Occupational Therapy — Advice Letter on Joint Protection for a Patient with Rheumatoid Arthritis
An occupational therapist writes an advice letter to a 46-year-old woman with newly diagnosed rheumatoid arthritis explaining the joint protection principles for daily activities involving the wrists and hands. This is a beginner case: three principles, practical daily application, and a brief safety net.
Letter type
Advice
Write to
Patient
Target length
170–190 words
The case notes
Patient: Mrs Carmen Diaz, 46 years old; newly diagnosed rheumatoid arthritis; wrists and MCP joints affected; working as a primary school teacher
Joint protection principles taught: (1) Distribute load — use the whole hand or forearm rather than fingers alone (carry bags on forearms, not by handles; use two-handed mugs); (2) Avoid sustained grip — set a timer, change position every 20 minutes when gripping (writing, cooking); (3) Use the largest/strongest joint — push doors with upper arm or hip, not hands; open jars using palm rather than fingers
Pacing: Plan tasks to alternate light and heavy work; rest before getting to pain level; morning stiffness is usually worst — plan cognitively demanding work before physically demanding tasks later in the day if possible
Equipment given: Two-handled mug, jar opener, easy-grip pen; given a catalogue of further aids available
Work: Discussed keyboard adaptations and pen use at school; advised to inform school about the condition so adjustments can be planned
When to contact: If pain or swelling significantly worsens, or activities become substantially harder — return for reassessment
Task: Write an advice letter to Mrs Diaz explaining the three joint protection principles and how to apply them in her daily life.
Writing task
Write an advice letter to Mrs Diaz explaining the three joint protection principles and how to apply them in her daily life.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The three principles with a practical daily example each
Joint protection principles taught without examples cannot be translated to daily life. 'Distribute load' is abstract; 'carry bags on your forearm rather than gripping the handles' is actionable.
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The 20-minute grip timer and pacing between tasks
Sustained grip is the most common aggravating factor for wrist RA at work. The timer is a simple tool that prevents sustained load without requiring the patient to judge when to rest.
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The contact instruction: return if pain significantly worsens or activities become substantially harder
RA is progressive. The patient needs to know the OT is available for reassessment as the condition changes, not just for the initial visit.
Leave out
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A full rheumatological explanation of RA joint inflammation
One sentence of context is appropriate: 'Joint protection helps reduce the strain on your joints during daily tasks, slowing down the impact of rheumatoid arthritis.' The disease mechanism belongs in the rheumatology consultation.
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The full equipment catalogue
The patient has the catalogue. Listing every aid in the advice letter pads the word count without adding value. Name the equipment given today; the catalogue covers the rest.
Criterion in focus · Conciseness & Clarity
OT joint protection letters are graded on whether each principle has a concrete daily application. 'Use the largest available joint' without an example is incomplete — 'push doors with your upper arm or hip rather than your hand' completes the instruction. Examiners check each principle for its application example. A principle without an example is a Content gap dressed up as a Conciseness problem.
Now write the letter — and find out what is blocking your Grade B
Write a 170–190 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.