Janet Fuller is a 65-year-old woman who was diagnosed with osteoporosis 2 years ago during her yearly medical examination with her family physician. She was referred to the osteoporosis clinic at a major teaching hospital. During appointments at the clinic, her diagnosis was confirmed. She has been given medication and has been counseled on changes she should make to her life in order to avoid fractures. Mrs. Fuller is married and has two adult children who live in the same city. She and her husband live in an apartment in the city and have a country home a 3-hour drive away. Mrs. Fuller worked as a librarian but retired at 50 years of age to accompany her husband on business trips. When not traveling, they spend 4 days a week in the city and spend 3 days in the country. Mrs. Fuller manages both homes herself, although she has found that she often has back pain after doing household activities. Mrs. Fuller volunteers at her local hospital, delivers meals-on-wheels once a week, and is on the board of a local women’s shelter. She enjoys outdoor sports, including golf and skiing, although she has given up downhill skiing since being diagnosed with osteoporosis. She also plays the piano but finds that she is not able to do so for long periods of time as she has in the past: I don’t downhill ski. That’s the one thing that I don’t do any more. And even sitting playing the piano, you have to sit upright. I can’t play for very long. I’m just too tired. And really I think to say, “Well, I can’t play the piano as long as I did.” I think that is frivolous. And I don’t think, if that’s all it interferes [with] or the fact that I can’t downhill ski, those things are frivolous. They shouldn’t be important and so therefore that’s why I don’t consider that. If I’m crippled and I can’t get up in the morning or like I see people who are so bent over, their bones are so brittle and I haven’t had any fractures. What can I complain about? Questions 1. How could you explore areas of occupational performance in more detail? 2. What is your impression of Mrs. Fuller’functional performance? 3. What other issues are important to assess in this situation? 4. What could be done to help Mrs. Fuller to maintain her activities and prevent further problems with her osteoporosis?
Janet Fuller is a 65-year-old woman who was diagnosed with osteoporosis 2 years ago during her yearly medical examination with her family physician. She was referred to the osteoporosis clinic at a major teaching hospital. During appointments at the clinic, her diagnosis was confirmed. She has been given medication and has been counseled on changes she should make to her life in order to avoid fractures. Mrs. Fuller is married and has two adult children who live in the same city. She and her husband live in an apartment in the city and have a country home a 3-hour drive away. Mrs. Fuller worked as a librarian but retired at 50 years of age to accompany her husband on business trips. When not traveling, they spend 4 days a week in the city and spend 3 days in the country. Mrs. Fuller manages both homes herself, although she has found that she often has back pain after doing household activities. Mrs. Fuller volunteers at her local hospital, delivers meals-on-wheels once a week, and is on the board of a local women’s shelter. She enjoys outdoor sports, including golf and skiing, although she has given up downhill skiing since being diagnosed with osteoporosis. She also plays the piano but finds that she is not able to do so for long periods of time as she has in the past: I don’t downhill ski. That’s the one thing that I don’t do any more. And even sitting playing the piano, you have to sit upright. I can’t play for very long. I’m just too tired. And really I think to say, “Well, I can’t play the piano as long as I did.” I think that is frivolous. And I don’t think, if that’s all it interferes [with] or the fact that I can’t downhill ski, those things are frivolous. They shouldn’t be important and so therefore that’s why I don’t consider that. If I’m crippled and I can’t get up in the morning or like I see people who are so bent over, their bones are so brittle and I haven’t had any fractures. What can I complain about?
Questions
1. How could you explore areas of occupational performance in more detail?
2. What is your impression of Mrs. Fuller’functional performance?
3. What other issues are important to assess in this situation?
4. What could be done to help Mrs. Fuller to maintain her activities and prevent further problems with her osteoporosis?
5. What client factors may be important in ensuring Mrs. Fuller’s safety?
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