Brushing teeth usually would take place in the environment of your own bathroom however could take place in other bathrooms such as in hotels. Materials needed for brushing include; a toothbrush, a bathroom with a sink, toothpaste and possibly mouthwash and dental floss.
Teeth brushing would usually take place twice a day, and takes approximately 3 minutes. This is important to consider in Mr M’s case as he has identified that he has particular difficulty in the morning so brushing his teeth may be most difficult then.
There are no particular safety issues to consider.
- Meaning, Purpose and Relevance
Cultural/Current – In our culture it is expected that people will have good personal hygiene and this includes having clean teeth and not having halitosis
Social relevance – The relevance of teeth brushing in a social sense is for personal hygiene reasons. If Mr M was to have bad breath or dirty teeth he may find that people do not want to be around him and he may become embarrassed going out socially.
Personal Relevance – Brushing teeth is relevant to Mr M as he will want to keep his teeth and mouth in a good condition in order to avoid going to the dentist and having to pay for expensive dental care such as having rotten teeth removed.
Performance Analysis
This will focus on the motor/physical and the emotional/psychological components of a performance analysis as these are the parts which are most relevant to Mr M.
Motor/physical
- Starting position/other positions
Due to Mr M’s pain in his knees it is important to consider whether he would be able to stand for the duration of the task at all. If Mr M became unable to stand for the task a perching stool could be brought into the bathroom so that Mr M was still able to carry out this task independently.
Mr M has problems with his hands becoming sore and swollen. In order to hold his toothbrush Mr M would have to be able to grip and be able to hold the brush quite tightly so he doesn’t drop it and so he can brush his teeth thoroughly
The task involves gripping the toothbrush and moving it up and down. This could be a problem for Mr M with his painful and swollen hands. A way to minimise this for Mr M may be to use an electric toothbrush which usually have bigger handles and would require less movement.
- One or two hands and feet
The task is one which allows Mr M to be stationary and have both feet on the ground or even sit down. The task requires the coordination of both hands in order to put the toothpaste on the brush however the actual brushing only requires one hand so Mr M could use the hand which is less painful.
The task does not require a great deal of strength however it does require that the brush be tightly held on to and that a certain amount of force can be applied so the teeth can be brushed vigorously.
The nature of the task means that Mr M would have to be able to stand for roughly 5 minutes in order to carry out the whole process. Due to the pain in his knees he may finding standing for this time painful so may require a seat. Also due to the pain in his hands he may find brushing for an extended period of time difficult.
The task does require a certain degree of coordination. It requires that Mr M use both hands to put the paste on the brush and that he is able to brush both sides of his teeth top and bottom.
Emotional/Psychological
Mr M is having problems emotionally at the moment as he is feeling low due to his reduced mobility and the fact that he is having to take time off work due to this. This could have an impact on Mr M’s ability to brush his teeth and his ability to carry out other personal hygiene tasks. This is because Mr M is already feeling low and if this could develop further, into depression. If this was to happen Mr M may lose all motivation and may not bother carrying out basic personal hygiene tasks. This would obviously have a big effect on Mr M’s social, personal and working life as people will not want to be around his or work with his if he has bad personal hygiene.
Section 2
One model of practice that could be used by an occupational therapist working with Mr M is the model of human occupation (MOHO). The therapist working with Mr M would be able to use this model to devise a treatment plan which is client-centred and holistic. This essay will describe briefly what the model is and what the advantages of the therapist working with Mr M choosing this model would be.
The model of human occupation was first introduced by Kielhofner in 1980 and has developed and evolved over the last 30 years (Lee et al 2009). The main concepts of MOHO are involved with people’s motivation for occupation, the routines evolving from occupation, skills involved in performing occupations and the environments influence on occupation. The model ‘focuses on engagement in purposeful activities and their central place in the experience of living’ (Radomski and Latham 2008 pg 926). This model could therefore be used by the occupational therapist working with Mr M to enable them to look at his activities, including his activities of daily living, and look at how appropriate and purposeful they are and how they can be improved.
The model of human occupation is arranged into three main concepts. These are volition, habituation and performance capacity (Kielhofner 2007). The first of these, volition, describes people’s need or want to act. It can be further split into;
- Personal causation – meaning if someone has the capacity to do a task
- Values – meaning if someone finds a task worthwhile/important
- Interests – meaning if someone is interested in a task.
In terms of Mr M volition is an important factor to consider especially in terms of his activities of daily living. Mr M has identified these as a priority for OT intervention so being able to carry out his own personal care is obviously something which holds great value for Mr M. However Mr M is finding that his personal capacity for these tasks is not great and therefore the OT working with Mr M will have to find strategies to make this easier for him.
The second of the main concepts of the model of human occupation is habituation. This is described at ‘semiautonomous pattern of behaviour in concert with familiar temporal, physical and social habit’ (Kielhofner 2007). In other words habituation refers to habits that people have over the course of their days, weeks, etc. Habituation can be considered in terms of Mr M in that his personal activities of daily living are something that he will have got into a habit of doing from a very young age so if Mr M finds himself unable to do these things this could contribute to his low mood, as this is something he will have got used to doing. It will therefore be important for Mr M to carry on his self – care routines.
The third concept of MOHO is performance capacity. This part is concerned with a persons ability to carry out a task. In terms of Mr M an occupational therapist could consider both whether he is physically able to carry out a task and whether he is mentally able to do it. At present Mr M is having difficulty carrying out tasks, specifically personal care tasks, due to the pain and swelling in this hands and knees.
URL: http://dx.doi.org/10.1080/07380570802455540
References
Kielhofner, G. 2007. Model of human occupation : theory and application. Baltimore: Lippincott Williams & Wilkins.
Landrock, A., Baxter, C., Blanchard-Lee, V., Henderson, S., Maclean, F., Muir, A. 2008. Conceptual Foundations of Occupational Therapy. Edinburgh: Queen Margaret University.
Lee, S. W. Taylor, R. and Kielhofner, G. 2009. Choice, Knowledge, and Utilization of a Practice Theory: A National Study of Occupational Therapists Who Use the Model of Human Occupation. Occupational Therapy in Health Care .[online] 23 (1) p60 – 71. Available from: [accessed May 11 2009]
Radomski, M. V and Latham, C. A. T. 2008. Occupational therapy for physical dysfunction. 6th ed. Baltimore: Lippincott Williams & Wilkins
