OCCUPATIONAL THERAPY FOR GERIATRIC PATIENTS IN A MENTAL HOSPITAL: THERAPEUTIC POSSIBILITIES AND LIMITATIONS

Occupational therapy for geriatric patients in mental institutions and clinics has been prescribed for many years, but usually only for its physical or orthopedic benefits. This kind of occupational therapy was directed to the maintenance of bodily function in patients with rheumatoid arthritis or hemiplegia, to the rehabilitation of patients with fractures, and to improving circulation, function of muscles and joints, and coordination in patients with neurologic diseases. Today, more attention is given in occupational therapy to psychologic and sociologic problems. O'Sullivan (1) defines occupational therapy as "the treatment under expert medical supervision, of mental or physical disease, by means of suitable occupation, whether mental, physical, social or recreational." G. S. and J. W. Fidler (2), however, express a more psychologic point of view; psychiatric occupational therapy for them is "a set form of psychiatric treatment which uses constructive activity as a modus operandi." The usefulness of occupational therapy for the treatment of emotional disturbances has been stressed by many psychiatrists. Menninger (3) believes that hobbies and recreational and occupational therapy are indicated to release tension, to compensate for real or fancied inadequacies, to decrease feelings of inferiority and to furnish outlets for restlessness and hostility. The Fidlers (2) recommend occupational therapy: 1) to help the physician to make a diagnosis and to evaluate the personality of a psychiatric patient, 2) to improve interpersonal relationships between the therapist and the patient, 3) to provide an opportunity for the patient to express and sublimate his emotional needs and drives, and 4) to explore the skills and capacities of the patient, to give him a social-economic goal, and to promote group identification. The application of occupational therapy to geriatric patients in a mental institution has not been exploited sufficiently. Collins and Mort (4) in a recent paper studied its special use and found the following problems: 1. Frequent occurrence of multiple disability. 2. A slow rate of learning. 3. Long periods of unnecessary bedfastness and inactivity before admission. 4. The feeling of loneliness and being unwanted. 5. The feeling of insecurity resulting from loss of home surroundings. 6. Loss of self-respect and usefulness. 7. A lowering of standards including those of: a. Mental activity