Ask someone what their occupation is and they will tell you about the job they do. The question is the prelude to a judgement about one's place in society; what status your work confers, what circles you move in, what standard of living you enjoy.
For an occupational therapist, "occupation" has wider meaning. Whilst awake, human beings are engaged in some form of occupation: education or productivity and earning a living; self-care and managing one's life; or leisure and pleasure. Together these define our being - what gives us self-esteem, autonomy and a purpose for living. "Work-life balance" is the fashionable term for getting the mix right - and that is the fundamental principle of occupational therapy, though in clinical jargon we talk of "occupational performance".
Illness and disability, physical or psychological, interferes with that balance. If the stiffness of rheumatoid arthritis makes it difficult to get going in the morning, you get up earlier or ask your employer if you can start work later. If the daily aspects of self-care and running a home are exhausting, leisure and pleasure get sacrificed. The aspiration of anyone who is sick or injured is to get better and the aspiration of people with disabilities is to be independent - to manage all the roles and tasks that maintain dignity and self-esteem. That is the business of occupational therapy: working with people whose occupations are disrupted to find solutions to their restrictions.
That might involve teaching new ways of approaching tasks - how to dress when a stroke results in paralysis, how to break down activities into achievable components if the effects of a brain injury make it impossible to sequence a complex process, like cooking a meal. Mental illness can rob the self-esteem and may result in withdrawal and social isolation. A visit to the supermarket might be about buying food, but it involves planning, making choices, and self assertion if an assistant is unhelpful. Daily living is challenging; all the more so in our built environment. If disability leads to using a wheelchair, a home becomes an obstacle course - power points are too low, thresholds and stairs can't be negotiated, cupboards are too high and getting into a bath is almost impossible. Occupational therapists adapt the environment, providing equipment or designing housing adaptations to remove obstacles or make them manageable. They also help family members, who provide so much support and daily care for seriously disabled and older people.
Rehabilitation services lost out in the cost constrained …