The occupation I have chosen to perform an occupational analysis on is brushing teeth. I believe this is appropriate for Mr M for a number of reasons. Firstly because Mr M has reported that he has pain and swelling in his hands so holding a toothbrush may be difficult for him. Also because Mr M has identified that he has most trouble in the morning and this is a time when people generally brush their teeth. Finally, Mr M stated that a priority for OT intervention was helping him with his personal activities of daily living. The essay will contain a general analysis, and a performance analysis, focussing on teeth brushing.
General Analysis A general analysis is used to place a certain occupation in cultural or environmental context. This general analysis will focus on teeth brushing for Mr M and why it is relevant for him to be able to carry out this occupation. This general analysis will follow a structure adapted from Watson D (1997) (Cited in Landrock et al 2008 p17)
Carrying out his occupation does not help to define Mr M in any particular roles, however it could be said that teeth brushing is part of a self care/personal hygiene role. It could also be said that if Mr M was not able to carry out this task (and other self care tasks) his other roles, such as husband and worker, would be compromised as it is part of an expected personal hygiene role.
This activity can be classified into the self care and maintenance category. This is due to the fact that it is important to brush teeth properly and regularly in order to keep up a good level of oral hygiene. If teeth aren’t brushed properly there is a risk that dental problems may develop for example tooth decay
The task does require a certain degree of coordination. It requires that Mr M use both hands to put the paste on the brush and that he is able to brush both sides of his teeth top and bottom.
Emotional/Psychological Mr M is having problems emotionally at the moment as he is feeling low due to his reduced mobility and the fact that he is having to take time off work due to this. This could have an impact on Mr M’s ability to brush his teeth and his ability to carry out other personal hygiene tasks. This is because Mr M is already feeling low and if this could develop further, into depression. If this was to happen Mr M may lose all motivation and may not bother carrying out basic personal hygiene tasks. This would obviously have a big effect on Mr M’s social, personal and working life as people will not want to be around his or work with his if he has bad personal hygiene.
Section 2 One model of practice that could be used by an occupational therapist working with Mr M is the model of human occupation (MOHO). The therapist working with Mr M would be able to use this model to devise a treatment plan which is client-centred and holistic. This essay will describe briefly what the model is and what the advantages of the therapist working with Mr M choosing this model would be.
The model of human occupation was first introduced by Kielhofner in 1980 and has developed and evolved over the last 30 years (Lee et al 2009). The main concepts of MOHO are involved with people’s motivation for occupation, the routines evolving from occupation, skills involved in performing occupations and the environments influence on occupation. The model ‘focuses on engagement in purposeful activities and their central place in the experience of living’ (Radomski and Latham 2008 pg 926). This model could therefore be used by the occupational therapist working with Mr M to enable them to look at his activities, including his activities of daily living, and look at how appropriate and purposeful they are and how they can be improved.
The model of human occupation is arranged into three main concepts. These are volition, habituation and performance capacity (Kielhofner 2007). The first of these, volition, describes people’s need or want to act. It can be further split into; Personal causation – meaning if someone has the capacity to do a task Values – meaning if someone finds a task worthwhile/important Interests – meaning if someone is interested in a task.
In terms of Mr M volition is an important factor to consider especially in terms of his activities of daily living. Mr M has identified these as a priority for OT intervention so being able to carry out his own personal care is obviously something which holds great value for Mr M. However Mr M is finding that his personal capacity for these tasks is not great and therefore the OT working with Mr M will have to find strategies to make this easier for him.
The second of the main concepts of the model of human occupation is habituation. This is described at ‘semiautonomous pattern of behaviour in concert with familiar temporal, physical and social habit’ (Kielhofner 2007). In other words habituation refers to habits that people have over the course of their days, weeks, etc. Habituation can be considered in terms of Mr M in that his personal activities of daily living are something that he will have got into a habit of doing from a very young age so if Mr M finds himself unable to do these things this could contribute to his low mood, as this is something he will have got used to doing. It will therefore be important for Mr M to carry on his self – care routines.
The third concept of MOHO is performance capacity. This part is concerned with a persons ability to carry out a task. In terms of Mr M an occupational therapist could consider both whether he is physically able to carry out a task and whether he is mentally able to do it. At present Mr M is having difficulty carrying out tasks, specifically personal care tasks, due to the pain and swelling in this hands and knees.