Media Project

Hey bloggers!

My creativity and innovative skills were recently put to the test. I was asked to take an original household material/item, given the description of a client with a neurological condition impacting occupational performance, and create an item to be used in OT intervention. The item I drew was a Pringle’s can, and I had no idea where I was going to start.

My client, Maurice, is a right-handed, married, 83-year-old retired dairy farmer diagnosed with Parkinson’s Disease (PD). In addition to his diagnosis, he has bilateral cataracts, which contribute to his extremely poor vision. His speech is somewhat difficult to understand at times, especially when he is fatigued. He reports increased feelings of isolation and frustration as a result of his speech production problems; the inevitable decline in his is speech skills with disease progression, and his increasing reliance on others for help with his ADLs.  He uses very few facial expressions and gestures in communicating, and his writing skills are limited as well.  He is described as a very social person and enjoys visits from friends and neighbors. His wife reports that his memory is becoming more impaired; however, he consistently recognizes familiar people and is oriented to person and place (and sometimes time as well). He likes to have choices in his daily routine such as what shirt he will wear, even though he needs moderate to full assistance for all ADLs. He has an elevated extensor tone in the neck and trunk, which makes wheelchair positioning and transfers difficult and makes him unsafe to sit unsupported. He has rigidity in all limbs and demonstrates little spontaneous movement most of the time. Movements are slow and awkward. Joint range is generally restricted, especially in hip and knee extension. He reports pain in hands, hips, and knees bilaterally. He displays a "mask-like" facial expression. He fatigues easily, requiring several hours of bed rest during the day.  It has not yet been determined whether or not he will go back to live at home or if he will remain at the facility. Maurice’s main concern is that he will get bored and/or lonely if he doesn’t get to return home in the near future.

After reading Maurice’s case, I decided to make the Pringle’s can into a weighted can holder for his activities. All of the activities are written on the paint sticks, which are placed in Maurice’s weighted can (Pringle’s can). The activities are centered on his main concern at the moment, which is that he will get bored and/or lonely in the SNF; as well other activities that focus on improvement in certain areas where he is challenged. Maurice is a very social person, so the theme of his tasks and activities are focused on that social aspect. By focusing on tasks that are meaningful to him, will keep him engaged, and that he can do with friends and family, he will be more likely to complete these tasks daily; and in turn work toward his goals.

Maurice has Parkinson’s disease, which is characterized by bradykinesia, tremors, rigidity, and postural instability. The can is slightly weighted in order to help control his tremors. He fatigues easily, so his selection of activities (written on the paint sticks) are in the can. Since he has poor vision, having Maurice reach for the sticks will help work on his visual perception. Maurice also likes to have choices in what he does with his time. By having multiple activities in the can for Maurice to choose from can give him that sense of independence, control, and lack of boredom he is looking for.

Goals:

• Maurice will continue to use his weighted can in choosing activities each day to increase satisfaction with leisure activities through December 1, 2019.
• Maurice will develop improved handwriting skills by writing letters to his family and friends with minimal assistance upon discharge.

Interventions:

Write letters to family [cultural context]

Play with mini bean bags [hand manipulation]

Pin up pictures of himself, friends, and family [cultural context & dynamic fine motor movements]

Work on a puzzle [fine motor skills]

Yoga/meditation [flexibility]

Stretching [flexibility]

Play piano or any other string instrument [fine motor skills - finger isolation]

The most meaningful and significant thing I learned from this project is that some of the best, and most effective or beneficial, interventions can begin with something as simple as an everyday household material item; in my case a Pringles can. The incorporation of this creativity is one of the things I love about occupational therapy. What I learned from this experience is that there is more to it than just being creative with your intervention. There are levels of creativity, and detailed thought processes that the therapist goes through in order to make sure the innovation is occupation-based, culturally responsive, and client-centered. Prior to completing this assignment, I considered my self a very creative person. Now that I have had the opportunity to put my creative and innovative skills to the test, I can say that I am a creative thinker. I now feel more comfortable in applying my creative ideas to occupational practice. 

Thanks, and always stay natural.

naturalOT