The American Occupational Therapy Association state the people with and ID have ‘’limited cognitive capacities and adaptive behaviours.” Occupational therapists work to help people perform their activities of daily living (ADLs) effectively and with the aim to help promote confidence, self-esteem, self-concept, overall happiness and often independence. As with any other patient population, occupational therapists help play an important role in aiming to promote meaningful engagement in a range of activities in a person-centred manner. Often this can involve engaging with the person themselves, their families, schooling/education systems, workplaces, government and councils and carers.

Depending on the person’s physical, cognitive, communication and sensory requirements, a range of interventions may be worked on with an occupational therapist. As part of any intervention the occupational therapist may also work as part of a multi-disciplinary team (MDT) including GPs, nurses, care staff, physiotherapists, speech and language therapist, teachers, social workers, and dieticians to name but a few. Furthermore, an occupational therapist may work with the person in a variety of settings including their home, schools, day services or community settings, work, respite services or residential services.

According to Justice et al., (2021) – some key areas an occupational therapist may work with this population include.

• Sensory interventions
• Seating
• Equipment provision
• Adapting environments/ environmental recommendations
• Use of natural environment
• Education for the person, family, care staff etc.
• Adapting activities of daily living
• Adapting roles and routines
• Visual arousal monitoring tools

Throughout Ireland, occupational therapists work in network disability teams (NDTs), charities, schools, and community teams with this population. Private occupational therapists may also work with this population. If you are looking for any additional information on what benefits an occupational therapist may have when working with you or someone you know with an ID – contact your local OT and learn more about the services they offer.

Great question! Occupational therapy helps patients in four main areas:

1. With fine motor skills (smaller movements such as picking up objects between the thumb and finger),
2. Visual-perceptual skills (the brain’s ability to make sense of what the eyes see),
3. Cognitive skills (thinking), and
4. Sensory-processing problems (over sensitivity to things in the environment).

The following disabilities and conditions can benefit from occupational therapy treatment:

• Birth injuries or defects
• Traumatic injuries to the brain or spinal cord
• Developmental delays or learning problems
• Multiple sclerosis, cerebral palsy
• Spina Bifida
• Chronic illnesses and pain
• Autism or sensory processing disorders
• Juvenile rheumatoid arthritis
• Mental health or behavioural problems
• Hand or foot injuries
• Memory disorders
• Broken bones or other orthopedic injuries
• Cancer

This is not an exhaustive list but it should give you an idea of the depth and breath of the assistance that an Occupational Therapist can provide.

Did you know that hospitals are one of the largest employers of occupational therapists (OTs). Acute care is a category which entails the treatment of sudden, serious injury and illness. Typically, OTs work with people in an acute setting who have experienced an incident ranging from strokes, acute mental health issues, to falls, or a road traffic collision – to name a few.

From a therapeutic standpoint, it is the priority of the OT to work as part of the multi-disciplinary team (MDT) in stabilising the patient, enabling early mobilisation, engage in therapeutic activities and create discharge plans. The multi-disciplinary team may incorporate a range of other health care professionals – including nurses, speech and language therapists, physiotherapist, social workers, doctors, therapy assistants, etc.

Some common responsibilities of an OT in an acute setting may include:

• Assessing any requirement from a positioning perspective – this may include splinting, using positioning aids, education on position in profiling beds and cushion or mattress prescription.
• Conducting cognitive assessments to determine if a person is ready to engage in therapeutic activities and to help to determine current level of functioning.
• Assessing a client’s mobility – this may require prescription of a wheelchair. Furthermore, the OT may liaise with a physiotherapist if a walking aid is required.
• Education of the client and their family around mobility, self-care activities, leisure activities, productive activities and any goals set out during therapy.
• Setting therapy goals with the client in a collaborative way.
• Discharge planning – this may include meetings with family members and other health care professionals to help determine the next steps. This may include a discharge home, an onward referral to a sub-acute or step-down unit, a referral to community teams or any other relevant organisations or support groups.
• Daily living -finally, it is the responsibility of the OT to ensure the person can meet all the activities of daily living either independently or with the help of a carer or family member.

As you can see, OTs provide vital support in a variety of settings, particularly acute care. From cognitive assessments to prescribing equipment and setting therapy goals – OTs will help work towards the best outcome.

An occupational therapist home assessment is an evaluation conducted by a qualified professional to assess an individual’s living environment and determine its suitability and necessary modifications to improve their functional independence and quality of life.

There are five key reasons for getting an occupational therapist to carry out a home assessment. Read the following list and identify and list those that would have a positive impact on your life.

1. Expertise in Assessing Functional Abilities: Occupational therapists specialise in assessing an individual’s functional abilities and how they interact with their environment. They are trained to evaluate a person’s physical, cognitive, and psychosocial abilities, as well as their specific needs and goals. This expertise allows them to identify potential barriers or challenges within a home environment that may affect an individual’s independence and safety.
2. Personalised Recommendations: By conducting a home assessment, an occupational therapist can provide personalised recommendations tailored to an individual’s specific needs. They consider factors such as mobility, accessibility, safety, and activities of daily living. They can suggest modifications, adaptive equipment, and strategies to improve the individual’s independence, safety, and overall quality of life within their home.
3. Maximising Safety and Independence: The primary goal of an occupational therapist is to promote independence and safety. By assessing the home environment, they can identify potential hazards, such as tripping hazards, poor lighting, or inaccessible areas, and provide recommendations to mitigate these risks. They can also suggest modifications to improve accessibility, such as installing grab bars, ramps, or stairlifts, which can enhance the individual’s ability to move around safely and independently.
4. Enhancing Quality of Life: Occupational therapists understand the impact that a well-designed home environment can have on a person’s overall well-being and quality of life. Through their assessment, they can identify ways to optimize the home environment, making it more functional, comfortable, and supportive. This can include recommending modifications to facilitate hobbies, leisure activities, social interactions, and other meaningful occupations.
5. Cost-Effectiveness: Investing in a home assessment conducted by an occupational therapist can be cost-effective in the long run. By addressing potential barriers and hazards proactively, individuals can prevent accidents or injuries that may result in costly hospitalisations or long-term care needs. Additionally, the recommendations provided by the occupational therapist can help individuals make informed decisions about home modifications or assistive devices, optimising their investment and avoiding unnecessary expenses.

It is important to note that the specific benefits of a home assessment may vary depending on the individual’s needs and circumstances. Having said that, there is no doubt that involving an occupational therapist in the process can lead to a comprehensive evaluation, personalised recommendations, and improved safety, independence, and quality of life within the home environment.

In this post, we cover the 5 the key financial considerations when working with an Occupational Therapist.  We finish off with a link to research that proves the cost effectiveness of working with an occupational therapist. Simply put, a cost-effectiveness ratio is the net cost divided by changes in health outcomes and research demonstrates that working with an OT delivers positive outcomes well in excess of the cost. 

1. Cost of sessions
   • Depending on the area of therapy, the cost of sessions varies depending on assessments used, therapist time, level of expertise, demand for the service and reports required.
   • From the very start, it is important to discuss this with your occupational therapist so that you have a clear understanding of the financial costs.
2. Equipment
   • There may a variety of equipment that may be a consideration when engaging in therapy. Whether a person may require a wheelchair, a new pencil grip, a piece of sensory equipment or some gardening equipment, your OT will be able to advise on where to find good quality and value products.
   • If you feel a piece of equipment is not needed – speak with your OT to see if there is any alternative option to reach your goals.
   • A medical card holder may be entitled to some equipment which the OT may prescribe.
3. Insurance
   • If someone has private health insurance, it may be possible to get money back on OT sessions (please check your individual policy details).
   • Some insurance companies cover medical equipment such as wheelchairs (again, please check your individual policy details).
4. Grants
   • There are a range of local authority grants which people may qualify for depending on equipment or work that may need to be carried out to achieve the desired outcome.
5. VAT
   • There are a range of items which can be purchased VAT free – these include wheelchairs, rollators, tri-walkers, wheelchair accessories, etc.
   • Apart from these items, VAT can be claimed back on a range of riser recliners, hoists, communication aids, domestic aids, commode chairs, etc.
   • How to reclaim VAT on aids and appliances for persons with disabilities (revenue.ie)

Cost effectiveness

• Occupational therapy has been shown to be cost-effective in a number of research studies.
  • (Occupational therapy: cost-effective solutions for changing health system needs – PubMed (nih.gov)

Rexe, K., Lammi, B. M., & Zweck, C. v. (2013). Occupational therapy: cost-effective solutions for changing health system needs. Healthcare quarterly (Toronto, Ont.), 16(1), 69–75.

• Cost‐effectiveness of Occupational Therapy in Older People: Systematic Review of Randomized Controlled Trials (wiley.com)

 

Financial considerations aside, occupational therapy has been shown to maximise health, well-being, and quality of life through effective solutions that facilitate participation in everyday living.

If you have any queries in relation to financial consideration – contact your local Occupational Therapist to find out more.

If you are applying for a grant from a local authority you will be asked for an occupational therapist’s report with advice on how best to adapt your home to meet your needs.

The Occupational Therapist will organise a time that suits you to meet in your own home environment. The OT will then discuss your past medical history, social supports, previous therapy input, and also address any areas of concern you have. The assessment may involve you moving around and interacting with various aspects of your home and generally lasts an hour.  After checking your performance while doing these activities, the occupational therapist will be able to determine if you might benefit by using a technical aid, or by some modification in your environment to improve your level of safety or independence.

Depending on the results of your assessment it may be necessary to complete a follow-up assessment to look into areas of your cognitive function or specific tasks identified in the initial assessment.

The OT may suggest modifications such as the installation of grab rails in the toilet or house entrance, the installation of ramps, as well as major equipment and adaptations such as stair-lifts, bath-lifts, and wet-floor shower areas.

If you are purchasing a product such as a stairlift privately, you do not require an OT assessment but it is always advisable to get one.

An Occupational Therapist can identify key areas where you may need assistance that may not be evident. During an assessment, the OT will identify what changes are required to help complete personal tasks to remain independent and safe. This is done by analysing how you interact in your environment and the OT can often spot potential problems that may not be evident yet, but that may be a problem in the future. This is vital as it can not only save money, but it will also make your home safer and ensure you don’t need to experience unnecessary inconvenience. 

Firstly, it is important to note that the first thing anyone can do the ensure they are maintaining their mobility and safety around the house is to encourage walking when suitable and appropriate. After that there are several environmental and personal factors to look out for in the house which may be making it a higher risk for falls to occur.

Here are 10 ways to reduce the risk of falling when engaging in your normal everyday activities:

1. Staying mentally active – it has been shown that cognition plays a key role in balance and risk of falling.
2. Check you vision and hearing – ensuring our visual and vestibular (balance) systems are checked up on regularly will help to reduce the risk of falls.
3. Environmental concerns – Review the household and make note of position of items which may prove to be a falls risk. These can include carpets, rugs, clutter, leads, poorly positioned furniture, seating etc.
4. Assistive technology – falls alarm, sensors, bed alarms etc – there are several companies (both private and non-profit), who sell or provide falls alarms kits, sensors and alarms to ensure there is precautions taken to help reduce the risk of falls AND to be prepared in the case of someone falling.
5. Footwear – ensuring you have well fitted shoes/slippers with good grip is vital to help reduce the risk of slipping/falling/
6. Toileting – to ensure maximum safety when toileting there is a variety of toileting aids which may suit. These include stationary or mobile commode, raised toilet seat, toilet frame, toilet seat and frame combined, grab rails etc.
7. Dressing – there are number of dressing aids which will help you to dress independently while reducing the risk of falling while in the process.
8. Mobility – discussing your mobility with your local OT and/or physio can play a big part in reducing the risk of falls. The OT and Physio can liaise with you to decide whether you might require a walking stick, walking frame, rollator, tri-walker, wheelchair, or other mobility device. The OT and physio have knowledge on how to assess mobility safely and effectively and will work with equipment providers to get you the right piece of equipment for you.
9. Seating – ensuring you are in a well fitted seat is vital in reducing the risk of falls (as well as a range of other benefits – postural management, digestion, respiratory system etc). Having a seat at the right height and/or having a rise and recliner will help make transfers on and off the chair safely.
10. Lighting – ensuring there is sufficient lighting to and from the rooms when they are going to be accessed. An example of this would be to ensure there is a night light, or easily accessible light when walking to the bathroom at night-time.

As always, if you are unsure or would like some guidance – why not contact your local OT and ask for an assessment to take place. Following the assessment, they will assist you so that you are taking the necessary precautions and will also provide you with the most relevant advice and information for your own individual and unique situation.

Good question as many people are unsure was to what we actually do. Occupational Therapists, or OT’s for short, work with people with live with intellectual and physical disability and developmental delays, physical illnesses and injuries, mental health disorders and emotional problems. Examples of situations where occupational therapy can help include:

• A young adult facing life with a disability such as Cerebral Palsy may find it difficult to sleep without developing pressure sores. An occupational therapist will work with her to identify the right pressure care mattress to help her sleep safely and peacefully.
• A teenage boy may have trouble putting his shoes on by himself, and writing his name. The occupational therapist will work closely with him to develop his fine motor skills through play-based therapy so he can become more independent in his life.

The Housing Adaptation Grants for Older People and People with a Disability play a critical role in empowering individuals to live safely and independently at home. The 2025 updates introduce transformative changes designed to enhance accessibility, affordability, and efficiency. Here’s everything you need to know about what’s new.

1. Increased Grant Limits

One of the most significant changes for 2025 is the increase in grant limits, reflecting rising costs in construction and materials:

• Housing Adaptation Grant for People with a Disability: Maximum grant increased to €40,000 for homes built more than 12 months ago.

• Housing Aid for Older People: Maximum grant raised to €10,700 for essential repairs like roofing, wiring, or heating upgrades.

• Mobility Aids Grant: Now provides up to €8,000, fully funded for eligible applicants, covering essential adaptations like stairlifts and ramps.

2. 100% Grant Coverage for Low-Income Applicants

For households in the lowest income bracket (earning up to €37,500 annually), the grants will now cover 100% of eligible costs, up from 95%. This change ensures the most vulnerable applicants can afford vital adaptations without any financial burden.

3. Revised Income Thresholds

The income bands for grant eligibility have been expanded to allow more households to qualify. Here’s the new breakdown:

• Up to €37,500: 100% of costs covered.

• €37,501 – €43,750: 85% of costs covered.

• €43,751 – €50,000: 75% of costs covered.

• €50,001 – €62,500: 50% of costs covered.

• €62,501 – €75,000: 30% of costs covered.

• Over €75,000: No grant payable.

4. Easier Application Process

To streamline the experience for applicants, the grants will move toward an online application system, allowing users to submit and track their applications digitally. The process will also be standardized across all local authorities to eliminate inconsistencies.

5. Support for New Builds

Applicants building new homes can continue to apply for Housing Adaptation Grants. Applications can now be submitted once planning permission is approved, making it easier to incorporate adaptations into new constructions.

6. Flexibility in Means Testing

The means test has been updated to account for a broader range of deductions, including:

• Caregiving expenses.

• Mortgage or rent payments.

• Expenses for children or dependents in the household.

• Nursing home fees or in-home care costs.

These changes ensure the means test reflects real household financial burdens more accurately.

7. Increased Exchequer Contribution

To ease financial pressures on local authorities, the Exchequer contribution will rise from 80% to 85%, reducing the local authority contribution to 15%. This ensures better funding availability for grant applicants.

8. VAT Hardship Relief

To address affordability challenges, measures will be introduced to eliminate the need for applicants to pay VAT upfront and claim it back later. This change reduces financial strain during the adaptation process.

9. Staged Payment Options

A new option for staged payments will be introduced, allowing applicants to receive funding incrementally as works progress. This reduces the need for bridging loans or upfront payments for extensive adaptations.

10. Support for Assistive Technology

Grant guidelines will now include assistive technologies to reflect modern adaptation needs, covering advanced tools that improve accessibility and independence at home.

Looking Ahead

The 2025 updates to Housing Adaptation Grants mark a significant step forward in supporting Ireland’s aging population and individuals with disabilities. These changes ensure that more people can access the resources they need to live independently and safely in their homes, while making the process more affordable and user-friendly.

With these updates, 2025 is set to be a pivotal year for creating accessible and inclusive housing solutions across Ireland!

Click here to download the updated Housing Adaptation Grants for Older People and Disabled People application form.