Posted: August 28th, 2015
Beth is a 35-year-old female who has Osteogenesis Imperfecta. She was living independently with a power w/c as her main source of mobility as she unable to walk or stand. She had an adapted van and could drive herself using hand controls. Beth lives alone and was independent was all self-care activities and transfers and worked full time as a school counselor. Beth is ambidextrous.
Two months ago, Beth fell out of her wheelchair while transferring to the toilet and suffered a severe fracture of her distal R humerus. She recently had surgery to repair the fracture and it is now in a full cast. Given the fragile state of her bones, her surgeon does not want Beth to use that right arm at all; no weight bearing, ROM, or removing the cast for the next 6 months.
You are seeing Beth in her home after surgery. Because of her precautions, she is now unable to complete her self-care and transfers independently and has hired a home health aide (HHA) to assist her. She has constant pain in that arm and struggles to find a comfortable position. Her main goal is to return to work and be able to care for herself so she does not require a HHA anymore
1. What Performance Areas may be affected?
2. What Performance Skills may be affected?
3. Why do you think Beth is no longer able to transfer by herself as she only has one broken arm?
4. You have only been authorized to treat Beth for 1 month. What are your priorities in working with her?
5. What outcomes would you expect for Beth after 1 month of therapy?
6. List any frames of reference you would use while creating your treatment plan for Beth.
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