The fact that we know so much about self-care and mobility and so little about activities is embarrassing. Our ignorance has contributed to over sedation in nursing homes.
The general public sees the word occupation as being related to their jobs. The current use of the word in occupational therapy is idiosyncratic and unrelated to the activities that a person with a cognitive disability can still do. Rather than clarifying the value of occupational therapy, occupation obscures the human need to do activities, at best. At worst, occupation makes therapists embarrassed about doing something so humble as painting an adult looking target on a piece of cardboard for a bean bag toss. I think our pride has become egocentric and needs to shift back to the experience of the person who needs to be kept busy doing activities.
Creating simple activities that people with severe cognitive disabilities can still do is extremely difficult. The time has come for our professional organisations and academic faculty to catch up with reality. That will not happen without grass root demands for accountability and change.