400907 Lecture Notes - Lecture 5: Fall Prevention, Physical Therapy, Shower
22 Jun 2018
School
Department
Course
Professor
CASE STUDY
An assessment of Mr Crawford
Mr Crawford- Overview of the Interview
Initial assessment conducted with Mr Crawford on (date) at 14.00 at his home
together with his wife and daughter. Assessment conducted at the request of the
community nurse who had observed that he was having difficulties with ADLs and he
was becoming reluctant to leave the house. He consented to the occupational
therapy initial assessment.
Mr Crawford is a 79 year old man who lives in his own home with his wife.
Medical History
Osteoarthritis in knees; mild stroke approximately 5 years ago, resulting in mild left
sided hemiparesis. He mobilises using a walking stick. He has had 2 falls at home
in the last 6 months, resulting in bruising but no fractures. He recently had minor
surgery to remove a basal cell carcinoma from his right forearm.
Social Background
Mr Crawford’s wife is able to provide daily assistance. They have a daughter
(present at the assessment) who can visit twice weekly to assist as needed. They
have another daughter who lives interstate.
Presenting Problem
Mr Crawford is fearful of leaving the house as he does not want to have a fall in a
public place. As a consequence he is staying at home more than usual. He also
reports having difficulty getting on and off the toilet as well as problems being able to
wash and dry his lower body when showering. At present he requires assistance
with showering due to the surgical wound
Mr Crawford - His home environment
The house is a single storey dwelling with 2 steps to the front door with no rail.
The toilet is easily accessible for Mr Crawford at present but there is insufficient circulation space
if he requires a wheeled walker or other mobility aid. There is a 30 mm lip between the toilet
floor (raised) and the hallway floor. The toilet seat is low (40 cm). There are no grab rails to
assist with transfers.
The bathroom has a narrow entry and is cluttered. There is a 30 mm lip between the bathroom
floor (raised) and the hallway floor. There is insufficient circulation space for a wheeled walker or
other mobility aid. The shower has a fixed showerhead, a 12 cm hob, a shower curtain around
two sides and no grab rails to assist with transfers in and out.
The kitchen and living areas are open plan areas but have multiple small mats and a lot of large
items of furniture, resulting in clutter and narrow walkways in the lounge area in particular. The
lounge chairs are very low at 40 cm and the dining chairs have no armrests. Consequently Mr
Crawford is having a lot of trouble getting in and out of chairs. The mats pose a significant falls
risk.
There are 4 steps to the backyard with no rail. Mr Crawford is having difficulty accessing the
back yard as a result.
An over toilet aid set at 55cm was trialled during the initial assessment. He was able to get on
and off this aid without difficulty.
A shower chair was also trialled. Mr Crawford could reach his lower body to wash and dry with
minimal difficulty. He was able to get in and out of the chair without difficulty when it was set to
55 cm height.
Both of these items were left in situ on a temporary basis until he can purchase his own.
Additional assistive devices (long handled shoe horn, sock gutter, hand held shower hose and
adjustable height arm chair and utility chair were discussed. The need for rails at the steps at
front and back of the house was also discussed with Mr and Mrs Crawford.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Initial assessment conducted with mr crawford on (date) at 14. 00 at his home together with his wife and daughter. Assessment conducted at the request of the community nurse who had observed that he was having difficulties with adls and he was becoming reluctant to leave the house. He consented to the occupational therapy initial assessment. Mr crawford is a 79 year old man who lives in his own home with his wife. Osteoarthritis in knees; mild stroke approximately 5 years ago, resulting in mild left sided hemiparesis. He has had 2 falls at home in the last 6 months, resulting in bruising but no fractures. He recently had minor surgery to remove a basal cell carcinoma from his right forearm. Mr crawford"s wife is able to provide daily assistance. They have a daughter (present at the assessment) who can visit twice weekly to assist as needed.
