Jaime is a 30-year-old Mexican American who loves soccer, brewing his own beer, and spending time with family. He is a successful real estate agent, and he and his wife are expecting their second child. They own their four-bedroom colonial style home in the upper eastern United States. He woke up one morning late for work with a splitting headache, the kind where your eyes hurt. He popped some pain pills and hurriedly got in the shower. As the day progressed, the headache wouldn’t go away. About lunch time, he started vomiting. Thinking he had the flu, he cancelled his appointments and went home to lie down. He felt better that evening but was seeing rainbow colors around the lights in the house, and they seemed so bright. Jaime’s right eye became blurry. His wife looked, and the white of his eye was red and the pupil large. They decided to go to the emergency room. The emergency room doctors learn that Jaime has experienced acute angle closure crisis. After some medical history, it was determined that Jaime has a family history of glaucoma and was not aware. He had not been to an eye doctor in years. Jaime undergoes treatment for both eyes and works with the American Federation for the Blind to adapt to his changing lifestyle.After four years, Jaime has adapted to his loss of sight in his right eye. He is rapidly losing vision in his left eye and doctors are becoming more aggressive with treatment. Items appear blurry, and Jaime uses a screen reader to help with his computer work. An enlarger assists with written documents and the voiceover feature on his phone is a mainstay. Jaime has been matched with a guide dog, Shadow, and he is becoming more confident in his recreational activities. Jaime wants to be more active as he has gained weight since his diagnosis and has just signed up for a snow skiing trip through the special recreation association. You are the CTRS who is leading the trip specifically designed for skiers with blindness and low vision. Jaime provides the following information on his registration form
Significant past medical history: Acute angle closure crisis causing glaucoma right eye total blindness. Left eye increasing in pressure 20/200. Family history of high blood pressure and glaucoma.
Medications: Eye drops, beta blocker
Cognition/perception: Excited to try skiing!
Physical examination: Right eye, no vision. Left eye, 20/200.
Client Goals
1.Increase the types of
.Enjoy activities from before vision loss
3.Increase independence4.Increase physical activity
- Create an inclusion plan for Jaime, using evidence-based practice to guide your decision on appropriate adaptations following the DENT problem-solving method.
a. Define the problem: Clearly identify and articulate the specific problem or challenge that needs to be addressed. This involves understanding the current situation, desired outcomes, and any constraints or limitations (1 paragraph)
b.Explore possible solutions: Generate a range of potential solutions or approaches to solving the problem. Encourage creative thinking and consider different perspectives or alternative options.(1 paragraph)
c. Narrow down options: Evaluate the potential solutions and select the most feasible and effective ones. Consider the advantages, disadvantages, and potential risks associated with each option.(1 paragraph)
d. Take action: Implement the chosen solution or solutions. Develop a plan, allocate resources, and set specific goals and timelines for execution. (1 paragraph)
3.What assessment would be most appropriate for you to give to Jaime? (1 paragraph: Question 2 and Question 3)
3.What factors must be considered when planning Jaime’s adaptations?
- What is your PICO question? (1 paragraph: Question 4 and Question 5)
5.What outcomes do you anticipate from your plan?
6.How will you evaluate the outcomes of your plan? (1 paragraph: Question 6 and Question 7)
7.What contraindications should you consider in Jaime’s inclusion?
8.What other recreational activities would be appropriate considering Jaime’s interests, goals, and current functioning level? (1 paragraph)
9.How would you communicate your recommendations to Jaime?” (1 paragraph)
