Sue: Wow!! from Engineering to OT. Very interesting career transition. It would be nice to know what motivated you to make such a career transition. Provided of course you feel comfortable sharing this with us on the list.
Anyhow, let me respond more specifically to your post. Firstly, it is not clear from your description of the situation whether the 80-year old gentleman has been assessed by a psychiatrist or other physician for depression. But based on your description of the gentleman's behaviour it is quite possible that he may be depressed. There is evidence of links between stress caused by physical disorders leading to depression. It would be a good idea if the gentleman could be seen by a psychiatrist to find out what is going on with him. In fact it would be very important to do so, in my opinion. Generally speaking however, activity-based approaches from an OT perspective for individuals who have depression would take the following approach: It would be helpful to facilitate routine(s) that the client was following when he was relatively better, in the recent past. It is important to take the client's preferences into consideration as well. It does not matter how basic these routines are, they might consist of waking up at a time that he used to, perhaps shaving, making a cup of coffee, or a morning walk with a close friend, etc. Sitting in the porch after completing his morning routine, listening to a favourite radio program (TV may place too many sensory demands, but this will also depend on the client's preferences) etc. It would be important to bear in mind that these routines be increased very very gradually (ideally ONE AT A TIME), and not be rushed, nor a return to them expected quickly. The client may take baby steps initially, but it would be important to encourage him to adhere to any single routine, once established another routine could be added and so on. To help decide what the client might want to do initially, in addition to the client, talking to the spouse and/or other CLOSE family members would also be very helpful. To develop clear priorities the use of the Canadian Occupational Performance Measure may come in handy. In conjunction, if the client's psychiatrist sees fit, medication therapy could be occurring concurrently (with anti-depressants). It also needs to be borne in mind that depressed individuals can often be irritable and become angry as well. Hopefully, these suggestions might form the basis of a potential and initial treatment plan. However, it is important that this be done by an OT who is familiar with the client's history and current situation. Psycho and health education to the client's family members would also help to supplement and facilitate the effectiveness of treatment. Once the client begins to feel better, it may be helpful (if feasible) if s/he could join a self-help group of senior citizens, preferably one in which some of the individuals have also had hip replacement surgery. These are some initial thoughts that come to mind. However, a word of caution. Please note that any treatment plan needs to be implemented by a qualified professional who is familiar with the client, and ideally one who is part of a multi or interdisciplinary team familiar with the client's clinical issues. It would NOT be appropriate for instance if you were to advise your friends directly as to what they need to do, based on my post to this listserv. Incidentally, two clinician-rated depression scales are the Beck Depression Inventory and the Hamilton Depression Scale. However, in this context this is purely of academic interest. Hope this gives you some understanding of what an OT treatment plan would look like roughly. I am afraid I can't give any suggestions on organizations in England, but this is why it is important for your friend's dad to be seen by a psychiatrist locally. Because organizational referrals generally emerge from a formal diagnosis. Best, Biraj Sue Hossack wrote: > Hi all, > > I need some advice. [Some quick background : I am from Britain originally, but > have lived and worked as an engineer in the USA for 20 years. I am now > changing career to OT]. I have a friend in England whose father (in his 80�s) > has recently had a hip replacement. He has had some trouble with it, it has > �popped out� a couple of times and he has had to be re-admitted to hospital. > He is back home now with his wife. > > The problem is, he is completely de-motivated, won�t eat or drink, won�t do > anything but sit around all day. Now, as an occupational therapy student I > know that we are trained to work with more than just the physical, that we > work with the motivation/depression/emotional state of the patient too, but I > haven�t got that far in my studies yet, so I am not able to give my friend > much advice to help his father. His dad knows he should eat, but says he is > not hungry, and eating makes him feel sick (he is taking appetite enhancers, > but they don�t seem to be helping much). He knows he should be doing things > to get better, and even talks about when he is mobile again, but doesn�t �feel > like� going out into the garden for instance, would rather sit around indoors > all day. > > So, my questions are: > � What would any of you do in these circumstances, how would you engage this > man into wanting to get better? > � Are there organizations in Britain that my friend can contact to get > Occupational Therapy for his dad, in the home? > > Thanks a lot! > > Sue > > *********��*********** > > Unsubscribe? Send a message to [EMAIL PROTECTED] > > In the message's *body*, put the following text: unsubscribe OTlist > > ** List messages are archived at: > > http://www.mail-archive.com/[email protected] > > *********��*********** *********��*********** Unsubscribe? 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