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2.2.5 ACCESS TO HOME AND COMMUNITY REINTEGRATION AND
ENVIRONMENTAL BARRIERS
It is the duty ofthe occupational therapist to do community assessment before discharge
and reintegration ofthe patient into the community. This helps in discharge preparation
of the patient when the occupational therapist knows exactly what the environment or
home of the patient looks like. The occupational therapist considers the concept of
environmental barriers and environmental support to occupational performance. These
are influenced by social, cultural, economic, institutional and architectural elements.
According to Trombly (1995:255) community assessment is not done well for all
amputees, as a result of which some amputees adapt poorly to the environment or
community after discharge.
All the amputees whose environment has been assessed should be recorder in hislber file.
This include purpose of assessment focus done by qualified occupational therapist, that
is, environmental factors involved and addressed, location of the environment assessed,
how assessment was carried out, for instance questionnaires or observation, clarity and
comprehensiveness of instruction, time taken to do assessment, its usefulness,
standardization, that is, literature used to base the assessment on or experts consulted for
reassessment, whether the assessment was published and whether the assessment have
undergone testing for reliability and validity. This information is very important for the
rehabilitation team to assess a successful amputee's rehabilitation on the community
level. This also depends on good discharge preparation, and an accessing home,
community and workplace (Trombly, 1995:258).
2.2.6 DISCHARGE PLAl\1'."'ING
Discharge planning is part of rehabilitation of the amputees whereby amputees are
involved in the care, planning andpreparation for their discharge before they are disposed
to community rehabilitation services. Thisis the cruciaJ period when the patient has to go
home and face the community for the first time after amputation; uncertain and not sure
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