Many of us view ageing and physical decline as being inseparable – as the years pass, our fine motor skills deteriorate, our bodies get weak, and, if chronic disease doesn’t kill us, we end in a wheelchair or permanently confined to our beds.
In reality, though, getting old is what we make of it. 60-70% of how humans age is the result of factors like diet, lifestyle and environment, which is why it’s so critical that we keep both our minds and bodies healthy [1].
In this article, we’re going to look at the role occupations play in supporting our physical and mental health, and how an occupational therapist can make a big difference to the way you age.
What is ‘Ageing Productively’?
The term ‘ageing productively’ is exactly what it sounds like – growing old with good health, in a way that enables us to stay independent and continue doing the activities we love [2].
The Importance of Occupations in Ageing Productively
Engaging in occupations is essential to ageing productively. By participating in physical exercise, social occasions, instrumental activities of daily living (IADLs), leisure activities and even basic activities of daily living (BADLs) like sleep, older Australians can experience serious health and quality-of-life benefits [3].
Many occupations also feed into social roles, which have been proven to closely correlate with life satisfaction [4]. Being able to perform occupations successfully means older people can be the person they want to be – a friend, a grandparent, a volunteer, or even a paid worker.
The Role of OTs in Ageing Productively
Occupational therapists enable Australians to age productively by implementing strategies across a number of different practice areas. These can include assisting with injury prevention and recovery, sleep and management of chronic health conditions.
Injury Prevention and Recovery
As we age, we become susceptible to certain types of injuries which can severely impact our ability to successfully engage in occupations. Fall-related injuries are the most prevalent, accounting for 41% of all hospitalised injuries in Australia, but injuries stemming from motor vehicle accidents are also common [5, 6].
OTs can use prevention strategies help mitigate the risk of accidents. For example, an OT aiming to reduce a person’s risk of falls might assess both the person’s dwelling and the person themselves for risk factors like impaired balance, sensory impairment, trip hazards or unstable handrails [7]. Once these risk factors have been identified, the OT can use a range of interventions to address them, which could include home modifications, training of family members and improvement of the person’s physical abilities.
When we suffer an injury, occupational therapy’s holistic approach can assist with improved recovery. Interventions can include therapeutic exercises, sensory re-education, pain management, orthosis assistance and safety education.
For example, a review of five studies found that occupational therapy following hip surgery (which is a common surgery among older Australians) marginally improved ADL function, general physical function and risk of fall occurrence, but significantly improved the patients’ perceptions of health and emotional wellbeing [8]. Better perception of health results in greater confidence, which leads to a quicker return to leisure and social activities [8].
Sleep
33-45% of Australian adults suffer from insufficient sleep, a statistic which includes Australians aged 65+, and numerous studies have found that sleep problems are “strongly linked to a variety of health problems and chronic diseases, such coronary heart disease, stroke, atrial fibrillation, diabetes, hypertension, depression, erectile dysfunction, nocturia, cognitive impairment and mortality risk” [9]. Interventions which address poor sleep can help improve both our health and general quality-of-life.
OTs use a variety of strategies to assist with better sleep. These can include addressing secondary conditions which affect sleep, improving diet and lifestyle choices, implementing cognitive restructuring techniques and changing the sleeping environment [10].
If chronic pain was keeping you awake, for example, an OT might recommend that you change to a therapeutic sleep system, like Revitalife’s Cloud Luxury Collection. These therapeutic beds feature remote-adjustable positions, Celliant (a patented technology that helps circulation), vibration therapy and memory foam, all of which helps minimise pain, improve healing and create better conditions for more restful sleep.
Management of Chronic Health Conditions
Chronic health conditions include everything from arthritis and osteoporosis to cancer and dementia – together, they account for roughly 90% of Australian deaths [11].
Here are some more statistics: 50% of all Australians have at least one chronic condition, and 60% of Australians over 65 years have more than one. It’s easy to see why managing them is such a massive part of what OTs do, especially if they work with older people [11].
Interventions vary hugely, depending on the condition, the patient and their situation, but typically OTs focus on improving the condition, minimising its impacts on the patient’s life and enabling them to continue participating in occupations.
In one case study, involving a 68-year-old man suffering from chronic back pain, interventions included a chronic disease management program, home improvements, sleep hygiene strategies, progressive muscle relaxation techniques and therapeutic exercises [12]. After eight weeks of treatment, the man, who had previously been unable to leave the house, was able to return to work and resume socialising normally with friends and family [12].
Conclusion
Ageing productively isn’t easy. In Australia, it’s definitely not the norm. But, with the help of OTs, more older Australians can enjoy better health and a better quality of life. Occupational therapy can help in areas like injury prevention and recovery, sleep and management of chronic health conditions, and ensure that we age gracefully while retaining the things that matter to us – our health, our relationships and our independence.
References
[1] Herskind, A. M., McGue, M., Holm, N. V., Sørenson, T. I., Harvald, B. & Vaupel, J. W. (1996) The heritability of human longevity: a population-based study of 2872 Danish twin pairs born 1870-1900. Human Genetics. 97(3), 319-323. DOI: 10.1007/BF02185763
[2] Schulte, P. A., Grosch, J., Scholl, J. C., & Tamers, S. L. (2018) Framework for Considering Productive Aging and Work. Journal of Occupational and Environmental Medicine. 60(5), 440-448. DOI: 10.1097/jom.0000000000001295
[3] Leland, N. E. & Elliott, S. J. (2012) Special Issue on Productive Aging: Evidence and Opportunities for Occupational Therapy Practitioners. The American Journal of Occupational Therapy. 66(3), 263-265. DOI: 10.5014/ajot.2010.005165
[4] McKenna, K., Broome, K., & Liddle, J. (2007) What older people do: Time use and exploring the link between role participation and life satisfaction in people aged 65 years and over. Australian Occupational Therapy Journal. 54, 273-284. DOI: 10.1111/j.1440-1630.2007.00642.x
[5] Queensland Government (2019, October 21) Falls statistics – Stay On Your Feet. Queensland Government. https://www.health.qld.gov.au/stayonyourfeet/facts/statistics
[6] Binder, S. (2002) Injuries among older adults: the challenge of optimizing safety and minimizing unintended consequences. Injury Prevention. 8(Suppl 4), IV2-4. DOI: 10.1136/ip.8.suppl_4.iv2
[7] American Occupational Therapy Association (2017) Occupational Therapy and Prevention of Falls. American Occupation Therapy Association. https://www.aota.org/About-Occupational-Therapy/Professionals/PA/Facts/Fall-Prevention.aspx
[8] Lee, S. Y., Jung, S. H., Lee, S., Ha, Y. & Lim, J. (2019) Is Occupational Therapy After Hip Fracture Surgery Effective in Improving Function? American Journal of Physical Medicine and Rehabilitation. 98(4), 292-298. DOI: 10.1097/PHM.0000000000001069
[9] Adams, R., Appleton, S., Taylor, A., McEvoy, D. & Antic, N. (2016) Report to the Sleep Health Foundation 2016 Sleep Health Survey of Australian Adults. The Adelaide Institute for Sleep Health. https://www.sleephealthfoundation.org.au/pdfs/surveys/SleepHealthFoundation-Survey.pdf
[10] Picard, M. M. (2017) Occupational Therapy’s Role with Sleep. American Occupational Therapy Association. https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/HW/Facts/Sleep-fact-sheet.pdf
[11] Australian Government Department of Health (2020, March 3) Chronic conditions in Australia. Australian Government Department of Health. https://www.health.gov.au/health-topics/chronic-conditions/chronic-conditions-in-australia
[12] Smallfield, S. & Elliott, S. J. (2020) Occupational Therapy Interventions for Productive Aging Among Community-Dwelling Older Adults. American Journal of Occupational Therapy. 74(1). DOI: 10.5014/ajot.2020.741003