Tuesday, March 10, 2009

Case review An interesting case, and interesting presentation and no diagnosis

Gender/age/primary diagnosis - Male/57/No diagnosis ? CJD/delerium/neurological
Reason for referral - confusion, poor attention, for cognitive assessment
Medical Hx: Nil
Social situ: Lives alone, separated, 2 adult daughters in location
Occupation: Real estate agent
Prior OT input: Nil
Supports before admission: Nil
How managing before admission: Fully independent, high functioning being
Assistance on ward (mobility/self cares): Independent mobility, Supervision/assistance with self cares

OT input this admission/ Assessment(s): Initial interview, cognistat, kitchen assessment, discussion with daughters, physio and medical team

Problems identified:
(1) Poor attention/concentration
(2) Trouble initiating tasks/steps/action
(3) Difficulty with searching/locating and problem solving
(4) Slow information processing
(5) Frustration/emotional
(6) Difficulty planning, organizing and sequencing (? terminating)
(7) Poor standing balance
(8) Difficulty with verbal information/prompts

(1) Insight into cognitive limitations
(2) Wanting to return to work - motivated
(3) Remembers OT on a daily basis, remembers when his daughters have visited
(4) Mobility and awareness of balance problems

Goals for rehab:
(1) Getting a diagnosis
(2) Returning home
(3) Returning to work (eventually)
(4) Work on problems identified

Mr W is very frustrated and emotional in regards to his cognitive issues - he is aware of some of his limitations and realises he is unsafe to go home. He is upset that no one knows what has happened to him and he is finding it hard to cope with his changes in function.
Mr M has agreed for a period of rehab to sort out what is going on and to help him "get better"
Mr M has agreed for the vocational OT to become involved to help him return to work

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