Teamwork between occupational therapy and informal caregivers essential
In Guyana, Rehab Assistants and Physiotherapists are working very hard to improve the lives of persons with temporary and permanent impairments and disabilities. Without their efforts, a lot of their patients would be unable to do the activities they want to do. Rehabilitation staff have the knowledge and skills to give their patients the right therapy and advice to help them to live their lives in as good a way as possible.
Rehab Assistants are trained in three subjects: physiotherapy, speech therapy and occupational therapy. I want to talk a little more about that last subject.  Occupational Therapy promotes the health and well-being of individuals of all ages who have disabling conditions.
This is done by improving their ability to perform everyday activities and tasks.  Rehab Assistants are problem solvers who empower people to take control of their lives.  They use and adapt occupations (activities) or the surroundings to enhance the development and treatment or prevention of disabilities. You can think about difficulties in activities as self care, household, work, leisure, transport, seating, ergonomics but also learning, thinking, mental health, using the senses or movement.
When a child is born or a person gets sick from an illness or has an accident which leaves them with limitations, not only the person with the impairment is involved but also their whole environment.
Think about parents, partners, children, other family members, friends and neighbors. They are part of the whole system around a patient and as such are an important part of the rehabilitation process. It is heartwarming to see how committed a lot of people are to help and/ or take care of patients going through rehabilitation.  These people play a very important role in the rehabilitation process.
What occupation therapy tries to do is to teach patients to take care of themselves again. This starts as early as possible after the injury occurs, sometimes already in the first year of a baby’s life, e.g., when the baby is delayed in developing basic but essential movements.
It is important to start therapy quickly after the injury happens or is recognized as people need to learn activities again or in a new way.
Learning is much easier than unlearning a habit. You can compare it with raising children or trying to quit smoking.  When you start therapy early, a person learns directly the most natural or independent way of performing a movement and activity.
It is fantastic that informal caregivers take care of the patients at home as they often need lots of help and support in the beginning.  However, patients hopefully improve and even without improvement it is important to stimulate their independency. Even when people have impairments they don’t need to feel handicapped. A handicap exists when a person is not able to do what he or she wants. This is possible because of physical or mental problems the person has but can also be because they live in an environment which is not adjusted to their needs. Think about the problems associated with the accessibility of buildings or transport in Guyana.
After an injury, patients sometimes feel that they are depending on others, and  can’t do anything for themselves and their self confidence and self assurance drops as a result. But even with an impairment, a lot is still possible!
With help of occupational therapy, patients can explore various ways of doing activities by themselves. However this is not always easy. Most of the time it involves trial and error and a lot of repetition. Rehabilitation is top sport. Rehabilitation is a 24h process. It needs a lot of time, patience and comes with frustration sometimes.  Remember as a child nobody learned to stand up and walk in one day.

The Rehabilitation Assistants need the help of the patients’ caregivers to continue their work at home. This doesn’t mean taking over the activity but instead stimulating and supporting the patient to try it themselves in the same way they learned during occupational therapy.
Some informal caregivers can have the intention to keep taking care of the patient and keep the patient dependent on them. Think about the future of the patient and yourself, will you be taking care of this person intensely for the rest of their life?  Remember it is also very ‘care giving’ to take a step back. It can be very difficult to see somebody struggling with an activity while you stand with your hands behind your back, but without trying the patient will never learn and improve. Give the person the time to learn the skill or activity again or in a new way and support them only where necessary. In this way your role as a care giver will disappear and will go back to that of only partner, child, parent, etc, which is what it is supposed to be.
So the strategies and advice a patient gets during occupational therapy also need to be known by the caregivers. When the caregivers can take the patient by the hand instead of taking over the activity, the patient can get their independent life and self confidence back. This only works when there is a good teamwork between Rehab Assistants, physiotherapists, patients and the informal caregivers. Rehabilitation: we do it together.