Assisting individuals to select appropriate work activities
Occupation is known to play an important role in maintaining health. Individuals who remain in active occupation demonstrate fewer disturbing behaviours, require less help with fundamental care, and cause less stress for their carers. On the other hand, lack of employment and personal achievement has been shown to significantly affect quality of life in clients, particularly those with learning difficulties or enduring mental health problems. For some clients their occupation may be the very reason why they find themselves requiring health care. Examples are the individual recently diagnosed with pneumoconiosis as a result of working in a coal mine, the person with repetitive strain injury from typing all day, or one injured as a result of an altercation with a forklift truck.
When examining and assisting clients to select work activities the following areas should be explored with the client, and their significant others as appropriate, to enable realistic and appropriate choices to be made.
• What is the meaning and perceived worth of work and chosen work activity to the person?
• What work activities was the person undertaking, and are these still realistic and achievable?
• What effects might changes have on the person’s abilities or capabilities to perform previous or other work activities in both the short and long term?
• Does the individual want and/or need to continue to work?
• Has their occupation any direct bearing on their current health status?
• What is the physical condition of the individual? Are their wants/needs realistic and achievable options given the individual’s short- and long-term capabilities?
• Can adjustments be made to their work environment to enable them to fulfil their desire?
• Can any other adaptations or aids help in the achievement of work-related activities and are these available?
• What knowledge and skills does the person have?
• Do they have any previously untapped skills?
• Will further education and training be required and, if so, is help and support available (practical and/or financial) to access this?
• Are they aware of their employment rights?
• Are there any other financial aspects to be considered?
As well as seeking answers to these questions it is equally important that we give clients the opportunity to express their individual concerns and fears, and demonstrate that we are genuinely listening, not just providing guidance related to a predetermined selection of what we believe to be a range of more appropriate work activities.
By working in partnership with the client, their significant others and the rest of the multidisciplinary team, we can enable them to make and set realistic short- and long-term goals, help them to accept any necessary changes and, hopefully, assist them in achieving a balance between home, work and rest. Targeting advice in this way can also help to empower the client, encourage decision making, promote autonomy and help them to achieve fulfilment in the work-related aspects of their life, thus promoting their future health and well-being.
Assisting individuals to select appropriate recreational activities
There is increasing evidence to support the view that ‘all work and no play’ not only makes Jack and Jill dull but that it can also seriously diminish his or her life expectancy. Indeed for infants, children and those with learning difficulties, participation in appropriate recreational and play activities may well mean the difference between achieving and not achieving their optimum potential. Developing an action plan of meaningful recreational activities for clients with dementia has also shown to reduce the speed of their mental deterioration, and has proved useful for clients’ post-acute phase of major illness in preventing boredom, creating a feeling of worth and restoring psychomotor function. Assisting clients to select appropriate recreational activities is therefore an important aspect of the role of any health care professional.
Assisting can take many forms, from listening, information giving and supporting them in decision making (and therefore helping them to make informed choices), to actively getting involved by providing equipment, participating or even campaigning for better resources in the community. Recreational activities generally considered appropriate are those that can help clients maintain and enhance their health, their quality of life and their overall well-being whilst enabling them to feel that they are fulfilling their desires and dreams.
When examining and assisting clients to select recreational activities the following areas should be explored with the client, and their significant others if appropriate, to enable realistic and appropriate choices to be made.
• What type of recreational activities does the client normally engage in?
• Do they prefer physically active or more sedentary tasks and are these appropriate, normally? Now?
• Do they prefer to engage in team activities or do they prefer to undertake more solitary tasks?
• Do they like to listen to music? How can this be facilitated without causing stress, anxiety or interference to others?
• How much time do they devote to recreational activities and is this appropriate, for example the child who normally spends hours in their room playing on a computer?
• Do they like or need to be mentally challenged or stimulated?
• Are there any social or institutional barriers that need to be overcome?
• Can play and recreation be usefully employed as a diversion or distraction therapy, for example when undertaking a wound-dressing change on a child or anxious adult?
• Is the client bored? Do they get bored very easily and therefore require a range of short activities?
• Do they undertake any sport in a professional capacity? Is this likely to be affected in the future?
• Do they have any commitments to any amateur sporting teams or events? Might they consider it in the future?
• Does the client have any disability that needs to be taken into consideration, for example loss of hearing or sight, sensory deficit or learning difficulty?
• Are they able to grasp complex concepts or follow rules?
• What is their attention span: are they able to concentrate for long or short periods?
• Are they motivated, depressed, anxious, suicidal? Are there any issues regarding safety? Of the client or of others?
• Is the environment appropriate for the activity(s) selected? Is the current change of environment likely to impinge on their recreational activities? If so in what way?
• Are there any health and safety issues that need to be considered, for example giving a child who is being nursed in isolation a favourite or very expensive toy that will need to be incinerated at the end of their stay? Or giving a very young child a toy which can be swallowed?
• Are there any other actual or potential problems associated with participating in recreational activities?
• Does the client have a mobile phone that they use for recreational and/or social purposes? Can this still be used in their present environment without causing a danger to others, for example cardiac monitors, ventilators or other electrical equipment in the vicinity?
• Are there any actual or potential problems arising from being removed from their normal family/social circle? Can these be avoided or overcome?
• Is the client and their significant others aware of the arrangements for visiting?
• Does the client use any recreational drugs or other substances? Is this likely to endanger their health or that of others? Are they aware of the legal position whilst in an institution?
As well as seeking answers to these questions and any other deemed appropriate, as with working activities it is important that we give clients the opportunity to express their individual concerns and fears, and demonstrate that we are genuinely listening, not just providing guidance related to a predetermined selection of what we believe to be a range of appropriate recreational activities. By working in partnership with the client, their family, their significant others and the rest of the multidisciplinary team, we can enable them to achieve balance between activity and rest, empower them, encourage decision making, promote autonomy and help them to achieve their potential, thus promoting their future health and well-being.
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