In the lead up to AHP Day on Monday 14 October 2019, we are sharing an interview a day from some of our Allied Health Professional staff. Today's features the lovely Fatema Mullamitha, Occupational Therapist, Team Lead for Early Supported Discharge Stroke Team, Integrated Community Rehabilitation Service.
Becoming an occupational therapist
To be honest, I didn’t know much about occupational therapy (OT) when I was growing up. A friend of mine was studying it and I got talking to her as I thought it sounded very interesting. I did some research about it and then decided to enrol on the course. After qualifying in India, I came to the UK.
Most of my experience is in adult physical health. I always loved working on the rehab wards whilst working in inpatient hospital settings, I particularly enjoyed neurology and stroke. I now work on the early supported discharge stroke team and I’ve worked in the community for about seven years.
About Occupational Therapy
OT focuses on developing, recovering, or maintaining the daily living and working skills of people with physical, mental, or cognitive impairments. OTs complete a holistic assessment of a person – physical, cognition, psychosocial, emotional, environmental and evaluate how all the different aspects impact upon the person. The core aim is to enable people to be as independent as they can be. For some, that can mean to being able to get dressed by themselves, going back to work, returning to driving, using public transport, being able to cook or just be able to feed themselves – whatever is important to them. Together with the patient, we set meaningful, realistic goals and a treatment plan to achieve them.
OTs work in a variety of fields like mental health, paediatrics and forensics. After an acute illness a person may be admitted to hospital; in such cases, the rehabilitation starts in hospital but then continues in the community. Having worked in these two settings I think there is a huge role for OTs in both the settings. More recently, there are many OTs working in A and E departments, trying to reduce admissions and helping people be looked after at home.
I do love working in the community as I feel you get a better idea about a person’s problems and impairments, and are able to work with them to achieve their goals. It sometimes surprises me to see how well people manage and develop coping strategies. The work can be challenging but also very satisfying.
People have a running joke that we OTs just get patients to make a cup of tea! But actually making a cup of tea is a very insightful activity. We do use this as part of our assessment as there are a number of things we can observe and analyse – you are able to see if a person can initiate the task, sequence the task, safety awareness, standing balance, hand function, cognitive functioning and so on.
The power of the human body
Every person is unique, a stroke will affect everyone differently depending upon what type of stroke it is, what area of the brain it is and their risk factors etc. Neuroplasticity is the brain's ability to reorganise itself by forming new neural connections throughout life. Neuroplasticity also allows the neurons in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.
We sometimes see patients a few years after their stroke, after they have left our service. In some of those cases, they have reached a plateau in their recovery, but others have continued to progress really well, which shows their determination and continued hard work – every person’s stroke impact and recovery is different.
OTs work with a wide range of AHPs and other professionals. In our team we have physiotherapists, speech and language therapist, nurses and therapy assistants. We undertake a lot of joint assessments with speech therapists and physiotherapists. We also liaise with orthoptists, social services and other services.
We can link in with the Driver and Vehicle Licensing Agency (DVLA) to support people with returning to driving. We also refer to local charities like the Stroke Association and to health services, such as Expert Patients Programme and Physical Activity Referral Service for continued support for patients.
The best thing about being an occupational therapist
My favourite part is when people achieve their goals that were set together during their initial appointment. Sometimes weeks or even months later we see that they have made so much progress, it is wonderful.
Our office always has chocolates and biscuits – people are kind and so thankful for their time with us. We have received some interesting gifts too: one of our team members was once given an air conditioning unit, which unfortunately we couldn’t keep and another received a tin of paint!
What means the most to me are the sentiments and sincere words. When someone has upper limb weakness and can’t use their hand, but weeks later can send us a hand-written card, it means a lot. One patient who had quite a dense stroke was an illustrator and sculptor. He was able to still use one hand and he made me a model of a dog. It is nice to know we make a difference to people.