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Mar 16, 2024

Assignment Task

CASE STUDY

How to assess and plan seating and positioning intervention for someone who lives with Parkinson’s disease. Case study is about a person named John aged 72.

This is their story.

John is a 72-year-old male with a diagnosis of Parkinson’s. He scored a 3 on the Unified Parkinson`s Disease Rating Scale (UPDRS) indicating Severe impairment which interferes with many activities of his everyday life, and is bothersome.

John Currently resides In a nursing home. Johns’ wife, Brenda, visits him daily, with his kids and grandchildren, attempting to visit weekly, however with John’s deteriorating diagnosis, they were no longer able to manage John’s care needs at home.

Johns’ Diagnosis affects his ability to walk, partake in bowling and other activities at the nursing home as well as affects his fine motor skills when playing piano which, he enjoys doing.

John struggles with daily tasks of self-care.. He is able to mobilise with a 4ww and 1 assist around his room, however, requires a wheelchair for longer distance. In addition to the above when seated in a wheelchair John struggles with sitting straight and tends to slide and move due to his posture.

John would like to be able to partake in more activities with his fellow residents, as well as return to playing music on his piano during happy hour at the home. John struggles with this currently due to his posture when seated on the wheelchair as well as his fine motor skills.

This assessment requires you to demonstrate that you can manage and treat a person who requires specialised seating and positioning interventions. This assignment enables you to develop skills in patient assessment and identification of problems, goal setting, and intervention planning, incorporation of evidence-based practice (EBP), clinical evaluation and clinical reasoning.

In the VIVA, the assessor will take on the role of a senior occupational therapist. You will assume the role of a newly graduated occupational therapist. The VIVA will run in the format of a supervision session where you as the new graduate therapist will present and explain the management of your case study client using the occupational therapy process to your supervisor. Please note your assessor will guide the discussion and ask questions related to the OT process you have used.

You will have 15 minutes to present your case study to your assessor.

You should focus on the following areas:

Brief description of the client

Introduce the person that is your created in your Learning Contract case study as your client. By doing so, you will establish the clients’ age, sex, living and / or family situation, occupational roles and their condition and / or problem, level of mobility. Tip: You should explain what their diagnosis is, typical prognosis, and illness trajectory (if applicable).

Description of the condition and its impact on occupational performance within their environment

Briefly describe the clinical features of the condition and how this condition would impact on your case study’s occupational performance. Be specific about how occupational performance issues would impact on the client you have developed and in relation to their life stage, illness or disability trajectory and community participation. You will also need to consider their seating and positioning requirements within their specific environments. 

Assessment

Describe the methods you would use to assess your client. You should discuss both subjective and objective assessment of the client and articulate a rationale for the assessment processes you have selected. You will also need to indicate what you might expect for that person’s postural assessment and be prepared to articulate or demonstrate what you would be looking for.

Occupational therapy goals

List the occupational therapy goals that you and your client have chosen to work on to enhance their seating and positioning. Use SMART goal format to document these goals. However, when explaining your goals, you may speak about them generally, rather than reading the SMART goals word for word. 

Occupational Therapy Intervention strategies (including application of evidence based practice)

Describe the appropriate intervention plan based on evidence and clinical reasoning. Detail number of sessions, length of sessions, session goals, what equipment might be needed, how this intervention is specific to your client. Here you might also need to consider a specific area of concern to examine about your seating and positioning intervention(s). (e.g. particular aspects of the equipment, learning to use a wheelchair or power chair, pressure relief, postural needs, need for implementation of specific assistive technology such as switches or electronic devices, etc.). Please refer to the marking rubric for further information on what to include in this section. Be prepared to articulate your clinical reasoning about why you have chosen the intervention(s) and link this to the best available evidence on the topic e.g. systematic reviews, clinical guidelines, RCTs. Present this information in a written treatment plan.

Outcome measurement

Report on the outcome measures used with your client. State why they were chosen and report on how the client scored. State the timepoints of re-assessment and whether re-assessment showed goals achievement.

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