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Sunday, 3 January 2016

Assessment Example

In order  to  demonstrate  how an  OT  approach  may  be used  in  assessment,  I  have  taken  an  example from  a  short   film  and listed  the  occupational  strengths  and  needs  of   the  individual  using  a  MOHOST  framework.  I  will probably  post  a    narrative  case  formulation  at  a  later stage. I  am  sure there  are  other  observations and  points  that  can  be   included   but   it  gives  you  a  general  gist of  what an  OT  assessment  of  the    situation  could  look like. As always  any  questions  or   feedback  is very  welcome.

The   film  is  found  here    https://vimeo.com/603058  
-  the  particular excerpt  I've  used  is  called  "Abandon"    which  is   the  final  segment  starting at  14.45 min


DOMAIN
OCCUPATIONAL STRENGTHS
OCCUPATIONAL NEEDS
Volition /Motivation
-Appraisal  of  ability
-Expectation  of   success
-Interests
-Choices



Indicates  desire  to change “I  wish  I  could  be  more  organised”

Has  achieved  success  with  clearing  in  the  past

Aware  that there  is  a problem   with  his  behaviours  and  habits “There’s something  lacking”

Wants more  social  contact

Has  various interests  such as  music, video and  maps,  photograph  indicates   he  has  travelled

Faith  appears  important  to  him


Fluctuating   motivation  to change  and  cope with  challenges “Sometime  I  think  what  the  hell I live  on   my own”

Previously struggled  to fulfil goal  of  inviting his  mother  to  his  flat which   he  regrets

Appears to  have  difficulty  engaging  in  goal  directed   behaviour and making  choices “I  look  at shelves  from  top  to  bottom”

Appears to  struggle  to  maintain   control  over   his  interests  e.g  buying  books and  maps  in  spite  of  limited  space  to  keep them- does  he  have  the  finances to  pursue  this  interest?

Limited  self  efficacy   regarding  tackling the problems  “There’s something  lacking”

Habituation/ Pattern  of  Occupation
-Routine
-Adaptability
-Roles
-Responsibility




Maintains  a  work role which  he  took on after the  death of  his  mother

Evidence of  some basic self  care 

Appeared to take some  responsibility and  change his behaviour  in  the past by  trying  to  clear  his  flat



Struggles to  make  time  to  maintain  a clear   and  hygienic  home environment  which he  attributes  limited  time   due  to  work  role

Difficulty  with  maintaining    routines  around  domestic tasks 
  
Loss  of  role of  son    and  greatly  misses his   mother -loss of previous  routine of  visiting  her

Has struggled to  adapt  to  smaller flat

Skills
-Communication skills
Non  verbal skills/conversation
/vocal  expression/
relationships









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-Process skills
Knowledge/timing/
organisation/problem  solving











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-Motor skills
Posture/mobility/coordination/
Strength and  effort /energy









Able to  communicate  his needs  

Appears  to  have  skills  to  relate  to  others










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Evidence  of   some maintained   areas  such   as shelves  containing  records and  videos










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Independently  mobile
Fine  and  gross motor  skills appear  intact in order  to  fulfil  occupational roles  and  tasks  relating to  maintaining  a  cleared  environment
Speech  slightly  pressured and  repetitive

Historically  the  state of   flat has  impacted  on  his   relationships  with  women of which he  appears  regretful and  preoccupied  


Hoarding  appeared to  impact  on  the  relationship  with  his  mother “What  am  I  going to  do  with  you”

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Inefficient  way  of   searching  for objects 

Disorganisation  of all  objects  leading  to   difficulties and  delay  locating items  “churning”

Appears  to  give  up  easily  when  faced   with  problems- difficulty  arranging  repairs


---------------------------------

Appears  easily  fatigued  (e.g  sweating and  breathless)


Repetitive bending and inefficient  searching   may  lead  to  injury and  increased   fatigue
Environment
-Physical
Physical space/physical  resources
























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-Social
Social  groups
Occupational  demands




Some areas  accessible and   organised in  categories
























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Evidence  of  at  least   one  friend  who   he  can  rely  on  for   financial  support


May  have  limited  funds e.g   asks  friend for  money

Some areas  of flat appear inaccessible such  as   part  of  living   room  and  bathroom ( cleans  teeth  in kitchen),  no  evidence  of  a  bed

Dust   and  mould   and  piles of  objects presenting  environmental  health risk    to  self  and  visitors

Potential  fire risk- papers  near  heater (?working)

Many objects  in poor state  of  repair  and   repair  men  refuse  to  enter

Many  items  are  not   easily  available  to  be  used  for  their   intended purpose

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Condition of  flat  has severely impacted on  social  contact  and practical  support  at  home

Appears  to  struggle  with  occupational  demands  of  both  maintaining  his  home and  his  work role  at  the  same  time. Financial demands  of  his   hoarding  habit possibly in excess of  his available funds