Sunday, 27 June 2010

Making a Cup of Tea – an Occupational Therapy Perspective


Can you make a cup of tea? Can you imagine not being able to? Can you consider any reasons as to why it might be difficult to make a cup of tea?

Let us take the task of making a cup of tea and look at how it is applicable to occupational therapy.

Making a cup of tea can be used as part of an evaluation to determine a person's level of independence in the kitchen. When would this be relevant and for who?

Firstly we take a look at the person's stage in the life cycle. Since a baby, a toddler and a small child do not make tea, we do not test their ability to do so. However, we might look at where a baby or small child is positioned while a mother, babysitter or caregiver is involved in making a cup of tea. Why?

There are two aspects of making a cup of tea that pose a potential danger, and therefore an important factor in the evaluation is safety. While some people use an electric kettle to make a cup of tea, others heat a kettle or metal tea pot on a fire or gas stove. In addition, when the water is boiling, the boiling water is a potential danger. The electricity too can pose a danger especially if the kettle is placed in a low electric socket that a small child can easily reach. Hence the first aspect of the evaluation is environmental. Is the person making the cup of tea aware of basic safety precautions and what needs to be done to make sure the kitchen or environment is safe? Does a baby need to be in a playpen, i.e. safely out of the way of a flame or boiling water. Does the table need to be elevated?

Related to safety, if your child is to be left in the care of another, can that person be trusted with the safety of your child? It might sound obvious or unnecessary to check. However, a child I treated while still a student came into a children's hospital with burns down her front from a domestic worker pouring boiling water over her in a fit of jealousy. What triggered the specific fit of jealousy I do not know, but what began as the domestic worker making a cup of tea, ended in a little 3 year old in hospital in pain with severe hot water burns. We don’t want this to happen, so keep your children safe, that way hopefully you can enjoy many cups of tea together.

Once safety has been dealt with, the OT can begin to look at certain physical factors. If the person is blind, can they structure their kitchen so as to find the cup, teaspoon, tea bags etc with ease and without breaking anything. How will they identify that a bag contains tea leaves and not spices? How will they know when the cup is filled or nearly filled; do they need a tea-level indicator?

If the person has arthritis, can they manage to pour the water into the kettle and the boiling water into the cup, or is there a need for a tap turner and kettle tipper which reduce the stress on the joints, thus enabling the task of making a cup of tea pain free and possible rather than a strain and aggravation on damaged joints.

If the person has a hand injury, do they need to strengthen their muscles? Do they have sufficient range of movement to grasp the kettle or to hold the cup? Can they pour the water without any tremor (a tremor can pose a safety risk). Does the person have use of both hands or just one hand? If only one hand is it his or her dominant hand or non-dominant hand?

If the person has a problem with their legs, can they stand for long enough to make the cup of tea, do they need a stool in the kitchen? Can they walk where necessary to gather the ingredients or do they need to use a trolley or have someone else bring the ingredients to where the kettle is? Can they stand or do they need to learn to manoeuvre a wheelchair in the kitchen.

If the person has an endurance, sensory or concentration problem, this too is important to evaluate.

These are just a some of the physical issues taken into consideration when evaluating making a cup of tea. Now let us look at perception, cognition and memory.

Does the person know the correct sequence that making a cup of tea requires? When is water placed into the kettle? Where is the water obtained from, a tap, bottle of water, a well? When is the kettle placed on the flame or the electric switch turned on? When does one place a tea bag in a cup? Do you always add sugar, if so how much and at what stage? These questions all come into perception, cognition and memory.

Of course there are basic questions, such as does the person like tea? Will they ever make a cup of tea? If they don’t like tea and perhaps don’t like the smell of tea, we don’t even evaluate, as these questions indicate the person will not need to use the skill of making tea, although another hot beverage might be applicable.

It is important to know whether a person uses tea bags or brews tea from the tea leaves. Do they make tea directly into the cup, or into a tea pot to brew and then pour the tea from the pot into a cup? Do they use a china cup, a mug, a glass, a glass mug or cup? All these factors and more about the persons culture, tastes, likes and dislikes are also factored into whether a person would actually make a cup of tea and if so what steps are involved that an OT would need to evaluate in order to help them to prepare that cup of tea themselves.

There are some for whom making a cup of tea is not a task of the personal care of daily living skills, neither is it for pleasure. Rather, it falls under the area of work. For those who work in a restaurant or in an office and need to make tea, there are other factors to take into consideration. Can they identify between different types of tea? How will they carry a number of cups simultaneously? Can they balance a tray or use a trolley? Can they remember an order from several people or do they need to write it down? If they need to write it down, can they write? Can they write quickly? Is their writing legible? Can they read their own handwriting, especially when written quickly? Where will they place a pad and pen / pencil or piece of paper with the order on or will they use a technological device? These and many more questions and factors will go into whether a person is capable of making tea in the work place.

As you can see, we have already covered quite a few areas and this has only been in evaluating whether a person can make a cup of tea and where an OT is needed, if at all to intervene. We have not yet entered into the area of therapeutic intervention.

In another post we will look at how to use the task of making a cup of tea therapeutically, including using it with new immigrants (specifically to Israel)

Have you enjoyed this post? Please post a comment at the bottom of the post. I'd love to hear from you.

Shoshanah

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