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Jerry Joe - CVA with L hemiparesis (Home adaptations (Lower the…
Jerry Joe - CVA with L hemiparesis
Home adaptations
Lower the countertops
Implement toilet bars/handles and provide shower chair
Limited areas to ambulate; reposition furniture in order to promote functional mobility
Dressing stick aid
Wider doorways for manual wheelchair use throughout the home
Provide apps to help control home environment; such as climate control, lights, emergency contact, implement Siri on iPad for voice recognition, add family contacts for accessible communication
Provide an accessible easel to enable art participation
Structural changes to shower: implement roll in shower, and handle bars for balance and support.
Sensory aids (blurred vision)
Larger fonts and brighter lighting/adjust contrast on iPad
Include art supplies and good lighting to promote painting and arts and crafts with brightly colored handles, and clear/bold materials that are accessible
Impairments of occupations
Dressing
Client would like to be able to don and doff his shirt independently
Provide dressing stick aid
Functional mobility
Rearrange furniture to promote more room for functional mobility
Toileting and toilet hygiene
Client would like to become more independent with toilet transfers from his wheelchair
Provide grab bars on both sides of the toilet
Bathing/showering
Client would like to become more independent with maintaining body position in shower
Provide shower chair
Driving and community mobility
Client would like to attend church
Collaborate with church members to provide transportation to church weekly
Meal preparation and cleanup
Client would like to be able to cook independently in the kitchen without the help of his caregiver
Lower the levels of his countertops in the kitchen in order for him to cook while in his wheelchair
Sleep participation
Disturbed sleep: insomnia and daytime sleepiness
Provide sleep schedule, and adapt environmental aspects such as positioning techniques
Current home and situation
One story home
Ramp at the front door
Small home; lots of furniture
His wife is his primary caregiver; secondary caregiver 8 hrs/day
Wife is unable to transfer Jerry Joe safely
Client factors
Artist
Has a large family
Retired school teacher
Normal strength and ROM in R UE and LE
Used to be active member of church
Requires mod assist for stand pivot transfers
References
Joa et. al. (2017). The effect of sleep disturbances on the functional recovery of rehabilitation inpatients following mild and moderate stroke.
American Journal of Physical Medicine & Rehabilitation,
96(10).* pp. 734-740.
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
https://class.usa.edu/bbcswebdav/pid-3614829-dt-content-rid-19763518_1/courses/USA1.201820.OCT.5330C.300/SEATING_LAB_CVA-Occupational-Profile.pdf
Assessments
Structural Home Assessment. Verdone, A. (2018). Home accommodation: modification and alternatives to structural changes.
Structural Home Assessment. Preform prior to interventions.
Home Assessment Form for Non-Structural Solutions Evaluation. Verdone, A. (2018). Non-structural accommodation: Assessment form and instructional manual.
Non-Structural Assessment. Preform prior to interventions.