It is easy - but not practical - to believe that life can continue in the same way for rheumatoid arthritis sufferers as it did before the onset of the disease. That is not to say that rheumatoid arthritis should be seen as a crisis or disaster, but should be recognized as a real situation which needs to be coped with through certain adaptations. The whole organization of the patient's daily life must be rethought. Living conditions can be designed to make life much easier for the sufferer.
The occupational therapist from the hospital has received special training in this field, so it may help patients with arthritis to go and chat with the occupational therapist about their own particular problems. The occupational therapist may well want to visit the home with the patient to see actually what difficulties may be encountered, before he or she makes useful and helpful suggestions.
The kitchen, for example, is often poorly designed, forcing the poor housewife to walk many unnecessary miles during the day whilst carrying saucepans between the sink and the stove, and food between work surfaces and the larder. Simple rearrangement of the kitchen can help her considerably. For instance, the cooker should be next to a working surface or draining board near to the sink, so that the housewife, if she has a heavy saucepan to empty, can slide it straight across from the cooker without having to lift it physically.
There is a wide variety of specially designed cooking utensils for patients with arthritic problems. For instance, if the patient has difficulty holding an ordinary knife because her fingers will not bend sufficiently to grip, then a knife with a specially fat handle may be the answer.
The lavatory can also be a problem. Patients with severe hip or knee diseases may have difficulty in getting on and off it. A simple grab rail and an adaptation to the bowl to give it a high seat may improve the situation. Another exasperating factor is that quite often the lavatory is virtually inaccessible, being up one or two flights of stairs which the patient finds impossible to climb. Today, there are several models of completely hygienic and aesthetically acceptable chemical commodes, which can be wheeled to the patient and then stored away without any unpleasantness. A severely crippled patient may have great difficulty with personal hygiene after using the lavatory. For them, a bidet with a spray followed by warm air for drying can be supplied. Likewise, specially designed bath seat can be used if the patient has difficulty climbing in or out of the bath.
Even turning a door knob can be very difficult for a person with a weak hand. The most sensible suggestion is that these be replaced by lever-type door handles.
Combs with long handles, gadgets for turning difficult taps and devices for putting on and taking off stockings are all readily available. There is a wide range of occupational therapy aids and appliances for disabled people. If a disabled person has a problem, someone has almost certainly invented an answer to it.
People with deformed feet have enormous difficulty in getting comfortable footwear. Suitable shoes cannot be found in ordinary shoe-shops and it is becoming increasingly difficult and expensive to have shoes made privately. Not having a shoe to fit the foot, in this country means essentially that it is impossible to go out of doors - slippers are no protection in this climate! There is now, however, a technique for taking plaster-of-Paris impressions of the feet and sending these impressions to a shoe factory which makes the shoes accordingly. The National Health Service will provide individually made shoes for those who require them for medical reasons.
A patient who has difficulty in getting around may also be helped by the simple method of using a stick or, in more severe disease, by the use of crutches or a walking-frame.
For many people, occupational therapy do, in fact, represent the distinguishing line between dependence on others and independent living. As such, their importance must not be underestimated. They are just as important to arthritis as glasses are to the short-sighted. All concerned with rheumatoid arthritis understand the problems involved and willingly give advice on all these points.