The Importance of Person-Centred Care in Occupational Therapy
Too often we try to justify why we struggle to implement person-centred care into practice. We argue that this individualised approach is only possible if we had more staff, more time, more funding or more access to better resources.
Alternatively, others argue that they are already person-centred and that developing, or challenging their approach isn’t necessary. Either way, we are unintentionally damaging our care, the individual’s experience of occupational therapy and the credibility of the profession.
Who am I?
My name’s Emma Gee. I am 39 and live in the Eastern Suburbs of Melbourne. I am a young stroke survivor, occupational therapist, inspirational speaker and author. I was working as an occupational therapist when I survived my stroke in 2005 at the age of 24 in Sydney. This was subsequent to the removal of a congenital abnormality in my brainstem called an arterio venous malformation (AVM).
My experience as both a therapist and patient has enabled me to share my dual insight to encourage others to improve their care.
Do you still work as an occupational therapist?
As I was unable to resume my previous role (due to it being too physically demanding), I now work in a more educational capacity. I have founded an inspirational speaking business at www.emma-gee.com and published a memoir, Reinventing Emma.
These endeavours enable me to draw on my experience and insights as a therapist and consumer to empower others. I aim to educate, challenge and inspire—particularly those working within the medical profession.
Why is person-centredness so important in occupational therapy?
Where do I start?
- I felt disempowered and vulnerable when the occupational therapist conducted a standard shower assessment
- The therapeutic relationship felt compromised when there wasn't a collaborative approach
- I found it demeaning when the occupational therapist made me practise my fine motor skills using a peg board
- Yet I found my performance improve when I engaged in tasks meaningful to me
My experience has taught me the huge role of person-centred care in all our intervention. Care that empowers the individual and is holistic. I write in my book:
“I knew as a therapist that a strong therapeutic foundation was crucial to elicit a person’s strengths, motivation and sustain their performance. But as a patient, I suddenly felt myself very closed to those who robotically assessed me assuming that I, the patient, would have nothing to contribute to the process. I needed to feel valued before I could reciprocate and build any rapport with them”.
Has the role and impact of occupational therapy changed throughout your recovery?
The roles of my occupational therapists have changed considerably throughout my recovery. Whether it was fitting me for a wheelchair in rehabilitation, carrying out a shower assessment, trialling public transport or modifying my home. More recently, my occupational therapist helped me with my NDIS appeals and procured visual equipment from Vision Australia.
In every phase occupational therapists have worked with me, they are a constant source of positivity, support and motivation in my life. They continue to enable me to endure the more challenging aspects of life after stroke, while simultaneously supporting me in all my endeavours.
Why did you take up speaking and writing?
Regaining the ability to write and speak again post-stroke and realising the importance of sharing my story to help others, were the catalysts for taking on speaking professionally.
I feel that by sharing my experience, I enable my audiences and readers alike to reflect on their own practices and situations. In doing this, it enables them to better understand and manage their own circumstances, both professionally and personally.
Writing my book was another means of relaying my experience. Although writing this was an extremely gruelling process, it was also immensely therapeutic. It enabled me to reflect on my own journey and relay many experiences—and articulate these in a way that others can better process, identify with and understand.
Did your background in occupational therapy assist in your recovery?
Initially, my background made my recovery more confronting. Yet as my recovery progresses, it has assisted me. Early on, being the ‘patient’ and undertaking therapy that I’d once carried out was so hard. I write in my book:
“OT was the most challenging therapy for me. More than in any of the other therapies, I found my role reversal hard to accept... it felt really wrong being a therapist in therapy. This was my former profession and I didn’t feel able to just relax and be a patient. My professional knowledge made me over- analytical and a little cynical.” p.143
I observed and experienced both good and bad care in all disciplines. In fact, at times I became embarrassed to be known as an occupational therapist who could have a negative role in one’s care. I relay a few of these ‘humiliating’ anecdotes in my book—like undergoing the standard shower assessment that put me in a very vulnerable position. But hopefully these examples expose the gaps that exist in our care.
Over time though, I began to see the HUGE positive role occupational therapists could have in each person’s life. I saw firsthand how care is so much more effective when it is holistic and meaningful. I write in my book how “the holistic and empowering nature of OT rekindled my love for the profession” p.145.
I felt more and more able to look at my experiences in healthcare and articulate how they could be more person-centred. I became adamant to try and use my experience to enhance experience of care, improve the role of occupational therapy and more so the credibility of our profession.
How have you injected meaning into your life?
Throughout my recovery, reinventing myself by participating in meaningful activities has been invaluable. Incorporating regular exercise (like swimming, yoga and walking my dog Gilbert) means my chronic pain is easier to live with.
These activities (my daily dose of meaning) also address the emotional toll that is huge in one’s recovery and vital in sustaining each person’s ability to participate. Further, withstanding the challenges that I encounter is easier to process and endure.
How do you practise what you preach?
I’ve returned to twice weekly rehabilitation at Epworth where I’m training to return to running. This is not only to improve my own posture, well-being and ensure that I practise what I preach, but it is also another means of advocating for others.
Returning to rehabilitation is beyond challenging. I’m having to ‘unlearn’ bad habits that I learnt post-stroke to get out in the community when I was in inpatient therapy 14 years ago!
This therapy and all the other interventions I receive, ensures that I have never ending content to draw on. I am also a recent participant of the NDIS and even that experience and the ongoing obstacles I encounter in this space provide me further examples and fuel my passion to advocate.
How can people hear more about your story?
My story is recorded in my memoir, Reinventing Emma. This is not just a detailed account of my stroke recovery, but also a valuable observational memoir for other health professionals, as I share my dual insights as a therapist that has travelled to ‘the other side’. The promotional video can be viewed here. It is available via my website www.emma-gee.com in paperback or ebook format.
I’ll also be presenting in the upcoming OT Exchange Conference where I look specifically at the three main concepts of Learn, Practice, and Enrich. I will draw on my dual insights as an OT and recipient of the care I’d once provided, focussing on the person’s perspective. To see me present, visit the OT Exchange 2020 event website.
I’m looking forward to continuing my journey and further advocating, educating and challenging at events like the OT Exchange. Another awesome opportunity for all of us to stop and reflect and improve our ability to provide person centred care in OT.