What are the things you enjoy most in your life? Showering yourself? Cooking? Remembering appointments? ….Probably not! For someone with a disability these are often the goals the occupational therapist and the client are aiming to achieve. Though these tasks are very important I am guilty of not thinking about the bigger picture. What gives someone satisfaction and enjoyment in their life? Often this is not their personal care tasks or domestic tasks, it is things like participating in hobbies, sports, spending time with friends and family or making an income. This gives meaning and purpose to one’s life.
Having a focus in therapy that comes back to achieving these bigger picture goals help with motivation and commitment. Showering may be a goal to achieve as a step in order to complete a hobby, but remember to alway bring it back to the WHY.
Client case story:
Ben* is 2 years post acquired brain injury. Prior to his brain injury his life roles included being a father and husband, an employee, being a friend and a surfer. Since his brain injury he had walking, cognitive and behavioural deficits. This led Ben to having a significant reduction in his ability to complete his life roles. He had large parts of his day at home without purpose. He was making slow progress with therapy goals and relationships at home were breaking down.
As a keen surfer myself I know that surfing is more than a hobby, it’s a lifestyle. Hanging out at the beach, seeing friends, chasing the ‘swell’. By Ben not being able to surf this created a massive gap in his life so no wonder things were hard at home. So there we had our goal: Return to surfing.
There were many steps involved to achieve this goal but because we could always bring it back to the bigger picture, Ben was motivated to engage in therapy and his progress surprised us all. Some of the steps to achieve this included:
- Working with his physiotherapist and support workers to develop and implement a surfing focused strength and balance program.
- Cognitive strategies e.g. to remember appointments, wake up in time, booking a taxi in advance and prepare himself to go to the beach.
- Returning to swimming at the pool, then progressed to the ocean.
- Learning to walk on the sand and carry a surfboard
- Safety and risk assessment
- Task specific retraining. Progressing from paddling a surfboard in calm water, catching small waves on his stomach, then his knees through to attempting to stand.
- Private surf lessons. He had to remember to book and catch a taxi, remember all his items, check the surf report and have a support worker collect him afterwards.
Ben is now able to go surfing with his peer mentor who Ben is teaching how to surf! Because we focused on something that was really important to Ben it allowed him to achieve not only return to surfing but so many other little goals along the way.
- Walking independently without any aids
- Showering independently without aids
- Going to the gym 3 times a week, including booking and catching a taxi on his own
- Walking the dog multiple kms everyday.
- Riding his bike.
- Playing lawn bowls at the local bowls club.
- Helping out with domestic tasks around the house.
- Using his diary every day with help from his wife.
*Ben is a fictional name to maintain client confidentiality.
Written by Zoe Adams
– Occupational Therapist
– Outdoor activity enthusiast
– Participant in clubs
– Family member
– Home maintainer