as holding a fork or grasping a paintbrush. In some cases, the occupational therapist can share educational information about your loved one’s condition or suggest equipment, such as a shower chair or adapted utensils, as noted by Russow.

Your loved one may be assigned “homework” to do on their own between sessions. Family members can help their loved ones by encouraging them to follow through with this individual practice.

Homework may not be part of the OT experience if your loved one has dementia. Their OT experience will generally focus more on maintaining current skills than gaining new skills.

“Occupational therapists like to find the right challenge for their patients — this means it should be hard enough to be challenging, but not so hard that you want to give up,” Russow says.

As a family member, you can act as your loved one’s cheerleader when they practice their homework. You can also attend appointments to support your loved one and provide additional background information on your loved one to the occupational therapist.

It’s important to remain supportive of your loved one and your loved one’s occupational therapist, Russow emphasized.

Assisted living questions? Get expert help

It’s ideal for the therapeutic relationship to be built upon trust, Russow said. As part of the therapy process, your loved one’s occupational therapist should learn as much as possible about your loved one and their daily routine.

When beginning therapy, an occupational therapist should ask questions to get to know the person receiving care on an individual level, as explained by Ben Canter, BA, OT/S, a doctoral candidate in occupational therapy at Boston University.^[03] The occupational therapist, Canter said, should ask your loved one any of the following questions:

• What’s important to you?
• What’s meaningful to you?
• What do you want to work on?

An older adult with a wrist injury from a recent fall may not want to work on things that others might feel are more important to their recovery. This is why occupational therapy should be individualized and holistic to the person receiving care, Canter noted.

For example, an older adult may express that they find it especially meaningful to maintain their appearance and therefore would like to learn how to do their hair on their own, instead of working on brushing their teeth. Their occupational therapist could support and empower this person by showing them the correct motions to use when brushing their hair with an adaptive hairbrush. While this may not directly address brushing their teeth, it could support the person’s self-esteem and overall rehabilitation by strengthening the wrist as it heals.

It’s important to understand that if your loved one doesn’t feel like their occupational therapist is the right fit, they do have the right to receive care through another provider, Russow noted.

On-site occupational therapy may be offered through a company that partners with the assisted living community and has an on-site outpatient office, or through a company that has traveling occupational therapists who offer on-site sessions in assisted living communities.

The cost of occupational therapy can vary widely, as can the way that payment is handled by the provider. To learn more about possible expenses, ask the following questions when you’re touring a community:

• Does your community offer on-site occupational therapy?
• Who provides the occupational therapy?
• How much does an occupational therapy session cost?
• Does the on-site provider work with insurance, or is private pay the only option?

In some circumstances, Medicare may pay for some of your loved one’s occupational therapy under specific plans as long as your loved one meets the medical qualifications. If your loved one has a private insurance plan, it may cover some costs associated with OT. However, this may vary from plan to plan.

You want your loved one’s quality of life to be a top priority. That’s why it’s vital to find an assisted living community with the right amenities, such as on-site occupational therapy, for your loved one’s unique situation. The Senior Living Advisors at A Place for Mom can help you discover assisted living communities in your area, all at no cost to you.

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