Great expectations....

On previous Fieldwork sites OT supervisors have told me to formulate a Plan A and a Plan B before working with a client, and then when you walk into their room, throw those plans out the window. This week absolutely personified that belief when I worked with my client (D.W.) for the first time! After reading through his chart, and all his ailments, I was expecting D.W. to be much more sickly than he actually was.

I had prepared for the day by making a "bag of tricks" that I filled with arts and crafts supplies and card games. I knocked on D.W.'s door and introduced myself, he invited me to pull up his wheelchair, and then we chatted for a while about his family, time in the Army, career, and interests. The chat was comfortable and like talking with a family member that I hadn't seen in a while. 

 

I then brought out my bag of tricks and offered D.W. the option to play some of the games I had brought.......not interested. Then I brought out some of the art supplies I had, and offered him the option to make a card for his wife, or other family members that he hadn't seen in a while.......not interested.  I then explained to D.W. that I would be working with him twice a week and helping him meet his goals for O.T. and asked him if there was something he was interested in doing that he's not able to do while he's at Rose Manor. Nope. This conversation continued for quite a while, until I realized that the extent of the day's session was going to be limited to learning about D.W. and his history.

 

I then broke out the SET Test and explained to D.W. that I was going to be asking some questions. He answered the questions as best he could, and but also told me that he hadn't slept well the previous night because his roommate played his t.v. all night long. His charted stated that he was "likely demented" so it was important to me that I assess this during our session. I then assured D.W. that it was alright if we didn't do anything this week, and I understood that he was tired, but I also told him  beginning next week we WOULD be working to meet his therapy goals.    

 

So while I didn't get D.W. into an activity I feel good about my flexibility, listening skills, and my empathy skills. I also feel like I was persistent, but I need to work on forced choice or, for lack of better words, eliminating choice. Perhaps if I would told D.W. "I'm going to take you to the therapy room" or something like that, I would have been more successful.  I think I was afraid of ruining any chance of building rapport if I was too forceful. However, when I broke out the SET Test and told him that I wanted him to answer the questions, he complied. This was probably my favorite part of the session because I felt that I made progress, and it showed me that if I eliminate the option to decline, the client is more apt to comply.

I have a game plan set for Tuesday....here's hoping I don't have to throw it out the window.