Ron,
How does she currently perform in the kitchen (min/mod/ max assist/or
verbal cues?). If the patient had completed the cooking prior to the
dementia it is possible that this will be an automatic task for her
like bathing and dressing is still generrally easy for her. I would
then find something in the kitchen for her to be able to complete so
the patient's husband goal of "able to help out in the kitchen" would
be clearly addressed. There has to be something she can do to help in
the kitchen that is safe and relatively simple. Are there any key
dementia problems in which you could address or educate the clients on?
1) wondering 2) agitation 3) reluctance to shower or dress 4)
reluctance to take her meds 5) other neurobehavioral issues.
Chris Nahrwold
-----Original Message-----
From: Ron Carson <[email protected]>
To: [email protected]
Sent: Mon, 13 Apr 2009 5:08 pm
Subject: [OTlist] NEED HELP WITH PATIENT
I evaluated a home health patient and I need help determining if OT is
indicated. The patient's primary diagnosis is Alz. dementia. She also
was recently d/c'd from the hospital secondary to a non-healing brown
recluse spider bite, s/p 5 years ago.
Her score on the SLUMS cogn screen is a 6/30, indicating mod-severe
dementia. She lives with her husband, who is healthy but has had two
recent falls in their modular home. The husband does all the housework,
cooking and driving. The patient performs her own basic selfcare with
supervison. She req. occasional asst. with sequencing for dressing.
The patient reports she is an active reader. She attends church services
every Sunday. The patient has no stated goals. She reports being "happy
and content" with her life. She says that everyone else is worried about
her memory but she knows that it will get better. The husband states it
would be nice if his wife were able to help out in the kitchen.
I told the husband that I needed to ponder the situation. I wasn't sure
if I could help his wife or not. So, I'm turning to you guys. My wife
suggested that I work with both the husband and the patient to teach him
how to better integrate his wife into the daily routines. I presented
this idea to him tonight on the phone and he said: "hum, I need to think
about that".
So, what do you guys say. Can OT help this lady? If so, how????????
Thanks,
Ron
~~~
Ron Carson MHS, OT
www.OTnow.com
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