Grace is a 49-year-old female client who is super obese. She was admitted to the hospital from a skilled nursing facility (SNF) where she had resided for the past 5 months. The client presented to the hospital with multiple medical problems that included acute respiratory failure requiring ventilation, obesity hypoventilation syndrome, obstructive sleep apnea, super obese with BMI of 82, sepsis, panniculitis, bipolar disorder, hypertension, chronic pain, and depression with an anxiety component.
Upon medical stabilization, a referral was made for OT to evaluate and treat. Prior level of functioning: Client was able to assist with approximately 50% of ADLs and transfer to wheelchair with Min A. Current level of functioning: Client noted to be dependent for all ADLs, transfers, and functional mobility, fatigue upon minimal exertion, BUE strength 2+/5. The OT course of treatment initially was to address safe handling for staff and client, begin UE ROM and increase to strengthening exercises as tolerated, tolerate EOB sitting for 5-minute intervals, and instruct in energy conservation techniques and adaptive equipment as indicated.
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