Enabling OccupationalPerformance

Meredith GardinerOccupational Therapist

Gold Coast Health

Patient Journey

Enabling Occupational Performance

Trevor: Independence

§ 75 yo male from home § Fall + head injury§ History of alcohol use§ ICU admission § Previous CVA, craniotomy + heart disease§ Referred for assessment + discharge planning

Trevor: Assessment

Trevor: Limitations§ Very minimal social supports§ Alcohol use§ New medications§ Impaired verbal memory§ Decreased insight§ Disorganised under stress§ Difficulty completing IADLs

Trevor: Interventions§ Home visit§ Rebuilding family relationships + family

education§ Task practice§ Webster pack + alarm reminder system§ Transition Care Program

Trevor: Interventions§ Sale of car + removal of brewery§ Emergency numbers + personal alarm + ID

card§ Referrals:

• ACAT • AODS • Mens Shed • Memory Clinic

Barry: Safety

§ 70 yo male from aged care facility

§ Admitted to ED due to physical aggression

§ Parkinson's + DBS with dementia

§ Depression

Sorrowing Old ManVan Gogh

Barry: Assessment

Barry: Limitations§ Person - environment fit§ Falls § Medication§ Frustration§ Knee pain§ Fatigue§ Communication impairment§ Constipation

Barry: Interventions§ Environmental changes§ Medication changes§ Gathering a life history§ Validation of self§ Flexible daily routine§ 1:1 physical activity§ Carer education (RACF) - A different approach

Michael: Quality of Life

§ 60yo male from home§ Wife primary carer§ Frontotemporal dementia diagnosed 2009§ A medical practitioner§ Active – gym, swimming

Michael: Assessment

Michael: Limitations§ Personal hygiene§ Carer stress§ Apathy§ Sensory processing difficulties§ Communication impairment§ Eating non-food items § Exit seeking + packing belongings

Michael: Interventions § Build relationship§ Shower story§ Regular daily routine§ Graded approach + alternatives§ Demonstrations + use of family§ Direct feedback

Michael: Interventions§ Redirection§ Family support§ Music group§ Placement in specialist dementia unit in aged

care facility + handover

Resources§ Dementia: Osborne Park Hospital Guidelines for OT in

Clinical Practice (WA – DTSC)§ A Clinicians Field Guide to Good Practice: Managing

BPSD (DCRC, DBMAS)§ At Home With Dementia (NSW Dept ADHC)§ Relate, Motivate, Appreciate: An Introduction to

Montessori Activities (Alzheimer’s Australia)§ Allens Cognitive Levels + Caregiver Guides§ Images sourced from Creative Commons

ContactMeredith Gardiner

Occupational TherapistGold Coast Health

meredith.gardiner@health.qld.gov.au