older adults great clients for ots

Why Older Adults Are Great Clients for OTs

The following article is a guest post from Kathleen Ponce, OTR/L. Kate has been an occupational therapist for nearly 5 years and has worked in a variety of settings. She is passionate about helping individuals overcome mental and physical obstacles in order to improve their quality of life.

In addition to her clinical work, Kate writes for and manages the website, AllThingsOT.com, an online collection of occupational therapy resources for students and practitioners.

When I was an OT student, professors and other OTs were always telling me why they chose to work in a particular setting or with a particular type of client. They’d say, “Working with kids who have disabilities is too sad, so I work with adults,” or “Working with adults who are approaching the end of their life is so sad, so I work with kids.”

I was fascinated by the brain and thought I’d work exclusively in neuro, perhaps even in a research focused setting where I could help develop the newest and greatest techniques to help my patients. But after nearly 5 years of working as an OT in a variety of different settings, I can say without a doubt that older adults – with any diagnosis – are my favorite clients.

The Developmental Process

Why, you ask? The answer lies in your class notes on development. If you look at the entire developmental process as one cohesive whole, you notice several trends. On the front end of that continuum, when the individual is very young in age, development across all domains occurs very rapidly and changes are happening all the time.

In a matter of weeks, the newborn goes from being completely dependent on his caregivers and his own reflexive instincts for survival to being able to hold his head up, smile, and recognize his own hands at the end of his little arms, even if he doesn’t yet have full control over them or a full understanding of their capacity.

Rapid Progress of a Child’s Development

And this once newborn is now crawling, pulling himself up on furniture and other objects, sitting unsupported in his highchair, and feeding himself small bits of cereal and other foods. He is making sounds in an attempt to communicate and may even be saying a few intelligible words.

Wait a few years longer and this child is now preparing to start school. He’s walking, running, and playing, kicking a ball and perhaps even “competing” on a sports team. He uses scissors and copies some letters. He knows his colors and numbers and may even be starting to read.

Even if this child is developing slower than his peers, his progress is still remarkable when viewed from the perspective of how far he has come in so little time. The infant you once knew is now barely recognizable in the capable and independent child standing before you. His life is ahead of him and he is full of potential.

Peak Physical Performance

The rapidity of his development will slow somewhat now but will still continue for a few more decades. By the time he reaches his twenties and thirties, his fine motor control, physical strength, and cognition will all be at their peak level of performance. If he is athletically gifted, he could possibly be playing sports professionally. He will likely be working at a career and perhaps even starting a family of his own.

Some might say that these are now the best years of his life, and at first glance it does appear that performance only goes downhill from here. Fine motor control will begin to decline as he enters his forties and grows through his fifties and sixties; so will his physical strength and his ability to learn new concepts and to multitask.

older adults occupational therapy

The more he ages, his memory will likely be affected and he may develop a decrease in his short term memory or even experience a decline in cognitive performance known as dementia.

Peak Social and Cognitive Performance

While the physical domains of fine and gross motor control and displaying a definite decrease in function, the social and cognitive domains are now shining.

This older adult is displaying increased wisdom and an increased wealth of knowledge, known as crystalized intelligence. His experiences over the preceding decades allow him to calmly address and resolve emotionally charged problems. He can see past the distractions and the clutter that cloud the judgement of the young and impart a perspective that they can only hope to someday possess.

Why Older Adults are the Best Clients

Perhaps the reason is a bit selfish, but with their wisdom, with their knowledge, with their perspective, they can give to us as their therapist as much or more than we can ever give to them. If they share their wisdom, knowledge, and perspective with us and if we are open to learning from them, we can leave our workdays filled instead of drained, with new perspectives and attitudes from the experiences that have been shared with us.

In the end, as OTs who work with older adults, we may help our clients perform the occupations that are important to them, but it is our clients who help us to see how those occupations make life meaningful.

And in so doing, it’s us—not them—who learn how to live life to the fullest. Our job is simply to make that fulfillment possible.

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  • maud makoni November 18, 2020   Reply →

    Hi Sarah,

    This a great website and very informative. I find that you speak to all relevant audiences within our profession, and that is amazing. I am interested in developing a resource for Level 2 hand therapy students for my OTD Capstone. I would love to have some time to discuss my project and get some of your opinions regarding this practice area.

    I can be reached at m.makoni@usa.edu.


    Maud Makoni OTR/L, CHT.

    • Sarah Stromsdorfer, OTR/L December 7, 2020   Reply →

      Hi Maud, I’m so sorry I just saw your comment, but if you’re still working on your capstone and would like to discuss, you can shoot me an email at Sarah@myotspot.com any time 🙂 Thanks!

  • Sherri Sones November 21, 2020   Reply →

    Dear Kate,
    Thank you for sharing your refreshing response to working with older adults. Compared to the developmental stages, an infant to a gradual decline as we age is a real analogy. Working with older adults has been my passion as an OT. Teaching work simplification is helpful, and using adaptive devices a relief. The patient seems enlightened and pleased to learn they can regain that task, which has become impossible. For instance, putting on their socks without effort and pain. It is such a pleasure to see them smile and say thank you! Have you found a device to meet multiple needs for a patient that seems to surprise the person in particular?

  • Kate Ponce November 27, 2020   Reply →

    That is a great question, and I had to think about it for a bit. Honestly, I think it has been the strategies and techniques I have taught to patients that have had a more significant impact on their independence and quality of life rather than any specific piece of equipment. If I have to choose one piece of equipment that has appeared to have had the most significant impact on client satisfaction, though, I would probably have to say it is the tub transfer bench. Being able to get into and out of a tub shower safely and without the assistance of others can provide a huge boost in perceived quality of life.

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