We know there is a direct correlation between participating in meaningful occupations and an individual’s well-being. As care providers, how can we ensure that we provide a supportive environment that encourages participation in occupations that are meaningful, purposeful, and fulfill valued roles for people?
As an occupational therapist, in answering this question, I would consider three main factors; the person, the environment and the occupation (Law, M. Et al, 1999). Within Meaningful Care Matters we have adapted this model to be about People, Places and Things.
People. We need to know about each individual person. Not just about their diagnosis, and functional abilities, but who they are, what is their life history? What important or valuable roles do they have? What interests do they have? What are their values and beliefs? We can’t make assumptions about this, we need to take the time to find out and develop a caring relationship with the person.
Places. The physical environment plays a significant part of supporting meaningful occupation. I can remember working for a disability services organization where there was a group of gentleman who had high behavioral support needs that lived in a really old, falling apart house, that had a dry, dusty outdoor space. They had to move at quite short notice as the landlord was selling the property. They moved to a lovely home that had a really nice garden and outdoor space. The number of occasions where ill being expressed as responsive behaviours, dropped significantly. The only thing that changed was the physical environment – it was the same people living and working together. The environment is more than just the physical environment though; it is also the cultural, socio-economic, institutional, and social environment that needs to be considered as well. You can have the most beautiful looking space, but is it cold and clinical or is it warm and inviting? Does it feel like a place you would like to stay and visit or do you want to get out of their as fast as you can?
Things. We need occupations, clusters of activities and tasks to engage in to meet our needs for independence, expression and fulfilment. These are carried out within the context of individual roles and multiple environments. We need to find out what are the activities and tasks that people want to do and engage with. If people are unable to complete the whole task or activity independently, what parts of it can they do? My nonna who lived with a dementia had amazing motor memory. I can remember still making hand made pasta with her for many years prior to her passing away, and she never used a recipe, just went by look and feel. I still can’t roll a gnocchi down the back of a fork to make those ridges the way she could. Activities and tasks should be active, changing throughout the day, and the environments they are undertaken in should too. This creates ongoing, meaningful occupation, that is purposeful and fulfils valued life roles.
Occupational performance is shaped by the dynamic transaction that occurs among the person, environment and occupation in which the person engages. Ensuring that we truly know people, provide a supportive environment, and have meaningful things for people to do and interact with, we can ensure we have optimized occupational performance, and contributed to positive well-being for the person.
Reference: Law, M (et at). (1999). The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy 63: 1, pp 9-23.