The Team's Assessment
Patient and health professional perspectives
The assessment of this actual Rehab Cycle highlighted a number of outstanding problems, as well as strengths gained up to this point in Martin’s rehabilitation. Body functions and structures related to movement continued to present with spasticity, pain and irritated skin. Each of these contributed to making Martin’s motions difficult.
While he was independent in many activity areas (transferring himself, wheelchair navigation, washing and dressing, etc.), Martin remained concerned about his future housing situation. Until the accident he had lived with a long-term roommate in a fifth-floor apartment. This apartment was not wheelchair accessible and he would have to move, but to where and under what conditions were still not clear.
While his mobility in a wheelchair was independent within a city, it continued to present a problem in hilly and forested areas — this included the area where his family resided, making visits a challenge. Within the area of participation, Martin was very engaged, returning home every weekend and going out with friends while there. Athletic activities continued to be a main interest and Martin was clear in his desire for independence in his community.
However, as the vocational counseling undertaken in the previous Rehab Cycle had not yet been completed, remunerative employment remained unclear.
Martin’s personal factors offered some perspective on both his strengths and weaknesses, and how they factored in his efforts at reintegration. On the positive side, he was very accepting of his disabled situation and had gained a great deal of patience through the months of rehabilitation. On the other hand, his ability to make decisions remained weak and thoughts of the future caused him stress, both with regard to housing and a profession — key aspects of community reintegration.
Figure 1: ICF Assessment Sheet
There were also environmental factors that presented both opportunities and obstacles. Regarding the former, an adapted automobile had been ordered, a wheelchair sports club had been identified in his hometown and there had been a statement of support from Martin’s former employer offering him a possible vocational opportunity. He also had much support from family and friends.
But other factors presented obstacles — insurance payments for both his car and the needed Swiss Track™ had been delayed and were not yet clarified.