Quality Occupational Therapy - Reducing Risk, Improving Independence

Case Study - Back to case studies

Reason for referral:

Mr G's family contacted me as they had growing concerns about their father who had suffered a stroke 10 years ago and his mobility and memory has since deteriorated. He has been living in his own home alone for a number of years now and he intends on staying as independent as he possibly can.

My aim was to assess Mr G in his own surroundings with regards to his activities of daily living and mobility around the home. Identifying any potential risks and reducing these where possible.

Problems identified following assessment:

  1. Rugs in the lounge and hallway pose a tripping hazard.
  2. A two seater sofa in the lounge is 16" compressed and a struggle to stand from.
  3. Sofa in the library/piano room is obstructing access to the window.
  4. Minimal lighting is utilised which reduces visual awareness.
  5. A large kitchen which is far from the lounge means a lot of transportation of items back and forth.
  6. A high wooden stool is used in the kitchen to assist with eating breakfast at the work surface.
  7. The main toilet used is a struggle to stand from as it is low and consequently the arm of a chair is used to aid this transfer.
  8. There is a large 11" step into the shower which is not currently problematic but may at times become difficult.
  9. Single divan bed is 16" in height and very soft which means standing from this is evidently difficult.
  10. The large step down through the front door throws Mr Gs balance when entering the property.
  11. There is no indoor walk around phone or mobile carried in the case of an emergency.
  12. Mr G is reluctant to take medications and has new added tablets.
  13. Mr G uses the walking stick in the opposite hand to recommendations.

Treatment plan:

  1. Remove all rugs where possible or utilise double sided tape to reduce movement of these.
  2. Raise the sofa on specialist blocks to approximately 20".
  3. Rethink layout of the library/piano room to allow easy access to draw the curtains.
  4. Invest in energy efficient small plug in lights for hallways and landings to increase lighting at night time.
  5. Purchase a 4 x wheeled kitchen trolley to ease transportation of items between rooms (ensure the stair lift is not obstructing the hallway).
  6. Consider a perching stool with back and arms to facilitate easier transfers.
  7. Source a free standing integrated toilet frame to provide extra height and arms to push up from.
  8. Consider a grab rail within the shower to assist with pulling himself in and gaining clearance of the right leg.
  9. Raise the bed to 20"-22" to prevent rapid descent into it and assistance with rising from it.
  10. Look to fix a small grab rail to the front door inside to allow easier and safer access.
  11. Explore lifeline pendants to assist in the unfortunate event of an accident.
  12. Manage medications with a dossit box (to be purchased) and seek pharmacy support with this.
  13. Following a mobility assessment Mr G is currently safe mobilising indoors unaided if the recommendations are adhered to. I Trialled Mr G with his walking stick in the left hand but this felt uncomfortable so he is to remain using it in his right hand.

A copy of this assessment was also sent to Mr G' GP with consent.

Outcome:

Mr G has continued to remain in his own home following the recommendation above to, he continues to live a full life and carry out meaningful activities under a watchful eye of his loving caring family.

No falls have since been reported and he has managed to stay on top of his medications.

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British Associations of Occupational Therapists Dementia Friends