Mrs. Offnfalls is suffering from osteoarthritis, cataracts, kyphosis and tinnitus. Osteoarthritis is said to be an enduring degenerative illness which results in the breakdown of joint cartilages. Associated signs and symptoms are stiffness, swelling and pain. Osteoarthritis is diagnosed by its typical indications of decreased movement, pain and deformity. Osteoarthritis can also be confirmed with a MRI scan or an X-ray (McGonagle, 2010). Common associated findings are narrowing down of the space between bone joints and loss of bone and cartilage spurs and bone growth. Common signs and symptoms of cataract are blurry, foggy and cloudy vision, progressive nearsightedness or second vision, alterations in the type one sees color as the discolored lens functions as a filter, glary vision during day, double vision and abrupt modifications in glasses prescription (Sutton, 2008). The associated diagnoses may include visual acuity test, checking papillary responses and eye movements, measure pressure inside eyes and examinations of the front and back of eyes after pupils have been dilated with eye drops. Kyphosis is said to be an abnormal curve of spine because of bony abnormalities of spine. The diagnoses of kyphosis may include computerized tomography scan, magnetic resonance imaging scan and bone density scan (Schoenfeld et al., 2010). Tinnitus diagnosis may include auditory assessment, MRI scan or computerized tomography scan. Symptoms include a continuous buzzing inside the ear, suffered only by the affected person (Schwalberg, 2010). This can affect concentration, life quality and sleep of the affected individual.
Palliative care is considered as an interdisciplinary team approach applied for the patients living with enduring illnesses which is life threatening, so their life quality can be preserved for the rest of their lives. The unique occupational therapy perception in promoting contribution in occupations or meaningful life actions balances palliative care. Its patient centered approach and holistic care promotes an independence sense and self-efficacy amidst the living challenges with incapacitating indications. A per the scientists Jeyasingam et al. (2008) the capacity to perform daily living activities is an essential aim for individuals with severe illnesses and also has inferences for social life, relationships, work, home structure and family (Keesing and Rosenwax, 2011). Occupational therapy personnel have competencies hat are primary in and complementary to palliative care. These are understandings of human anatomy and patho-physiology and disease process; knowledge of usual medical processes as they are relevant to the services related to occupational therapy comprising pain management and precautions alternatives; clinical reasoning capabilities in patient centered assessment, ongoing monitoring and intervention planning and progress towards mutual identified goals; training and education with individual patients and with their family members or care providers to smooth the progress of therapy carryover throughout and further than rehabilitation process.
The clinical picture of Mrs. Offnfalls mentions that she is in good health but is suffering from osteoarthritis in knees and hips, kyphosis, tinnitus and cataracts. Under medicinal administration she was performing well but had a fall. Mrs. Offnfalls was exhausted because of her frequent fall. It can be said that the condition of her osteoarthritis is the major cause of her frequent falling incidents. She has also developed bruising because of fall. The bruising has given rise to fear of falling. The doctor has referred her to home care. To relieve her from fear of falling she has been transferred to her daughter’s place where she received home assistance despite of her son-in-law’s un-enthusiasm. From the above mentioned illnesses it is quite apparent to mention that her daily living activities have reduced to a greater extent. Therefore, she should be assisted with nursing aide to help her in her home to support her daily living activity. She has developed kyphosis and that might harm her normal movement and in this situation she should be assisted with a walking stick or a nursing assistance.
The two LTG’s for Mrs. Offnfalls would be daily living activity and functional transfers. The STGs for daily living activity would be dressing and walker commode. The goals to improve this patient condition require modifications of her daily living activity (Report, 2014). She requires maximum assistant in case of UE dressing. Patient will be dependant completing grooming and hygiene like: washing face, brushing teeth for the aim of recovering independence in home circumstance. Patient needs full assistant during sitting position to recover independence. Patient will complete LE dressing with help in sitting position. In this context the STG would be: patient will complete LE/UE bath with maximum assistance to get back independence. The LTG would be: patient will complete LE/UE bath at tube shower or walking shower with maximum assistance to recover independence (Wong Espiritu, 2013). She will complete toilet hygiene with full assistance to prevent breakdown in skin and also able to feed with help to recover proper nutrition. She will perform bed mobility like transfer from bed to chair with maximum assistance for reason of independence. To achieve this goal patient will take maximum support of walking commode. Patient and care provide will manage the extent of pain with medication, positioning, rest and exercise to increase acceptance for daily living activities.
The first and foremost treatment plan for Mrs. Offnfalls should include increase of her daily living activity by reducing pain because of osteoarthritis, lessening the problem of tinnitus and removing the problem of cataract. It is the healthcare professional’s responsibility to understand and categorized her treatment requirements as per the priority. It is also known from the case study that bruising from frequent fall is an utmost important matter of concern. Her treatment should aim to reduce the problem of bruising and also diminishing the fear of fall. She should be assisted with physical therapist, who will assist her with light exercises so that she can regain back her joint movements in order to overcome the problem of stiffness and help her in performing the daily living activities (Rastrick, 2003). It is also known from the case study that her son-in-law is not willing to keep her with them in their resident; therefore, she should be admitted to a care home where she can be in touch with multidisciplinary health care assistance.
Keesing, S. and Rosenwax, L. (2011). Is occupation missing from occupational therapy in palliative care?. Australian Occupational Therapy Journal, 58(5), pp.329-336.
McGonagle, D. (2010). I-12 IMAGING IN HAND OSTEOARTHRITIS. Osteoarthritis and Cartilage, 18, p.S5.
Rastrick, S. (2003). Your role in the treatment plan. Vital, 1(1), pp.48-49.
Report, S. (2014). Celebrating OT Month 2014: Snapshots of Occupational Therapy Education, Promotion, and Research. OTP.
Schoenfeld, A., Wood, K., Fisher, C., Fehlings, M., Oner, F., Bouchard, K., Arnold, P., Vaccaro, A., Sekhorn, L., Harris, M. and Bono, C. (2010). Posttraumatic Kyphosis: Current State of Diagnosis and Treatment: Results of a Multinational Survey of Spine Trauma Surgeons. Journal of Spinal Disorders & Techniques, 23(7), pp.e1-e8.
Schwalberg, C. (2010). Tinnitus. CHEST, 138(4), p.1018.
Sutton, A. (2008). Eye care sourcebook. Detroit, MI: Omnigraphics.
Wong Espiritu, E. (2013). Standing Tall: A Self-Management Approach to Fall Prevention. OT.
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