Rheumatic Arthritis and Occupational Therapy

Subject: Nursing
Pages: 8
Words: 2022
Reading time:
8 min
Study level: College

In life, people always contract various diseases some of which are curable, and others that are chronic and end up causing lifelong effects. People are forced to live under one form of handicap or another, and their lives completely transformed, turning some who were breadwinners of the family into dependants. Rheumatic arthritis is one of the medical conditions that physically incapacitate people, making them fully dependent on others throughout their lives on earth. In as much as Rheumatic arthritis is a thorn in the flesh of the sufferers and their families, therapy can alleviate some of the emotional and physical pain, that flank the disease (Thew, 2011). With relentless therapy, it is possible to achieve some semblance of normalcy in the lives of the affected.

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Rheumatic arthritis is defined as an inflammatory disorder that infects synovial joints of the body. This disorder affects the small joints which include: hands and feet joints, though in some cases rheumatic arthritis also affects larger joints like shoulders, knees and hip joints (Govonzy & Weyand, 2001). Additionally, the disorder can spread to other soft tissue organs like the lungs and the heart (Lahita, 2001). Medically speaking, Rheumatic arthritis is caused by the erosion of the articular cartilage of bones within a joint. This leads to increased friction between the bones, which causes pain and discomfort especially when moving the joint (Lahita, 2001). For the most part, patients usually present symptoms such as inflamed joints that are soft and have a temperature that is slightly higher than the rest of the body. Furthermore, joints become stiff and painful, thereby impeding movement (Lahita, 2001).

Much as many people attribute genetic makeup to the cause of Rheumatic arthritis, medically the exact cause of the disorder is not known (Govonzy & Weyand, 2001). There are some researchers who purport that the disorder might be caused by some kind of bacteria, which activates the process of cartilage and ligament erosion (Lahita, 2001). The disease highly affects people who are in their thirties and above, though it affects women more than men (Thew, 2011). Rheumatoid arthritis affects one out every 1,000 children in a given year (MedicineNet, 2012). These children face a lot of challenges in school because their peers and teachers cannot reconcile with the fact that the disease can be found in children too (MedicineNet, 2012). Due to the genetic predisposition, the disease is more prevalent in some families than others (Lahita, 2001; Govonzy & Weyand, 2001). Disability is a medical condition that can be physical or mental in nature and tends to affect a person’s senses or motion (MedicineNet, 2012). Incidentally, Rheumatic arthritis is a physical disability, because it curtails ordinary body movement due to the severe pain that comes about, when one tries to move the joints. Rheumatic arthritis is an interesting area of medical study because it is a disability that is not known to many, and people find the disease strange when it affects children (Dudouioz, Laporte, Hall, Ashe & Douglas, 2004).

People suffering from physical or mental disabilities require special attention. Occupational therapists are professionals, who help people with mental and physical problems live fairly normal lives (Lahita, 2001). Occupational therapists are majorly concerned with; making the environment conducive to the affected people, as well as making domestic utilities user-friendly, to enable them to cope with their condition. On top of that, the occupational therapists have a role of teaching the incapacitated people, how to do the conventional day-to-day activities in a rather unconventional way, which is easier for them (Thew, 2011).

Physically disabled people get offended very easily, sometimes what other people may take as a normal joke can be offensive to them (Johnson, Carlauist, Storesson & Eberhardt, 2005). Consequently, occupational therapists take up the role of sensitizing various institutions on how to relate with these, and also counsel the incapacitated. They need to be informed that they are still useful in society, to help them avoid feelings of low self-esteem, depression and even death because others commit suicide (Dudouioz et al., 2004). Occupational therapy is an interesting career because of the satisfaction an individual derives from helping the disabled, and making patients adjust to a society that is perceived as normal.

Occupational therapists are regulated by the International Classification of Functions (ICF). The ICF is a framework that incorporates social, psychological, and biological facets of therapy, in an effort to ensure that the lives of people with disabilities or terminal illnesses are as close to normal as possible. The ICF prescribes the best practices, which occupational therapists ought to adhere to in their duties (Govonzy & Weyand, 2001). Patients with rheumatic arthritis are helped within the framework of ICF to learn how to intermingle with others, and at the same time become self-reliant. This leads to proper care being administered to these people (Atchison & Dirette, 2006). Furthermore, ICF exhorts patients to religiously take their medication, to avoid deterioration of their condition (Didier & Bigand, 2010).

The society needs to be educated to accept the afflicted and treat them as part of the society, a duty that is achieved through the integration of ICF (Atchison & Dirette, 2006). Victims of disability many a time go through a denial phase that erodes their self-worth and makes them wallow in self-pity (Ebart & Kerns, 2010). The ICF provides the framework for helping victims come to terms with their inadequacies, while at the same time appealing to the public on the need to be more receptive to the handicapped (Ebart & Kerns, 2010). By and large, the ICF provides guidelines on how the sick should be cared for, in a bid to ensure that there is professionalism and high-quality assistance in the care for the sick (Hammond, Young & Kidao, 2004).

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Individuals who are disabled by RA usually face a host of challenges both at work and at home. At workplaces, the RA patients usually find it difficult to cope with the pace of work, because their joint movement is impeded especially when their duties are physically demanding. At the same time, the inability to move around due to stiffness of the joints will make communication a bit harder for people with arthritis, a scenario that is worsened by prolonged sitting (Mackenzie & O’Toole, 2001). For example, it is difficult for a mother who is disabled by RA to do the laundry at home, wash her kids and move from one room to another to take her children to bed. Additionally, there might be other people who have negative attitudes towards people with arthritis, and this might be difficult to deal with leading to difficulty in getting jobs (Didier & Bigand, 2010).

At the same time, the family of the afflicted suffers major economic setbacks. This is the case especially if the afflicted is the breadwinner of the family, and cannot be economically productive due to the disorder. On the same note, managing the disease requires the purchase of prescribed medications, as well as the presence of an occupational therapist and this requires money (Didier & Bigand, 2010). Consequently, the savings of the family are depleted in the course of taking care of the patient, thus rendering the family economically unstable. In addition, people with rheumatic disabilities sometimes find it difficult to engage in their desired careers, since the careers might be requiring some form of physical commitment which they may not be able to provide.

Though there has been creation of public awareness as far as Rheumatic arthritis is concerned, there is a group of people who take it to be a mystical disease, hence will be skeptical when it comes to interacting with the patients (Mackenzie & O’Toole, 2011). As a result, people with arthritis find it difficult to have long-term friends. In some instances, friends try to avoid people with rheumatic arthritis because they look at them as a burden, since they are unable to carry out certain mandatory activities.

Houses of people with chronic RA have to be customized with special facilities like wheelchair ramps, in order to help them move from one room to the other (Mackenzie & O’Toole, 2001). At the same time, school-going people who have rheumatic arthritis find it difficult to walk to school. Ordinarily, school work entails a lot of writing during course work as well as exam time. A lot of motion accompanies hand movements when writing and this causes a lot of pain to students with RA (Radomski & Trombly, 2007). Even when the patients have other means of going to school other than walking, they have problems sitting for long hours because this increases stiffness in the joints, which makes walking a problem.

Occupational therapists have a duty of identifying areas in which RA patients require attention (Radomski & Trombly, 2007). Firstly, rheumatic arthritis patients usually suffer from emotional torture, due to stress associated with the disorder (Kielhofner, 2007). Therefore, occupational therapists give counseling services to these patients and enable them to accept their condition, thus avoiding depression (Atchinson & Dirette, 2006). Additionally, occupational therapists teach the rheumatic arthritis patients how to go about their domestic chores with minimal dependency on others, because people will not always be around to assist (Didier & Bigand, 2010).

Moreover, the pain in the joints can be reduced by regular therapeutic exercises and proper diet. Consequently, the occupational therapists must assist the patients in doing exercises that will increase the strength of the joints and muscles, as well as eliminate the stiffness that usually occurs when one sits for long (McIntyre & Atwal, 2005). It is important also to note that the joint pains can sometimes be excruciating, therefore occupational therapists need to treat the joints by using warm water, ice cubes or pain killers (Kielhofner, 2007). In addition, the occupational therapists help in giving massage to RA patients, given the fact that they are professionals and know which parts of the body need massage and which ones do not. However, in extreme cases when the patients are unable to go about their daily activities, occupational therapists step in and do the work for them (Kielhofner, 2007).

Usually, occupational therapists use various strategies to carry out their work of assisting people with Rheumatic arthritis. One of the strategies is assessment of the state of their condition to recognize areas where one needs assistance, and thus document where the patient unnecessarily uses his or her energy (Ebert & Kerns, 2010). After this, the occupational therapists are able to formulate a therapeutic plan on how to administer the exercises (Dudouioz et al., 2004), depending on whether the patients need to increase their strength or not. Arguably, occupational therapists usually ensure that RA patients use minimum effort in conducting their daily duties, by making known to them the areas where they waste time and effort, in unnecessary movement (McIntyre & Atwal, 2005).

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People with Rheumatic arthritis need supportive devices to help them move from place to place, because of the pain associated with non-assisted movements (MedicineNet, 2012). The role of the occupational therapist is to recommend assistive devices, which are appropriate for every patient. The devices may be crutches, conventional wheels chairs or even electric wheelchairs in worst-case scenarios (Atchinson & Dirette, 2006). People who are actively engaged in the corporate world and students who are suffering from RA usually need writing splints to assist them to do needful writing. A writing splint is a device that aids RA patients to write with minimum discomfort. The device is modeled to fit into the palm where it provides a rest point on which the patient can comfortably grip a pen which is clamped between the thumb and the index finger and is usually made of plastic (MedicineNet, 2012). Rheumatic arthritis is a disease that causes disability, and should never be trivialized. It should be treated like any other physical impairment (Kielhofner, 2007). Therefore, the ICF in conjunction with occupational therapists should always champion the interests of patients with Rheumatic arthritis, to demystify the disease (Hammond et al., 2004). Furthermore, the work of occupational therapists should be highly appreciated, because without them many disabled people would have a hard time coping with life.

References

Atchison, B., & Dirette, D. K. (2006). Conditions in Occupational Therapy: Effects on Occupational Performance. Amsterdam: Wolters Kluwer.

Didier, J. P., & Bigand. E. (2010). Rethinking Physical and Rehabilitation Medicine: New Technologies Induce New Learning Strategies: New York: Springer.

Dudouioz, C. L., Laporte, D., Hall, M., Ashe, B., & Douglas, C. (2004). Transformation of Meaning Perspectives in Clients with Rheumatoid Arthritis. American Journal of Occupational Therapy, 50(4), 398-407.

Ebert, M. H., & Kerns, R. D. (2010). Behavioral and Psychopharmacologic Pain Management. Cambridge: Cambridge University Press.

Govonzy, J. J.,&Weyand, C. M. (2001).Rheumatoid Arthritis. Basel: Karger Publishers.

Hammond, A., Young, A., & Kidao, R. (2004). Annals of the Rheumatic Disease. The EULAR Journal, 63(1), 23-30.

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Johnson, P., Carlauist, C., Storesson, A. L., & Eberhardt, K. (2005). Occupational Therapy During the First Ten Years of Reumatoid Arthritis. Scandinavian Journal of Occupational Therapy, 12(3), 128-135.

Kielhofner, G. (2007). Model of Human Occupation: Theory and Application. Philadelphia: Lippincott and Williams and Wilkins.

Lahita, R. G. (2001).Rheumatoid Arthritis: Everything you Need to Know. New York: Penguin Group.

Mackenzie, L., & O’Toole, G. (2011). Occupation Analysis in Practice. Hoboken: John Willey & Sons.

MedicineNet. (2012). Arthritis in Childhood: Juvenile Arthritis, Juvenile Rheumatoid Arthritis. Web.

McIntyre, A., & Atwal, A. (2005). Occupational Therapy and Older People. Hoboken: John Wiley & Sons.

Radomski, M. V., & Trombly, C. A. (2007). Occupational Therapy for Physical Dysfunction. Philadelphia: Lippincott Williams & Wilkins.

Thew, M. (2011). Role Emerging Occupational Therapy: Maximizing Occupation Focused Practice. West Sussex: Blackwell Publishing.