Reason for Services
What was Annette’s initial reason for hospitalization?
Weakness, flu-like symptoms, and difficulty breathing due to COVID pneumonia.
What was Annette’s level of independence before her hospitalization?
Completely independent with all ADLs, IADLs, mobility, driving, cooking, and cleaning.
What type of home does Annette live in?
A split-level home with living areas on the middle floor and bedrooms upstairs.
What performance issue occurs when Annette tries to sit up?
Her oxygen saturation drops into the 70s.
What self-care goal is a top priority for Annette?
Being able to shower and wash her hair again.
What medical complications did Annette experience during her hospitalization?
Right-sided pneumothorax, atrial fibrillation, and an episode of unresponsiveness requiring intubation.
What kind of work does Annette do?
Part-time greeter at a museum.
What potential barrier exists for accessing her home?
Multiple stairs from the garage to the main living level.
What routine ADL task is emotionally significant to Annette right now?
Washing her hair
What family-related activity is a goal for Annette?
Resume crafting and caring for her grandchildren
What procedures were required to manage her condition?
Tracheostomy and a PEG (gastrostomy) tube placement for feeding.
What roles does Annette value most in her daily life?
Wife, mother, grandmother, and active community member.
Where is her most accessible shower located?
On the bottom level of the home.
How might Annette’s previous activity level influence therapy intensity?
She may want to progress quickly and may need education on pacing and energy conservation
What instrumental activity of daily living is important to her return home?
Cooking and cleaning for herself and her husband.
What is Annette’s current oxygen status?
On 8 liters of oxygen; oxygen saturation drops into the 70s when she sits up.
What activities did Annette previously engage in with her grandchildren?
Crafts, baking, reading, and playtime.
What social supports does Annette have at home?
A supportive husband, an adult daughter nearby, and frequent contact with grandchildren.
What are key physical performance challenges post-COVID?
Respiratory fatigue, reduced endurance, and need for supplemental oxygen
What goal reflects Annette’s desire for social engagement?
Going out to movies and dining with friends.
What personal hygiene goal is most important to Annette?
She wants to be able to wash her hair again.
How might her pre-illness independence impact therapy planning?
She may experience frustration or grief related to her current limitations.
How might her environment need to be adapted for safe re-entry?
Consider stair lifts, shower benches, oxygen management, and activity pacing.
What previous patterns may help in structuring therapy goals?
Independent daily routine, regular social interaction, and meaningful engagement in crafts and family care
What occupational therapy outcome is essential for Annette’s well-being?
Restoring independence with ADLs/IADLs while managing oxygen needs and pacing.