Occupational therapists (OTs) are frequently called upon to help individuals manage fatigue. A variety of diseases can produce symptoms that lead to pain and fatigue that limit daily living activities.
Hospice patients tend to live relatively short lives and are frequently suffering from conditions that limit activity tolerance. Occupational Therapists (OTs) can teach energy conservation techniques such as pacing, prioritization, delegation and physical/environmental modification that help preserve energy reserves in hospice patients.
Adaptive Equipment
Adaptive equipment is an indispensable asset in an occupational therapist’s toolbox for treating patients of all ages and health conditions, including energy conservation occupational therapy practices that are integrated into treatment plans for an array of injuries and chronic conditions. Adaptive equipment includes products like long-handled reachers, sock aids and dressing sticks that reduce bending or reaching, convenient clothing such as front closure blouses with snap closures or elastic shoe laces and bathing devices like tub benches and shower chairs that facilitate sitting comfortably in water environments.
Depending on a patient’s condition, adaptive equipment may be needed as part of energy conservation techniques to combat fatigue. For instance, respiratory patients frequently utilize supplemental oxygen therapy, yet too much movement may cause oxygen desaturation – dropping below safe levels that leads to dizziness, discoloration of skin and nausea – prompting occupational therapists (OTs) to advise use of a pulse oximeter so patients know when it is important to slow down or take a break from activity.
Energy conservation is a daily priority for patients living with debilitating injuries or chronic illnesses like multiple sclerosis or COPD, in order to avoid overexertion which leads to fatigue and even discomfort. Occupational therapists (OTs) can assist patients in learning how to pace themselves, prioritize tasks, delegate any difficult ones to family or hired caregivers and teach strategies such as pursed lip breathing which reduce energy expenditure while still being able to complete daily activities.
Occupational therapists (OTs) can educate their patients about safe body mechanics to help avoid repetitive strain injuries such as carpal tunnel syndrome, tennis elbow, tendinitis or rotator cuff injuries. In addition, they provide educational services on energy conservation for nursing staff and healthcare providers such as proper ergonomic positioning when transporting patients in order to reduce strain on back, arms and legs.
Pacing
Pacing is an integral component of energy conservation treatment for ME/CFS patients and those suffering from other autoimmune and neurological illnesses such as rheumatoid arthritis, MS and COPD. Pacing involves balancing activity with rest periods, setting priorities, delegating tasks to others and using assistive devices such as wheelchairs.
Pacing differs from graded exercise therapy (GET). Instead of setting predetermined goals or plans, occupational therapists (OTs) teach patients how to use their energy efficiently throughout their day by monitoring how they feel throughout the day and using this technique when their body has exceeded its limits. When fatigue strikes they should stop participating immediately!
Sometimes clients can learn to pace themselves better through assistance or altering the home environment. For instance, an individual having difficulty reaching into cabinets could be instructed to perform half the task before sitting for five minutes before continuing; this will prevent energy usage peaks and valleys and will ensure more sustainable behavior patterns.
Occupational therapists (OTs) can teach clients proper body mechanics to prevent repetitive stress injuries such as carpal tunnel syndrome, tennis elbow or tendinitis. Patients can be instructed to use equipment like long-handled sponges, reachers and sock aides when performing activities that require bending and stretching as well as shower chairs or tub benches as seating when performing activities requiring sitting down such as showering and tubbing. Furthermore, occupational therapists encourage frequent breaks when engaging in any physical activity to reduce muscle fatigue.
Recent research into the effectiveness of an energy conservation program found it had a marked effect on participants’ ability to complete everyday tasks. The authors of the study highlighted its flexible nature, adapting itself to each individual. While this scoping review only covered studies related to energy conservation-based treatment, its results are promising and indicate further research needs be done to establish an optimum delivery method; six techniques were clustered together ranging from client-centered approaches to more structured goal-based models in its findings.
Prioritizing
Prioritizing is an effective strategy to help patients identify which tasks are of primary importance and should be completed first. It involves analyzing all work to be done and ranking its importance according to difficulty or length of completion time; this enables patients to focus on more essential work while delegating lesser tasks to others for completion, thus helping avoid overworking and potentially decreasing pain levels.
This method can be implemented across a variety of settings, from home care to repetitive use injuries like carpal tunnel syndrome and tendinitis to rotator cuff injuries. Occupational therapists can teach both patients and caregivers how to conserve energy and streamline tasks by decreasing physical strain or providing adaptive equipment, or provide education on safe body mechanics so as to avoid injuries when transporting patients.
Patients living with terminal illnesses like amyotrophic lateral sclerosis (ALS) or advanced cancer need their energy conserved so they can spend quality time with loved ones and engage in meaningful activities before death comes. Occupational therapists trained in palliative care can create treatment plans tailored specifically towards this goal, including education of both patient and caregiver regarding pacing, fatigue-inducing activities, rest periods and using a client-centric approach to therapy.
Occupational therapists (OTs) can teach patients how to prioritize and tailor their work based on the results of an initial assessment. For instance, if reaching into cabinets fatigues them, an OT can teach them how to reorganize them so items are at lower levels or teach how to use tools such as grabbers for added support.
Researchers recently examined data from six databases to identify the optimal method for providing energy conservation strategies to patients. They discovered that the strategies most frequently implemented by providers included planning and organization, establishing priorities, activity analysis, balance between activity and rest time and physical/environmental adaptation; moreover, client-centered approaches with structured interventions were most frequently chosen as delivery models.
