A new development at Chase Park Rehabilitation Suite is set to support clients to further improve their independent living skills. The Activities of daily Living (ADL) kitchen will be used by clients working with therapists and their personal assistants to develop skills such as meal preparation and domestic skills in preparation for living in their own home.

The latest investment in the rehabilitation service was inspired by one of the regular case studies Keiro produces as part of the Outcomes and Impacts Project. The case study about a client whose level of independence increased as a result of using a kitchen work station, made the team determined to find a way of adapting the suite’s ground floor space to develop a larger and more functional ADL Kitchen for all clients of the service.

Work on the Kitchen is beginning this month and clients will be benefiting from the new facility in the next few weeks. In the meantime, please see below the case study that inspired the development, showing how it can sometimes be the seemingly small things that make the biggest impact in rehabilitation…

John’s Story - Inspiring the development of Chase Park Rehabilitation Suite’s New ADL Kitchen

Diagnosis: Stroke, Hemiplegia, Aphasia

Presenting Problems: Right upper and lower limb- Stimulation as slight muscle movement noted, Aphasia, Lack of initiation, Pain in right shoulder

As we go about our daily lives it is easy to take the simple things for granted. Tasks we have learned, practiced and perfected over many years, become automatic. Most of us don’t think too much about making breakfast or a cup of tea in the morning. These are things we do automatically, almost on ‘auto pilot’. However, for some people the ability to complete these tasks is effected by injury or illness.

After suffering from a stroke, which left him with hemiplegia (the inability to move a group of muscles on one side of the body) and aphasia (a loss or reduction in language) John found the simple things in life were a lot more difficult than before.

John underwent a period of assessment at Chase Park Neuro Centre, before becoming a client of the service. During the assessment process, nursing and therapy staff worked with John to understand his goals. As part of John’s rehabilitation program, an Occupational Therapist worked with him to support him to improve his functional skills.

John’s Goal

One of John’s main goals was to become independent once more in preparing basic meals. Kitchen tasks had been identified as a therapeutic intervention tool and so work commenced to support John to become more independent in basic meal preparation.

As someone who had always worked with his hands John was used to planning out and preparing his work. This natural propensity towards being organised was something that assisted in his rehabilitation. John began his programme with less complex tasks such as preparing a hot drink and toast or bowl of cereal for his breakfast.

Progress

During his rehabilitation program John made particular progress in the areas of sequencing, communication of needs, fine and gross motor skills. He was previously unable to prepare a hot drink independently and had difficulty communicating his needs. One major component to the success of John’s programme was the introduction of the ‘Kitchen Workstation’ – a portable work block housing clamps for bottles, raised surfaces for applying spreads to bread and compact graters for the preparation of vegetables.

The use of the Kitchen Workstation facilitated John’s independence in meal preparation in the following ways:

• Sequencing: Planning which task to start with and how much assistance he needs.
• Spatial awareness: Increasing awareness of right hand side during tasks. The Kitchen workstation giving a visual cue of how thing should be arranged.
• Communication: Helping John to communicate how much assistance he needs for a particular task using gestures and symbols. Aiding understand of risks/ dangers communicated to him through signs and gestures.
• Tolerance: Helping John to manage all tasks with minimal assistance, to tolerate staff intervention and understands staff role better.
• Fine motor: Use of the clamping device helps John to grip small items and open containers.
• Gross motor: As confidence has improved, John has been able to demonstrate better gross motor skills.

Outcomes and Impacts

• Able to prepare a hot drink with minimal assistance (previously dependant on staff for hot drink preparation)
• Able to prepare toast and a bowl of cereal (previously dependant on staff for all small meals and snacks)
• Improved communication skills through gestures and symbols
• Able to communicate choices
• Ability to communicate needs effectively impacts on mood and motivation (Previously mood and motivation were influenced due to reduced ability to effectively express himself
• Improved participation in all activities of daily living (previously dependent on staff intervention to assist with all activities of daily living).

Summary

As his confidence grew with his rehabilitation programme, John began to demonstrate more efficient ways of carrying out tasks and required less staff intervention.

The work of a skilled and experienced occupational therapist using the kitchen workstation as a therapeutic tool has been instrumental in John’s progress with his rehabilitation program and has led to further positive impacts in other areas of his life.