The CMOP-E model has been chosen to apply to the client who had a motorbike accident. The CPFF is a generic tool to guide therapists’ work. It is designed by eight actions that occur in societal practices and frames and frame of reference contexts. The process is connected with solid and alternative pathways. This model is helpful in organizing and gathering the information and providing a holistic view of the client. Thus, it was stated that a client is an old man who values writing. The client is cognitively oriented, alert, and has good insight, for example, he stopped driving when his vision decreased three years ago. His mobility is impaired physically. Therefore, he uses walk aids and wheelchair due to arthritis of left hip joint leg fracture along with left foot drop resulting from the accident occurred in his teenage. Regarding occupation, the client is independent in self-care including the use of rails in the shower and walls to support him. However, he relies on his wife in meal preparation, domestic activities, and driving. As for shopping, they do it online. Sometimes, the client has difficulty sleeping. Consequently, he drinks to fall asleep. Regarding productivity, he is retired and spends his time between writing for a newspaper and passive rest such as watching TV. Speaking of the environment, he lives with his wife in their house located in the retirement village with Australian culture.
As the major focus of CMOP-E is directed at occupational engagement, it would be great to enable geriatric people with limited mobility to social engagement and community access, in particular, to collaborate with the client to enhance his independence.
The theoretical argument of the CMOP-E approaches humanistic occupation theory stressing the client-centeredness, which ensures that clients are the experts about their needs. Hence, they are active participants who set and facilitate goals to be achieved as a result of occupational therapy. Although clients might be well aware of what they need, they might have no idea about the other options of fulfilling their needs. Therefore, they cannot decide. Thus, in this case, the model could enforce collaboration between the client and the practitioner to meet the client’s requirements, help him structure his life in a safe and independent way, and enable him to make adhesion about his future taking advantage of having residential respite and applying to Aged Care Assistance Services.
Moreover, the model recognizes the environment as an essential element of the critical impact on the individual’s occupation. It signifies a strong influence of the environmental theories. Therefore, the CMOP-E emphasizes the modification of the environmental context that makes it useful for housebound clients and the geriatric population. In this case, the advice to replace the slip mat at the toilet by the non-slip mat would prevent fall risks. The front ramp installation would allow the client to go out in his wheelchair to access community being a part of it. Besides, it is necessary to consider how environmental resources could be used to meet client’s needs by focusing on the provision of the corresponding support and opportunities. For example, taking measures that would allow the client to take a taxi when his wife at the hospital seems important.
Therefore, the CMOP-E’s function is reflected through the interdependent association between the individual, occupational, and environmental theories. Consequently, the harmonious unity of three components of the model is significant for the improvement of the client’s standard of living.
The Canadian Model of Client-Centered Enablement (CMCE) is one of the resources and techniques related to the theme under review. It is focused on relationships between clients and professionals taking into consideration such aspects as risk-taking, changeability, dynamism, and power differences (Townsend & Polatajko, 2013). The CMCE explores all possible ways of the client’s engagement. In the case, the CMCE could assist the old man with transportation because due to his injury he has problems with getting to the community.
Regarding the assessment, the Canadian Occupational Performance Measure (COPM) could be used to identify performance and satisfaction levels. As a result, the therapist would focus on occupation provision determining gaps between desired and actual occupation. It is also should be noted that identifying occupational issues that the client might be experiencing from his perspective is considerable.
Identification of occupational performance issues: determine what to assess
The client is an aboriginal grandmother who had the spinal cord injury. I would like to define what roles are performed by this client because she is often disorganized with her medical appointments and day structure. One of the potential assessment tools is the role check list. It reveals details about the chronological role changes. In addition, it helps to learn if the client has multiple roles and over involved in daily obligations as well as the value she puts in that occupational role. Also, it should be stated if the client is able to meet these expectations and able to structure her day in accordance with her roles.
Identification of occupational performance issues and select and administer an assessment used in occupational therapy
Home assessment considered as the initial assessment tool for occupational therapy was conducted at Allied health based house. The point of the assessment is to evaluate performance abilities of woman in his home. It is also important to define safety issues at home and to evaluate if the person is able to react adequately to circumstances connected with safety. The assessment examines living conditions, fire hazards, mobility, kitchen, household, wandering, grooming, bathroom, dressing, medication, eating, communication, memory aids, transferring, and general aspects concerning the client’s awareness and environment. For example, my client is able to perform self-care activities independently. It includes having a shower, washing, drying, grooming, toileting, and transferring, and eating along with medication management. However, the client needs assistance in home maintenance, laundry, shopping, finance management, and associated daily activities. Regarding home assessment, the toilet has two rails on both sides with no slip mat while the bathroom has a shower stool and handheld shower. In the bedroom, there are bedside phone that helps her to call in case of need and adequate bedside light. The kitchen was accessible and has enough space. The fridge and lower cupboard are accessible, too. The upper cupboard is not. Regarding safety, there are smoking alarm, enough lightning, personal alarm, accessible telephone, stable floor surfaces with no slip mats, and power cords. The house has both front and back accesses, and the client often uses the front access that has the ramp and rails. Additionally, the client lives in her one-floor house with no stairs. The client receives home help in relation to cleaning and laundry. Moreover, the client is alert, cognitively oriented, and able to tell her medical history and type of medication. Also, she is able to walk with 4WF in the house, but she reported that this aid is not helping her to access community.
Principal advantages of the home assessment model are its client-centeredness and a diversity of areas to evaluate the performance, occupation, and environment. It gives the overall picture of the occupational performance in the home environment. It is quick and easy to use (the therapist could gather plenty of information by means of the home inspection). In addition, it is very useful for housebound and elderly people.
On the other hand, the shortage of construct validity and lack of proper investigation might be seen as a limitation. Also, the differentiation between levels of performance abilities might complicate the process of the classification of clients’ needs as some of them might not fit into one of the four performance categories. For instance, in some cases, it is difficult to decide whether the client is independent or needs some supervision or assistance. The following example of meal preparation illustrates this situation. The client was independent in preparing snacks and performing simple tasks, but he was not able to make all kinds of meal, it means she needs assistance in cooking.
The potential occupational therapy that could be recommended is based on the outcomes and provides the client with a wheelchair engaging her to access community without fear of being tired or risk of fall.
Identification of strength, resources, and negotiations outcomes: developing goals and objectives
The main occupational issues for the old woman with dementia are difficulty in getting on and off the chair and difficulty in getting on and off the toilet. Those issues are crucial as they are the part of everyday activities and have an impact on the primary carers, their health, and well-being. The carer needs to bend over his trunk and have poor posture to help the client to get in and off. Also, these difficulties increase the potential fall risk.
The strength and resource (Schaber & Lieberman, 2010) for this client is that she had a supportive family that is want to provide a continuous care. Also, she is still able to maintain walking with close supervision. Moreover, the occupational therapy could support the client with adaptive equipment such as toilet raised seat and electric recliner chair. It would help to maximize client’s functioning and reduce the burden on the caregiver. The overall goal of providing electric recliner chair is to enhance client’s life quality by enabling her to get on and off easily and safely through adjusting the height and the angles. Also, it helps to promote client’s health by improving the circulation and decrease peripheral edema in the foot and lower limbs swelling. Moreover, this chair would protect the carer wellbeing (Van’t Leven, Graff, Kaijen, De Swart, Olde Rikkert, & Vernooij‐Dassen, 2012).Therefore, the goal could be achieved by the arrangement of the occupational therapist with Aidacare supplier to deliver chair within two weeks and then apply for SWEP funding.