meredith gardiner - gold coast health - enabling occupational performance
TRANSCRIPT
Enabling OccupationalPerformance
Meredith GardinerOccupational Therapist
Gold Coast Health
Patient Journey
Enabling Occupational Performance
Trevor: Independence
§ 75 yo male from home § Fall + head injury§ History of alcohol use§ ICU admission § Previous CVA, craniotomy + heart disease§ Referred for assessment + discharge planning
Trevor: Assessment
Trevor: Limitations§ Very minimal social supports§ Alcohol use§ New medications§ Impaired verbal memory§ Decreased insight§ Disorganised under stress§ Difficulty completing IADLs
Trevor: Interventions§ Home visit§ Rebuilding family relationships + family
education§ Task practice§ Webster pack + alarm reminder system§ Transition Care Program
Trevor: Interventions§ Sale of car + removal of brewery§ Emergency numbers + personal alarm + ID
card§ Referrals:
• ACAT • AODS • Mens Shed • Memory Clinic
Barry: Safety
§ 70 yo male from aged care facility
§ Admitted to ED due to physical aggression
§ Parkinson's + DBS with dementia
§ Depression
Sorrowing Old ManVan Gogh
Barry: Assessment
Barry: Limitations§ Person - environment fit§ Falls § Medication§ Frustration§ Knee pain§ Fatigue§ Communication impairment§ Constipation
Barry: Interventions§ Environmental changes§ Medication changes§ Gathering a life history§ Validation of self§ Flexible daily routine§ 1:1 physical activity§ Carer education (RACF) - A different approach
Michael: Quality of Life
§ 60yo male from home§ Wife primary carer§ Frontotemporal dementia diagnosed 2009§ A medical practitioner§ Active – gym, swimming
Michael: Assessment
Michael: Limitations§ Personal hygiene§ Carer stress§ Apathy§ Sensory processing difficulties§ Communication impairment§ Eating non-food items § Exit seeking + packing belongings
Michael: Interventions § Build relationship§ Shower story§ Regular daily routine§ Graded approach + alternatives§ Demonstrations + use of family§ Direct feedback
Michael: Interventions§ Redirection§ Family support§ Music group§ Placement in specialist dementia unit in aged
care facility + handover
Resources§ Dementia: Osborne Park Hospital Guidelines for OT in
Clinical Practice (WA – DTSC)§ A Clinicians Field Guide to Good Practice: Managing
BPSD (DCRC, DBMAS)§ At Home With Dementia (NSW Dept ADHC)§ Relate, Motivate, Appreciate: An Introduction to
Montessori Activities (Alzheimer’s Australia)§ Allens Cognitive Levels + Caregiver Guides§ Images sourced from Creative Commons
