Overcoming everyday difficulties

Your rheumatoid arthritis (RA) can affect you in many different ways, but your occupational therapist will help you with some of the difficulties you face.

Making everyday activities easier

Your occupational therapist can help you to analyse your work, household and leisure activities, find out where there are problems and suggest changes that might help you. 

You may need to rethink the way you do things, such as:

• using your hands differently
• positioning yourself more comfortably
• taking more rest breaks
• getting help with heavier jobs.

For example, if you have problems with ironing because it’s uncomfortable to stand for too long or to hold the iron, then the solution may be to sit or perch on a stool, to wear a supportive wrist splint and/or to use a lightweight iron.

Gadgets and equipment

Your occupational therapist can advise on the best gadgets to make tasks easier at home or at work. There’s a huge range of aids and appliances available – from chunky-grip pens to vegetable peelers. If need be, the therapist can help you get special equipment such as kettle-tippers, bath seats, raised toilet seats and stairlifts.

You can get equipment through a local retailer or from a community equipment store or via a local retailer. Your occupational therapist can advise on what you need and where to get them.

Community occupational therapists are experts in home adaptations such as ramps, level-access showers and stairlifts.

Getting around

If you have difficulties getting around, your occupational therapist can suggest vehicle adaptations to help you, such as a panoramic-view mirror if turning your head is difficult. Or they can help you decide on the best choices for your next car, such as an automatic car. 

For more complex problems your occupational therapist can assist with getting help from other agencies or a specialist mobility centre. They may also be able to advise you about wheelchairs and scooters.

What is occupational therapy?

Occupational therapy aims to help people who have difficulty with their everyday work, home or leisure activities because of illness or disability. Some occupational therapists (OTs) have specialist knowledge in dealing with problems caused by RA, and they’ll work with you to find solutions to these difficulties, allowing you to carry on independently with your daily activities.

Occupational therapy can help you manage your RA in a number of ways:

• advice on using your joints without straining them
• splints to support your joints while working or resting
• recommendations on gadgets and equipment to help you with your comfort in your home and at work
• exercises to improve hand and wrist movements and grip
• advice on planning and balancing daily activities with rest to reduce tiredness (fatigue)
• help and advice on driving and mobility problems
• relaxation techniques
• help and advice on coping physically and emotionally with the changes your condition may bring.

Occupational therapists may work within the public health services, in private practice or in a charity. Your GP, rheumatologist or rheumatology nurse may refer you to an occupational therapist, or you can ask to see someone if you feel it would be helpful. In some cases, you may be referred to a specialist hand therapist who’ll be able to offer similar help and advice.

If you’re having trouble managing at home, you can ask your doctor to put you in touch with an occupational therapist. They may be able to see you in your own home.

How does occupational therapy help?

At your first appointment, your occupational therapist will assess your condition, including which joints are affected and where you have pain. They’ll ask about any problems you’re having with everyday tasks. It’ll help if you think about these before your appointment. This might include difficulties with:

• washing and dressing
• household tasks and cooking, including difficulty using appliances
• getting around both inside and outside your home
• driving
• work activities
• leisure and social activities
• childcare and looking after others
• sleep
• using your hands.

When they’ve highlighted particular problems, your occupational therapist will explore possible solutions with you. This may include:

• practical advice on overcoming everyday difficulties
• suggesting different ways to help you do things more easily
• advice on managing work and leisure activities
• discussing your condition and helping you to help yourself
• providing advice on your condition either one to one or through education/information groups
• advice about managing mood and stress
• providing splints or arthritis gloves to rest or support your joints and help reduce your pain
• suggesting hand exercises to help improve movement and grip
• referral to other agencies, for example physiotherapy or Social Services.

Helping you to help yourself

For people living with RA, it’s important to start looking after your joints as soon as possible. Your occupational therapist will show you how to reduce the strain on your joints. This is known as joint protection. It doesn’t mean you should stop using your joints, just that you should try to use them differently. for example by:

• spreading the load over several joints
• allowing larger, stronger joints to take more of the strain
• making sure you’re not twisting or straining your joints when you use them.

They can be applied to household, leisure or work activities.

Your occupational therapist can also advise on how to manage the fatigue that’s often associated with arthritis by:

• balancing activities with rest
• planning ahead
• prioritising your tasks.

Relaxation techniques can help to counter the effects of stress and fatigue, and can help with pain control.