Written By: Cristina Klymasz, MS, OTR/L, CBIS, RYT, CLT, MSCS

I write this blog during a difficult time in healthcare. COVID-19 is on every news station and the topic of most conversation. Healthy and immune compromised people are panicked, anxious, and taking extra precaution. Many healthcare institutions are open during this trying time, as they provide essential care to those that are battling not only COVID-19 but other diseases, viruses, or disorders.

It is during this trying time that rehabilitation can provide an extraordinary service. All rehabilitation professionals, particularly occupational therapists, have an aspect of wellness or health literacy in their scope of practice. Whether we are treating healthy or immune compromised individuals, education on topics such as hygiene and stress reduction are needed.

As I continue to treat during this pandemic, I am finding most of my patients are seeking information on how to stay safe and practice good hygiene. While good hygiene, such as hand washing, is common practice in healthcare, it is not as heavily highlighted in others. Many of my patients have asked me within the past few weeks the correct process for handwashing and prevention of disease.  This education is a billable service under therapeutic activity and/or self-care/home management. Additionally, this education is empowering patients to take control of their health and keep themselves safe.

When educating patients on hygiene, you may be more comfortable using a hand-out as a guide or referring the patient to a resource for more information. The Center for Disease Control (CDC) has multiple hand-outs and references for multiple types of hygiene, such as: hand hygiene, dental hygiene, foot hygiene, and hygiene etiquette. Neurological disorder associations and foundations have posted videos and hand-outs on their websites for hygiene education that is targeted for the population of interest. For example, the Michael J. Fox Foundation has a great resource for those with Parkinson’s on how to prevent COVID-19 but also how to decide if he/she should venture out for a doctor’s appointment.

Not only can we be a great resource for education on hygiene, but we can also provide stress management during this anxiety ridden time. Stress has been documented to decrease cellular immunity, thus making us more susceptible to illness, such as colds and viruses (Segerstrom & Miller, 2004; Dhabhar, 2014). Educating patients on stress management techniques is a billable service under therapeutic activity or self-care/home management. This is particularly in the wheel house of occupational therapists, but can absolutely be included in a physical therapist or speech therapists practice.

Stress management techniques can include, but are not limited to, the following: mindfulness meditation, therapeutic yoga, breathing techniques, Tai Chi, and exercise. These stress techniques can not only increase our immune systems but also decrease anxiety, increase quality of life, and allow for clearer thinking for decision making (Scott, 2019). If you feel competent in stress management techniques, rehabilitation scopes of practice allows therapists to introduce these techniques during sessions. If you do not feel competent, educating patients on the importance of stress management can be provided. Via motivational interviewing, patients can identify stress management techniques that he/she are interested in learning or already know how to perform. Sometimes patients need a gentle nudge to return to healthy routines or assist with a plan for the courage to try a novel healthy role.

As April celebrates occupational therapy, I encourage all occupational therapists to return to their roots and incorporate education and stress management into their practice. Particularly in the current upheaval, occupational therapy is needed for prevention of disease and obtaining healthy roles and routines. In my mind, this is a great way to advocate for and celebrate occupational therapy. Happy OT Month!

To learn more from Cristina, check out the video below for a preview into her course, “Neurological Disorders,” with Summit. To register for this course, visit https://summit-education.com/c/GNEUCK.1.




Dhabhar FS. Immunol Res. 2014 May; 58 (2-3):193-210. doi: 10.1007/s12026-014-8517-0.

Dulham, R. (2020, March 11). Ask the MD: Coronavirus and Parkinson’s. Retrieved March 21, 2020, from https://www.michaeljfox.org/news/ask-md-coronavirus-and-parkinsons?et_cid=1532953&et_rid=225449454&et_lid=Ask the MD: Coronavirus and Parkinson's&em_cid

Scott, E. (2019, October 23). 5 Effective Ways to Clear your Mind. Retrieved March 21, 2020, from https://www.verywellmind.com/how-can-i-clear-my-mind-3144602

Segerstrom, S. C., & Miller, G. E. (2004). Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological Bulletin, 130(4), 601–630. https://doi.org/10.1037/0033-2909.130.4.601

Water, Sanitation, and Environmentally-Related Hygiene: Information for Specific Groups. (2016, August 2). Retrieved March 19, 2020, from https://www.cdc.gov/healthywater/hygiene/audience.html