Assessing Individuals Ability to Work and Play

The activities of work and play will be unique to that person; a full assessment of these aspects is therefore essential to ensure that the client is not left with unmet needs. Gaining insight into a client’s usual work and play activities and ability to participate in these may not seem readily apparent nor indeed appropriate at first encounter, particularly if the client is seriously ill. However, a brief initial assessment should always be undertaken on admission or arrival, to identify any significant actual problems that may be causing the client anxiety or distress and which can easily be resolved, such as telephoning the client’s employer, school or friends to advise of their whereabouts, or contacting the police to arrange to secure business premises for example.

In relation to infants and children, during this initial assessment it is clearly important to involve the parent, guardian, family or main carer. The child may have a comforter or special toy that can be used as a means of relaxing them during the initial stressful period of hospitalization.

A more comprehensive assessment can be completed later, once the client’s condition is stable and/or the full implications of the change in their health status are known, or in preparation for discharge. Remember, some clients who have been absent from work or school for a significant period of time may be frightened or anxious about returning to work or school, and these issues will also need exploring.

As with other activities of living it will also be necessary to reassess the client’s ability to work and play should their condition change. Examples may include: the client who has an extension to their stroke following admission to hospital; the client whose health status has deteriorated as a result of the effects of planned treatments or prescribed medications; or the client who has become confused or disorientated, as previously planned interventions may no longer be appropriate or indeed safe.

For some clients in employment, financial issues may not be a cause for concern at the outset, as some employers provide full pay. However, they very often reduce the level of payment as time passes, for example full pay for one month, half pay for a further month and then no pay, barring sickness benefit. Also clients receiving a state pension or other state benefits often have their payments stopped after the first few weeks in institutional care. Referring clients to a social worker, with their express permission of course, can often be of great help in addressing financial issues, as well as assisting us in obtaining suitable aids for clients to enable work and/or play on discharge.

Remember that assessment of work and play is only part of a holistic nursing assessment and should not be undertaken in isolation without reference to or consideration of the client’s other activities of living.