Assessment

Occupational therapy (OT) can be initiated when a physician writes a referral for rehabilitation, which is similar to writing a prescription. The referral should be detailed, including a brief history of the problem (eg, type and duration of the disorder or injury) and establishing the goals of therapy (eg, training in instrumental activities of daily living). The referral is written to an occupational therapist, a rehabilitation center, or a physiatrist for evaluation by an interdisciplinary rehabilitation team, which may include physicians, nurses, physical therapists, occupational therapists, speech language therapists, psychologists, and social workers. The team can help determine whether OT, other types of rehabilitation, or a combination is indicated. Lists of occupational therapists may be obtained from a patient's insurance carrier, a local hospital, the telephone book, state OT organizations, or the website of the American Occupational Therapy Association.

Patients are evaluated for limitations that require intervention and strengths that can be used to compensate for weaknesses. Limitations may involve motor function, sensation, cognition, or psychosocial function. Examiners determine which activities (eg, work, leisure, social, learning) patients want or need help with. Patients may need help with a general type of activity (eg, social) or a specific activity (eg, attending church), or they may need to be motivated to do an activity. Patients are asked about their social and family roles, habits, and social support systems. The availability of resources (eg, community programs and services, private attendants) should be determined.

Determining when driving is a risk and whether driver retraining is indicated is best done by occupational therapists with specialized training. Information that can help elderly drivers and their caregivers in coping with changing driving abilities is available from the American Occupational Therapy Association and the American Association for Retired Persons.

This topic was last updated April 2006.