___________________________________________________ Pain Assessment and Management, 2nd Edition
Time estimated is 5 minutes. Effort is ranked as 4 because heavier items will need to be moved, and putting pots and pans into lower cabinets will involve more bending. When looking at this breakdown, a practitioner should notice the increase of effort required for unloading the bottom drawer. Suggestions to decrease effort and therefore reduce pain would include the following: • Taking a break between unloading the top and bottom drawers of the dishwasher • Replacing heavier pots and pans with lighter ones • Asking for help from a partner, family members, or roommates • Reorganizing the kitchen to limit reaching and bending by placing frequently used or heavy items more on a level with the core of the body
A practitioner should examine pacing and energy conserva- tion from the smallest details of a self-care activity to the entire structure of a client’s day or week. The practitioner should consider the time of day that the client reports the most energy. Often mornings and evenings are difficult, but each client is an individual. The client could structure more mentally or physical challenging occupations during the time in which they report having their “best energy.” If this time is limited to just 2 hours, for example, the client’s choice of activity becomes crucial. A useful therapy tool to address the balance of time is a “bal- ance wheel” (Korb-Khalsa et al., 1991) with which the client can describe a typical day and analyze their balance of activities and strategies to improve balance and pacing. Figure 5 shows how such a balance wheel might look.
BALANCE WHEEL
Source: Adapted from Korb-Khalsa, K., Azok, S., & Leutenberg, E. (1991). Life Management Skills II. Copyright Wellness Productions Inc., Melville, NY. http:// www.couragetochange.com/Life-Management-Skills-II-Book. (800)-440-4003. Reprinted with permission. Figure 1
77
EliteLearning.com/Social-Work
Powered by FlippingBook