Question

A OTR is working with an 85-year-old client who sustained a hip fracture after a fall. The client previously fractured her back as she was bending to pick up an item off the floor. The OTR recommended that the client use a long, handheld assistive device to minimize bending forward during activities. The OTR was demonstrating how to use a long-handled shoe horn and reacher. The client did not seem willing to use the assistive device, saying, 'See, I have always put my shoes on in a certain way all these years.' How should the OTR INITIALLY respond?

1) 'Well, at least give it a try.'
2) 'This is the best way to do it?'
3) 'Can you show me how?'
4) 'Ok, do what you want to do.'

Answer 1

The best initial response from an OTR to a client reluctant to use an assistive device is to ask 'Can you show me how?', as it respects the client's autonomy and opens up a dialogue.

Step-by-step explanation:

The initial response an Occupational Therapist (OTR) should have when working with an 85-year-old client resistant to using a long-handled shoe horn and reacher is to encourage the client to express their concerns and demonstrate their usual method. This empathetic approach cultivates trust and allows the OTR to better understand the client's preferences and limitations. Therefore, the best initial response is 'Can you show me how?'

This question invites the client to participate actively in the therapeutic process and may provide the OTR with insights on how to adapt the intervention to better suit the client's needs. It shows respect for the client's autonomy and acknowledges their experience in performing the task their way for many years. Additionally, it may open an opportunity for the OTR to gently introduce the assistive device after the client has demonstrated their method, by showing them how using the device can reduce the risk of injury and increase independence in a non-confrontational manner.