Returning to work after illness or injury
MediumGraded Return to Fitness Instruction Post-Wrist Fracture
Setting: Hand therapy room. Your role: Occupational Therapist
Ms Chloe Evans, 31, a fitness instructor, is attending her first occupational therapy appointment. She is recovering from a distal radius fracture of her dominant right wrist sustained 8 weeks ago and has been cleared by her doctor for occupational therapy to plan her return to her physically demanding job. She is eager to get back but is also concerned about the risk of re-injury.
- Greet Ms Evans and confirm the purpose of her visit regarding her return-to-work plan for her wrist injury.
- Gather a focused history about her current right wrist function, pain levels, and the specific physical demands of her fitness instructor role (e.g., demonstrating exercises, lifting weights).
- Examine or clarify the current range of motion, grip strength, and specific functional limitations of her right wrist relevant to her professional duties.
- Explain the principles of a graded return-to-work plan, including phased hours and ergonomic adjustments for teaching fitness classes, based on her current assessment and job demands.
- Confirm Ms Evans' understanding of the proposed plan and establish her ownership of the initial steps for a safe return.
Practise this cardCarer strain and support planning
HardMr. O'Connor: Managing Carer Strain for Stroke Recovery
Setting: Hospital rehabilitation ward. Your role: Occupational Therapist
Mr. Frank O'Connor is the primary carer for his 65-year-old wife, Mrs. Mary O'Connor, who is recovering from a right-sided stroke sustained 3 weeks ago. The medical team has observed Mr. O'Connor looking increasingly fatigued and concerned about his wife's discharge. He has been referred to you to discuss strategies for managing carer strain and preventing burnout.
- Assess Mr. O'Connor's current readiness to make changes to his caring routine or accept external support.
- Understand Mr. O'Connor's specific motivation for exploring support options today, linking it to a recent concern or personal event.
- Set a SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goal with Mr. O'Connor for a tangible step towards managing his carer strain.
- Discuss concrete support options Mr. O'Connor can rely on, such as local respite services, carer support groups, or practical assistance for household tasks.
- Schedule a follow-up appointment to review his progress and adjust the support plan, timed to a natural milestone related to his goal.
Practise this cardHome safety with low vision
MediumHome Safety for Low Vision: Nora Hughes
Setting: Hospital rehabilitation ward. Your role: Occupational Therapist
Mrs. Nora Hughes, 77, a widowed pensioner, was admitted after a fall in her hallway. She has significant low vision and reports difficulty navigating her home and finding items, leading to tripping hazards. She has been referred for occupational therapy to improve her home safety and independence.
- Assess Mrs. Hughes' readiness to implement changes to her home environment to reduce fall risks, considering her past experiences with low vision.
- Understand Mrs. Hughes' specific motivation for addressing home safety now, such as her recent fall or other personal reasons.
- Set a SMART (Specific, Measurable, Achievable, Relevant, Time-bound) goal with Mrs. Hughes for a manageable home safety improvement, focusing on one area like contrast, lighting, or organisation.
- Discuss concrete support systems Mrs. Hughes can rely on, such as family, neighbours, or community services, to help achieve her home safety goal.
- Schedule a follow-up appointment or phone call to review Mrs. Hughes' progress and offer further guidance on her agreed-upon home safety plan.
Practise this cardDaily routines in dementia care
HardDementia Care: Addressing Agitation Routine Adherence
Setting: Hospital rehabilitation ward. Your role: Occupational Therapist
Ms Priya Shah, daughter and carer for her 85-year-old mother Mrs Asha Shah (who has dementia), is attending this follow-up. Mrs Shah continues to experience increased agitation in the late afternoons. The OT strategies previously agreed upon (structured activities, environmental modifications, visual cues) have not been consistently implemented. You need to understand the barriers and co-design a more effective plan.
- Explore the barriers Ms Shah has faced in consistently implementing the agreed-upon structured routine and environmental cues for Mrs Shah's afternoon agitation, without judgment.
- Validate Ms Shah's challenges in maintaining the recommended schedule while emphasising the clinical importance of managing Mrs Shah's increasing agitation and its impact on her well-being.
- Co-design a revised, more flexible afternoon routine plan with Ms Shah, incorporating simpler visual cues and activities that build on what she has found manageable, such as reducing background noise.
- Safety-net what Ms Shah should do if the new, revised routine still proves difficult to implement or if Mrs Shah's agitation significantly worsens despite the new strategies.
- Schedule a specific follow-up phone call in 3-4 days to check on the initial implementation of the revised afternoon routine and address any immediate concerns.
Practise this cardFatigue management and energy conservation
MediumCarer Fatigue: Revisiting Pacing Strategies
Setting: Hand therapy room. Your role: Occupational Therapist
Mr. Frank O'Connor, who is the primary carer for his 65-year-old wife with MS, is returning for a follow-up. You previously provided him with strategies for managing his own fatigue and energy conservation (pacing, prioritising his own activities), but he has admitted to struggling to implement them. Your goal is to explore the barriers he faced and co-design a more achievable plan for his self-care.
- Explore the specific barriers Mr. O'Connor faced in implementing the previous pacing strategies for his own fatigue, ensuring a non-judgmental approach.
- Validate Mr. O'Connor's difficulties and the immense challenges of caring for a spouse with increasing MS symptoms, while reinforcing the importance of his own energy conservation.
- Co-design a revised, more realistic fatigue management plan with Mr. O'Connor, focusing on small, actionable steps for his own self-care that can be integrated into his demanding caregiving schedule.
- Safety-net Mr. O'Connor by discussing what he can do or who he can contact (e.g., a community support service) if he finds himself struggling to maintain the new plan again.
- Schedule a specific follow-up appointment within two weeks to review the revised plan's effectiveness and provide further support for his carer fatigue.
Practise this cardWrist Splint Adherence: Carer's Challenge
Setting: Hospital rehabilitation ward. Your role: Occupational Therapist
Mr Frank O'Connor, a 68-year-old carer for his wife with advanced dementia, has recently been prescribed a custom-fitted wrist splint by the orthopaedic team for a severe left wrist strain sustained while assisting his wife. He has come to Occupational Therapy today for education on the splint's use and care, but he appears hesitant about committing to the prescribed wear schedule of 6 weeks.
- Assess Mr. O'Connor's readiness to consistently wear his new wrist splint as prescribed, exploring any concerns he has about its impact on his demanding caregiving responsibilities.
- Understand the specific reasons and motivations that might encourage Mr. O'Connor to prioritize his own recovery and adhere to the splint wear schedule despite his caregiving demands.
- Set a realistic and measurable goal with Mr. O'Connor for his splint wear and exercise routine over the next two weeks, ensuring it aligns with his daily caregiving activities.
- Discuss practical support strategies and resources available to Mr. O'Connor to help him manage his splint adherence and caregiving responsibilities concurrently.
- Schedule a follow-up appointment or phone call within two weeks to review his progress with the splint and adjust the plan as needed.
Practise this cardPlay and daily skills in developmental delay
MediumNoah's Self-Care and Play Development
Setting: Hand therapy room. Your role: Occupational Therapist
You are an Occupational Therapist in a hand therapy room. Ms Rachel Green has brought her 5-year-old son, Noah, for an assessment. She is concerned about his difficulty with self-care tasks like dressing and his limited engagement in age-appropriate play.
- Greet Ms Green and confirm her concerns regarding Noah's self-care and play skills.
- Gather a focused history about Noah's developmental milestones, specific difficulties with dressing (e.g., buttons, zippers), and his typical play activities over the past 6 months.
- Clarify any previous assessments or observations from Noah's preschool and explain any relevant informal assessment findings you might perform regarding his fine motor skills or play behaviors.
- Explain that Noah's difficulties may indicate developmental delays in fine motor and social-emotional skills, and propose a treatment plan focusing on parent-led practice and specific play-based interventions.
- Confirm Ms Green's understanding of the plan and her willingness to engage in home-based activities to support Noah's development.
Practise this card
