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The Challenge of the Duvet Cover

Or: “What is Occupational therapy?” (OT)

People often ask me what it is exactly that occupational therapists (OTs) do. I often reply that OT has to do with any activity people engage in during the day. It addresses any sensory-motor, visual, perceptual or cognitive deficits that might prevent people from performing their daily activities. Be it self-care, work or leisure.Somebody struggling to put on a duvet cover

An example of the complexity of a very basic daily task and its requirement dawned on me as I was making my bed last night.  I am always so happy having my bed linen all washed and dried, all clean and fresh. But there is always this daunting task of putting the cover on the duvet or rather putting the duvet in its cover. For this task I need to prepare both physically and mentally. I try to increase my chances for a smooth, efficient and energy saving experience by breaking down this chore into its different components and engaging in what is termed in the occupational therapy jargon as “activity analysis”.

In order to do the above I consider the following:

1.  My body structure and function:

  • I have to consider the fact that my short stature is not to my advantage when trying to complete this task. I will probably have to adapt/plan in accordance. To my benefit I have full range of motion in all upper limb joints, normal tone, good muscle strength and good endurance. I have no cardiac or respiratory problems so I will not be at risk of becoming short of breath or exert too much energy.

2.  Skills needed to complete my task:

  • Sensory/perceptual: I will need to visually work out which is the narrow side of the duvet cover and where to position myself. Should I attempt to crawl/dive inside the duvet cover with the aim of reaching its narrow end in relative darkness or should I stand still, maintain a solid standing balance which will allow me to abruptly and with the use of some momentum turn the duvet cover inside out? Visual abilities, such as oculomotor control, visual discrimination and hand-eye coordination are among other skills that I will need to have to increases my chance of success. At some point my vision will be excluded and I will be required to rely on my proprioception (being aware of the position of my joints in space) to find my way through the dark maze of the duvet cover.
  • Motor/praxis skills: In order to have any success I will have to adjust my body position while maintaining my balance. I will have to coordinate my right and left in a symmetrical manner some of the time and in a complementary manner other times. I will also need to employ a strong grip and to have some fine motor abilities.
  • Cognitive skills such as an ability to focus, plan and sequence my actions as well as to be prepared to problem solve should unexpected obstacles occur. I will need to have some insight into my performance in order to evaluate how well I performed and whether the outcome is satisfactory.
  • Emotional regulation: Given that this particular activity is demanding for me I am prone to become frustrated. I will need to try to stay calm and collected. My self- esteem may also be affected by the level of success or by the ease with which I am able to complete the task.

3.  The environment needs to be spacious enough

  • and free of any hazards (such as my cat) so that I don’t injure myself or others in the process.

This is only one example of an everyday task and its demands. Most of the everyday personal activities of daily living (PADL) and instrumental activities of daily living (IADL) which people engage in come almost automatically to them. Everyone develops specific ways that work for them and never think twice about what it takes to complete them.  It is only when people are debilitated by an injury, illness or old age that they realise what needs to be accomplished even before they step out of their front door.

Occupational therapists employ different approaches and techniques.  Some have to do with strengthening what’s needed for the different components of the required tasks, re- educating the client regarding correct movement patterns and the correct approach required to perform a task, and some have to do with modifying the task, teaching the client compensatory techniques and adapting the environment to facilitate the clients participation and success.

If you think that you or someone you know could benefit from OT input, please contact us. We will try to help you overcome barriers and to fully participate in activities which are important to you.

 

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