Bathroom adaptation to meet the expectations of the client suffering from Multiple Sclerosis (MS) as an example of occupational therapy process

Introduction
Multiple sclerosis is a disease attacking the central nervous system. It develops when the myelin sheaths of nerve fibres, glial cells and immune cells are damaged [3]. The aim of this study was to present the project of adapting a bathroom to the needs and expectations of a person with MS and to show its implementation.

Method
A direct interview with an MS client was conducted with COPM questionnaire (often used in occupational therapy) and medical documentation was analysed.

Case study
Tadeusz (the client) was a 46-year-old man. He was diagnosed with MS when he was 43 years old. However, the first symptoms occurred two years earlier. In 2007 he underwent magnetic resonance and spine puncture examinations. The results confirmed a primary progressive type of MS. Identification of the client’s problem: the need of independence while washing, shaving and bathing. Tadeusz was not able to take a shower by himself because of the fear of losing balance and falling down in the bathroom. The weakness of the left hand muscles and the lack of support rails made it impossible to use the bathroom independently. During several meetings with the client, a plan of adapting his bathroom (fixing handrails and a wooden step) was developed and the manner of using these devices was practised.

Conclusions
Two weeks after the bathroom adaptation was finished, it was assessed together with the client. It was concluded that the adaptation meets his expectations and the aim is being gradually achieved. In the reassessment process, an improvement by 3 points was noted. The “task performance” and “satisfaction” criteria were given 7 points (in the scale from 1 to 10) by the client. However, in the first assessment he evaluated these criteria by giving them 4 points each.