Occupational therapy (OT) can assist energy conservation efforts by providing strategies and tools. This may include providing patients with strategies on pacing themselves by scheduling frequent rest breaks, switching tasks frequently, prioritizing daily activities and planning ahead for them.
Hospice patients may benefit from reducing physical intensity to avoid overspending on oxygen, thus helping avoid oxygen desaturation, fatigue, discoloration of skin or falls.
Cardiac Patients
Fatigue is a frequent side effect of cardiac issues. Occupational therapists can educate their patients on energy conservation techniques to help manage fatigue. For example, if an individual was used to a busy lifestyle before heart failure came along and symptoms included difficulty breathing with minimal exertion and fatigue, occupational therapy can work with them to alter it and train safe body mechanics. They may also provide education about planning tasks prioritization rest periods as well as switching off between heavy and light tasks to minimize fatigue.
Norma suffers from congestive heart failure and her physician advises her not to lift anything more than 5-10 lbs. The occupational therapist works with her to identify household tasks she can delegate to family or friends, and also teaches her voice command on her phone for appointment reminders.
Respiratory Patients
Fatigue can be an everyday struggle for those living with respiratory conditions like chronic obstructive pulmonary disease (COPD), lung cancer, cystic fibrosis or asthma, due to illness effects, medication or just daily life demands. While proper rest and diet may help alleviate some symptoms of fatigue, fatigue is still often unavoidable – occupational therapy plays an invaluable role in teaching patients how to effectively manage this symptom and do what’s important while minimizing unnecessary exhaustion.
Energy conservation for respiratory patients often means managing their workload and taking frequent rest breaks, as well as not overbooking tasks throughout their day or week to avoid overstressing their bodies with too much activity. Therapists can teach patients to use adaptive equipment for everyday activities and delegate tasks to family members or hired caregivers as necessary; additionally they provide education on various energy conservation techniques like pacing and pursed lip breathing for energy savings.
Pulmonary rehabilitation (PR) is a multidisciplinary intervention that seeks to increase exercise capacity and the ability of an individual to complete ADLs while decreasing breathlessness. Occupational Therapy plays a pivotal role within PR programs and has demonstrated positive impacts on ADLs, pulmonary function, quality of life, dyspnea, mortality.
However, original research and guidelines surrounding the role/tasks/roles of occupational therapy within PR programs is limited, leading to underutilization by clinicians. Therefore, this scoping review sought to synthesize and clarify its effect on PR.
To do this, a systematic literature review and consultation with an experienced librarian were employed. Four databases were searched, including: MEDLINE via Ovid (1946-2021), EMBASE via Ovid (1974-2021), and CINAHL via EBSCOhost (2037-2020). A full search strategy was devised in consultation with an experienced health sciences librarian from McMaster University’s Health Sciences Library to ensure all pertinent articles were captured; additionally a targeted gray literature search of occupational therapy association websites was also performed to capture any additional pertinent data that would otherwise go undetected.
Hospice Patients
Ms. Smith is a 75-year-old woman who recently returned home after being hospitalized with a hip fracture and her physician requested an occupational therapy evaluation. At her assessment, it became evident that she would no longer be capable of conducting daily living activities such as meal preparation, cleaning and shopping as she had prior to hospitalization. The therapist provided her with tailored energy conservation recommendations tailored specifically to her unique needs and social situation. She received instruction on pacing, planning, positioning, reusing items multiple times before washing them and pursed lip breathing to maximize efficiency for daily activities. Additionally, she was advised to utilize adaptive equipment like a shower chair and long-handled bath sponge when bathing, and she was advised to schedule several rest breaks throughout her day. Furthermore, they informed her of free or low-cost services that could assist her in meeting daily tasks, like Meals on Wheels or professional cleaning services.
Hospice patients generally expect their lives to be limited and do not anticipate functional improvement (for more information, refer to this article). Therapists can assist these patients by helping them alter their lifestyles to include energy saving techniques that will extend the remainder of their lives. Example solutions could include scheduling several rest breaks throughout the day, using a handheld showerhead for bathing and assigning tasks to trusted family members or hired caregivers. A therapist could also instruct their patient how to repurpose household items such as rolling laundry carts for moving items around their house; and encourage push-pull techniques as opposed to lifting and carrying when performing daily tasks.
Hospice patients may suffer from various ailments, such as heart conditions, COPD, cancer, dementia or multiple sclerosis. Occupational therapists are specially equipped to apply energy conservation principles across these conditions and create personalized plans based on each patient’s unique needs and situation.
Multiple Sclerosis Patients
Multiple Sclerosis (MS) patients can face symptoms that make everyday activities challenging. Fatigue, for example, can significantly diminish one’s engagement in daily routine activities. Luckily, energy conservation strategies exist that can help those with MS minimize exhaustion and live more satisfying lives; techniques may include simplifying schedules to reduce decision fatigue; scheduling demanding tasks when you have more energy available and grouping similar tasks together; practicing stress reduction techniques as well as using other means to promote sleep hygiene are just a few examples.
This scoping review of literature on energy conservation interventions occupational therapy reveals a range of approaches for helping patients manage fatigue. While most studies focused on MS patients, some were conducted with ALS patients as well. They included both pharmaceutical and non-pharmacological treatments; physical rehabilitation; cognitive or psychosocial interventions led by occupational therapists or other professionals may have also been included.
Studies reviewed in this review focused on interventions designed to increase manual dexterity for MS patients, programs that reduce falls risk through sending information about safe falling or tape training sessions, or increasing self-efficacy or decreasing depression levels among these individuals.
Numerous reviewed studies examined how to assist individuals living with MS or ALS manage their energy. Many employed behavioral and physical strategies such as changing diet and increasing exercise to manage energy. Some used medications like methylphenidate, modafinil or amantadine to manage fatigue.
Occupational therapy can be an invaluable asset in combatting fatigue. It has proven helpful to individuals living with various medical conditions by saving energy and helping them focus their focus on what matters most in life. If you are feeling exhausted, talk with your physician about all of the options available to you; they may recommend a practitioner who will offer customized treatment plans tailored specifically to you and your unique circumstances.
