As an Occupational Therapist during the COVID-19 pandemic, adaptation and creativity has moved into the forefront of practice.

Firstly, what is occupational therapy? As an integral part of the rehabilitation team, occupational therapists utilize a wide variety of tools to mitigate challenges that interfere with an individual’s ability to participate in “occupations”.   Occupations in this context are the everyday essential and meaningful tasks of life (e.g. self-care, leisure, employment, community involvement, familial roles etc.). Occupational therapists are not only trained to understand the medical, physical and emotional aspects of a disability or injury, but also and perhaps more importantly the ability to adapt to extraordinary factors that impact an individual’s ability to function.

COVID-19 has been no exception.  The pandemic has been a significant variable that has altered our clients’ day to day environment impacting their physical and emotional well-being in the face of impairment.

To understand what it has been like working as an occupational therapist during the pandemic, we have to reflect on how the pandemic has impacted the lives of not only our clients but the community as a whole.  COVID-19 has led to significant mortality globally, financial destitution, deepening inequalities (e.g. low income communities), and unparalleled challenges to public health.  This in turn has resulted in increased mental health challenges brought on by isolation, financial stressors, and fewer opportunities for support.    Physical well being has been challenged by reduced access to medical oversight and rehabilitation care.   As clinicians we are witnessing increasing levels of distress and anxiety, sleep disruption, poorer nutrition, increased substance abuse, overburdened household routines and reduced opportunities for physical activity. Children are unable to play or attend school with their peers, adults are tasked to adjust their schedules while working from home, and the elderly, being considered more vulnerable, are isolated from what they might consider meaningful occupations like visiting their grandchildren. Additionally, and often overlooked is the toll COVID-19 has had on family members when caring for a disabled individual in the absence of available services. No single individual has escaped occupational disruption during the pandemic.

The COVID-19 pandemic has not only made us rethink the delivery of therapy services but also how to help our clients re-engage in meaningful activity amidst restrictions in everyday life. Fortunately, adaption is not a foreign concept to occupational therapy but an inherent value of practice. Occupational therapists have been well positioned to support their clients in navigating the new (and often restrictive) realities brought on by the pandemic. We have been tasked with exploring options for remediation and adaptation of complex activities impacted by COVID-19; for instance, hospital discharge planning, or in home care of the medically fragile. We have also helped our clients enhance their use of technology to connect to family, friends, providers, support groups, online classes and recreation.  Where relevant we have helped remediate issues related to environmental strategies like physical distancing. We have supported our clients in creating meaningful social and community opportunities in alternate and creative ways from home. We have helped clients stay physically active in their daily routines with self-directed home programs and virtual classes. We have helped clients develop pragmatic solutions to the challenges faced when working from home, or participating in rehabilitation amidst the lockdown.

What has it been like working as an occupational therapist during the pandemic? COVID-19 has been a time of challenge but also a time to reflect on our practice and create different, and often creative opportunities to enhance our clients’ lives. We have had the opportunity to contribute to the well-being of our clients by helping them “unlock” locked-up occupations against a backdrop of a global pandemic to once again bring meaning and purpose to life.

Alyssa Bierbrier MA, MScOT, OT Reg. (Ont.), CCLCP