Occupational Therapists (OTs) are registered with the Royal College of Occupational Therapists and the Health Care and Professional Council (HCPC) and are health care professionals ideally placed to empower and advocate for individuals, to facilitate and maintain independence.

OTs treat clients with the varying symptoms that can be experienced when a diagnosis of lupus is present and, in doing so, aim to increase or preserve mobility so that clients are able to perform activities that are necessary or desired in areas such as self-care, home management, work, leisure and social participation. Lupus may impact on a person’s physical, mental and emotional well-being which, in turn, can affect their ability to perform activities. As such, OTs will work alongside the client in adapting and modifying their activities of daily living (ADLs) and instrumental activities of daily living (IADLs) with the aim of decreasing, avoiding and preventing dysfunction and promoting and improving, where possible, a healthy lifestyle.

Clients with lupus can have flares and periods of remission, disrupting their everyday life. Occupational therapy practitioners can teach these clients the self-management skills that will help them cope with their daily activities. OTs have the unique skillset and specialised knowledge required to create and modify the environment, enabling individuals to carry out the activities they wish to be involved with. With a theory base of anatomy, pathology and the physical and emotional demands placed on the body,

OTs are able to engage clients by introducing interventions that give the client insight into their condition and how it progresses, resulting in interventions to support the management of pain and fatigue.

The occupational process begins with an evaluation to determine what areas the client wishes to focus on and what activities they wish to carry out. As one of the only health care professionals to use the skill of activity analysis, OTs will observe and assess a client’s ability to carry out an activity, breaking the activity down into its core components and, in doing so, the OT is able to identify where in the process the client faces barriers to completing their chosen occupation – this may include assessments around range of motion, muscle strength, sensation, pain and activity endurance. Through evaluation, OTs identify the need for splints and other support equipment, home, work and environmental adaptations, and post-surgery support. Through evidence-based practice, they are able to introduce suitable adaptations and techniques to promote and facilitate independence.

Through the use of therapeutic activities, OTs are able to promote gross and fine motor control and endurance, strength and range of motion, so improving functional abilities when carrying out daily tasks such as self-care, work and leisure activities.

These approaches educate clients to plan, simplify and pace tasks as a way of protecting joints, reducing strain, fatigue, pain and avoiding joint and tissue overuse while participating in activities. Modification and adaptability go hand in hand with energy conservation and joint protection. Easy-grip handles, adjustable shelves, grab bars, a raised toilet seat, a height adjustable chair with arms, the removal of clutter and introduction of specialist equipment are just some of the examples of adaptive equipment and approaches that can be used to positively influence a client’s independence in the environment. These combined strategies address clients’ functional needs and maintain or increase their participation in home, work, leisure and community activities by accommodating for decreased joint motion, strength, and endurance.

Paula Hughes BSc (Hons) OT
Member of the Royal College of Occupational Therapists