The COPM with an Alternate Respondent

Mr. Edwards is a 82-year old man with Alzheimer's disease. He has been admitted for an assessment after an acute episode of behavioural outbursts and unsafe conduct. He lives with his wife, who is 69 years old, and in good health, although very worried and upset about the possibility of bringing her husband back home. The Edwards have been referred to occupational therapy for consideration of the requirements for moving Mr. Edwards back home.

Here is another example where we have one person’s name on the referral for occupational therapy, and another person answering our questions on the COPM. In this case, Mrs. Edwards is participating in the COPM interview, whereas her husband is the one who has been referred to us. Thus, the issue of who the client is again becomes paramount. As we stated above, the client is the one who is expected to make a change as a result of therapy. Arguably, in this case, it is unlikely that Mr. Edwards would be expected to make a change, because of the nature and prognosis for his condition. Instead, it is Mrs. Edwards who will potentially benefit from the involvement of OT. Therefore although his name appears on the referral, for all intents and purposes, she is the client. She is the one who will change her routines to adapt to his needs, modify the home environment to make it safer and more accessible for him, seek support and respite to manage his care. Thus it is her occupational performance issues and problems that are of interest to the OT involved with this couple. Mrs. Edwards should answer the COPM with respect to her own occupational performance and her own expectations about bringing him home.

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