Quality Occupational Therapy - Reducing Risk, Improving Independence

Case Study - Back to case studies

Reason for Referral: Re-assessment of needs on admission to care home.

Mrs M was admitted to a residential care home. Mrs M had been transferred from a different home as her family wanted her to be closer to them so that they could visit more frequently.

The care staff report that on arrival Mrs M was very anxious and reluctant to mobilise. The previous care home was transferring Mrs M with 2 care staff and a manual handling belt. She required assistance to transfer on and off of the chair and assistance for most activities of daily living. She was not mobile.

Mrs M was referred to the Occupational Therapist as a request from her son to review her current abilities.

Assessment and treatment plan:

Mrs M was very anxious and expressing her concerns regarding pain in her legs. Mrs M reported that she was unable to get out of the chair without assistance and was unable to mobilise.

The initial assessment began in the privacy of Mrs M's room and consisted of some upper and lower limb range of movement exercises and lower limb strength. A brief sensation test did not highlight any issues.

Mrs M was encouraged to stand from the arm chair without letting go and sit down again which she managed several times. A Zimmer frame was placed in front of Mrs M and she was able to stand independently and hold onto the frame. Her balance was good both static and dynamic. Mrs M remained very anxious but with lots of reassurance she maintained this stand. Over the next week Mrs M continued to practice her exercises and the care staff encouraged her to stand independently.

Mrs M was assessed again to ensure that her abilities to stand from the arm chair were maintained. Mrs M was managing this well and required no assistance for this task. Mrs M was then encouraged to take a few steps around her room with guidance, reassurance and support. Mrs M managed this very well and there were no reasons why she couldn't continue. Mrs M was encouraged to take herself to the en-suite bathroom and she managed her hygiene needs independently, reassurance was required throughout due to the anxiety of Mrs M.

Whilst in the communal area with the other residents Mrs M continued to transfer independently, she was then encouraged to mobilise over to the dining room table for her supper, she managed this with ease and no support. After practicing this with the care staff this then became the 'norm' and Mrs M was able to mobilise approximately 25 metres with her frame independently.


Mrs M was very dependent on the carers prior to admission and would have deteriorated if her abilities were not re-assessed. Mrs M is now able to wash and dress herself, manage her own hygiene needs and always mobilises in and around the care home. She does not always remember that she has this level of independence and so the care staff continue to reassure her.

This has freed up the care staff to ensure that those residents that are more dependent are receiving the care they need and Mrs M and her son remain happy and content.


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British Associations of Occupational Therapists Dementia Friends