OT CARE FOR RHEUMATOID ARTHRITIS

SN: I think you know that rheumatoid arthritis (RA) is an auto-immune disease that is the most common form of the chronic inflammatory rheumatism condition. And it’s also a systematic illness that in its severe forms would even touch organs like the heart or lungs, and therefore can be life-threatening.

Ot: Yes, I know, and I did my term paper on the subject by the way. We know that RA evolves in successive flare-ups and mainly touches the hands, wrists, feet and knees. And in the absence of treatment, joints will be painful, puffy, stiff and will self-destroy and deform and provoke a real handicap, which will reduce the quality of daily life, and even at times make it an ordeal. Which is why, in Occupational Therapy (OT), we can implement a plan of care that would improve the patient’s quality of daily living.

SN: So, what care provision would an Ot carry out? I mean, in medical care, we would only give systematic treatments to relieve the pain and puffiness, like non-steroidal anti-inflammatory drugs and painkillers. Mind you, in the absence of curative drugs, we use background treatments, like biotherapy, that aims at enhancing the patient’s condition, and whose objective is to reach remission if possible.

Ot: You know, since impairments give rise to major esthetic and functional handicaps, social and psychological exclusion might follow. In this sense, we would also think of adapted activities to be practiced outside inflammatory breakouts, so as to reintegrate the patient into the community.

SN: However, I guess that functional rehabilitation in a multidisciplinary team is best.

Ot: No doubt about that. And this is where OT has all its potential. For example, we might first take into account patient education on their illness, using splints, orthotics and rehabilitation in general. Also, in OT, we speak of ecological adaption, that is adapting the patient’s home environment for their specific needs, which we call a patient-centered approach that starts with a functional assessment to evaluate the patient’s goals and needs.

SN: Can you tell me more about that?

Ot: For example, we would start by giving advice on using joints without straining them, splints to support joints while working or resting, and recommendations on devices and equipment to help with comfort in home and work environments. We might also think of riser/recliner chairs, stairlifts to go upstairs and hoist-slings to get up from bed. In the kitchen, we might propose vegetable peelers with adapted ergonomical hands, kettle tippers, perching stools, bottle top removers, and trolleys and non-slip mats. Personal care is also appreciated by users, like dressing aids, bath boards and seats, bottom washers/wipers, raised toilet seats, long-handled hairbrushes, a sock aid and dressing stick. Other useful items can be a reacher to pick up things from the floor. Adapted splints are often specially made by OTs to fit the user, which include thumb, finger, ankle, knee and leg splints.

SN: That seems to be very interesting. I’m looking forward to working with you so that we can improve our patients’ daily life and give them a more long-term vision.

Ot: Looking forward to it too.