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Technology Application: CVA Diagnosis (Client Profile (Occupational…
Technology Application: CVA Diagnosis
Assessment
HSSAT (Home Safety Self Assessment Tool)
This assessment takes 45-60 minutes to administer. The therapist will assess the home environment and provide ADA guidelines for home modifications. The therapist will identify potential hazards and create solutions to fix the hazards.
Reference
Horowitz, B., Almonte, T., & Vasil, A. (2016). Use of the home safety self assessment tool within community health education to improve home safety.
American Journal of Occupational Therapy, 70.
Doi: 10.5014/ajot.2016.70S1-PO5081
Client Profile
Problem List
Mod assist for stand pivot transfers
Would like to become independent within the home
Medical Diagnosis
CVA with left hemiparesis; right homonymous hemianopsia (left side vision loss in both eyes)
Normal strength and ROM w/ right UE and right LE
Current mobility device - rear wheel manual push wheelchair
Recommended mobility device - Right side power wheel chair
Occupational Engagement
Leaves home for work and therapy
Active in church and volunteering at the school; retired school teacher
One story home; ramp at front door; small with lots of furniture
Wife is primary caregiver with a paid caregiver for 8 hours/day
65 year old male
Reference
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.).
American Journal of Occupational Therapy, 68,
S1–S48. Doi: 10.5014/ajot.2014.682006
Home Adaptation
Bathroom Adaptation
Occupation - This adaptation will affect the client's participation in ADL activities, specifically hygiene, toileting, and self-care.
Rationale - This client indicated that a priority of his was to become independent in the home as to not be a burden on his wife. Creating bathroom adaptation allow him to complete ADL independently and safely. This can provide peace of mind to the client as well as his wife.
Adaptation - For the client's bathroom, the shower-tub will be converted to a walk in shower to help eliminate a fall/tripping risk. Grab bars will be installed to provide extra support for the client. A shower chair will be provided to ensure safety when showering and a non-slip mat will be used to ensure a secure surface. The toilet and and sink heights will be adjusted to fit his needs while using a wheelchair.
References:
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.).
American Journal of Occupational Therapy, 68, S1–S48
. Doi: 10.5014/ajot.2014.682006
The Internet Stoke Center. (2018). Bathroom modifications. Retrieved from
http://www.strokecenter.org/patients/caregiver-and-patient-resources/home-modification/bathroom/
Visual Aid
Peripheral Prism Glasses - to address clients homonymous hemianopsia.
Rationale - Prism glasses will provide visual field expansion up to a certain degree. This is important for this client to address his safety concerns and awareness of his surroundings. Addressing this client's vision loss will also address the need for independence in ADL's.
Reference:
Massachusetts Eye and Ear. (2013). Researchers show peripheral prism glasses to be a simple, inexpensive rehabilitation tool. Retrieved from
https://www.masseyeandear.org/news/press-releases/2013/11/2013-prism-glasses