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Difficulty: MediumCollaboration with Interdisciplinary Team

A client with progressing multiple sclerosis is transitioning to a home health care program. The client's spouse reports that the client frequently drops utensils due to hand tremors and struggles with buttoning clothes, though chewing and swallowing remain intact. Which interdisciplinary collaboration or action should the home health nurse prioritize to address these specific challenges?

  1. A
    Consulting a speech-language pathologist to evaluate for occult dysphagia and modify dietary consistencies
  2. Requesting a consultation with an occupational therapist to recommend adaptive devices for feeding and dressingAnswer
  3. C
    Delegating the daily tasks of feeding and dressing the client entirely to the home health unlicensed assistive personnel
  4. D
    Reassuring the spouse that a decline in fine motor coordination is a normal age-related change requiring no specialized intervention

Answer

The nurse should prioritize requesting a consultation with an occupational therapist to recommend adaptive devices for feeding and dressing.
Occupational therapists specialize in promoting independence in activities of daily living (ADLs), such as eating, bathing, and dressing. Because the client is experiencing fine motor deficits (tremors) that interfere with ADLs, the occupational therapist is the exact interdisciplinary team member trained to evaluate these limitations and prescribe adaptive equipment (e.g., weighted utensils, button hooks) to help the client maintain autonomy.

Step-by-Step Solution

1
Analyze the client's specific clinical presentation and deficits.
The client has intact chewing and swallowing but exhibits fine motor deficits (hand tremors) that specifically impair activities of daily living (ADLs), such as feeding and dressing.
Accurately identifying the functional deficit is required to determine the correct allied health specialty.
2
Differentiate between the scopes of practice for various interdisciplinary team members.
Occupational therapists handle fine motor skills and ADLs; speech-language pathologists handle swallowing and speech; physical therapists handle gross motor skills and mobility.
Ensuring the referral targets the professional uniquely qualified to address the specific deficit prevents delays in care.
3
Select the intervention that best promotes optimal patient outcomes.
Collaborating with an occupational therapist is the correct action because they can provide targeted strategies and adaptive equipment (like weighted utensils or button hooks) to maximize the client's independence.
Rehabilitation goals prioritize maintaining autonomy before resorting to total assistance.

Key Concept

Collaboration with Interdisciplinary Team (Scope of Practice)
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Topics

Collaboration with Interdisciplinary Team

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