How Occupational Therapy Can Help Older Adults Thrive

Many of us have experience with physical therapy, perhaps after trying a new sport or overdoing it with a set of dumbbells. However, for older adults who want to age in place (at home), occupational therapy is the ideal profession to support and advocate for successful, productive aging.

Phyllis Simon, OTD, OTR/L, an assistant professor of occupational therapy in Rehabilitation and Regenerative Medicine at the Vagelos College of Physicians and Surgeons, specializes in occupational therapy for older adults. Based on her 38 years of experience working with patients, Dr. Simon explains what occupational therapy is, how it complements physical therapy, and why prevention is especially important for aging adults.

What is occupational therapy, and how does it differ from physical therapy?

My elevator pitch is that occupational therapy (OT) helps people do what they need and want to do in their daily lives. We look at the whole person—not just one’s physical abilities, but also cognition, vision, mental health, habits, routines, and their living environment.

People often think occupational therapy is work-related because of the word “occupation,” but in this context, occupations are simply everyday activities, such as getting dressed, cooking, socializing, or managing a home.

Physical therapy and occupational therapy collaborate all the time, but the focus is different. Physical therapists often emphasize strength, mobility, and the biomechanics of a particular motion. Occupational therapists take the next step—we look at how those abilities translate into daily function. For example, building strength allows a patient to shower independently, cook a meal, or get on and off the toilet safely.

Who might need occupational therapy?

Honestly, I think every older adult could benefit from occupational therapy in some way. But most commonly, we see people after hospitalizations, falls, or declines in function. Even a short hospital stay can have a big impact on older adults—people can lose significant muscle strength from being in bed for just a few days.

Also, occupational therapists help people face the many challenges of aging: arthritis, frailty, chronic illness, cognitive changes, and even depression. Sometimes, people stop socializing because of hearing loss or confidence issues, and that affects their overall health.

There are two sides to OT: reactive care, after something happens, and preventive care. I emphasize prevention. Screening for fall risks, cognitive concerns, depression, and other functional changes can help people maintain their independence and quality of life. Ideally, we want to address issues before they become crises.

How can occupational therapy help seniors age at home?

A big part of occupational therapy is looking at how someone lives in their home. When I do a home assessment, I start the moment I enter the building—how accessible is it? Are there railings? Is there adequate lighting?

Inside the home, we look room by room. Bathrooms are where many falls occur, so we evaluate showers, grab bars, toilet height, and safety supports. In kitchens, we look at whether people can safely reach items or whether they’re improvising in risky ways—like climbing step ladders or using improvised tools to pull things off shelves.

Often the solutions are simple: rearranging cabinets, improving lighting, adding motion lights for nighttime bathroom trips, or introducing adaptive devices such as reachers or sock aids to help perform daily tasks. You’d be surprised how small environmental changes can make a huge difference in an individual’s safety, comfort, and independence.

We also help older adults use technology, such as accessing health portals, using phones or video calls, and staying socially connected.

What are some early signs that suggest an occupational therapy consultation could be helpful?

In my experience, earlier is better. If someone is functioning fine but wants guidance on how to stay that way—that’s a perfect time for an OT consultation to plan ahead.

However, many people wait until something goes wrong. Families might notice subtle cognitive changes, small declines in daily activities, or someone becoming less active socially.

Other signs include difficulty managing everyday tasks, changes in balance, or near-falls. But even if someone hasn’t fallen, installing grab bars or improving lighting can prevent future problems.

Are there times when a senior could benefit from both occupational therapy and physical therapy?

Absolutely. It is best practice, especially with older adults, for therapists to work as a team. A physical therapist may focus on improving walking, strength, or mobility. As an occupational therapist, I focus on how those improvements carry over into daily life: getting dressed, bathing safely, cooking, or managing the home. This combination produces the best outcomes because function depends on both physical ability and real-world application.

As an occupational therapist, what’s the best part of your job?

For me, it’s realizing how small things can make a meaningful difference in someone’s life. Sometimes it’s helping a person continue doing something important to them—like cooking, living independently, or simply walking to the bathroom on their own.

The therapeutic relationship is also central. We call it the “therapeutic use of self.” Building trust with my patients allows them to accept guidance that helps them stay safe and independent. When you connect someone’s story with what matters to them, therapy becomes meaningful and joyful rather than just a set of exercises.

Those relationships—and seeing people maintain dignity and independence later in life—are what I remember most.

What are some important things for aging adults to keep in mind?

I’d like to re-emphasize the importance of prevention, because starting early with older adults makes such a difference. Teamwork among health professionals—physicians, therapists, social workers, and others—is essential and considered best practice for older adults.

I’m also a strong advocate for connecting my patients with community resources and support systems. Aging at home isn’t just about physical health; it’s about staying physically active, cognitively stimulated, and socially engaged.

Those three things really apply to all of us, but they’re especially important as we age.

Phyllis Simon, OTD, is an assistant professor of occupational therapy in the Department of Rehabilitation and Regenerative Medicineat the Vagelos College of Physicians and Surgeons. Dr. Simon has worked as an occupational therapist for 38 years.