Question 1
You have just been asked to do your first private
independent living assessment outside of your normal work at a general
hospital.
a.) Do the assessment and pocket the money for a special dinner out.
b.) Do the assessment, invoice the client and add it to your income tax file.
c.) Check with your employer and obtain written permission and guidelines before agreeing to do the assessment.
d.) Check with your provincial regulatory body re: conflict of interest and other practice concerns.
e.) Ask CAOT and/or your provincial professional association for further information and guidance on documentation, confidentiality and other practice information.
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Question 2
Your client needs a new wheelchair and has no family and few friends in
the area to help him with the purchase.
a.) Purchase the wheelchair for him.
b.) Refer him to a specific supplier who you know has a wide variety of choice and will give him a reasonable price.
c.) Refer him to three suppliers in the area, encouraging him to shop around, and offer to help him ìfine-tuneî his choice or customize the order to his needs, after he has chosen the supplier.
d.) Review with the client a list of features that you feel he should have on his new wheelchair. Lend him some catalogues to review the variety of models, makes and prices, and suggest he begin his search by calling suppliers and then visiting those he feels would be able to help him best. Consider exploring funding through a local philanthropic organization such as the Rotary Club.
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Question 3 (from January/February
1999)
You are referred to visit an elderly woman in her home. She lives with
her son and his family. You are concerned that your client has become
very isolated because she is not able to safely manage the stairs from
her bedroom on the second floor to the kitchen and living areas on the
main floor. Your client reports she often misses meals because does not
feel well enough to go downstairs to eat. You suggest that the family
move her bedroom downstairs. They refuse stating that your client can
easily manage the stairs if she tried. Your client does not want you to
create a fuss in her family.
a) Discharge the client because you are not able to offer her assistance.
b) Tell the client you will try to have her admitted to a long term care facility.
c) Work with your client to assist her to explain to her family why she needs to change her current living arrangement.
d) Arrange for assistance from social services for family counseling.
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Remember! When in doubt, contact your provincial regulatory body or CAOT for advice.
Question 1
C,D,E. If you plan to moonlight then get your house in order. Your employer,
your provincial regulatory body and CAOT can help you set up your private
practice ethically and professionally. "Under the table" deals
are a fast route to discipline actions.
Question 2
D. Tempting though it may be to help your client out by saving some time
and decision making, purchasing the wheelchair and/or prescribing a specific
brand and model of wheelchair can be seen as conflicts of interest. C
is correct from a practice point-of-view. D is correct but also more client-centred,
allowing the client full control over the decision making and helping
him to problem solve barriers regarding seating specifications and actual
shopping for the equipment.
Question 3
Dealing with potential abuse situations is not simple and is not solved
by one easy solution. It is most important to recognize and not ignore
potential abuse situations. As a general rule, first work with the client
to work out solutions to the problem, answer C. Obtain assistance from
others, answer D as necessary.
March/April 1999 Table of Contents
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