LMN-65 y.o. male client with CVA & L. Hemiparesis (Impairments of…
LMN-65 y.o. male client with CVA & L. Hemiparesis
Client has a ramp at front door but it is not the recommended rise over run ratio (too steep)
Build new ramp (aluminum)
This will allow client to bathe independently
Include handles/bars for support in order to accommodate for possible progression in his functional mobility
Hot and cold water knobs/handle should be placed at a height that prevents client from reaching/bending and risking falling out of his chair.
Counter top cutouts
This will allow his wheelchair under the counter so he can independently shave, brush his teeth, etc.
His wheelchair will be able to fit under the counter so he can participate in meal preparation
Client already uses iPad to send e-mails to family
Incorporate smart home/home adaptations
Emergency contact capability
Incorporate voice control on the iPad so that he can choose between using his R UE or voice control if he is otherwise occupied
Use voice control to video call family
Provide mount or pocket for iPad on his wheelchair and next to his bedside for easy access
Consider using iPad for additional religious participation & volunteer opportunities
Rearrange or consolidate furniture
Home is small and arrangement of furniture makes home mobility challenging. Rearrange furniture first and if that is still too difficult discuss the possibility of consolidating/storing excess pieces.
Sensory aid for vision impairment
Big button remote for TV so client can see numbers
Large font on labels for art supplies
Increase contrast on iPad screen
Increase font size on client's iPad
Bright lighting in order to improve visibility
Accessibility to tools
Customize height of easel in order for client to be able to access by rolling underneath it. Also secure/stabilize easel so it will not fall over, causing a safety risk.
Install a shower basket attached to the wall at an appropriate height for client to access with R. UE without excessive bending or reaching.
Install a handheld shower head so client can easily access and maneuver shower head in order to ensure cleanliness.
Place comb, toothbrush, toothpaste, razor, and shaving cream in a basket on the bathroom counter or a drawer that is easily accessible
Keep general meal preparation items on accessible counter such as bowl, plate, utensils, glass etc. Include a tray for transportation of food.
Impairments of occupations/limitations
Requires moderate assist for pivot transfers
Ability to move within his own home is limited because he requires moderate assist for transfers
Religious & spiritual activities/expression
Client has not attended church since his CVA
Has not volunteered at the school since his CVA
L. hemiparesis causes difficulty donning & doffing clothing
Client needs moderate assist with pivot transfers
L. hemiparesis hinders ability to wash R. UE
Tub/shower combo means he cannot get into the shower on his own
Client does not use a cellphone. Uses e-mail to communication with family
Client has difficulty brushing teeth, shaving, etc. because his bathroom does not allow him to get next to the sink
Client is an artist
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.).
American Journal of Occupational Therapy
, 68. , S1–S48.
AOTA Occupational Profile Template. (2018). Retrieved from
Nonstructural and structural home assessments were performed in order to determine possible home adaptations.
Interviews were also conducted to address adaptations that the client would be comfortable with but financial options have not yet been discussed.
Client wants to be independent & not be a burden to his wife.
Depends on his wife for assist with transfers
Wife performs meal prep
Wife assists with bathing & hygiene