Heart failure means that the heart no longer works at optimal efficiency to pump blood to the rest of the body. According to the MayoClinic.com, some of the underlying causes include a heart attack, leaking heart valves, congenital abnormalities, and infections. Because the heart doesn’t pump effectively, the body lacks enough oxygenated blood for the muscles to work properly and for the brain to function well. Many people find that their functional abilities change as this disease progresses and they seek care from an occupational therapist to help them regain independence.
Activities of daily living, or ADLs, are the tasks performed every day to care for the body. They include bathing, toileting, dressing and basic meal preparation. An occupational therapist provides training to a patient with heart failure to ensure he can perform these chores independently, efficiently and in a safe manner. Training may entail task simplification or instruction in new techniques to perform an activity.
People with heart failure become fatigued easily, which can increase safety risks, especially for those living alone. Occupational therapists provide education in making the home as safe as possible, rearranging items if necessary to lower the risk of falls or injuries. Patients with heart failure benefit from having items moved from high shelves to lower ones or even to countertop level. An OT may recommend removing throw rugs or installing grab bars as additional safety precautions.
Because the muscles of the body are chronically deprived of oxygen, heart failure patients may eventually feel weak and frail. Occupational therapists provide exercises to improve muscle strength, primarily focusing on the upper extremities. Beginning with a gentle program of active movement and steadily progressing to more challenging exercises with resistance bands or hand weights, the OT builds strength and improves use of the arms.
OTs also focus on training heart failure patients in the techniques needed to conserve energy and limit episodes of shortness of breath and exhaustion. M.V. Radomski and C.A. Trombly in "Occupational Therapy for Physical Dysfunction" report that the OT’s goal is to maximize a patient’s ability to function independently in his surroundings. To reach that objective, the occupational therapist provides instruction in deep breathing exercises, compensatory techniques and recommendations on environmental adaptation so that movement is as efficient as possible.
Most people with heart failure struggle to complete self-care tasks as a result of their muscle weakness, low endurance or a combination of the two. At times, special equipment is necessary to maintain independence as the occupational therapist helps to address these issues. A tub bench, raised commode, dressing aide or reacher device may be recommended to assist in the completion of daily activities. The OT then trains the patient in use of the adaptive equipment for safety and self-reliance.