Words by Samantha Shannahan – Occupational Therapist
Once I completed University, I had etched in my mind that as OT’s our goal was to put the “Fun” in Functional. Well, that’s what was written on my Year Level Hoodie anyway! But personally, my main takeaway from Uni was that I had the power to help create meaningful lives and give people the opportunity to be as independent as possible.
With Community and NDIS referrals this is where I can utilise these skills to the maximum. Community and NDIS referrals can seem daunting but they also come with great reward. We get to be the knights in shining armour that fight for our client’s independence and help them achieve personal goals. It certainly is a challenge but being challenged is powerful! It gives us the drive to want to be better and the desire to learn. We get to be creative and think outside the square, as no two referrals will be the same. We get to trust in our basic OT knowledge and build on this with our own ideas, support of others, and resources to create unique solutions.
Community referrals can include equipment prescription, home modifications, falls safety assessments, ADL assessments, and much more. In regards to NDIS, we can also see a variety of referrals including functional assessments (one of my favourites as we get to look at the whole person and their environment), assistive technology assessment, life skills training, seating assessments, and much more.
I recently completed a Home Safety Assessment for a client. It dawned on me during this assessment how easy it is to focus on what is in front of me rather than thinking about how things could be completed differently. Often these are simple little changes for the client, but as they are so set in their routine, a different way of doing something doesn’t even cross their mind. This elderly client lived independently and was having difficulty preparing meals due to carpal tunnel in her wrists, chronic back pain, and extreme shortness of breath when completing standing/walking. She also had intolerances which made it difficult to order a “meals on wheels” type service. She advised that due to pain with standing at the bench and inability to use her bench height chair (due to it being too heavy for her to manouvre), she would sit on a stool in the kitchen and prepare her food on her 4-wheel walker! I was internally shocked trying to picture this lady standing up from a low stool when moments ago she struggled to get out of her dining chair without almost pulling the table with her!
Then the problem-solving ideas kick in. How can I make it easier for this lady to prepare and cook her own meals? Yes, it would be easier to throw every piece of kitchen aid at her, however, this is not practical as it is not a cost-effective solution but may also take away from what she is able to do. It is important to focus on what our clients are able to do, as we don’t want to take away any parts of their independence.
This lady loved cooking meals and had the capacity to prepare breakfast and lunch meals if she had the correct tools. She reported difficulty opening cans, holding items to chop them, and cutting her cooked meals. These issues were related to her inability to complete a closed fist. These are easy fixes!
I investigated and provided links to the below equipment:
A food preparation system that secures food items that are being cut.
A Cone-shaped jar opener.
Cutlery with built-up plastic handle.
This lady was able to sit comfortably at her dining table. She had a small table with a chair near her fridge/kitchen where she had breakfast. I proposed she prepare her meals at this table. The thought had never crossed her mind but was simple and close to all items she would need. The only catch was that her chair did not have armrests and I was concerned she would pull the small table over during sit-to-stand transfer, so I sourced an appropriate armchair. Other strategies discussed included energy conservation techniques. Again, a simple solution but not often considered. How can we break down the task to make it less taxing? Things such as preparing sandwich fillings when you are feeling your best. This may be a few hours after waking up and taking pain medications. Preparing a weeks’ worth of fillings. Completing 10 minutes at a time with rest in between.
Regarding dinner meal preparation this involved more steps that were outside of her current capacity. She wasn’t able to stand for extended periods and she wasn’t able to carry heavy pots/pans of food. This lady couldn’t tolerate delivered meals, so I needed to consider other options. She could however access her freezer and microwave frozen meals. So, the plan was to get a Carer in for a couple of hours, once a fortnight, to assist this lady to prepare bulk meals. This lady was able to plan her meals, get the grocery items delivered prior to the Carer attending, and still actively participate in preparing her meals with the support of a carer to do the components of the task she couldn’t.
It may have been easier to just get a carer to do the whole process. But one thing I have learned is that Independence gives us purpose and purpose is a fundamental component of a fulfilling life.