Quality Occupational Therapy - Reducing Risk, Improving Independence

Case Study - Back to case studies

Reason for referral:

New resident admission and requiring more support than suggested by the acute setting.

Mr W also had his own concerns about various aspects of his care such as:

  • Long wait for assistance when the call bell has been alarmed
  • Privacy issues at the patio window when toileting on the commode
  • Inappropriate moving and handling equipment
  • Lack of physiotherapy input
  • Lack of understanding of his Parkinson's condition

The transition from his own home to a 24-hour care setting was proving distressing for him and his family.

Assessment:

Mr W and his wife were present in his own room and on arrival 2 carers were assisting Mr W from sitting on the bed to a standing position using a handling belt and a zimmer frame. He then mobilised between 2 carers with the wheeled zimmer frame across the room to the armchair. When the carers had completed their care Mr W complained of lacking confidence in the staff and his confidence was very low.

The assessment began with gathering information about Mr Wís previous abilities and techniques and discussing what his short term goals were with reference to activities of daily living and mobility/transfers. Meaningful activity was discussed and his wife assisted in suggesting tasks Mr W will often engage in.

Mr W then consented to demonstrating his current abilities. He stood from the armchair he was sitting in which was considerably low with the assistance on 1 person and then mobilised across and around the room with supervision only, on 3 wheeled walker. He required some encouragement and verbal prompts for foot placement but eventually retired to the bed which we had raised and he could sit down safely and independently.

Mr W's lunch then arrived to the room and a feeding assessment was carried out to assess for sitting posture, how his tremors impact on this task, appropriate adaptive cutlery and whether assistance was required to complete the task.

The care staff were informed of the assessment outcomes and guided with moving and handling techniques

Treatment plan:

  • Time to be given to Mr W for each transfer and mobility with positioning and verbal prompts.
  • Senior carer to educate staff about the condition Parkinsonís disease.
  • Laminated sign to prompt carers for best management.
  • Listen to Mr W as he understands his condition better than anyone.
  • Zimmer frame not to be used and 3 wheeled walker to be used for all transfers and mobility.
  • Handling belt not to be used but assistance of 1 x carers for all transfers. Close supervision when mobilising.
  • Clear verbal prompts and instructions to be given to ensure safe and consistent transfers.
  • Bed to be raised to aid sit to stand from this furniture.
  • Armchair to be raised to 20".
  • Ensure identified set up for feeding.
  • Mr W does not currently wish to socialise in communal area so Activity coordinator to follow activity plan set out by Occupational therapist within his private room on a regular basis and incorporate him family.

Outcome:

Better management of Mr W has led to improvements in his wellbeing and staff are able to meet his needs more effectively.

By following the advice and instructions, the risk of falls and poor moving and handling has been significantly reduced and Mr W has found confidence in the staff and is happy to venture out of his room.

Availability

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Tus 8.00am - 5.00pm
Wed Closed
Thu 8.00am - 7.30pm
Fri 8.00am - 7.30pm
Sat Closed
Sun Closed
British Associations of Occupational Therapists Dementia Friends