Stroke is a significant public health concern and has a notable impact on individuals and their families. The most significant and permanent impact of stroke is a long-term disability. Occupational therapists often work with individuals who have experienced a stroke and complete assessments, goal setting, interventions and evaluations throughout the therapeutic process.
Assessments help therapists understand the extent of impairment, limitations with activities or participation in occupations, and help understand how environmental and social factors influence performance. Occupational therapists attempt to understand a client's (or patient's) care relative to their culture and lifestyle needs. Often, family and friends involved in the patient's care are consulted to help develop a better picture of the client's wants and needs.
Goal setting is always a collaborative process between a therapist and their client. This step involves in-depth conversations involving negotiation and education. Goals are set to inspire the client, instilling hope, motivation and promote engagement in the therapeutic process. Goals should be meaningful to the client's identity and shift over time as they gain skills and capacity into their strengths and limitations. Occupational therapists often use the acronym SMART for goal setting, which stands for specific, measurable, achievable, realistic and timely.
Interventions ultimately enable clients to meet their goals and promote activity and participation in daily activities. Occupational therapists attempt to focus on occupation-based interventions, including using occupations to establish or remediate client skills and body functions to promote health or prevent dysfunction. Occupation-based interventions are connected to the longstanding occupational therapy philosophy as they are linked to occupational performance goals. Unfortunately, occupation-based interventions may not be possible for all clients or care settings. Occupational therapists are strongly encouraged not to lose sight of occupation as the means for interventions.
Evaluation allows the intervention's suitability to be monitored, providing the therapist opportunities to make adjustments if required. Evaluation of client outcomes is essential to monitor to determine if therapy interventions have been successful. Without clearly defined goals, it is difficult to determine whether clients are satisfied and achieved their goals. Occupational therapists continually evaluate efficacy and safety when working with clients living with stroke.
Edmans, Judi. Occupational Therapy and Stroke. John Wiley & Sons, 2011.