Académique Documents
Professionnel Documents
Culture Documents
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(01) Introduction
It includes,
Because;
Not showing any distracting behaviors when talking with the client.
We have to talk as he/she feels that we are the most trustful people.
When they are asking the location of the patient’s home , they did not
use the condition of the client at any time. On behalf of that they are
asking the details or name of someone else in the family or directly
asking the place of the address.
Mr. A is 40 years old unmarried person who lives with his younger
brother’s home in Thanthirimulla area.
Observations
Suggestions
• Educate family members about his psychiatric condition.
• introduce a meaningful leisure activity for the client.
• Introduce a purposeful daily routine for the client.
• Increase the social interaction of the client.
Related pictures
His living place Injecting Modecate
His bed room
Ms. B is 64 years old married lady who lives with her husband in
ground floor & her son & his family is in upstairs.
Diagnosed as schizophrenia.
Social background
- She lives with her husband
- Poor social association , according to her daughter in law.
Client’s complaints
Observations
Suggestions
• Educate family members about his psychiatric condition.
• introduce methods of joint protection & energy conservation for
her physical condition.
• Increase the social interaction of the client.
• Doing some home modifications (for OA).
Related pictures
Mr. C is 43 years old unmarried person who lives with his mother &
father in Kuruppumulla area in a rented house.
- Diagnosed as schizophrenia.
- Currently taking treatments from base hospital, panadura.
Social background
- He lives with his mother & father
- Poor social association & no friends, according to him.
- He is going to work in a concrete workplace in day time
Observations
Poor ADL & IADL (hair & nails are grown, not washing
plates & cups after using, not washing cloths)
Poor family support
Poor insight about psychiatric illness.
Living in a rented house & no vehicle accessibility.
Making “vesak” lanterns & sailing.
Using all money for smoking.
No care about poor ,old parents.
Poor personal hygiene.
Suggestions
• Educate family members about his psychiatric condition.
• Increase the social interaction of the client.
• Planning the day according to a productive daily routine.
• Doing some therapy sessions on money management.
• Improving his ADL & IADL activities.
Related pictures
Ms. B is 40 years old married lady who lives with her mother , father
& his 2 son (22 & 13 years old).her husband has separated.
Social background
- Poor social association & lazy to go out from the home,
according to her sister.
Client’s complaints
Observations
Suggestions
• Educate family members about his psychiatric condition.
• introduce massage techniques to reduce contracture in fingers.
• Increase the social interaction of the client.
• Improve ADL & IADL .
Related pictures
Mr. A is 44 years old unmarried person who lives with his mother &
brothers family.
Social background
- There are number of family members
- No social association identified . but he is going out of the
house & coming again.
Observations
Suggestions
• Educate family members about his psychiatric condition.
• introduce a meaningful leisure activity for the client.
• Introduce a purposeful daily routine for the client.
• Increase the social interaction of the client.
Related pictures
Mr. A is 40 years old married person who lives with his wife.
Observations
Suggestions
• Educate family members about his psychiatric condition.
• introduce a meaningful leisure activity for the client.
• Introduce a purposeful daily routine for the client.
• Increase the social interaction of the client.
Related pictures
Ms. B is 64 years old married lady who lives with her husband in
Kolamediriya area.
Social background
Poor social association not going out from the home & spending the
day on bed.
Observations
Suggestions
• Educate family members about his psychiatric condition.
• Increase the social interaction of the client.
• Improve ADL & IADL.
Related pictures
Client’s room & the door used to Client is lying on a bed in whole
lock her inside. day.
We did more other 5 home visits. The observations we did are more
similar to above cases.
Related pictures
Reflective writing on Panadura home visits
Introduction:
We did 12 home visits in Panadura area which related to the
Psychiatric field.Main aim was to inject Modecate injection for the
patients who are not participating for their clinics.
We did all 12 home visits within the day & for that we hired van.
After going to client’s settings, we talked with client & his/ her
family members.it was a difficult task to build up a good rapport
with some of them.
But most of them tried to hide their real situation in front of us.
Some were bed ridden, & some are trying to do their day today
activities with different issues of the illness.
Conclusion
It is more successful if we give enough time for the each
home visits.
2nd day
Mr. X is 65 years old person who is living in Thalpawila area with his
wife, daughter and mother.
He was a cook before the incident & currently not engages in any
productive activity.
He has poor family support. Because his wife is the only person who
can help him as his mother it too old & his daughter is working in a
garment factory in Galle ,during day time. Financial background is not
in a satisfactory level.
Segment Description
ACTIVITY COMMENT
Feeding Fully Dependent on his wife
Self care Fully Dependent on his wife
Washing Fully Dependent on his wife
Dressing Fully Dependent on his wife
Mobility Partially independent & difficult to
manage steps
Toileting Partially independent with a home
made commode chair
Motor skills:
Mobility- fair in walking in a flat ground . & difficult to
manage steps
sensory issues - little reduction of sensation
Strength- Poor & muscle atrophy can be seen in both
upper limbs
co-ordination – poor in both upper limb
SUMMARY OF VISIT
Problems identified
suggestions
- Educate the client & his family member about the value of doing
therapeutic activities .
- Introduce an adaptation for self-feeding.
- Introduce a safety and comfortable commode chair.
- Suggesting a plan for newly building bathroom.
- Suggested to use 2 steps of less height to the main entrance.
- Suggested to change the furniture arrangement of the house for
safe accessibility.
Related pictures
Introduction
His home is situated in a cross road from main road about 300
m away.that was a hilly, narrow (about 2 feet) & muddy road.
His upper limb (mainly shoulder & elbow) range of motion has
reduced due to disuse.
For that we planned to do therapeutic well activity daily. Then
sir got measurements to make a splint to reduce the
contracture of the elbow joint.
Conclusion
This was the 1st home visit I did under physical field. It was not much
successful. Because we were not more familiar with this experience &
we had no any idea about what to do in a home visit.
Mr. Y is 53 years old person who is living in Thalpawila area with his
wife & daughter.
He was a labor before the incident & currently not engages in any
productive activity.
Segment Description
ACTIVITY COMMENT
Feeding Fully Dependent on his wife.
Self-care Fully Dependent on his wife
Washing Fully Dependent on his wife
Dressing Fully Dependent on his wife
Mobility Need more support
Toileting Partially independent with a
commode chair
Motor skills:
Mobility - need more & more support to walk & not
propelling the wheel chair also.
sensory issues - little reduction of sensation in lower
limbs
Strength- Poor & muscle atrophy can be seen in both
upper limbs & lower limbs.
co-ordination – moderate in both upper limb
SUMMARY OF VISIT
Suggestions
Educate the client & his family member about the value of doing
therapeutic activities.
Suggested to use the adaptations given for feeding & brushing.
Suggested to engage in therapeutic activities which already
facilitated
Related pictures
Introduction
His home is situated in a cross road from main road about 1km
away. That was a hilly, narrow (about 6-7 feet) & tarred road.
Conclusion
This was the 2nd home visit of the day. Mainly we got an idea
about the dedication of the family members to take their family
member in to the previous position. They have made the similar
therapy Equipment in the OT & PT departments to engage the
client in same activities. But the client was not supportive to do.
Segment Description
Problems identified
- Educate the client & his family member about the value of doing
therapeutic activities.
- Suggested to use walking aids with proper heights.
- Suggested to engage in therapeutic activities which already
facilitated in home.
- Suggested to reduce the heights of the steps.
- Suggested to reduce the slope of the road to home.
Related pictures
Introduction
Conclusion
This was the last home visit of the day. It was not much successful as
we had no enough time to observe his performance of ADLs.
We were unable to extract the necessary information from the client &
we missed to ask or observe inside the home.
Visit of Sarwodaya Suwasetha Ananda Grero Memorial Centre for
Disabled Women, Thalpawila.
Introduction:
Eg:-
When we work with an institute, it is harder to work with their rules &
regulations.
Conclusion
She is unable to walk due to a congenital disorder. And also her both
hip joints were dislocated, shortened & wasted lower limbs &
observable & due to above reasons she is wheel chair bounded from
her childhood.
Problem 01
Analysis
She is having pain in both shoulder & elbow joints in both upper
limbs.
Door width is just 2” larger than the width of the wheel chair. This
space is not enough to propel the wheel chair.
Suggestions
Discussed with the matron about their plan to build a new bath room
with more facilities. For that we gave a report about the modifications
should be done to the current wash room.
4/6th of the members are using wheel chairs. To reduce the pain of
upper limbs, we suggested new, modified wheel chairs with a handle
& can use easily with minimum energy use.
Problem 02
Analysis
Height of the wheel chair is not enough to the wire to hang cloths by
her hands & if the wire placed near to the ground , animals will take
their cloths away.
Suggestions
For now,
We asked to take the wire down by using a stick & then put the cloths
in the wire & keep the stick as a jack to the wire for support.
Problem 03
She is difficult to rub her back of the trunk without help of anyone.
Analysis
She lost her trunk balance when bending forward to take her hand
back.
Suggestions
Introduction
There was only one class & school time was 8.00 am to 12.00 pm.
Students in this school are differ from each other by age , diagnosis ,
cognitive level , skills & abilities. This becomes an advantage as well
as a disadvantage for the children.
Common suggestions to teacher……….
- Give a star or a smile face in their books at the end of each task
to increase motivation.
- Maintaining a chart in the wall to give a star in each day for the
good performances of child & not giving it, if he/she done a
wrong thing.(pasting a photo of them to recognize themselves)
& at the end of the week giving a gift for the best performance.
- Practice mouth massaging techniques to reduce drooling.
- Asked to take them for a trip after completing a given task.
- Suggested to take the help of an occupational therapist at least
once a month.
Related pictures
4th home visit
Segment Description
ACTIVITY COMMENT
Feeding Independent with a normal spoon
Self-care Independent
Washing cloths Need moderate support
Dressing Need minimum support in
buttoning.
Mobility Independent.
Toileting Independent.
SUMMARY OF VISIT
- Ms. P (client)
- Her sister
- Mr. W.R.A.Shantha (Occupational therapist, New District
General Hospital, Matara)
- 9 students of occupational therapy.
Problems identified
Suggestions
Educate the client & her sister about methods of joint protection
and energy conservation.(asked to use a sharp knife ,using
palm or forearm when carrying large/heavy objects & asked to
take meals without keeping the food plate on her palm & eat
while keeping the plate on a table. )
Advised to do day today activities with resting period during
each activity.
Suggest them to decrease more stressful activities to joints.
Related pictures
Introduction:
This is the 1st home visit of the day and Mr. W.R.A.Shantha
(Occupational therapist, New District General Hospital, Matara) and 9
students of occupational therapy were participated for it.
It was a very rural area & a bus is travelling once per hour. The client
was Ms.P, 65 years old unmarried women who lives in
Wewahamanduwa, Matara with her younger sister.
Then we talked with client and identified problems and done a home
and home environment assessment.
What was my learning experience?
Ms. P’s house was very large with a huge garden. There is no any
male person lives with them & both of the sisters have to do heavy
work load in a house & their garden by themselves.
Ms. P’s hands and feet are deformed at its worst, but she hasn’t any
pain in involved joints. This is good experience because her hands
deformed with many types of deformities but she is independent in
most aspects in her daily life.
She is dependent on her sister only for cooking & washing heavy
cloths.
Her gait pattern also changed due deformed legs & it may cause to
develop further deformities.
Maintaining the garden is also a big challenge for them. It may cause
to have the same illness for her sister too.
Conclusion:
Segment Description
A small step
Entrance Door width is normal
ACTIVITY COMMENT
Feeding Fully independent with an
adaptive spoon.
Self-care Independent
Washing Need minimum support.
Dressing Need minimum support.
Mobility Independent & can manage steps
Toileting Independent
Motor skills:-
- Miss.Q (client)
- Her parents and brother
- Mr. W.R.A. Shantha (Occupational therapist, New District
General Hospital, Matara)
- 9 students from School of physiotherapy and occupational
therapy.
Problems identified
Suggestions
Introduction:
This is the 2nd home visit of that day and Mr. W.R.A.Shantha
(Occupational therapist, New District General Hospital, Matara) and 9
students of occupational therapy were participated for it.
The client was Miss.Q & she is 19 years old girl who lives in
wewahamanduwa, Matara.
She was diagnosed as Right sided hemiplegia.
Then we got an idea about the strengths & weaknesses of the client
& what are the opportunities of her functional level.
She has less sensation in thigh & below the thigh in her affected side.
Currently she is able to walk and upper limb functions are somewhat
poor. Coordination, gross & finer grips are the weak areas.
Conclusion:
1st day
Who to involve?
The patient/ person
Another health care professional (some members in multi-
disciplinary team (PSW) )
Family members & carers.
What we did?
We did 2 home visits. Both are under pediatric category and regards
to cerebral palsy (CP).
1st home visit
His house is about 5kmm away from karapitiya hospital & that is not a
rural area.
There is no evidence on family history regarding cerebral palsy.
Reasons for the home visit
For studying purpose.
Segment Description
Vehicle accessibility
Screening of baby
Developmental stages
ACTIVITY COMMENT
Feeding Dependent (Mother is feeding
him in sitting position. Can eat
solid foods. Can take a biscuit in
to the mouth individually by hand
, but not eat. He can’t drink water
by a bottle also)
Self-care Fully dependent
Washing Fully dependent
Dressing Fully dependent
Mobility Carrying by parents or by wheel
chair. ( he is unable to propel )
Play skills
Communication
Hand skills
Problems identified
- Unable to walk.
- Poor cognitive level.
- Difficult to grasp something with hands.
- Decreased ROM in hip joints (In Abduction and adduction)
- Developing scoliosis.
- Dependent in all ADL. & spending the whole day sitting on a
chair or lying on a bed.
- Poor knowledge of the occupational therapy treatments.
- Architectural barriers in the house (slopes & steps).
- Mother is having a back pain due to carrying the child by
bearing in her hand.
suggestions
Introduction:
Earlier his mother also was not much supportive for us for
giving information about the child. But later she gave us enough
details.
What did I learnt
Parents are tired enough by struggling with the child. They are
seeking help from anybody they met. But some of them are
cheating. Therefore the poor parents are always in a doubt about
to whom we should go. From that I understood what is the
importance of explaining what we are going to do & how it affects
the client.
We experienced how the hospital set up is not practicable for
the home set up. Suggestions for the adapting the physical
background may not be possible to make into action because of
some problems. For an example if we asked to make a
temporary ramp to keep on a step, there may be several issues.
Eg :-whether there is enough space to keep a ramp in standard
inclination , is that easy to move here & there , what is the weight
,what is the strength etc. By considering all these things a person
may select the option to portage the baby as previous.
In baby’s room there were some safety issues. One is the height
of the plug points are in the same level of the bed. Baby is
entering fingers in to it. Next thing is there are ants on the
mattress & in one time they have ate baby’s sexual areas as he
does not have sensation.
Conclusion
Our home visit program was successful as our senior therapist
Ms. Nirosha Priyangika was with us. After going to baby’s
house she guided us very well by highlighting what we missed.
But we wasted more time by travelling by foot more than 2-3
km. If we had a good communication with baby’s mother, it
would not be that much difficult to find the place and we could
save our time and the energy.
2nd home visit
Segment Description
Main road to gate Distance from main road – 500m
Vehicle accessibility - accessible
Gate to house Distance- about 1-2 m to the varenda
Surface- uneven (there is a step, about 1
feet height)
vehicle accessibility - no
from compound to verenda again there is a
step of nearly 8” height.
Entrance There is a step of height of 5”
Door width is enough for wheel chair
accessibility.
Inside the home Space – not having enough space due to
furniture
Steps – there are no steps in ground floor.
Upper floor is not built.
Kitchen & dining area – not using the
kitchen. But to go for a wash or for the
toileting activity, she has to pass kitchen.
Bed room – situated in a far corner of the
living room. Difficult to access through
furniture.
Beds are accessible for the baby.
Screening of baby
Developmental stages
ACTIVITY COMMENT
Feeding Depend on her mother. can eat a
biscuit individually.
Self-care Depend on her mother
Washing Depend on her mother
Dressing Need more support
Mobility Need more support to walk. She
is difficult to propel wheelchair
Play skills:
Not like to play with her brother.
She likes to play with elderly ladies.
Communication:
Not talking. But using symbols to express feelings, smiling, crying.
Hand skills:
Having a little amount of gross grasp. But with diskynetic movements.
It is difficult to use for a function.
Summary of visit
Problems identified
Strengths:-
Limitations:-
Suggestions
Introduction:
We participated for the home visit in Magalle area. The
client is baby P who is 14 years old. We, 8 Occupational
Therapy students and the senior Occupational Therapist of
teaching hospital Karapitiya, Ms. D.L.N. Priyangika participated
for the visit. It was about 1.30pm when we were reaching there.
The client, her mother, grandmother and her twin brother were
supported us by giving information.
Baby is moving here & there with more support of her mother.
Grandmother also can’t help as she is suffering with a hernia.
His brother is healthy & he likes to help her sister. But she is
not like to be with him.
Baby is always in smiley face & she is having more diskinetic
movements when she is going to a work.
She is difficult to express her ideas in words. But she has her
own way of responding that can be interpreted by her mother
and grandmother.
Conclusion
He had suffered with back pain before 1 & ½ years ago the
injury. On 09th of february2013, suddenly he felt numbness in lower
limbs & unable to walk.
Segment Description
Main road to From yakkalamulla-magedara main road= 1.5km
gate Vehicle accessibility:- can access by a three wheel.
Narrow & un even road
Gate to house Distance :- about 10m
Vehicle accessibility :-accessible
Entrance There is a step about 6”.but to overcome it he has
used a wooden ramp.
Door width is sufficient for wheelchair.
Inside the Space:-having enough space.
home Steps:- there are no steps inside the house .the 3”
step to kitchen is also replaced by a concrete ramp.
Kitchen & dining area:- limited space in kitchen. But
client can propel wheelchair through it.
Bed room:- a small room with a bed. Client needs
more effort to turn the wheelchair towards the bed.
Toilet & bathroom :- he is having a wheel chair with
a commode & he can propel the wheel chair to the
squatting type toilet & transfer in to the commode
chair & propel it inside the toilet can manage
toileting activity independently.
Bath also independent same as the toileting activity.
Switch height :- accessible
ACTIVITY COMMENT
Feeding Independent
Self-care Independent
Washing Independent
Dressing Independent
Mobility Independent
Toileting Independent
Motor skills:
o Mobility- independent with wheel chair.
o Sensory issues - no sensation in both lower limbs. Having
burning like sensation in whole day.
Problems identified
suggestions
Educate the client & his family member about the value of doing
therapeutic activities.
Introduce a safety and comfortable commode chair & wheel
chair.
Suggested to take the help of his wife or any other family
member to transfer from three wheel to wheelchair.
He is having a pain in his upper limbs when propelling the
wheel chair through the ramp. For that to reduce the energy
expenditure, asked to reduce the inclination of the ramp.
Related pictures
Way to bathing area & toilet from Way that client keeps his lower
home. limbs & his upper limb
functioning.
Modified three wheel. Place he scrapes coconut.
Introduction:
We participated for the home visit in Yakkalamulla-
Magedara area in Galle district. The client is Mr.A who is 43
years old. We, 9 0ccupational Therapy students were
participated with the guide line of senior Occupational Therapist
of Maliban hospital, Galle, Mr. Thenu Guruge. The client, his
father & his wife were joined with us to share details with us.
How can I learn it? What was my plan for further improvement?
Discuss with a senior occupational therapist.
Referring books & related articles.
Search through the internet.
By increasing the practical exposure & getting more
experiences.
Conclusion
Our home visit program was successful as our senior therapist
Mr. Thenu Guruge guided us very well.
By this home visit we got an idea about how we can contribute for
the independency of the client.
4th home visit
Branch of tree fallen on his back of the neck on 07.03.2013 & injured
on C7, T1 & become complete paraplegia. After doing ACDF with
peek cages he has referred to occupational therapy & physiotherapy
for rehabilitation.
Due to a pressure sore in his left buttock area & colostomy was
done.
Segment Description
Main road to gate From Wadhurabha main road to his house =
2.5km
Vehicle accessibility :- accessible
Narrow & un even road
Inside the home Space:- very little space & it is also limited
by furniture .
Steps:- there are no steps inside the house .
Kitchen & dining area:- limited space in
kitchen. Client can’t propel W/C in to it &
door width also not enough. Kitchen is
covered with wood.
Bed room:- a small room with a bed.
Living room:-client’s bed is there.
ACTIVITY COMMENT
Feeding Partially Independent (because
client can’t reach to the kitchen)
Self-care Independent
Washing Independent .but he is difficult to
reach to the tap without help of
any one.
Dressing Independent
Mobility Partially dependent (because
there is no even & enough space
in compound or inside the home)
Toileting Depending on his wife to fix &
remove the colostrum bag.
Motor skills:
o Mobility- independent with wheel chair. But with the
barriers of the home & home environment he is difficult to
propel the wheelchair.
o Sensory issues - no sensation in both lower limbs.
Having burning like sensation in whole day.
Problems identified
Suggestions
Educate the client & his family member about the value of doing
therapeutic activities.
Introduce a safety and comfortable wheel chair.
Suggested to take the help of his wife or any other family
member to transfer from three wheel to wheelchair.
If we can make even his compound, then he can propel the
wheelchair independently. For that it is better to concrete the
area as he can reach to the door & bathing place.
There is no enough space inside the house. for that we can ask
to remove all the furniture without his bed & fan. But it is not
practical as there is no space to in his whole house.
Poor economical level is the main issue in this family. For that
we can arrange a job for his wife.
There is a slope near the washing area & for that suggested to
make a fence to avoid slipping to down.
Related pictures
Introduction:
We participated for the home visit in Wandhurabha area in
Galle district. The client is Mr.S who is 38 years old. We, 9
0ccupational Therapy students were participated with the guide
line of senior Occupational Therapist of Maliban hospital, Galle,
Mr. Thenu Guruge. The client, his wife & 2 daughters were joined
with us to share details with us.
The way to his house is very difficult & hilly with rocks. But he
drives the three wheel to his house. His house is situated in a
top of a mountain in a very limited space.
Conclusion
Our home visit program was successful as our senior therapist
Mr. Thenu Guruge guided us very well.
By this home visit we got an idea about how we can contribute for the
independency of the client.
3rd day
Introduction
Our plan was to divide in to 3 groups & do observations near the bus
halt, near the school gate & inside the class room at 7.00 to 7.30 am.
Then discuss with the principal of the school & have an idea about
the structure and the plan of the school towards the children with
special needs.
Then to select 4 students and observe them within the class room &
to plan what we can do for them?
Most of them are coming with their parents by their private vehicles
(by motor bicycle, three wheel mainly). Less number of them is using
public transport. And one boy came by his bicycle alone.
Taking them to school is also a help for the parents, to spend their
daily activities normally.
It is only by their IQ Level. But for aged children, they are separating
in to classes according to the gender also.
End of the year teachers are gathered together to discuss about the
strengths and weaknesses of students. Then they are choosing
students for up grade classes.
Related pictures
We explained our plan to his class teacher & asked him to find what
he did with his father daily. When teacher is asking the same
question daily, his father also can’t neglect the task.
What did I learnt?
Special need children need more care & attention than other children.
They are learning things by practicing. For that we have to do more
with the active participation of the child. They are keeping fewer
amounts in their memory.
How the stigma causes to change the mind of special need children
as well as their parents & other family members.
Visit to “Senehasa” Children’s Resource Centre
Human resources:
Medical specialist in pediatrics, child psychiatrist
and Medical officers.
Occupational therapist
Physiotherapist
Speech & language therapist
02 Music teachers
A dancing teacher
4 special education teachers
Specialist center officers(president, vice president,
secretary, treasurer assister and committee
members)
parents
volunteers
Services
Income
Interests
Donation
Ordinary & life membership fees
Daily attendance fees
Sales of bags & greeting cards
Expenditures
Staff allowances
Stationaries
Electricity
Water
Telephone bill
Unit expenses
Security charges
Conclusion
The day was successful , because Ms.Nirosha
Priyangika was with us. She guided us very well & explained what
Occupational therapist can do to improve the functional & cognitive
levels of the differently abled children , while she is observing the out
patients came to the institution. It was a great opportunity for us.
Related pictures
Introduction
• Strengths
Having a young, supportive staff & supportive
parents.
Financial support of German foundation.
Belief of the need of love & affection for a child.
Calm & quit environment.
• Weaknesses
Poor theoretical & practical knowledge about
management of children with special needs.
Property problems & because of that they can’t do
any changes in buildings or in environment.
But they are going to build a new building due to a property problem
that they faced.
Related pictures
Non appropriateness of table & Special room for special need
chair. children.
Baby B is a 3 years & 9 months old child, living with his mother ,
father, his 2 elder sisters & his aunty. His father is having a grinding
mill. His mother is a primary school teacher & she is in satisfactory
education level. They are living in Hammeliya – Galle area & all
neighbors are very supportive. Even baby’s parents are doing jobs ,
they are in poor economic level.
Segment Description
Main road to gate Distance from main road – 500m
Vehicle accessibility - accessible
Gate to house Distance- about 5-6 m to the veranda
Surface- even
vehicle accessibility - yes
from compound to veranda there is a step of
nearly 4” height.
Entrance There is a step of height of 5”
Door width is enough for wheel chair accessibility.
Inside the home Space –having enough space & no more furniture
Steps – there are no steps in.
Kitchen & dining area – not using the kitchen.
Bed room –easily accessible
Beds are too height & not accessible for the baby.
Developmental stages
ACTIVITY COMMENT
Feeding Depending on his family member. can eat rice .
but the hygiene is poor.
Self-care Depending on his family member
Washing Depending on his family member
Dressing Depending on his family member
Mobility Rolling or dragging on the floor
Play skills:
Very interesting in play activities. Like to play with water more time.
Communication:
Having a vocabulary of about 30 words. But difficult to pronounce &
only telling 1st letter. Mother has to understand by practicing. He is
having an unique way of speaking.
Hand skills :
Having gross grasping ability. Poor finer grasping in both hands. Left
hand is little better than right hand
Summery of visit
Problems identified
Strengths
His family members , mainly his mother is with good insight &
good education level to understand the child
Baby is having 2 elder sisters who can engage with him in play
activities
Enough space in living room for babies play activities
Better occupational therapist who is very supportive &
knowledgeable
Baby’s pre school
Limitations
Suggestions
Educating mother.
Reflective writing on 5th home visit in Galle area
Time : 11.45 am
Introduction
Then she engaged the child with play activities while keeping in
the 90 90 sitting position with the support to the hips.
Next we observed the way of feeding. He is dependent on a
family member for that activity.
He drinks water with a soother.
Then we gave the opportunity to eat & drink independently
while sitting on a special chair.
He was able to hold the cup with both hands & drink water.
He ate with his left hand. But difficult to eat neatly due to having
poor grips & finger opposition.
How to build up the rapport with parents & specially with a child
What are the needs that should be with the baby to do CIMT
(good cognitive level, one hand should be well working)
Conclusion
Finally the home visit was very successful & baby & his family
members were also satisfied very much due to the participation
of Mrs.Thakshila Senavirathne.
SPECIAL THANKS ,
Ministry of health
Mr. Rohana Perera (Principle of School of Physiotherapy &
Occupational Therapy)
Mrs.Thakshila Senavirathne (Tutor of Occupational Therapy,
Coordinator of Down South Group)
Mrs.Wasana Dahanayake (Tutor of Occupational Therapy)
Mr. Ashoka Sanjeewa (Tutor of Occupational Therapy)
Mrs.Thilini Vithanage (Occupational Therapist, Base Hospital -
Panadura) , & Dr. Gayan Jeewantha, Psychiatric nursing
officer, Mr. Sunil gunawardhana of Base Hospital - Panadura
Mr.W.R.A.Shantha (Occupational Therapist, New District
Hospital - Matara)
Mr. Senaka Satharasinghe (Occupational Therapist, New
District Hospital - Matara)
Mr.Thenu Guruge (Occupational Therapist, Maliban Hospital -
Karapitiya)
Miss. Nirosha Priyangika (Occupational Therapist, Teaching
Hospital- Karapitiya)
And
THANK YOU … !