ENOccupational therapy helps people manage everyday tasks on their own again after illness or injury — dressing, eating, writing, cooking. Families coming to Germany for rehabilitation usually expect physiotherapy and are surprised by a second therapist who works not on walking but on buttons, spoons and pens.
That is an occupational therapist, and the treatment is called Ergotherapie in German. Below: what it is for, who gets it and how occupational therapy in Germany is organised for international patients. The wider field is covered under rehabilitation in Germany.
What occupational therapy is, and how it differs from physiotherapy
Physiotherapy works on movement itself; occupational therapy works on what that movement is for — holding a cup, fastening a button, using a phone, getting into a car.
Ergotherapeut is a regulated profession in Germany: the licence is granted after a three-year training and a state examination, and nobody may work under the title without it. In clinics, therapists work to the doctor’s prescription in a team with physiotherapists, speech therapists and nurses.
Goals are concrete tasks the patient names, such as buttoning a shirt unaided, rather than «improve hand function». Each task is broken into steps and measured, written into the rehabilitation plan and reviewed on the ward round. Movement training is covered under physiotherapy in Germany.
Who is referred to an occupational therapist
Anyone whose illness or injury gets in the way of everyday tasks can be referred. After a stroke or brain injury, that means a weak or paralysed arm, poor attention, memory or planning, or losing track of a simple sequence such as making tea. See also rehabilitation after a stroke and neurological rehabilitation in Germany.
In orthopaedics and trauma care, occupational therapy follows surgery or injuries of the hand and wrist, including tendon injuries, and joint replacement. In rheumatic diseases the aim is different: protecting the joints in daily life, for example when opening jars or carrying bags.
Children with developmental problems or cerebral palsy work through play — building, modelling, threading beads. For older people with dementia, the aim is to keep familiar routines and remaining skills for as long as possible. Programmes for children are described under rehabilitation for children with cerebral palsy.
What a session actually looks like
A session starts with observation: the patient puts on a jumper, butters bread or writes their name, and the therapist notes where exactly the task breaks down — weak fingers, a tremor, a forgotten step. That says more than measuring strength in the abstract.
Then the task itself is practised repeatedly, with grip and fine motor exercises. For the arm after a stroke, one option is mirror therapy: the patient watches the healthy hand in a mirror, which makes it look as if the affected hand is moving. Attention, planning and the weaker arm’s part in dressing are trained too. Session length and frequency in an inpatient programme are set in the therapy plan to suit the diagnosis and stamina.
For household skills, German clinics may have training kitchens, and some also training bathrooms. Patients in Germany who cannot reach a practice for medical reasons may be treated at home, in their real kitchen and bathroom; international patients can bring photos and measurements instead. The World Health Organization counts adapting the home as part of rehabilitation, for instance modifying an older person’s home to improve their safety and independence there.
Aids, adaptations and teaching the family
Splints, thick-handled cutlery, dressing aids, grab rails or a wheelchair cushion are chosen with the therapist. In Germany many aids are prescribed by a doctor, adjusted — often together with an orthopaedic technician — and the patient is shown how to use them; under the statutory health insurance law, training in their use is part of the supply itself.
The family learns what to help with and, just as importantly, what not to take over: if someone always does up the buttons, the hand never relearns it. Exercises continue at home, while new goals need an occupational therapist where the patient lives, helped by the report from Germany.
Inpatient programme or outpatient practice
For an international patient, an inpatient programme usually makes most sense: occupational therapy sits in the daily schedule alongside physiotherapy and medical supervision, with several disciplines in one place.
An outpatient practice (Praxis für Ergotherapie) suits a shorter course or a follow-up stage. When booking an occupational therapist in Germany, ask about free slots at times the patient can attend, the language of sessions and the final report. Clinics are presented under rehabilitation clinics in Germany.
Frequently asked questions
Do you need a doctor’s prescription for occupational therapy?
Usually, yes. In Germany occupational therapy is prescribed by a doctor and the therapist works to that prescription; without one, the health insurance fund does not pay for it. For an international patient, the rehabilitation clinic’s doctor adds it to the programme after an examination, based on the diagnosis, scans and a description of what the person can do alone.
Does occupational therapy help after a stroke?
It can, although the evidence is not yet strong. A Cochrane review from 2017 pooled trials of occupational therapy aimed at everyday activities after a stroke: low-quality evidence suggests it can improve how people manage these activities and reduce the risk of deterioration. What to expect in a given case is for a doctor to judge.
How long does a course of occupational therapy last?
There is no fixed length: the doctor sets it by the goal and the patient’s progress. In German outpatient care, a prescription covers a limited number of sessions, and continuing needs a new one. For an inpatient programme, the length is agreed before the trip and stated in the estimate; any extension is discussed with the clinic’s doctor.
How AlenMed arranges occupational therapy in Germany
We start with a remote review of discharge papers and scans, agree the goal with the family and match a clinic whose programme fits it. Then come a written estimate, the visa invitation and admission dates, and an interpreter in the therapy room, where words matter as much as movement.
At the end, the clinic issues a report on what was achieved and what to continue. The patient takes home exercises and aids, and we can arrange a repeat course. Prices are explained in the written estimate, which lists what is included and what is charged separately.
This material is for information only and is not an offer. The occupational therapy programme is set by a doctor after examining the patient.