Occupational Therapy in Community-Based Practice Settings 2nd Edition by Marjorie Scaffa, Maggie Reitz

Exercise 4

RP
RP is a 56-year-old female who was diagnosed with Amyotrophic Lateral Sclerosis (ALS) 8 years ago. She is currently in a manual wheelchair that has tilt in space and recline functions, elevating leg rests, and a head rest. She has limited mobility in her right thumb, and in neck flexion, extension, and rotation. She has no other controllable movement. She speaks in a whisper and is able to control her eye gaze. Her mobility is currently accomplished by her husband and caretaker pushing her wheelchair. She is experiencing ongoing, slow deterioration in function as a result of ALS and is declining from stage 3 to stage 4. She is referred to occupational therapy for evaluation of her technology needs. She indicates that she used to work on the computer, using e-mail to interact with friends as well as Web sites for shopping and support group participation. She is no longer able to access the computer. Her husband reports difficulty in understanding her and is concerned about leaving her alone in another room because he cannot hear her call for help.
What considerations need to be included to address RP's continuing functional decline as a result of ALS?