Problem: OT letters contain the richest functional detail in OET — and the worst organisation, because everything feels important. Answer in brief: paragraph by domain (mobility, self-care, cognition, home, plan), one domain each, ranked by discharge risk. This guide teaches domain paragraphing with cognitive-rehab and palliative applications, and OET Writing for Occupational Therapists — Course 3 trains organisation, stroke, TBI, cognitive rehabilitation and palliative discharges across 18 topic sections.
Paragraph by domain, ranked by risk
Five domains, fixed order: mobility and falls risk (kills or hospitalises first, so first); self-care (daily dignity); cognition and supervision needs (determines care hours); home environment fit (stairs, bathroom, living situation); numbered plan. Within each domain: today’s function, trajectory in one clause, outstanding need. Anything that fits no domain is cut — “pleasant gentleman” has never secured a single service.
Stroke, TBI and cognitive rehabilitation
Cognition paragraphs need task evidence: “requires step-by-step prompting for dressing; unsafe with medication and cooker; intact social chatter masks deficits — warn explicitly against chatter-based judgement”. Rehabilitation potential gets its own honest line (engagement, insight, carryover between sessions). Goals must be observable (“prepare a hot drink with standby supervision”) never aspirational (“improve cognition”).
Master domain paragraphing supervised? The full OET Writing for Occupational Therapists — Course 3 trains organisation, stroke, TBI, cognitive rehabilitation and palliative discharges across 18 topic sections with 34 lessons and mock tests. Explore the course →
Palliative and high-dependency discharges
Aim-first openings (“for comfort-focused care at home following…”), function as comfort measures (positioning, pressure care, swallow safety for pleasure vs nutrition), equipment for ease (hospital bed, commode — with delivery status), family capacity in one line, numbered community actions with out-of-hours contacts. High-dependency discharges add: package-of-care hours stated, escalation thresholds, who holds clinical responsibility overnight. Kindness with precision — vague comfort language helps nobody at 2 a.m.
Worked example: TBI discharge home
Fictional case, newly written: Mr Halloran, 34, severe TBI four months ago; mobilises independently, impulsive on roads; needs prompting for hygiene and meals; cooker unsafe; personable and plausible — supervision masks needs; mother providing all structure, exhausted.
Shape: handover purpose with interval. Mobility paragraph (independent but road-unsafe — the key risk pairing). Self-care with prompting levels. Cognition paragraph with the chatter warning explicit. Home and mother-capacity lines. Actions: “1) twice-daily support-worker visits; 2) cooker isolation device; 3) road-safety programme referral; 4) carer respite assessment.” Risk-ranked — roughly 185 words.
FAQs
Should I really warn against being fooled by chatter?
Yes, explicitly — it is the commonest community-placement failure in TBI. One sentence protects the patient more than a page of strengths.
Do palliative OT letters skip rehabilitation language?
They redirect it: goals become comfort, ease and family time rather than independence gains. State the redirected aim openly so services calibrate.
What is in the course?
Eighteen topic sections on organisation and paragraphing, stroke, TBI and cognitive rehabilitation, palliative and high-dependency discharges, with 34 lessons and 5 complete mock tests.
The matching course
OET Writing for Occupational Therapists — Course 3 organises the richest detail in OET: domain paragraphing, cognitive-rehab honesty and palliative precision — 18 topic sections, 34 lessons, 5 mock tests. If everything feels important, learn ranking here.
Sources and note
- OET Writing format per the official OET site: oet.com — Writing. Check current format guidance before the exam.
- Course details verified from its public staging page (read-only): 18 topic sections, 34 lessons, 5 mock tests.
- Case and letter lines are newly written and fictional; other valid structures exist.
Put this into practice
Compare these course outlines and choose the practice that matches your next goal.
