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Even though my client was unable to complete any parts of the ACL, I really enjoyed my experience at the COA. I am always excited to hear we will be going there for a class or fieldwork experience because I always learn something new, both about diagnoses as well as myself as a future therapist. My client appeared to have extreme difficulty with both receptive and expressive language. When I initially noticed that she was unable to answer most questions, I slowed down my speech, broke more lengthy questions down into 3-4 word statements, and gave her extra time to process what I had said and formulate a response. I noticed this was slightly more successful in getting her to communicate, but it was still nearly impossible to keep her on task or to stay consistent with a particular train of thought or topic of conversation. Even though she was unable to initiate any of the stitches that correlated with the standardized ACL, I still used the tool to have her participate by “helping me” to lace the stitches by using verbal cues as well as hand over hand assistance. This allowed her to feel successful in completing the task, even if it was with my help, and I tried my best to make her feel good about this by sort of celebrating afterwards and letting her know she had done a great job with helping me in the task, and I also thanked her for assisting in my learning process as a student when we parted ways.

If I were to do this assessment again, I would choose a quiet room or table away from the rest of the group. My client seemed very anxious by all the commotion, loudness, and people in the room. She asked if we could “talk about this another time somewhere quiet,” so I have a feeling she would be more functional and able to participate if we were in a different setting. I would also research additional methods of nonverbal communication that may be successful with clients with dementia and prepare more simple activities or assessments to include in the session. This situation provided me with a great opportunity to learn about and exercise my therapeutic use of self. I absolutely adore working with this population, and I enjoy the challenge of being patient and creative with them. Even though our conversations probably didn’t make much sense, I was able to share a few laughs with my client, and truly felt a connection with her at times. Unfortunately, I feel like those who seem slower to understand or verbally communicate with others are often overlooked and seen as “incompetent,” which is a shame, because they will always have the capacity to experience connection with other humans, and should have the opportunity for these experiences! I hope I was able to make a positive impact on my client today in some way, because she absolutely influenced me in positive ways both personally and professionally.

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My client, Al, was immediately very resistant in not completing the ACL. He stated that he could not see the holes due to his vision impairment and had trouble completing the ACL during a previous class visit. Trying to convince Al to attempt the ACL turned out unsuccessful. Al was able to answer every question on the occupational evaluation sheet without difficulty. If I had the opportunity to go back, I would bring an ACL specifically made for people with vision impairments. Because Al was unable to perform the ACL, I could tell he was a little frustrated in himself. What I learned about myself after going to the COA today was that I should have more confidence when delivering instructions in order to improve my effective communication skills. I caught myself stumbling over words and not making the most sense of what I expected the client to do.

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I think my COA experience went well for the most part. The client I did the assessment on seem to understand directions well and was able to do all of the different types of stitches that were demonstrated. I did, however, notice that when I would ask her about her background that there would be subtle changes in the client’s story every time, which was interesting because she was able to do everything in the ACL quite well.  I thought it was difficult to fill out the evaluation form. I didn’t quite know exactly where everything went or where to document my findings of the ACL. I also found it difficult to keep the client interested in the assessment. The client would do the activity; however, it seemed like she just did it to finish the activity so that she can move on to the next one. If I had the opportunity to go back again, I would probably utilize other assessments or activities that the client could do so that I may get a better picture of their status, but also so that I can keep the client engaged in more activity. I would also like to administer the ACL on a different client and compare and contrast the assessment results so that I can see how the clients were. It would be very interesting to observed other client’s performances. Overall my COA experience was a very interesting one, it was great experience to be able to utilize the ACL on actual clients and to interpret the results.

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My COA experience was good. It is always a great insight when we get a change to go there. I originally was paired with my first client and she was unable to complete the Alan Cognitive Test at all nor, able to tell me much about her hx or answer questions for the assessment piece. However, I was switched to another client who was able to complete the Alan Cognitive Test very well however, had issues answering questions for the assessment. It was pretty cool to be exposed to different cognition levels to see how differently they operate. It also challenges me as a future healthcare provider to think what these people will and will not have issues with and how independent that will be based off one assessment.

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The COA experiences are always interesting and a great learning opportunity because we never know who our partner or client will be. Right when my client sat down I introduced myself and I realized he had his eyes closed, and then I noticed his cane/guiding stick. I already knew that the ACL was not going to work with this gentleman, so I interviewed him instead. He was very cognitively intact, and when I asked about what he does for himself to include bathing, toileting and dressing to which he replied he did independently. He did need help with medication management which his daughter, who he live with him is in charge of, and she also makes all of his meals and guides him to his plate and silverware. He only recently became blind, and admitted to not accepting it or tolerating it well. He also told me he does not participate in any leisure activities and that he is embarrassed to go out to eat unless it is food that he can hold so that he doesn't make a huge mess. It was very easy to talk to him, and he had a very interesting life story- he was a public educator for 35 years and a clown with his now deceased wife for 15 years. His favorite food place is 1-2-3 Burger and he swears by the "sammich" and meat lover's pizza. I recommended he go to a support group for other adults his age experiencing recent blindness, and he didn't seem to keen. I realized about myself that I am very persistent, and mentioned he was lucky I wasn't his daughter because I'd force him to go to a support group. I also realized, looking around at my classmates, how we have to change in an instance based on our client's mental status and how important it is to be able to read our client. Obviously he was more cognitively intact than others, so I enjoyed having a conversation about his life and what areas we, as OTs could capitalize on to help him accept his new blindness.

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I had a very interesting experience at the COA. I tried to interview my client but her speech was not coherent, and I couldn't make sense of what she was saying. As I showed her the ACL running stitch, she immediately grabbed it out of my hand and started doing the running stitch immediately. She did very well with this kind of stitch, so I preceded to show her the whip stitch. When I was done showing her, she went back to making the running stitch; she ended up doing the running stitch the whole time I was there. I think next time, I should bring other types of activities for my client to do, since it seems that the only type of stitch she can complete is the running stitch and she has mastered that.

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My experience at the COA was very good! My client had a great attitude and seemed eager participate.  Soon after we began talking, however, it got very loud and my client told me she could not hear so we had to switch seats into a quieter space.  This tremendously improved my ability to communicate with her and made the task much easier for both of us.  She explained she sewed a lot in her past so was excited to participate.  One thing that was very hard for her was the fine motor control of feeling for the needle and putting it through the tiny hole.  I could tell she was trying but she experienced significant shaking and tremors so I had to help at some points.  Because of this, using a different cognitive assessment would provide better insight into her true abilities.  When I asked my client if she wore glasses, she said she did but did not want to put them on so next time, I would also make sure she wore them.

This experience taught me that I should not have any preconceived notions before working with a client.  I was nervous this would be too difficult for these clients because I had been there before.  However, my client appeared to understand several aspects of the stitches and was most restricted by her motor function.  She exceeded my expectations in understanding my questions and following directions even though I had to redirect at times.  Therefore, I will work to not have any preconceived notions before working with a client.

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During my time spent at the COA, I enjoyed getting to know the client that I was working with and gaining experience in performing the ACLS on an actual client who was not a classmate. The client who I was working with was very open to answering questions and telling me about herself, so the conversations that we had went very well and I was able to learn a lot of information about her that pertained to the evaluation sheet. However, it was difficult for her to maintain her attention on the task that was presented to her, and I was not able to get much of the assessment done due to her inability to stay focused. Sometimes I would have to redirect the conversations in order to get back on task, but she was never able to stay focused on a stitch for more than one minute, which I found to be the most difficult.

If I had the opportunity to go back, I would have chosen to sit at a quieter table with less people around so that my client would have less distractions. My client and I also had trouble hearing one another during the session, so moving to a quieter area would have benefitted the overall situation. During this experience, I learned that I need to be more assertive when performing assessments such as the ACLS, in that I need to keep the client on task as much as possible instead of allowing the conversations to veer. Although, it is important to establish a rapport and to get to know your client, it is also important to know how to effectively redirect the conversation when tending to a task so that the client is aware and has an understanding of what they are supposed to be doing. This experience also reminded me the importance of effective communication skills and having the ability to be open-minded to each and every session with a client, because each client is different and not everything will go as planned. I felt like during my experience at the COA that I was able to effectively communicate with the client and receive majority of the answers to the questions listed on the evaluation form.

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My COA experience went very different than expected, but I feel that I gained a lot from it. My client was very distracted and had very little verbal skills. Because of this, my partner and I had to make many on the go changes to the assessment and evaluation. We quickly found that the client did not answer questions when prompted most of the time, so we had to find things that she was able to talk about and gain information through those. As for the assessment, our client performed the running stitch very well, however when prompted to do the whip stitch, she went back to the running stitch.

If I were to go back, I would have another activity or assessment to go along with this. There is a chance another client will only be able to complete one stitch and so I would need to be able to do more with my time. I also would want to practice finding different ways to find information about my client without asking direct questions, or other ways to ask the questions. I also would try to eliminate all distractions from the area to perform this task. There were many people in the room that the client was constantly looking at and getting distracted by.

From this experience, I learned that I have more patience than I thought I did. However, I did learn that I could use more practice in areas when things do not go as planned. Being able to act on the go will be a key skill to have as a future OT.

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This community experience at COA was definitely a learning opportunity for me. Although I had prepared questions to ask, I still found it difficult to obtain all of the information I needed for the evaluation. Knowing the form better definitely would have helped. I found myself continuously flipping between the pages to find the spot where each piece of information went. I anticipated a fair amount of communication challenges, but with the room being loud, it was difficult for him to hear all of my questions despite moving closer. Next time I will change locations to a quieter room to prevent distractions and improve communication.  The client I worked with had macular degeneration. He was cognitively aware and oriented, but had trouble completing the ACLS. He initially refused to complete it, but with some coaxing, completed a few running stitches. While he did not complete the assessment, he was able to engage in the activity. His macular degeneration contributed to him not being able to complete the ACLS. I would have prepared more questions and been very familiar with the evaluation form if I revisited the COA. I learned that there are different challenges that arise when evaluating the psychosocial aspect of clients. Information is a lot less objective and clinical reasoning is a very important tool for the therapist. It was nice to get practice administering assessments and giving evaluations.

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The COA community experience happened differently than I expected but overall was a good learning experience.  I thought it was important to use observations to get an initial understanding of the client.  There were a few sections in the occupational evaluation sheet that I was able to pick up on within a couple of minutes of interacting with the client and without asking questions.  This shows that it is important to start making observations right away when meeting a client for the first time because it can help guide the evaluation process and your interactions with them.  If I had the opportunity to go back I would make sure to be more aware of this.
I also found it harder to communicate with our client than I thought.  We were able to communicate certain questions but our client was hard to understand.  She also was not very interested in talking because she seemed anxious to go home so it was harder to get evaluation questions asked.  I did not think that it would be difficult to get a few questions answered but next time it would be important to have a variety of simple and short questions.  Also, if I were to spend more time with this client it would become easier to understand her through verbal and non-verbal communication.  I also thought it was hard to administer the ACL in the standardized format with the exact wording.  It was a lot of wording for a client that was not fully interested but it was good to get some subjective information from the way she handled simpler instructions. This experience taught me that it is important to be prepared but also to be flexible and creative when things don’t go as planned.

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I always love visiting the COA. The client I worked with was very good at following directions and understood what I was asking of her. She was able to spot and correct my mistake when I made one. It became tricky after the assessment because her memory was so far gone. She could not remember her husband's name, and she said that she lived with him. Later I found that she lives with her daughter, and her husband had passed a few years back. Her son-in-law, who was not mentioned once, came to pick her up after our activity. She told me that she takes the bus home. When asked what state we were in, she said "Detroit".

I learned that each client is different. My classmates worked with people who were unable to complete the ACL but their memory was stronger. Or they would get frustrated with the assessment. The difference in memory in the clients that all had the same diagnosis was drastic.
If I went back, I would love to come up with some tools that she could carry around to remember things about her immediate family. Not being able to remember those things could be unsafe, should she ever be alone or lost.

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I thought overall the interview went well. Also, having a classmate to do the interview with made it more comfortable. I think interviewing is a skill that I need to improve. I did not think it would be as challenging as it was. I thought the conversation would flow more but the lady I was interviewing would answer the question with a short response and not elaborate.  For some of the questions I asked, it took some time to get a response so there was an awkward pause. I should be prepared for that and have different questions and various ways of asking the questions to receive the information I need.

If I had the opportunity to go back, I would like to have done the ACL assessment and interview in a quiet room. There was talking and other distractions happening and that might have influenced her results. When I was reading the instructions, I became distracted with all the noise so I know this must have been difficult for the lady to follow these instructions.

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One thing I learned from this experience is how important it is to ask the right questions to get the most information from your client. It was important to talk to the client to make the feel comfortable but also learn things about their daily occupations. All of this information comes from asking the right questions. I did notice however that our client go particularly frustrated with too many questions. It took her a long time to retrieve the information from our questions so she was easily frustrated. Its important to be able to make these kind of observations quickly so that your client is comfortable with you.
One thing that went well during this experience was the beginning of the ACL assessment. The first two stitches the client was able to do easily however with increased time. The whip stitch was a little bit more difficult because she was very focused on making sure the leather lace wasn’t twisted. And the cordovan stitch was even more difficult. If I had the opportunity to back and do this assessment again I would make sure to give it in a quiet place and away from distractions. and make sure that I was sitting next to the client so I could teach them the stitches in the most accurate way possible.

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The Council on Aging (COA) is a great resource for older adults in St. Johns County, as a student at the University of St. Augustine I appreciate and value how open they are to student learning experiences. During this visit to the COA, I practiced giving an occupational therapy evaluation for the first time as well as administering the Allen Cognitive Level Screen (ACLS). My experience was much more challenging than I expected but there were some great moments. I began the experience by getting to know my client and asking general questions about them. I quickly noticed that the client was not oriented to their location, and asked long-term memory questions such as “Where did you grow up?” “Do you have any siblings?” These questions were easier for her to answer and I felt as though they made her feel more comfortable with me. As I began administering the ACLS, my client became quick irritated with the noise level in the room and complained about not being able to concentrate as well as hear what I was saying. If I had the opportunity to go back and try this experience again, I would bring my client to a quieter area with less stimulus. Furthermore, I also realized how difficult it can be to follow the administering directions of a standardized assessment. Although I had practiced administering the ACLS with my friends, it was difficult to stay on the script while the client was asking questions about the assessment and looking confused as to what I want them to do. In the future, I should practice standardized assessments more before administering and ask my partner to be less compliant.
Another obstacle that I faced with my client was that she was unable to do the first task of the ACLS, which I was not expecting. Although the ACLS still provided valid information on the client’s cognitive level, in the future, I would like to bring other cognitive assessments if my client cannot complete the running stitch, such as the mini mental, MOCHA, or KELS.  Additionally, because we finished the ACLS so quickly, I had a lot more time to interact with the client, and I had not prepared enough questions to ask her. In the future, I would have more questions ready to ask.
During this experience, I also learned the importance of talking to a caregiver or family member. Per ACLS directions, when I asked, “Have you ever done anything like this before?” the client reported No, that she had never seen anything like it. However, when her daughter arrived to pick her up she talked about how much the client likes activities like the ACLS, and last time a student administered it the daughter went out and bought a similar stitching pad.
In the past, I have always thought of myself as extrovert that can easily strike up a conversation. However, at the COA today, I found myself challenged to continue the conversation. I believe that through experiences like this, it will only become easier to interact. Tentatively, one of my level 2 field works is at a Skilled Nursing Facility. Before I embark on that I experience, I need to immerse myself into similar experiences of today, to become a more rounded, client-centered, therapist.

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The COA is always a great learning tool to see how clients function first hand with the different assessments that we learn in class. I was a little nervous about trying out the ACL on clients in the COA today. I did not get to use the ACL today, but the experience I had with my client was still another good way to learn to build a rapport with clients and use my interview skills. My client was blind, so he could not effectively use the ACL. He was very pleasant to work with and was very engaged with all the questions asked to him. He lost his sight due to glaucoma 3 years ago and comes to the COA 4 times a week. His daughter lives with him and is his primary caretaker, and they also have 3 dogs. His daughter helps set up his medication each day and picks out his clothes for the day. He independently gets dressed and bathes independently as well. He has the most difficulties with eating, and states that he does not like eating in public. Me and my partner did get to assess how he eats. He was able to open up his apple sauce with guidance to start, but independently the rest of the way with some verbal cues. He ate independently with verbal cues on where his spoon was located.

Overall, I think my experience there went well even though I did not get to assess the ACL. I learned about how to interview and what questions to ask a client needed for the evaluation process. Next time, I would make sure to have all my questions together so the process will flow a little easier, because I was flipping through the evaluation form to come up with some questions. I had to think about what to ask and I was a little all over the place but the client was easy to talk to, and make the evaluation easier to handle. With more experience, I will get more confident and comfortable with the evaluation process.

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My client at the COA today was a very pleasant, high functioning male who participates at the COA everyday of the week.  I found out through the interview he has been married for 30 years and his wife stays at home while he is at COA.  I feel like how I explained the directions went well because he did not need any extra direction or cueing until the cordovan stich. This meant of course my client was a had level of cognition to be able to perform the running and whip stich with only the directions explained once.  If I had to identify one area that didn't go well and that I would do differently would be how prepared I was to ask the initial interview questions. I found myself a little nervous for a reason I'm still not sure of when I was asking my client some simple questions.  When I go back to the COA I will brainstorm more before I go to come up with questions that can keep the conservation going, especially after the assessment has completed.
At the end of the short time we had at the COA today I did reflect on how I needed to be more patient with the geriatric population when my client was following the directions.  I've learned that I might need to wait patiently for the client's response simply because they might require a little extra time to process what I am saying.  With this, I need to be cognizant of how fast I talk sometimes.  Often, I have my peers tell me to slow down when talking, so especially for this setting I need to slow down my speech and allow more time for a response from the client.  I look forward for our next opportunity to give a new assessment or participate with the client in any way at the COA.

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The COA always gives great opportunities for us to work with people and try some of the assessments that we are learn in our courses on actual people.  Today I was unable to work on the ACL with a client, but I was able to practice my interview skills which is an important area of our job.  My client was a 90 y.o. male who was diagnosed with glaucoma which caused him to lose his vision 3 years ago.  Upon losing his vision he moved into his eldest daughter’s 1 story home with 3 medium-sized dogs.  She is his primary caregiver.  She helps sort and disperse his morning and night medicine, as well as other household duties like laundry and cooking meals.  Client is independent in donning and doffing clothing, bathing, and needs assistance with eating meals.  The client spoke about having trouble finding the food on his plate and knowing when he was finished with the food or if there was more left on the plate.  This affects the client’s social participation.  Client feels embarrassed when eating in-front of others and feels that assistive utensils cause a scene during public meals.  He does go to the COA 5x/wk and is picked up by a taxi company who is schedule to come in the morning and drop him off at home in the afternoon.

If I were able to go back to the COA I would love the ability to work with this gentleman with his eating and meal prepping.  I think that education and tricks would help him feel more comfortable and confident to go to social events and eating at those events.

While doing this activity I found that I was able to come up with questions to ask the client but many of them were scattered and flip flopped on subjects.  While doing evaluations in the future I should have my questions flow more easily and get all the information for one area at the same time instead of going back and forth from it.  Overall, I enjoyed working with this gentleman and enjoyed learning about his interesting life.

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The COA community experience turned out to be an educational and interesting trip. Having been to the COA before, I felt comfortable and thought I knew what to expect. However, this was my first time working with these clients to fill out an evaluation, so I was nervous for that. As soon as I began talking to my client, my nerves went away. She was very friendly and answered every question that I asked. I also felt that the ACL assessment went very well for both the running and the whip stitch. For each one, she was able to complete it on the first try. It did begin to get difficult when the client attempted the cordovan stitch and could not figure out what way it went so she continued to ask for guidance. I made sure to limit the feedback and let her attempt to complete the stitch on her own. She was able to identify that she was not doing it correctly, but could not figure out what she was doing wrong. I found that the volume of the room and the amount of people walking around affected not only the attention of the client but also myself.
One of the things that I could have done is better prepare myself for what page information was to be recorded on the evaluation form. I found myself spending time flipping through pages, instead of using my time to talk to the client. Since the cognitive level of the client was unknown prior to arriving, I would have come up with more questions for different types of cognitive levels.

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Going into the COA experience, I was a little nervous, but only because we had to perform an evaluation. I was looking forward to talking with the participants, because it has always been a pleasant experience. Upon arriving, I sat with a sweet woman who appeared to have tremors in her hands while eating a cup of fruit. She had dropped the cup on the floor, and was slightly agitated about it, so going into the ACL, I was a little nervous. I expected that administering the ACL would be difficult, but I did not account for her tremors, and she also appeared to have vision impairments. We were also in a small room with many people in it, which made hearing my directions more difficult as well. She was able to complete the running stitch, but often could not find the hole due to a lack of contrast in colors between the leather and the string. I could sense she was getting agitated, so I moved onto the interview portion. The interview went well, and I found myself feeling much more comfortable in a more personal, less structured situation. She could not recall every detail of her life, and often repeated information, but she seemed happy to talk with me and to discuss some of the happy memories of her life. Overall, it was very pleasant, and she had a good sense of humor (and both like the color blue), and I enjoyed it very much. If I had the opportunity to go back, I would think of a better way to present the ACL. I am not always very good with being precise in my words, and once I started getting flustered, it only got worse.

I have known for the most part that I don’t generally have a difficult time talking with people, but sometimes, when I have to administer an assessment and I know I am being watched, I “clam up” and forget what I am supposed to do. As this is pretty much how grad school works, sometimes I become discouraged and wonder if I will actually be a good occupational therapist. It was a good reminder that once you establish rapport, an assessment situation can become much more comfortable, and it was a reassuring experience.

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Overall I thought the COA experience was pretty challenging. The client I was working with had a difficult time communicating so it was hard to ask her questions and receive notable feedback. It was also hard to give her instructions for the ACL because I could she was not attentive to what I was trying to tell her. I did find it very interesting that I barley had to give her instructions for the running stitch before she took the test and immediately started doing it. It is clear that this was something she had done many times in the past despite her not telling me that when I asked her at the start of the assessment. Although it was hard to communicate, when I finally found a topic she was interested in the interaction between myself and the client went a lot better. At first I had asked her what she likes to do for fun but didn’t get much of a response. However, once I was more specific and asked her if she likes to play BINGO her affect changed and she verbalized a lot than before.

If I had the opportunity to go back I would have some back up plans just in case I was having difficulty with my original plan, like today.

From this experience I learned just how crucial it is to think on your feet and to be prepared for anything. I took this as a great learning experience and I will work on trying to always have back up plans ready to go just in case.

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I felt like my interview went really well. I was able to get a seemingly accurate response for every question I asked, and I was able to write a lot of the evaluation form. The administration of the ACL also went well as my participant was able to complete both the running and the whip stitch. He did report that he was having problems with his vision, which could have impacted his ability to perform better. A few things that I would do differently would be to correct my position during the ACL. I was supposed to be sitting directly beside the participant, but instead I was sitting diagonal to him. I would also correct my cueing, as I felt that I was giving more cues than I should have been giving. Lastly, I felt that my participant kept getting distracted by others. I would have liked to see how he would have performed in a one-on-one setting where it was more quiet and had less distractions.
One thing negative thing I learned about myself was that I too was getting slightly distracted by others asking questions and having conversations with their individuals. This is something that I will have to work on as I know many occupational therapy settings can involve crowded spaces with multiple things going on at once. One positive thing I learned about myself was that I felt comfortable working through the evaluation form. I felt like my questions were open-ended and one question gave me insight into other parts of the evaluation form.

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This COA experience was different than I expected. It was definitely beneficial that I was prepared and had practiced administering the ACL on a partner. If I had not spent the time practicing this assessment I would have had a difficult time. Initially, I was sitting across from Joyce and knew that if I didn’t move it was going to be very difficult to administer the ACL because she had a hard time hearing me when I introduced myself. Once I moved my seat next to Joyce it was much easier to hear her, and to have a conversation with her. Joyce was very good at performing the different stiches, and moved through them rather quickly. Once she was done with the ACL I asked her general questions, and questions from the evaluation form. She got frustrated with me and all my questions, therefore, it I were to do differently in the future, I would ask more questions before doing the ACL, and ask questions after the ACL.

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I always enjoy visiting the COA and having the opportunity to work with different clients. Today’s session at COA was more challenging than previous times because I was working with a client who was very difficult to understand. I found that engaging the client in a conversation about something she enjoyed made the session go better. For this particular client, that topic was bingo. The ACL assessment went well at the beginning, and the client was able to complete the running stitch and whip stitch with directions and one correction. It was difficult for the client to hear me, however, over all the others talking in the room. The client was also having trouble hearing me. I felt that the session may have gone better if we had been in a quieter, less crowded area. It would have been easier to hear each other, and the client would probably have been less distracted.

If I had the opportunity to go back, I would come more prepared with other activities to work on since I was having trouble engaging the client. Because I have mostly worked with clients who participate actively in activities when I have gone to COA in the past, I had not prepared myself to work with someone who was not as responsive.

In order to make today’s assessment functional for a future session, I think the client would benefit from working on ADL’s and leisure activities. She could use the skills needed for the ACL, such as grasping, visual perceptual skills, and hand-eye coordination, to engage in ADL and leisure occupations. For example, she could work on buttoning a shirt or tying a lace for dressing, or completing a craft to increase leisure participation.

I found this experience valuable because I hope to work in a geriatric setting in the future, particularly with clients with dementia. Each time I visit COA, I learn something new and challenge myself to use the skills I have learned so far throughout my coursework. Today’s session reminded me that each client is unique, and it is important to use an individualized approach for each session and to remain open-minded, patient, and flexible.

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At the COA the client I worked with was blind, so I was unable to administer the ACL assessment to him. Even though my client and I did not do the assessment I was able to interview him and learn about his life. My client was a 90 y.o M who went blind 3 years ago due to glaucoma, He was a teacher for 35 years teaching almost all subjects from 2nd grade to 9th grade. After he retired from teaching he and his wife joined the circus! (i know how cool). He moved to FL in 1990 with his wife when she became ill. He is now living with 1 of his three children in a 1 story home where she is his primary caregiver. If I had the opportunity to go back to the COA I would like to interview other clients to learn about their life experiences and also get the chance to administer the ACL to a client. When asking what I learned about myself while at the COA, it was that when interviewing clients on sensitive subjects such as my clients blindness, it is important to be empathetic and try to understand what they are going through especially if it is a recent change they have not yet come to terms with. I also learned that I need to live more, my client had so many talents and has traveled all over the country, makes me realize there are so many things out there I still have yet to experience.

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Our visit to the COA went a lot differently than I expected. I figured that there would be some issues with completing the evaluation portion, but did not realize the high extent to which that would be true. Me and a partner worked together to evaluate a client. While he seemed to be very cognitively aware, he was hard of hearing and seeing and spoke in a very quiet voice. We had to repeat questions multiple times, and often the client misheard us and gave us answers that were not relevant to the question. There was a lot of rerouting that had to be done. Knowing the form better would have been very helpful for when the client shared information with us that belonged on another page which we had to quickly flip to to document. Also, it probably would have been very helpful to move to another location with our client where it would be easier for him to hear us and us to hear him.
As soon as we showed our client the ACL, he told us that he could not complete it because he could not see the holes (due to his macular degeneration). It took a bit of convincing, but we finally got him to try it out. While he was not able to complete any portion of it properly, once he realized that he could get the hang of it with us starting him out, he became much less frustrated with himself and almost seemed to enjoy it. This was a very good example of when the use of a standardized assessment has to be done a different way and, while it can no longer be documented as standardized, it is still a functional activity/assessment for the client.

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I really enjoyed the COA and my client. He told me all about his life past and present and would go off of anything I asked to a million other details about his life. Talking with him about his life and asking some certain questions to get a better understanding about his functional capacity was easier than I thought it would be. My client has macular degeneration so the ACL was hard for him to perform and we would have needed a larger one for him to fully participate and do it by himself.  I had to help him hand-over-hand because he could not see the holes and I feel like the dark on dark coloring also made it more difficult.  He was hard of hearing so if I could go back I would want to be in a side room so he could hear me better and I could understand him better.
The environment is a huge factor when doing a testing because if the client cannot hear really well then understanding what he is supposed to do makes things almost impossible with a loud environment around.  He is very smart so if he could have heard me better than he may would have been able to do the third stitch because concentration/attention was not a problem for this task.  The only factors were hearing and macular degeneration keeping him from doing the third stitch.
I learned that I can easily find things to talk about when talking with older people. They have lived a long life so they have plenty of stories to tell and as long as you get them started on their stories they will keep going. I also learning that according to my client, I need to learn how to play chess because it is a great game. My view of the COA changed because of this client; last time the client was unresponsive, but this client was very high functioning.

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Describe the following: what went well, what didn’t go well, and what you would do differently if you had the opportunity to go back.

What did you learn about yourself from this experience? Explain.