Melodie is a 26 year old woman who was injured in a car accident about six months ago. Although she experiences a small amount of ataxia, she is physically well-recovered. However, she is left with a number of cognitive deficits, which prevent her from living alone. Melodie's memory impairment, judgement lapses and volatile temper have resulted in some problems at home, and Melodie has been referred for the development of community living skills.
In addition to the problems outlined for William, a client like Melodie may also have difficulties dealing with abstract scoring procedures, and may require the therapist to be more creative in how he or she derives baseline and progress values for the performance and satisfaction with occupation.
A further challenge with cognitive impairment arises out of attention and memory problems. It may be doubly important to conduct the COPM in an area that is free from distractions and minimally stimulating, in order to obtain useful information from the interview. Further, it may be necessary to complete the interview in multiple sittings if fatigue or distractibility become apparent.