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OT student with kids in pediatric lab

Written by Elise Krause & Alyssa Synek, OTD Students

Occupational therapy is defined as “the therapeutic use of everyday life activities (occupations) with individuals or groups for the purpose of enhancing or enabling participation in roles, habits, and routines in home, school, workplace, community, and other settings.” (American Occupational Therapy Association, 2014).  

Occupations include “things people need to do, want to do, and are expected to do.” (World Federation of Occupational Therapists, 2012).  

The 8 occupations defined in the Occupational Therapy Practice Framework (OTPF) are as follows:

  • Activities of Daily Living (ADLs): Dressing, bathing, toileting, feeding, etc. 
  • ​Instrumental Activities of Daily Living (IADLs): Meal preparation, financial management, pet care, community mobility, health management, home management, etc
  • Rest and Sleep: Sleep preparation and sleep participation 
  • Education: Formal and informal educational participation 
  • Work: Employment seeking, job performance, retirement preparation, volunteer participation, etc.  
  • Play: Play exploration and play participation 
  • Leisure: Leisure exploration and leisure participation 
  • ​Social Participation: Community, family, friends, peers, etc.  

Occupational therapy also involves the analysis of your performance patterns. Performance patterns are defined as “the habits, routines, roles, and rituals used in the process of engaging in occupations or activities that can support or hinder occupational performance.” (American Occupational Therapy Association, 2014).  

Blue arrow Yellow arrow orange arrow The goal of the following information is to help individuals explore ways in which they can still participate in the occupations listed above despite being confined to their home.  

The following pages will walk individuals through each occupation and provide tips, tricks, and ideas of how to combat the “stir- crazy” feeling we are all experiencing during this time.  

Activities of Daily Living (ADLs) 

When it comes to activities of daily living, routines and habits become incredibly important.  

According to a study by researchers at Tel Aviv University, “predictable, repetitive routines are calming and help reduce anxiety. They'll also help you take control of your day and subsequently, your life” (Piedmont Healthcare, n.d.). 

  • Bathing and Showering 

Routine is important. If you typically shower in the morning on days you go into work, shower in the morning when working from home. If you usually shower at night before work the next day, continue to do so. This will keep you from having to scramble to get back on track when your office re- opens.  

If you are feeling sluggish in the morning due to your less rigid schedule, try taking a shower to wake yourself up.  

  • Dressing 

If you are feeling unmotivated to complete your work, try dressing as if you were going into the office or the classroom. Sitting in your pajamas all day may make you feel lazy or tired and affect your productivity.  

Remember that although you are at home, you may need to connect with peers, coworkers, or students via video call. Make sure your outfit for the day is appropriate for all audiences. 

  • Eating and Feeding 

When at home, try to eat your meals at the same time you would if you were going about your typical workday.  

Avoid snacking by planning your meals ahead of time or packing your lunch as you would if you were going into work.  

Set a timer on your phone reminding yourself to eat your lunch or grab a healthy snack. It is so easy to become consumed by your work which may result in forgetting to eat a meal or ignoring your hunger cues. This may cause you to eat too much in one sitting.  

  • Personal Hygiene and Grooming 

Although you are working from home, you will still come into contact with your spouse and/or children, potential delivery services, neighbors, etc. It is important that you continue to practice good hygiene techniques (handwashing, nail care, toothbrushing). This will help to eliminate the spread of germs to others around you. 

Instrumental Activities of Daily Living (IADLs) 

  • Care of Pets 

Do you have a dog? Take them on a walk around the neighborhood to get some fresh air! Even better, get the whole family involved. This is a great way to ensure your pet is continuing to receive the care they need while providing you and your family with a bit of physical activity! 

  • Child Rearing 

Having your children home from school can disrupt your typical daily routine. It is important to have a plan in place of how you will provide your child(ren) the appropriate education they need as well as fun activities to keep them busy!  

See Appendix A for a list of fun indoor activities you can do with your child. 

  • Communication Management 

It is important to maintain social relationships even when confined to your home. Using various technologies to keep in touch with friends and loved ones is simple and incredibly necessary during times of social isolation. 

Set up a phone call, Skype, FaceTime, or Zoom session to connect with others. 

  • Driving and Community Mobility 

If you need to access the community for grocery shopping, etc. be cautious when utilizing public transportation. 

Do your best to avoid touching the many surfaces on public transportation. Upon arrival at your destination,  immediately use hand sanitizer or wash your hands thoroughly to remove germs and prevent the spread to other individuals. 

When possible, consider walking to your destination to avoid interaction with community members and the spread of germs. 

  • Financial Management 

It is important to keep a detailed watch on your finances during times of crisis. Take the extra time to look at your expenses and figure out where you may be able to adjust your budget.  

“A good rule of thumb is to budget 50% of your income to essentials like housing and utilities, 30% towards non- essentials and 20% toward financial goals” (Sell, 2020)

  • Set a budget a stick to it with these free apps:  
  • Mint: Personal Finance & Money 
  • EveryDollar Budgeting App 
  • Empower: Bank, Budget, & Save 
  • ​​Health Management and Maintenance 

Do you take prescription medication for a chronic condition? Are you concerned your supplies will run out during this time? There are alternative options you can utilize to continue to obtain your medication. 

Drive-thru pharmacies are a great way to avoid having to go into the building to retrieve your medications. Again, be sure to sanitize/wash your hands after interacting with the pharmacist! 

CVS, Rite Aid, and Walgreens all deliver prescription medications within 1-2 business days.  

  • Meal Preparation and Clean-up 

Be sure to wash your hands before touching or preparing any food.  

Use your extra time at home to plan out meals and participate in meal preparation to ensure you and your family are eating well- balanced, nutritious meals.  

Remember that germs are “stable for several hours  to days in aerosols and on surfaces, according to a new study from National Institutes of Health, CDC, UCLA and Princeton University scientists in The New England Journal of Medicine” (National Heart, Lung, & Blood Institute, 2020).  

  • Religious and Spiritual Activities and Expression 

Has your place of worship closed due to the pandemic? Check out alternative options such as online services, live broadcasts on television, or a phone or video call with your religious leader to maintain a feeling of connectedness to your faith. In addition, explore ways to participate in random acts of compassion, spend time in nature, or practice meditation.   

  • Shopping 

When going grocery shopping, try to shop in bulk or stock up on common items to avoid having to make constant trips to the store and back.  

If you feel uncomfortable going to the grocery store during this time, explore alternative options to obtain your groceries such as buying them on amazon, utilizing shopping, delivery, and pick- up services such as InstaCart, or buying a subscription to HelloFresh. This will help to increase social distancing and decrease the spread of germs in public spaces. 

Rest and Sleep 

  • Rest 
    • Amidst the chaos at this time, it is important to take the time to unwind and relax. This may look different for each individual and may include things such as: 
    • Reading a book 
    • Watching TV 
    • Meditation or yoga
       
  • Sleep Preparation 
    • Engage in routines that prepare you for a comfortable rest, such as: 
    • Grooming (e.g. brushing teeth, washing face) 
    • Reading or listening to music 
    • Engaging in meditation or prayers 
    • Establish sleep patterns such as going to bed and waking up at the same time each day as if you were going to work.  
    • Prepare the physical environment for sleep.  
    • Set an alarm clock 
    • Adjust the temperature of the room 
    • Lock doors or close windows 
    • Turn off electronics and lights 
       
  • Sleep Participation 
    • Do your best to sustain a sleep state without disruption for optimal rest. 
    • Avoid drinking coffee or a lot of water before bed. 
    • Take care of the needs of children (if applicable) before bed to avoid disruption in the middle of the night. 
    • Avoid bright light in the evenings as this may disrupt your circadian rhythms. 
       
  • The Benefits of a Good Night’s Rest:  

“Getting enough quality sleep at the right times helps you function well throughout the day. People who are sleep deficient are less productive at work and school. They take longer to finish tasks, have a slower reaction time, and make more mistakes” (National Heart, Lung, & Blood Institute, 2020). 

“Studies show that a good night's sleep improves learning. Whether you're learning math, how to play the piano, how to perfect your golf swing, or how to drive a car, sleep helps enhance your learning and problem-solving skills. Sleep also helps you pay attention, make decisions, and be creative” (National Heart, Lung, & Blood Institute, 2020). 

Education 

For Professors:

Tips for Helping your Students Succeed in a Non-Traditional Classroom Setting 

Environmental Modifications 

  • Have them sit at a desk or at a table during the online lecture just as they would if they were at school. 
  • Encourage them to find a quiet space in the home that is free of distractions. 
  • Allow them to record the lesson so that they can listen now and take notes later. 

Take the time to check- in more often with students. Make sure they aren’t feeling socially isolated or overwhelmed by the new changes in their schedule. 

Send numerous reminders of due dates to keep your students on track.  

Encourage students to start utilizing a planner, or desk calendar to organize their work. Some students may struggle with a less rigid class schedule. 

Encourage students to allow video access, not just audio access, while teaching on a virtual platform.  

This will allow students to feel less isolated and engage more directly with their peers.  

“Communication scientists claim that a technology platform's richness matters. Platforms like video chat are rich with nonverbal cues like tone of voice, facial expressions, and eye gaze, whereas text and email are lean. The richer the platform, the fewer miscommunications occur because more nonverbal cues increase our likelihood of effectively understanding one another” (Hall, 2020). 

For Other Staff:

Have you been wanting to learn more about a specific aspect of your job? Have you wanted to complete an online certification of any sort? 

Take the extra time away from work to educate yourself on topics such as these. 

  • Research different certifications or sign up for online classes that will enhance your performance. Take the time to educate yourself on topics of interest or current events. Look into the research, take notes, and share your findings with others who may be interested.  

Work 

Dress 

Dressing in your typical work attire can help you to feel motivated and maintain your daily routine while working from home. Do your best to change out of your pajamas and get ready for the day as you typically would! 

Environment 

Set up a workspace following these simple tips: 

  • Avoid working on the couch as this may make you too tired 
  • Choose a space with ample lighting to keep you focused 
  • Try to limit distractions (TV, kids, etc.) 

Keep a dedicated workspace where you do work and only work 

Breaks 

Schedule breaks into your day to avoid burnout.  

  • Set a timer for 30-40 minute intervals. Once the timer goes off, allow yourself to step away from your work for a few minutes. 
    • "We know that after about 30 minutes, concentration starts to decrease, so it's important to take small breaks to stay focused on your main task" (Stringer, 2017).  

Continue to eat meals at the same time you typically would if you were physically at work.  

Ergonomics 

  • Be mindful of your body while you work from home  
  • Choose a chair with proper back support  
  • Consider utilizing a hands-free headset 
  • Find a spot in your house that can serve as a “stand-up” desk.  

Volunteering 

  • According to the University of Maryland (2019), rates of volunteerism have decreased throughout the United States. In our busy lives, it can be difficult to find the time to locate volunteer opportunities that will fit your schedule. Use this time at home to explore various volunteer opportunities in your community you can become involved in once permitted.  
  • In addition, if you are healthy and able, volunteer to run errands for a family member, friend, or neighbor who cannot venture out into the community during this time. 

Leisure 

Leisure is defined as “non-obligatory activity that is intrinsically motivated and engaged in during discretionary time, that is, time not committed to obligatory occupations such as work, self-care, or sleep” (Parham & Fazio, 1997). 

Why is Leisure so important? 

A study published in the Annals of Behavioral Medicine shows that leisure activity can provide immediate stress relief and other health benefits to just about anyone (Zawadzki, Smyth, & Costigan, 2015). 

A statement made by Zawadzki claims that “when people engage in leisure activity, they have lower stress levels, better mood, and lower heart rate and more psychological engagement - that means less boredom, which can help avoid unhealthy behaviors” (Leonard, 2015).  

Leisure Participation 

  • Definition: planning and participating in appropriate leisure activities; maintaining a balance of leisure activities with other occupations; and obtaining, using, and maintaining equipment and supplies as appropriate (American Occupational Therapy Association, 2014). 
  • While working from home, make sure to set aside enough time to engage in your usual hobbies and leisure activities! Here are a few examples: 
    • Reading 
    • Knitting 
    • Yardwork/gardening 
    • Board games with family members  
    • Walking 
    • Physical Activity 
    • Playing a Musical Instrument 

Leisure Exploration 

  • Definition: Identifying interests, skills, opportunities, and appropriate leisure activities (American Occupational Therapy Association, 2014). 

At the end of your workday, try to research, identify, and trial new leisure activities to fill your extra time while working from home. 

This link provides you with an extensive list of different leisure activities. Use this list to help explore your interests and get involved!  

Social Participation 

Social participation can happen in numerous ways with a variety of different people. Social participation can happen within your community, with your family, or with your friend or other peer.  

Social participation can occur in person or through virtual platforms such as phone calls, emails, texting, and video conferencing.   

So, why is social participation so important?  

According to a meta-analysis co-authored by Julianne Holt-Lunstad, PhD, a professor of psychology and neuroscience at Brigham Young University “lack of social connection heightens health risks as much as smoking 15 cigarettes a day or having alcohol use disorder” (Novotney, 2019). 

Research has also found that “loneliness and social isolation are twice as harmful to physical and mental health as obesity” (HoltLunstad, Smith, Baker, Harris & Stephenson, 2015).  

HoltLunstad states in another article that “there is robust evidence that social isolation and loneliness significantly increase risk for premature mortality, and the magnitude of the risk exceeds that of many leading health indicators" (Novotney, 2019).  

  • Ways to Stay Social While Practicing Social Distancing: 
    • Set up a Facetime date so you and a loved one can eat dinner together 
    • Set aside time to play board games or card games with the members of your household 
    • Allow your children to have a virtual playdate with their friends using Skype 
    • Host a virtual happy hour with your friends using Zoom 
    • Gather the family and complete an at-home workout together  
    • Reach outside your typical friendship circle and try to connect with an old friend  
    • Make a conscious effort to check-in regularly with those who live alone - make a phone call, send a text, send a card, etc.  
  • Top Free Apps for Video Calls with Co-Workers and/or Students: 
    • Zoom Cloud Meetings 
    • Hangouts Meet by Google  
    • Microsoft Teams 
    • Google Classroom 

Citations 

American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process.  American Journal of Occupational Therapy, 68(Suppl. 1), S1–S48. http://doi.org/10.5014/ajot.2014.682006 

Hall, E.D. (2020). Maintaining relationships while practicing social distancing. Psychology Today. Retrieved From https://www.psychologytoday.com/us/blog/conscious-communication/202003/m...

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352 

Leonard, J. (2015 March 19). Relax: benefits of leisure go beyond the moment. University of California MERCED. https://news.ucmerced.edu/news/2015/relax-benefits-leisure-go-beyond-mom...

National Heart, Lung, & Blood Institute (2020 March 17). New coronavirus stable for hours on surfaces. https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hou...

National Heart, Lung, & Blood Institute (2020). Sleep deprivation and deficiency. https://www.nhlbi.nih.gov/health-topics/sleep-deprivation-and-deficiency 

Novotney, A. (2019). Social isolation: it could kill you. American Psychological Association, (50)5, 32. 

Peidmont Healthcare (n.d.) Why routines are really good for your health. Retrieved from https://www.piedmont.org/living-better/why-routines-are-good-for-your-he...

Sell, S.S., (2020). Financial tips for an emergency: guidance to help you through the coronavirus pandemic. ABC 7 News. Retrieved from https://abc7news.com/finance/financial-tips-to-help-you-through-a-pandem...

Stringer, H. (2017). Boosting productivity: research identifies small changes that lead to big improvements in performance. American Psychological Association, (48)8, 54. 

World Federation of Occupational Therapy (2012). About occupational therapy. https://wfot.org/about/about-occupational-therapy 

Zawadzki, M.J., Smyth, J.M., & Costigan, H.J. (2015). Real- time associations between engaging in leisure and daily health and well-being. Ann. Behav. Med (49), 605-615. 

Appendix A 

1.    Tape Shape Game: Use this tape to put a variety of shapes, letters and/or numbers on your floor. Have your child stand on their favorite one then give them instructions to follow that will lead them to their next destination (for example: “bear crawl to the square”, “hop like a Frog to the T”, “Run to the rectangle”). We love that this game from Toddler Approved keeps your child moving, but also helps them learn their shapes, letters and numbers!   

2.    Freeze Dance Party! Turn on the high‐energy music and have a dance off! Make sure you have a large open space (clear of toys to trip on) and twirl, twist and shimmy your way around the room. Add in musical instruments or turn off the lights and break out some glow‐sticks to prolong the party. When one person stops the music and everyone else must instantly freeze. If you catch someone moving, they’re out. The last one standing (or dancing in this case), wins. 

3.    Mission Impossible Obstacle Maze: Using either Crepe Paper, Toilet Paper, Painter’s Tape, Yarn, etc. create an intricate maze in a hallway for your kids to navigate their bodies through. Put the tape up high and down low, forcing them to step over and crawl under at various points. The only problem with this one is that once you make it, your kids will constantly be begging you to make another!  

4.    Obstacle Course: This tried‐and‐true idea is always a huge hit with kids and can be made different every time, so it never gets old. Make sure to create an engaging course that includes a variety of motions (jumping, crawling, balancing, etc.) and uses a large area. Have your kids help make the course (which is half the fun!) using some of these creative ideas: 

·       Hula hoops to jump through 

·       Line of tape to balance on 

·       Couch cushions to hop between 

·       Table to crawl under 

·       Blanket over 2 chairs to crab walk through 

·       Tupperware containers to hurdle over 

·       Stuffed animals to roll over 

·       Plastic cups to run around 

We love that obstacle courses are great for kids of all ages to participate in – the younger tots enjoy just being able to complete all the obstacles, while older kids can race against each other or the clock. You could even have them attempt it balancing a bean bag or stuffed animal on their head, or with 1 hand behind their back.   

5.    Mattress Slide: Do you have an old crib mattress in your basement that you have no idea what to do with? Bring it out, prop it up on the couch and sit back while your kids slide down it for hours. I bet your kids will come up with other uses for it too!   

6.    Musical Chairs: The chairs are set up in two rows back to back (one chair less than the number of players). The music is turned on, and the players walk around the chairs. When the music stops the players race to sit in the available chairs. The player left standing is taken out of the game. The players all stand again and a chair is removed. The music is started and the walk around the chairs begins again. This procedure is continued until only one person remains. This person is the winner. 

7.    Active Stations: Make signs for different activities: jumping jacks, planks, crawling through tape/rope, balancing activities. Set a timer, and have your kids move through the stations with you!    

8.    Wheelbarrow Puzzle Walk: Take your average Wheelbarrow race to the next level by having your child complete a puzzle in this brilliant idea from Stir The Wonder. Set‐up a wooden puzzle board and scatter the pieces around a room. Grab your child’s ankles (or hips to make it a bit easier for little ones) and hold them up so they can walk on their hands to collect them. They have to bring each piece back 1‐by‐1 and fit it into the board until the puzzle is complete. (editor’s note: this is one of my kids’ favorites and is great for upper body strengthening!)   

9.    Snowball Fight: Create an indoor snow fight by creating your own snowballs with scrunched up pieces of newspaper. Make your own fort to take cover in between throws. This is a kid‐favorite and they burn a ton of energy ducking and darting out of the way of incoming blizzards   

10. Movement Songs: Music is a great way to move, but interactive music is even better! Here are some favorites to dance along to… Macarena, Chicken Dance, Hokey Pokey, Baby Shark, etc. 

11.    Relay Races: Race your children from one side of the room to the other in different ways such as three legged races, bear crawling, crab walking, hopping, wheelbarrow races, etc.   

12.    Recycling Bowling: Find any empty plastic bottles, cans, containers, etc. and line them up like bowling pins in a hallway or open area. Take turns using a ball to knock them all over. Have your children keep score to practice their math skills.   

13.    Movement Chain: You need at least 2 players for this interactive game where the first person starts by performing a certain movement. This could be something simple like jumping 2 times, or more complex like a 30 second plank. The next person has to perform the first movement, and then add another, forming a chain. The following person does the previous two movements, plus adds their own. You continue in this fashion until the chain is broken (usually forgotten!). The last one standing is the winner!  

14. Simon Says: A great way to have fun while also practicing listening skills. Have your child listen to your commands which can be anywhere from “stand on one foot” to “do 5 sit-ups”. The best part about this game is you can make it as physically active as you want! For additional fun, switch places and let your child be “Simon” and give you commands.  

15. Keep It Up: Gather the whole family and play a classic game of “keep it up.” All you need is a balloon or two! To make this more challenging, designate that all players may only use a specific body part to keep the balloon from hitting the ground or add another balloon into the game.