Physical Vs. Occupational Therapy: Differences in the Field of Elder Care

As an elder-care therapist, the most frequent question I was asked by caregivers was "What's the difference between physical and occupational therapy?" The types of activities the physical and occupational therapists complete with an elderly loved one may seem similar, but their professional focuses are very different, yet complementary.

The scope of practice for each therapist will depend on their elder-care specialty area (stroke rehabilitation, orthopedic rehab) and the environment where they work (nursing home, home health care, outpatient therapy). The following description is basic and provides a general outline of distinction between the two professionals and is not exclusive to elder care.

Let's first cover ground of commonality between the two types of therapists.

Those wanting to be occupational and physical therapists are required to enter into a Bachelor's or Master's level therapy program to initially begin practice. NOTE: the mandatory college entry requirements are changing for therapists but this description does apply for most therapists who graduated before 2001. Entry into a therapy program is very competitive. After successfully completing the therapy training program, therapists are required to complete several supervised clinical internships. These clinical internships span a range of settings including elder care, senior centers: nursing homes and rehabilitation centers. After the internships, a graduate is required to successfully pass a national board examination and secure a professional license to practice.

A physical therapist generally focuses on balance, walking, and general movement. For example, a physical therapist will teach an elderly stroke victim in a nursing home how to walk again or sit without leaning to one side. The general and informal dividing line is, physical therapists work with the body from the waist down, and occupational therapists work with the body from the waist up. This is not a cut and dry distinction but in terms of physical rehabilitation of movement it is fairly consistent.

Occupational therapists work with a elder to maintain independence in their basic self care needs and performance of activities of daily living (self care tasks). Ensuring independence with self care includes recommending appropriate devices and gadgets to increase safety and functional ability. For example, an occupational therapist may recommend modifications to a home to help a senior age in place, rearrangement of furniture and home layout, equipment to prevent hand tremors during eating, and teaching a elderly stroke victim how to get dressed with one hand.

Most often, physical and occupational therapists work together to provide rehabilitation therapy. This collaborative effort ensures a patient can move well and remain as independent as possible with caring for him or herself.

*This description does not apply to therapist assistants.