Milieu therapy and the elderly: a role for the occupational therapist consultant

In the evolving world of improved care for the elderly, the skills of an occupational therapist are increasingly being called into play. This article presents a conceptual framework--Milieu Therapy--for treatment of institutionalized elderly persons, and describes the underlying principles of the therapeutic community. In a redefinition of roles for staff and residents, OT's become consultants whose client becomes the staff and organization within the institutional environment. Some basic assumptions in working with staff are discussed and the major components of the process of change are briefly described. The result is a winning experience for everyone concerned--including the OT.