HIV/AIDS: A New Service Continuum for Occupational Therapy

Abstract

e first cases of what is now known as AIDS were reported In the USA in June 1981. The first article on occupational therapy for people with HIV/ AIDS was published 6 years later In July 1987. Since that time, much has been written about the work of occupational therapists with people affected by HIV or AIDS. This article presents some of the material published on this area of work, and suggests that occupational therapy has much more to offer this group of people than is described in the literature. A new continuum of service provision is outlined and discussed. This Includes practice that falls outside what might be considered the traditional role of occupational therapists. Although this article is specific to HIV/ AIDS, many of the Issues raised are applicable to other areas of practice.

Understanding the Experience of HIV/AIDS for Women: Implications for Occupational Therapists

“…For persons experiencing difficulty with mobility and ambulation, orthotic, splints and adaptive equipment may be utilized (Fish & Rudman, 1998). Seating and wheelchair training, education concerning energy conservation and work simplification have been reported (Fish & Rudman, 1998;Molineux, 1997;O'Dell & Dillon, 1992). Other areas of intervention that focus on the cognitive perspective include education about disease process, anger and stress management and relaxation techniques.…”

Patterns of Referral and Intervention for Persons with AIDS

“…The Center for Disease Control and Prevention (CDC, 1986) classified the HIV/AIDS progression into four stages: Stage 1 (body's initial short-lived flu-like response to AIDS virus); Stage 2 (HIV continues to replicate in the body and affect the immune system); Stage 3 (HIV has caused enough damage to the immune system to cause signs and symptoms); Stage 4 (fullblown AIDS; the immune system is severely damaged and compromised). Throughout all the stages, persons with HIV/AIDS require services in several or all of the performance areas (Anderson et al, 1990;Chan et al, 1996;Fish & Rudman, 1998;Gutterman, 1990;Molineux, 1997;Pizzi, 1990a;Pizzi, 1990b;Pizzi, 1996;Weinstein, 1990;Williams, 1990). Denton (1987) delineated five functions for occupational therapy practitioners who provide services to PWAs: (a) education of occupational therapy personnel about HIV/AIDS, (b) observation of precautions, (c) evaluation, (d) treatment, and (e) consultation with other health team, family and support members.…”

“…Ten years later, Molineux (1997) similarly related strategies used by practitioners during each of the four CDC stages. Additionally, in an addendum to the CDC's four classification groups of AIDS stages, Molineux also discussed end-stage AIDS (stage 5) and recently bereaved (stage 6).…”

“…Additionally, in an addendum to the CDC's four classification groups of AIDS stages, Molineux also discussed end-stage AIDS (stage 5) and recently bereaved (stage 6). For stage 6 (recently bereaved), psychosocial interventions would be most appropriate to help the survivors of the PWAs to cope with their losses (Molineux, 1997). Persons in this group were learning to deal with and accept their diagnosis, and so would benefit from being educated on the disease and learning mechanisms for coping with fear, anxiety, and stress.…”

“…To date, the occupational therapy intervention-oriented literature related to PWAs has addressed the progression of HIV/AIDS (Pizzi, 1990b;Schindler, 1988;Weinstein, 1990;Weinstein & DeNeffe, 1990), issues PWAs face throughout the progression of the disease (Palinicek, 1998;Schindler, 1988;Snyder, 1993;Weinstein, 1990), and described evaluation and intervention strategies (Anderson et al, 1990;Denton, 1987;Fish & Rudman, 1998;Gutterman, 1990;Molineux, 1997;Pizzi, 1990a;Pizzi, 1996). However, the literature has not included descriptions of occupational therapy referral patterns for PWAs and subsequent intervention frequency patterns or priorities, for each of the four CDC stages of the disease.…”