I was recently approached by a social worker, asking if I could give a talk on how to improve meaning in one’s life for a group of widows who are 55 years and older. This topic is very suitable to occupational therapy and the type of intervention that I provide. As a result, I readily agreed.
Confusing information
Some time later, I was surprised to hear that the social worker had shared with the group how sensory integration assists with transitions. I was a little confused. Sensory integration was not the topic that we had agreed upon. Further, there was no indication that sensory integration was necessary at all.
I’d like to take the opportunity to clarify some facts related to the profession of occupational therapy which could assist in clearing up some confusion here.
Let’s learn a little about occupational therapy
- What is occupational therapy.
- How developing meaning in one’s life relates to widows and to what extent this is relevant to OT intervention.
- What sensory integration is and when it is indicated.
- Whether a widow would experience sensory integration problems.
- To what extent transitions are dealt with in occupational therapy.
Let’s take the first topic at hand and then work through the others
What is occupational therapy?
I usually like to quote a recognized definition of occupational therapy. However, there are so many definitions of OT, which surely is confusing to everyone. As a result, I decided to share my own definition as I shared in a recent guest post.
To me, the title occupational therapy describes everything we are about. We use occupations as a medium of treatment in order to assist our clients to be optimally independent in all areas of their life, throughout the life cycle. Occupational therapy is concerned about what our clients need to or want to achieve in their lives both as long term goals and on a day to day basis.
We evaluate our clients’ unique situation in much detail in order to establish how the person functions as an individual, in their family, school / work, environment and their community and how each of these impacts on his / her daily functioning. This information guides us in formulating a treatment plan that is case specific and evidence based to enable our clients to live a functional and active life of meaning and purpose.
To clarify a few points before we leave the topic of occupational therapy, there are many models and frames of reference used in occupational therapy, this point will be important in a later section.
Aside from which model or frame of reference is used, in the above definition, you will see two important facts which relate to widows. The first is that we work with our clients throughout the life cycle. Where a transition from one phase of the life cycle to another is presenting with some difficulty that results in the client experiencing difficulty in fulfilling their daily life tasks, OT intervention will be necessary. Hence one can see that transitions in and of themselves are an integral part of OT and not limited to SI (Sensory Integration)
Further in the definition one can see that we look at how our clients function within the family. When a life role within the family has been affected in any way, as is the case of someone who loses a spouse, there can be a need for OT intervention.
How does developing meaning in one’s life relate to widows? Is this relevant to OT intervention?
Losing a loved one is hard for most of us and even more so when that loved one is a spouse. There are many areas of daily function that require adjustment, attention and, at times, intervention. Some examples can be where there were shared household tasks that now fall on the shoulders of the surviving widow. This can result in feeling overwhelmed, a need for assistance, time management, learning new skills especially where the husband used to take care of all banking and financial matters.
There can be very practical difficulties e.g. if one of the couple would take a child or children to school, extra mural or other commitments and the other would take different children to other commitment. This can become a logistical problem that may require planning and problem solving.
There can be a need for grief therapy, forgiving the husband for leaving this world with the widow having to continue with all the responsibilities that running a home and raising children entails. When it comes to marrying off children, as many in their 50’s might find themselves doing, this can be a challenge to a widow to manage on her own.
For some widows, the difficulties related to losing a spouse can present in sleep disturbance or other signs of stress. These in turn can affect one’s sensory processing, however, in this situation I would address the underlying problem first before considering a need for SI.
Companionship, love and intimacy are all areas of daily life that one usually finds in a healthy marriage. When a woman finds herself left a widow, there are many needs that can arise in terms of having to develop new relationships, to consider whether seeking another husband will be wanted and setting goals to achieve this and more.
These are just a few adjustments to be made for someone who becomes a widow. As is normal when faced with a time of change, many find themselves questioning the meaning in their lives, having to set new life goals or to find a new path to achieve previously important life goals.
All of these areas can benefit from occupational therapy intervention.
What is sensory integration and when is it indicated?
Sensory integration as defined in the book “Occupational Therapy for Children” by Jane Case-Smith, Anne S. Allen and Pat Nuse Pratt is explained as follows: ” Sensory integration holds special meaning for occupational therapists. In some contexts it is used to refer to a particular way of viewing the neural organization of sensory information for functional behaviour. In other situations this term refers to the clinical frame of reference for the assessment and treatment of persons who have functional disorders in sensory processing. Both of these meanings originated in the work of A. Jean Ayres, an occupational therapist and educational psychologist whose brilliant clinical insights and original research revolutionized occupational therapy practice with children.”
As we can see, sensory integration relates to a persons ability to receive sensory information, process it effectively and translate this into appropriate function. Whether sensory integration is necessary is determined by a qualified occupational therapist carrying out an evaluation, usually in the form of a sensory profile together with an interview in order to determine whether this frame of reference is applicable and whether there is any problem in the process of receiving sensory information effectively, processing this information and translating it into action. As mentioned in the second section, if the cause of a difficulty in receiving sensory information effectively e.g. a woman who has difficulty concentrating on a discussion is due to grief, then it is often necessary to deal with the grief, rather than apply sensory modulation.
Would a widow experience sensory integration deficit?
In more recent years, sensory integration has been found to benefit older children and even adults however, this is usually when there is a problem with sensory processing. As mentioned, sensory integration is only provided after an evaluation by an occupational therapist to determine that there is a sensory integration deficit that requires intervention. A major life transition such as the loss of a spouse although adjustments are needed to be made, does not automatically equal a problem in the area of sensory integration and hence a talk on sensory integration would not be my topic of choice for a group of widows.
To what extent do occupational therapists deal with transitions?
Being able to adjust to changes in one’s life and how this impacts on life roles and life goals is definitely an area that occupational therapists can have a role in. There are a number of models and frames of reference used in occupational therapy and I would not begin with sensory integration. That does not mean that I would not implement sensory modulation if the need was identified, however, it would not be my first choice without having met the widows or established the need.
What would be important is to identify the areas of daily life that are being affected by the women who have become widows and how this impacts on their occupational performance. From this suitable goals can be developed that the widow or widows would work on together with the occupational therapist. The potential intervention can be individual, in a group with other widows or even as a family with the orphans when this is necessary. It can be in the form of a talk, a talk that initiates further discussion or brain storming or a workshop or series of workshops.
I hope that the above information has given some insight and clarity as to occupational therapy and how OT intervention can apply to widows. If anyone reading this post is a widow or would like a talk or workshop for a group of widows / widows and orphans, please be in touch to schedule an appointment or to set up a talk / workshop.
I look forward to hearing from you.