Nurturing Individual Beliefs and Practices Through Occupational Therapy
Nancy Kelly, MS, OTR/L

The Occupational Therapy team
Jean Watson’s third Caritas Process of “being sensitive to self and others by nurturing individual beliefs and practices” dovetails naturally with the very premise of occupational therapy.
Occupational therapy is not something that is done to a patient but is something that is done with his or her active participation. We believe that the patient should choose his or her own goals and priorities for therapy.
The field of occupational therapy began nearly 100 years ago, when it was observed that people institutionalized for mental illness, polio and tuberculosis demonstrated improved overall well-being when they performed activities that were important to them. Its premise is that nurturing, respecting and building upon a person’s own beliefs and preferences intrinsically motivates the person to participate in therapy and overcome challenges. Occupational therapists (OTs) have extensive training in psychosocial and physical rehabilitative approaches to promote health and function.
As an OT in practice for more than 30 years, I am asked on a daily basis: “What is occupational therapy?”
According to a 2016 paper published by the American Occupational Therapy Association (AOTA): “In its simplest terms, OTs help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities.”
At BWH, OTs work with people who have had strokes, brain injuries, burns or orthopedic injuries to help them return to activities of daily living such as eating, bathing and dressing themselves. We address the cognitive, visual, psychosocial and physical limitations that hinder participation in patients’ daily routines and work roles.
An inpatient I worked with, John*, developed severe weakness in both legs that prevented him from getting out of bed in the morning and walking. This was difficult for him, as he loved nature and being active. When we first met, he tearfully shared his frustration and fear with me – he just wanted to go home.
John had his priorities very clearly outlined in his mind. We worked together to create a new routine, allowing him to bathe and dress himself in bed, even though he couldn’t move his legs. I gave him some adaptive equipment that allowed him to compensate for his weakness and do these activities by himself. Each time we had a session, I would ask, “What do you want to focus on today?” Sometimes he wanted to focus on learning how to dress more independently and other days he wanted to practice repositioning himself in bed.
OTs recognize that our role is to align ourselves with our patients’ specific goals and priorities. John knew that I would problem-solve and try to adapt any activity to help him reach his goal of going home. What a privilege it is to partner with someone during a time of illness and challenge, so that they can achieve success.
Please join us in celebrating National Occupational Therapy Month in April.
*name has been changed to protect patient’s privacy