Consultation Case Example

 

This is one example of how your OT consultant may support you.

Mary was caring for her mother, Susan, who had an unspecified type of dementia. Prior to the onset of dementia, Susan was a professional artist, raised 3 children, and managed many of the household tasks such as dishes and laundry.

​

Session 1:*

During her first session with the occupational therapy (OT) consultant, Mary provided important background and context for the occupational therapist including Susan's work and social history, the home layout, and any past activities enjoyed by Susan. Mary also identified the following challenges in caring for her mother: 

1. Susan was waking up about 3-4 times in the middle of the night most nights, often pacing through the home  

2. Susan was often resisting taking medications 

3. Susan was often bored or inactive during the day

​

The occupational therapy consultant also worked with Mary to ensure she had her own stress reduction strategies and that she was adequately caring for herself in this process. 

​

Session 2: 

Mary confirmed that her mom's waking at night and pacing in the home upon waking were the top priority for this session. The OT consultant worked with Mary to identify why this challenge/behavior was occurring. The OT consultant did this by engaging Mary in the Skills2Care® program's problem-solving process and used their knowledge of dementia care models and recent research. In this case, it was determined that Susan was likely waking at night due to:

• Limited activity engagement during the day, often leading to naps

• Drinking caffeinated tea before bed 

• Mirrors in the bedroom made Susan think someone was in the room with her

​

With this information in mind, the OT consultant and Mary developed strategies for how to reduce Susan's waking at night and pacing, and they developed strategies for how to respond to and handle Susan's behaviors when they did occur. 

​

Session 3: 

The OT consultant provided Mary with a Skills2Care® Action Plan for her mom's waking and pacing at night, incorporating all of the strategies identified in Session 2 along with any additional strategies from available research.

These strategies included items such as:​

• Removing/covering the mirrors in Susan's bedroom​

• Enhancing Susan's activity engagement during the day

  • Communication strategies for how to engage her in activity​

  • Recommendations for specific, meaningful activities and how to adapt them to enhance Susan's participation including

    • Painting, including how to set-up the necessary items

    • Washing dishes, including how to adapt the task 

    • Folding laundry, including how to adapt the task

    • Activities to do with her grandchildren

• Limiting opportunities for Susan to nap during the day​

• Providing Susan with her preferred tea at lunch time or considering another hot beverage for the evening such as hot water with lemon.

​

The OT consultant reviewed this action plan with Mary to ensure she felt comfortable and confident using the recommend strategies and made any necessary adaptations to the action plan. Mary and the OT consultant practiced/role played these strategies, as appropriate. 

​

Once Mary reported that she felt confident in her implementation of the recommended strategies for handling Susan's waking/pacing at night, the OT consultant and Mary then began to address Mary's second priority, which was Susan's resistance to taking medication. Future sessions followed the same general structure.

​

* It is possible that your OT consultant may be able to support you in fewer sessions. If you are already clear on the target problem area you would like to address, we may be able to jump right into a problem-solving session during our first visit.