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Independent toilet hygiene – meaningful or purposeful?

  • Adam Ferry

In a recent presentation delegates and I discussed the difference and potential overlap between the terms ‘meaningful’ and ‘purposeful’ activity.

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The discussion focused around whether Occupational Therapists often use the term meaningful to justify an assessment process or pay lip-service to their professional philosophy without truly reflecting on which elements of the task are important but actually purposeful. For example, a bathing assessment that focuses on supporting a client to get in and out of the bath safely is misunderstanding the meaningful element of the task. The meaning comes with the ‘why?’ rather than the ‘how?’ as we all bathe for different reasons, hygiene often being a by-product of relaxation or play for example. The transfer in and out therefore is purposeful but not meaningful.

However, what happens when something purposeful becomes inhibited? Does the purposeful task then take on meaning or as Occupational Therapists are we setting purposeful goals to achieve the meaningful occupation? When reflecting on this I used a different scenario, namely toilet hygiene, with the intention of challenging my own focus on meaningful occupation objectively.

The question therefore is, ‘is maintaining toilet hygiene meaningful or purposeful?’

Now on the surface I agree that of course it is meaningful, however, delve a little more closely into why it is important and we likely get into discussions about social norms, interaction, dignity and health/wellbeing (particularly skin integrity). So is that actual act of getting clean meaningful or is it important so that we can continue our ‘normal’ and fulfilled lives through meaningful activity?

Regardless of which way you go on this there is no doubting its importance or significance and I consider the possibility that it is purposeful until we have difficulty doing it at which point it takes on greater meaning.

It could be argued that it is not actually the task itself that it meaningful even in that situation but the ability to complete the task independently or with dignity. Therefore when either of those things are compromised an appropriate response is to apportion additional meaning to something that would be otherwise purposeful.

This is the reason why companies like Closomat offer such a responsive service. When their product or indeed product support is requested they understand that it is because someone is having difficulty maintaining either their independence or dignity which has an impact on every other aspect of their day. They therefore ensure that site surveys and demonstrations are conducted within 5 working days followed by a quote within 48 hours. They also respond to emergencies within 24 hours as they appreciate the impact on health & wellbeing that the inability to use equipment like the Palma Vita can cause.

The debate leads to another fundamental question, when conducting a toileting assessment what are you looking for? For this to be an Occupational Therapy assessment the assessment must focus on the meaning of the task to the individual and therefore should not simply be about the transfer. This means that every assessment should be client centred, focused on the individual differences/understanding of what is indeed meaningful. This is further supported by Closomat who provide a follow-up, termed a commissioning visit, primarily to ensure that toilet settings are meeting the individual’s requirements and preferences. I find that the term ‘commissioning visit’ has been mis-interpreted in the past, or put therapists/potential customers off given that other companies use terms such as self-commissioning. All it really means is that an engineer will call out to make any required adjustments to suit the client’s individual needs. During the follow up they will also check that the system has been installed correctly with appropriate floor fittings, electrical connections to give you further peace of mind. This doesn’t mean that the client can’t use the toilet in the mean-time, simply that Closomat can enhance the experience of each individual, supporting the Occupational Therapists client centred approach.

The debate over meaningful versus purposeful activity is an interesting one for Occupational Therapists and challenges us to reflect critically on what our focus is with clients. What we can rely on though is that a company like Closomat understand the critical nature of toilet hygiene and will support Occupational Therapists to meet their client’s critical needs and beyond.

Adam Ferry
Occupational Therapist
The OT Service

Closomat Limited, Building 1, Brooklands Place, Brooklands Road, Sale Cheshire, M33 3SD