Rachel Booth, an occupational therapist, experienced post-COVID rehabilitation after being hospitalized for 3 months with COVID and pancreatitis. She struggled with weakness, confusion, loneliness and occupational deprivation as she adapted to her new limitations and environments in the hospital and rehab. Over time, with support from family and health professionals, her resilience and independence improved as she engaged in goal-setting, daily living activities, and occupations like writing about her experiences. She thanked all who supported her recovery journey.

1. MARCH 2021 FROM MY HOSPITAL BED
Rachel Booth
Experiencing post-covid rehab
- from practitioner to patient
“Resilience, Adaptation, and the New Normal”.

2. Lead Occupational Therapist Secure Services - 15 years experience.
Special interests include, intensive care units (PICU’s), Feminism within OT
and the impact of a woman’s menstrual cycle on functioning, the lived
experience of occupational therapists with disabilities.
Born with mild cerebral palsy, affecting right side. Also Dyslexic.
Member of #OTalk - Weekly chat about OT on twitter (Tuesdays 8 pm)
Engaged, Crime Drama Addict, Tin Collector, Vintage Enthusiast, Cat lady,
Intersexual Feminist, Disability Activist, Blogger, Who loves a good pattern
Current favourite Occupation - Colouring in
Favourite band - The Furtureheads.
Currently in hospital Admitted 3rd April 2020, with Covid and Pancreatitis.
ABOUT ME

3. Resilience -The capacity of a dynamic
system to adopt successfully to challenges
that threaten the function, survival, or future
development of the system. - Ann Mosten
Adaptation - A change in structure, function,
or behaviour by which a species or
individual improves its chance of survival in
a specific environment.
The new Normal - Social distancing, Face
masks, limited access to leisure activities,
video calls, isolation, unemployment, PPE,
restrictions on movement.
“RESILIENCE, ADAPTATION, AND THE NEW NORMAL”.

4. Occupational
Deprivation
‘Occupational
deprivation refers to
situations in which
people’s needs for
meaningful and
health promoting
occupations go
unmet or are
systematically
denied’ (Wood et al,
2005).
OCCUPATIONAL TERMS
Occupational
Alienation
“Sense of isolation,
powerlessness,
frustration, loss of
control, and
estrangement from
society or self as a
result of engagement
in occupation that
does not satisfy inner
needs.” (Wilcock
1998, page 343)
Occupational
Injustice
‘’An outcome of social
policies and other
forms of governance
that structure how
power is exerted to
restrict participation in
the everyday
occupations of
populations and
individuals’’ (Nilsson
and Townsend 2010 p.
58).
Occupational
justice
Typically framed as
an aspect of social
justice, a
philosophical
perspective that
has traditionally
emphasised
treating people with
respect and ensure
access to societal
resources.

5. Experienced awful heartburn, After a few hours
rang an ambulance.
A and E quickly determined I had Acute
pancreatitis, they also swabbed me for Covid
and it came back positive.
The next few months are a bit of a blur, I spend
some time in the ICU, then move to a specialist
hospital an hour away for treatment.
Staff were difficult to understand and to
recognise due to PPE.
APRIL - MAY 2020
Resilience - was low, very weak, unable to
manage, often tearful
Adaptation, all change. Unfamiliar environment,
being so unwell impacted on all ADL’s and
abilities to function.
My new normal, involved being confused, out of
it, not seeing family and friends, muscle
weakness, unable to communication well,
loneliness, but never alone, beeping, feeling
sleepy, unable to carry out most occupations
myself, having to reliance on staff.
Very little ability to use own professional skills

6. In ICU, on and off a Ventilator
Feeling very weak and unable to hold my phone.
Nil by month, feeding tube
Urinary and Rectal catheters in place.
I could hardly move,
Voice was strained and difficult hear, due to having tubes
down my throat when unconscious.
Began to work with Physio Therapist and Speech and
Language therapist
Dreams felt real even when conscious
I believed that things like being kidnaped, and having a
swimming pool on the roof of the hospital were true.
MAY - JUNE
Resiliences - At this time I felt I had little
resiliences, but I was less tearful, had had
visits from family, and began working with
a Psychologist, which all helped to build
my resilience
Adaptation - Staff and environment
becoming more familiar, still requiring help
with ADL’s and abilities to function.
My new Normal - Not being sure what
was real and what was not, seeing family
for limited time, them wearing PPE
Still to unwell to use own professional skills

7. Moving to new ward surgical in a side room by myself
Having to pay large amounts of money to watch the
television
Operations on pancreas and bladder
Important dates pass without celebration, my Hen-do, my
Birthday, our Wedding day
Continued work with PT, SALT and began to engage with
occupational therapy.
Some small improvements in movement and strength,
Collaboration with OT, PT and SALT to access
assessment room for looking at swallow.
Beginning to eat, working with Dietician
JULY - SEPTEMBER
Resilience - My resilience fluctuated at this
point, support from AHP’s really help and
encourage movement and activities to manage
with some independence.
Adaptation - A new environment often on my
own, being to be able to sit in wheelchair
meant that visitors could take me of the ward,
spent a lot of time in the chapel. Using
equipment like like the hoist to enable
showering and sitting in wheel chair.
The new Normal - Still everyone wearing
PPE, watching the news and understanding
more of the new normal in the outside world.
Very weak but working with OT felt good, respect was given goal setting together.

8. Improvement in upper limb function able to
attended to some ADL independently
Being to find enjoyable occupations
#BlackHistoryMonth
Standing and transferring with Arjo
Had a job interview over video call
Start documenting my experiences in blog posts
Visits from my mum and niece Lyra
Referrals to Rehab, waiting and more waiting
OCTOBER - DECEMBER 2020
Resilience - My resilience is much better able to
see improvement, beginning to think of others.
However rejection form Rehab, impacted resilience
Adaptation - Beginning to problem solve myself,
pressing buttons, opening drinks, finding pleasure in
new and old occupations I could do from my bed,
social media, colouring in, watching films, writing
blogs.
My new Normal - Very used to everyone wearing
PPE, Establishing a routine, of therapy
interventions, engaging in meaningful activities,
having regular visits from my niece.
Much better at advocating for self, began to set own goals, engaged in some CPD

9. News of acceptance to rehab
Moving hospital, This time placed in a bay with five
other ladies.
False positive covid result, meant 14 days of
isolation on another ward
Rehab was started in isolation
Finally get to Rehab, intensive Physio weekdays,
Occupational Therapy focuses on concentration and
engagement in CPD activities.
Limited Visits with screen between.
Experiencing flashback of being in ICU
JANUARY - FEBRUARY 2021
Resilience - My resilience continued to improve,
Motivation for therapy is high, new company is
comforting.
Adaptation - Another new environment, having to
live with and be considerate of others. Further
improvement able to stand and transfer with rota
stand.
My new Normal - PPE, sharing living space,
Establishing a new routine, Change to visiting rules
due to lockdown.
Lots of observations of others, wanting to do a MOHO
with someone, saw practise I felt uncomfortable with,
used skills to help lady with dementia, sometimes
difficult not to get involved.

10. ANY QUESTIONS?
• Follow me on twitter @OT_rach
• Follow @OTalk_ on twitter
• Follow me on Instagram @OT_rach
• Follow @OTalk_ on Instagram
• Read my Blog https://otrach.wordpress.com
With thanks to my Partner Anthony, Mum Mary, all my family and Friends
Staff I have worked with at the Freeman Hospital and James Cook Hospital.
Dr Wendy Bryant for helping me with some research.
All my twitter OT family that have kept me going.
To all those that send cards.
Kirstie and Kelly who kept me up to date with all the gossip.
I could not have got this far without your support, and encouragement.
And a special thanks to my amazing Niece Lyra who FaceTimes me all the time
to play games, show me things and always puts a smile on my face.