Cаse Study pаrt 1 Mаria, age 82, has been a widоw fоr 20 years. One week agо, Maria fell while returning home from a community day program but did not injure herself. She was prescribed a four-wheeled walker. However, Maria has not been using the walker at home. Maria stated that she prefers to hold onto the furniture when moving around her home. As an occupational therapist, you receive a referral from the community day program to improve Maria’s safety and mobility at home, so she can return to the day program. Information in the client record: · Maria was diagnosed with Parkinson’s disease 10 years ago. It was managed well with medication until three months ago; · Three months ago, Maria began to have more difficulties with balance. Her gait changed and she appeared to shuffle (walking without lifting the feet) more when walking. Maria’s movements also became slower; · Maria is afraid of falling because of the changes in her balance and mobility; · Maria has not followed earlier recommendations to use her walker at home; · Although Maria’s balance has worsened, her standing tolerance is good; · There is an increase in the tremor in Maria's right hand, and Maria is right-handed; · Maria is soft spoken and has a monotone voice, but her speech is clear; · Maria lives in an apartment with her eldest daughter, who is single. · It is a two-bedroom apartment and there is an elevator in the building; · The flooring inside the apartment is hardwood. The flooring in the main hallway from the elevator to her apartment door is carpet; · The bathroom has been equipped with one bar in the shower/bathtub; · Maria complains of difficulty getting up from toilet. · Maria has lived in the apartment building for many years and has developed friendships with several neighbours in the building; · Maria was a high school teacher until she retired at age 65. She has a good pension with extended health benefits; · Maria’s daughter is a full-time nurse. Her shifts are 12 hours long, and either 7:00am – 7:00pm, or 7:00pm – 7:00am; · Maria really enjoys attending the community day program. The day program has a bus that picked Maria up at her apartment building. Maria must wait on the main floor of her apartment building to meet the bus; · Maria’s daughter is afraid her mother will fall again and therefore does not want her mother to return to the day program; Self-Study Exercise Part 2 Read the additional case information below and: 1. Determine the client’s occupational performance issues 2. Determine your goals, as well as your intervention or treatment plan for the client 3. Identify the client's diversity, values and/or beliefs You are provided 60 minutes to complete this self-study exercise. Following this, the assessor will take you through a series of oral questions related to the case. Case Study part 2 As an occupational therapist you conducted your initial assessment and determined: Marie's daughter does most of the meal preparation and housekeeping. Maria is required to heat the food that her daughter has prepared. A kitchen assessment identified that Maria has difficulties with the following: o lifting pots from the cupboard to the stove and from the stove to the table, o opening the oven door o picking up utensils and cutting food. Loose carpets (rugs) were noted in front of the stove, by the living room chairs and by Maria's bed. Maria believes family should take care of their sick and elderly family members. Maria attends a community day program for seniors three afternoons a week. She has attended the program for five years. After the fall, though, Maria has not attended because she’s afraid of falling again. Maria wants to return to the day program and remain in her own home with her daughter. Maria does not have any cognitive deficits and agreed to participate in an assessment with you. Maria likes knitting and playing cards with her friends. After church on Sundays, she enjoys tea with her friends. Maria really values her friendship with the older women in her apartment building and at the day program. Maria said, "I would rather die than leave my apartment and friends." Maria said she is afraid to stay alone in the apartment at night when her daughter is at work.
Whаt is the mоst likely cаuse оf the pаtient’s symptоms?
This cоnditiоn is оften cаlled “physiologicаl аnemia of pregnancy.” What is the primary difference between this and true iron-deficiency anemia?