What OT techniques are common following heart bypass, and how do these correlate to resuming normal daily activities?

Question

An elderly person has suffered a heart attack, and later had an extensive cardio bypass surgery. The patient is now undergoing Physical Therapy (PT) and Occupational Therapy (OT) with the goal to return to independent living in several weeks.

In trying to help this patient to resume shaving himself or to cooking his own dinner, I can understand that you do not necessarily want to begin by handing him a sharp razor or a hot frying pan. What activities might an OT begin with to assist the patient, or to evaluate what steps the patient will need to reach the goal?

Further, is there a standard set of tests that are used in all situations in order to assess the patient's current abilities?

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_{Disclaimer: My motives behind this question are my own father and his ongoing recovery. I have not been present for his OT, but the things he describes are baffling to both him and me, having the feel of kindergarten arts and crafts. However, I do not wish to question the methods of a person with extensive training and experience in a field where my level of knowledge is how to abbreviate it.}

_{It is difficult to separate myself from these emotions and biases. I have tried to frame this question in as general a manner as I could to benefit multiple readers. If I have strayed, I apologize. I welcome any edits that improve the neutrality of the question while still helping me learn what I need to. Please leave this disclaimer. See also this meta.}

Answer 1

Occupational therapists primarily use functional activities to assess and treat individuals who have lost independence due to illness or injury. It is uncommon to use craft type activities outside of mental health and paediatrics unless it holds some specific meaning for the individual undergoing treatment.

In assessing an individual who has undergone cardiac surgery and is looking to regain independence, I would observe/assist them with a regular activity, such as getting dressed or preparing a hot drink depending on their current level of function. I would specifically be looking at standing and exercise tolerance, functional mobility within the area, balance, and fine motor function. Observing the activity would allow me to ensure other functions were intact - for example, those related to cognition. Once I understood their present physical presentation, I would prepare a treatment plan that enabled me to work on the skills required to develop their independence.

The key thing, for me as a therapist, is to ensure that the treatment activities I am preparing are meaningful to the individual, and that they address the areas identified within my assessment. Every treatment session is also an assessment so that treatment is fluid and adapts as the needs of the individual change. If your father's current treatment is not meaningful and is not helping him to progress, I would certainly speak to his therapist in order to understand why they believe the activities are beneficial and what the goals of the intervention are.

About me: Occupational therapist of 13 years.