While observing Occupational Therapy Assistant Fatima deCouto-Garcia, (a BCC program OTA graduate), at The New Bedford Rehab Hospital, we were tasked with focusing on recognizing the performance skill deficits and contextual factors that brought a client to seek Occupational Therapy services. The facility we visited is considered an acute long term rehabilitation hospital and the patients we observed each had complex multi-facetted symptoms, diagnosis and treatment protocols. For the purpose of this reflection we will focus on one patient, a 45 year old woman, Jane Doe, who 6 weeks prior had her left leg amputated above the knee. Jane was described as a homeless, diabetic, suffering from depression. The high level of Jane’s daily methadone dosage was preventing her acceptance to a skilled nursing
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Initially Jane resisted the activity as she prefers sponge baths. This was an example of a Processing Performance skill as she had to manage and modify her actions to accomplish the Activity of Daily Living (ADL) of bathing from her newly acquired wheelchair. Jane demonstrated good knowledge and organization skills to execute the task by initiating, continuing, sequencing, and completing actions effectively. She smoothly maneuvered the wheel chair into the bathroom, lined herself up next to the tub without bumping into anything, safely locked the wheels and successfully executed a stand and pivot transfer to and from the adapted tub/shower seat. From the ADL room we followed Jane and Fatima to the “gym” and on the way she pointed out that her upper body was sore and she was fatigued. Jane received training in techniques to enhance her functional mobility with the wheelchair. The Motor Skill of endurance was addressed with a triceps push down exercise. Performed from the wheelchair the resistance and frequency are modified to build muscle strength and
Initially Jane resisted the activity as she prefers sponge baths. This was an example of a Processing Performance skill as she had to manage and modify her actions to accomplish the Activity of Daily Living (ADL) of bathing from her newly acquired wheelchair. Jane demonstrated good knowledge and organization skills to execute the task by initiating, continuing, sequencing, and completing actions effectively. She smoothly maneuvered the wheel chair into the bathroom, lined herself up next to the tub without bumping into anything, safely locked the wheels and successfully executed a stand and pivot transfer to and from the adapted tub/shower seat. From the ADL room we followed Jane and Fatima to the “gym” and on the way she pointed out that her upper body was sore and she was fatigued. Jane received training in techniques to enhance her functional mobility with the wheelchair. The Motor Skill of endurance was addressed with a triceps push down exercise. Performed from the wheelchair the resistance and frequency are modified to build muscle strength and