Role of Occupational Therapy in Coronavirus Disease 2019 in a Home Health Setting: A Case Report

Abstract

The pandemic has amplified interest in home health-care programs in the United States as an alternative care model for acutely ill patients in institution-based care, which were under a significant burden due to the rapid emergence of people needing intensive care services. Several studies indicated that frail older adults are at a high risk of morbidity and mortality and may have incomplete recovery from coronavirus disease 2019 (COVID-19). Occupational therapy (OT) practitioners have a unique skill set to guide clients through recovery from long-term functional impairments post-COVID-19 throughout the continuum of care. The case report focused on OT interventions in a home health setting for an 80-year-old male recovering from COVID-19. He was a big car company mechanic and retired around 20 years ago. His main symptoms were dyspnea and weakness that affected his self-care task participation and caregiving role. The patient had consulted for eight OT sessions, including the follow-up. The interventions used were participation in dyspnea management using controlled breathing and energy conservation techniques, aerobic training to promote overall well-being, and activity tolerance. Significant improvement at discharge was noted in all areas mentioned above, evidenced by scores improvement in all four standardized tests, 15% improvement in the Modified Barthel Index Shah Version, and 40% improvement in the Borg Rating for Perceived Exertion Scale. The case study explores OT’s role in improving the health outcomes and functional skills of a COVID-19 survivor from a home health-care perspective. The patient’s medical records were retrospectively reviewed to collect information for this case study. This case highlights OT service delivery in acute home health-care settings. This allowed the shift of care from an inpatient acute care episode to an intensive at-home treatment enabled by digital technologies, multidisciplinary teams, and ancillary services to promote the recovery and functioning of COVID-19 survivors.