course material

1. Assessment Case Study
Topic: Assessment Case StudyRichard is a 56 year old man. He has a medical history of high
blood pressure & type 2 diabetes. Richard is overweight and describes himself as a social
drinker and smoker. A year ago Richard had a left sided stroke. Following his acute
admission to hospital, he underwent 6 weeks of inpatient rehabilitation followed by 3
months of outpatient therapy.At his 12 month review with his rehabilitation specialist, a
referral to the community occupational therapy service was recommended for community
access and participation. The rehabilitation specialist initiated the referral and advised that
Richard has mild right hemiparesis, mild right sided neglect, moderate dysphasia & some
executive functioning impairments.Richard lives with his wife and 2 adolescent sons, aged
15 and 17. They live in their own, single storey home in Granville. His wife is very
supportive and wants to do everything possible to support her husband in his recovery. In
aIDition to supporting Richard, she is currently completing all of the domestic ADL’ s (i.e.
shopping, cooking & housework) and providing the majority of assistance to their two sons
(i.e. schoolsupport, taking them to sport and providing transport to their eldest son who
works casually). She also works 3 days per week.Since completing his outpatient
rehabilitation program he has predominantly stayed home. Richard is mostly independent
with his self-care however does still receive some minimal assistance from his wife with
showering and dressing in the morning. He is able to eat meals independently, which his
wife has pre-prepared. Richard is able to mobilise independently with a walking stick
around the house. He has mobilised short distances (500m) when he has gone to the local
shopping centre with his wife on a few occasions . When fatigued, he sometimes bumps into
things on his right side. He also has some residual right upper limb weakness (i.e. affecting
fine motor abilities). His wife also reports that he sometimes forgets his appointments and
to take his medication.Richard feels frustrated and depressed by being so reliant on his wife
and having to rely on her to drive him everywhere. He is also upset that he has not been
able to be involved with his sons’ sport and leisure activities since he has had his stroke.
For many years, Richard was on the committee of their sons’ soccer club. Richard would
also like to resume the task of obtaining the weekly family groceries.Richard also feels
socially isolated as he and his wife have not socialised with their extended family and
friends very much since he had the stroke. Initially their family and friends were concerned
and sympathetic and visited him in hospital and at home a few times. In recent months, they
have not visited as much. Richard and his wife used to enjoy going out to dinner, going to
large sporting events, and going out to see live shows and concerts occasionally.Prior to his

2. stroke, Richard worked as a senior accountant for a company in the city. He used to drive
to/from the local train station and catch the train to/from work. Richard is currently on
extended leave however is keen to return to work. Richard is concerned about how he will
financially support his family once his paid leave runs out. His employer has indicated that
they are supportive of his return to work.As the community occupational therapist, you
received the referral from the rehabilitation specialist requesting occupational therapy
assessment and interventions to facilitate Richard’ s community access and participation.In
preparation for conducting the initial community occupational therapy assessment, prepare
the following assessment portfolio (2,500 word limit):1. Research the following terms
related to stroke, provide a definition of the following terms and describe how they may
impact on Richard’ s community occupational performance. This may be presented in a
table format.a. Left sided strokeb. Right neglectc. Right hemiplegiad. Dysphasiae. Executive
functioning2. Develop a 2 page occupational therapy initial assessment
guideline/formintended to guide your initial meeting with Richard & ensure you collect all
the relevant information. Use an occupational therapy model/framework as a basis for your
assessment form and provide justification as to why you selected this model/framework
and how it is appropriate for a community based occupational therapy assessment. Present
this as blank initial assessment form that you would complete when you conduct the initial
interview with Richard.3. Prepare a 1-2 page handout to give to Richard at the initial
assessment. The handout should provide Richard with 5 information sources or services
that may assist with his self-management post stroke. Provide a brief description of each
source/service, contact details/links and indicate why they may be useful to Richard.4.
Identify 3 types of environments in which Richard carries out his community occupations.
From your own knowledge of these types of environments, describe the potential barriers
or enablers to his community performance & participation in these 3 environments. This
may be presented in table format.Choose one of the environments (identified above). Locate
a similar environment in your local area and complete a community access audit using the
SPACES (Systematic Pedestrian and Cycling Environment Scan) Instrument (The University
of Western Australia, n.d. Retrieved from
http://www.cpah.health.usyd.edu.au/pdfs/2007_SPACES_Audit_Instrument.pdf) .The
SPACES instrument can be downloaded
from:http://www.cpah.health.usyd.edu.au/pdfs/2007_SPACES_Audit_Instrument.pdfThe
SPACES observer’ s manual can be downloaded
fromhttp://www.cpah.health.usyd.edu.au/pdfs/2007_SPACES_Observers_Manual.pdfInclud
e the completed SPACES instrument as an appendix to your assessment (please note: this
will not be included in the word count).Identify 3 potential issues that Richard may
encounter if he were to access this environment & explain why they may be an issue for
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