Client Case Study: “Household Tasks”

Sue sustained a traumatic brain injury as a result of a road traffic accident in 2005. She was referred to Emma to assist her in returning to general function. Sue’s husband died in the accident so, as well as working with the brain injury, Sue was also grieving her husband and fighting depression.

After an initial consultation, Emma and Sue established that
Sue was lacking in confidence and motivation. Sue explained
that she had previously enjoyed cooking for her family but found
that she could no longer do so as she found even simple tasks
muddling and confusing and she was now relying on her
teenage children to plan meals, do the shopping and even
cook the meals.

Emma conducted an observational assessment where she
asked Sue to cook a familiar meal from start to finish without
assistance. From this, Emma was able to determine that whilst
Sue’s kitchen skills were very much intact, she could chop, whisk,
pour, measure etc she was struggling with sequencing the steps
of the task and with recalling which of the steps she had already

The following week Emma provided Sue with the same recipe
written down in very specific steps, with each step having a tick
box next to it. With Emma’s help Sue was able to complete the
tasks using the check list as a guide and a reminder. The
following week Emma provided Sue with an entirely unfamiliar
recipe broken down into the same checklist format and Sue
was able to complete the recipe independently.
Sue’s children helped her breakdown some of her favourite recipes which they laminated so that they could be re-used.

Emma then worked with Sue on menu planning for the week using a simple timetable and a shopping list which they did on the computer. Because Sue wasn’t able to recall what she already had in the cupboards it was suggested that she and the children stock take everything they had and catalogue it on the computer. Now Sue can check the ingredients list or a recipe against her stock and if not there add it to the shopping list. It took a while for Sue to get in the habit of doing this but with close monitoring it soon became habitual and continues to be an effective tool for her.

Emma went to the supermarket with Sue to observe how she went about her shopping routine. It was immediately apparent to Emma that Sue was not scanning effectively meaning that, for example, when looking for ‘tomato ketchup’ she might find the right aisle and right location but would stand in front of the shelf simply not seeing it. Emma taught Sue how to scan slowly but methodically from the top shelf, left to right going down to the bottom and repeating the process if the item was not found the first time. Sue found this frustrating but acknowledged that it did work if she did it properly. She had not realised that she had this problem until Emma pointed it out.

Sue continues to cook regularly for her family and her confidence is slowly improving as she and her children continue rebuilding their lives.