Occupational therapy in extra-hospital care offered by hospitals

The Extra-hospital Care offered by hospitals is one of the performance areas of the "Occupational Therapy in Hospital Care Contexts" specialty and refers to the assistance provided by the hospitals at the patients' homes. The aim of this article is to introduce the area main concepts and describe the practice of Occupational Therapy. There are four kinds of home health care assistance in Brazil, as recommended by the Ministry of Health, and all of them are in the area of occupational performance. The main focus of the occupational therapist's intervention depends on the assistance level, and it may include preparation and information for hospital discharge, assessment and adaptation of the home environment, recovery of meaningful activities, promotion of independence and autonomy, cognitive rehabilitation, sensorial stimuli, information about positioning, prescription and manufacturing of adaptive devices, and guidance for family and care givers. There are many challenges to be faced in this professional area, such as: domiciliary context complexity, payment and organization, team work, support networks, etc. Occupational Therapy plays a very important role in extra-hospital care.