Analysis Of The Movie A Simple Life In Terms Of Occupational Therapy Theory

Synopsis of analysed section

Ah Tao served the Leung family for 60 years. She lives with and takes care of the only family member still residing in Hong Kong, Roger, a film producer. However, Tao suddenly suffered a stroke which resulted in her left body partially paralysed. She was unable to utilise her left hand but could walk slowly using a quad cane. When Tao decided to quit to stay at a nursing home, Roger took responsibility of her care and found her a nursing home. The analysis was done when Tao was transferred from the hospital to the nursing home to the point where she was re-admitted to the hospital again. This report evaluates the changes of Tao when she slowly adapts to the new environment, the new relationships formed with the other residents and her relationship with Roger.

PEO Analysis

An analysis using the Person-Environment-Occupation (PEO) Model was done and shown below.

1. Person Role

Tao lost her role as a helper for Roger, which was essential to her as she had been nothing else but a servant for the last 60 years. The role had reversed and she now receives care from Roger instead. She gained the role as a resident in the nursing home and became friends with the residents.

2. Physical characteristics

Motor: Initially, Tao had little control of the left side of her body, especially her hands and she walked with a limp. Her mobility returned back to normal after therapy sessions.

Sensory: Remains normal.

3. Affective characteristics

Tao remains stubborn about not putting burden on Roger. She initially did not fit in to the nursing home and was pessimistic about the environment as sees herself differently to the other residents staying there. She eventually found comfort and was friendly to others. She had low confidence and felt that she did not deserve the help given to her. Her mood improved once she was able to engage in social outings with Roger and looked forward to their weekly dates.

4. Cognitive characteristics

Tao’s cognitive performance remains the same. She was able to engage in meaningful conversations and even jokes with Roger. Her memory was well and was able to explain the story behind every item in the house (e. g. her first pay, the cloth she used to carry baby Roger).

5. Spiritual characteristics

Tao was a strong believer in Christianity and regularly prays to God. A priest visited and prayed for her when she was in the hospital. She values her relationship with the Leung family, especially with Roger. She feels happy for them when they are doing well in America. She did not want to put any more burden on Roger and thus decided to stay at a nursing home. She dislikes troubling anyone and always tries to refuse help from others. Tao felt that she was useless as she was unable to perform her sole job as a helper.

6. Environment

Cultural: The individuals at the nursing home had their own illnesses and thus there was no stigma faced by Tao who suffered a stroke. The residents were very supportive and enjoyed the company of each other. (e. g. playing mahjong, dancing)The physiotherapist was enthusiastic and motivated Tao to improve.

Institutional: The nursing home was sufficient for Tao due to the presence of nurses. There were government subsidies available for Tao to pay for the nursing home fees. Tao was escorted for physiotherapy sessions at the hospital.

Physical: The park near the home was good for Tao to exercise at. Restaurants were narrow and difficult for Tao to navigate when her mobility was still restricted. The nursing home had chairs and tables littered all over, creating a potentially dangerous environment for Tao to walk with her quad cane, which might hook onto the legs. The toilet doors were difficult for Tao to open as they did not stay open and kept swinging close. Tao did not have sufficient stamina to walk to the toilet which was located far from her room and there were no chairs for her to rest too.

Social: Tao had an extremely supportive family, the Leungs, especially Roger who took responsibility of her (e. g. paying for her nursing home, bringing her out). Roger’s mother visited her twice and brought gifts for her. Tao made good friends at the nursing home (e. g. the head of staff, Uncle Kin)

7. Leisure

She enjoyed her weekly outings with Roger, gone out to walk at the park, ate at restaurants, attended a birthday party and even attended a movie premier. At the nursing home, she engaged in activities with the staff and residence.

8. Productivity

Tao was very serious and pro-active during her physiotherapy session to regain her mobility. She was unable to carry out her duties as a helper and thus interviewed others to find the perfect helper to replace her.

9. Rest

Tao had her own comfortable room and thus could rest adequately.

Impact of Stroke on Tao’s life

Stroke is a sudden neurological malfunction that may be caused by bleeding of vessels or inadequate blood supply to the brain. Stroke causes varying degrees of outcomes depending on the time treatment is given; delaying treatment would cause poorer recovery rates. Tao was fortunate enough to receive early treatment, thus she only suffered from hemiplegia, a condition that causes temporary loss of mobility on her left side while her cognitive functions remain the same. Tao’s activities of daily living (ADL) were affected to a small extent. She could complete her ADLs independently but required more time and effort. However, due to hemiplegia, she was unable to continue her main role as a helper which was vital to her for the past 60 years. Tao thus made the decision to retire and undertook the role as a nursing home resident. Tao’s social circle expanded and her relationships deepened. Roger took up the role as her caregiver which brought them closer together. Previously, Tao was the one caring for Roger but the roles reversed. Their bond deepened during their weekly outings. For example, during the first outing, Roger walked too fast and did not notice Tao struggling to keep up. However, in subsequent outings, Roger not only walked alongside her, but also held her hand. Before her stroke, Tao only had acquaintances from the market. After living in the nursing home, she became close friends with the residents through playing mah-jong and chatting with them.

Tao valued her independence and avoided placing burden on others. Even when her balance and strength was weak, she did not want to call for help and instead walked slowly to the toilet by herself. The reason behind her decision to reside in the nursing home was her reluctance to burden Roger. During Roger’s mother visitation, Tao attempted to reject all gifts. She also rejected the nurses’ offer to help her settle into her room. It was encouraging to see Tao being so serious and eager to improve during her rehab sessions, that allowed her to fully recovered her physical mobilities so much that she was able to carry a sewing machine using only her weaker left hand.

Discussion on PEO Fit

In the PEO model, the person is seen as a special individual that holds multiple roles and adopts specific traits: mentally, physically and spiritually. The environment includes areas surrounding the individual, focusing on cultural, socio-economic, institutional, physical and social aspects. Occupations are activities that the individual participates in to meet his fundamental requirements of life. Occupational performance occurs when person, environment and occupation complement one another. PEO is transient and temporal and Tao’s PEO changes with time. Initially, when Tao just entered the nursing home, PEO was unfit, but as time progresses, PEO became increasingly fit. For person-environment, even though there were nurses at the home to care for her needs in the social environment, Tao did not have a sense of belonging and comfort there. The clutters of chairs and tables lying around were also hazardous in the physical environment, causing the overall person-environment to be unfit in the early stages. However, later in the movie, Tao felt more comfortable and made valuable friendships with the other residence at the home. The home also helped by easing her transport to her therapy sessions in the hospital, thus speeding up her recovery from hemiplegia. Therefore, person-environment fits over time.

Initially, the person-occupation is unfit as Tao lost her main role as a helper and had yet to assimilate into her role as a resident, and a friend to other residents. Her relationship with Roger had yet to improve as they were still adjusting to new changes, thus her role as family to Roger had yet to develop. As Tao settled, she became close friends with the residents and also had frequent outings with Roger. She played mah-jong with the others and even attended a movie premier with Roger. Thus, person-occupation as a resident and family to Roger becomes increasingly fit. Tao’s decision to move into a home, instead of staying home alone had resulted in environment-occupation fit. The nursing home provided a place for her to rest adequately, especially since she had her own room. The escort service provided also allowed her to attend physiotherapy session, recovering her mobility to almost perfection. The overall occupational performance of Tao improved over time due to better PEO fit. However, if the concept of occupational performance expands to include productivity, Tao’s occupational performance may not be as high due to low productivity at the nursing home. This is due to the environment. Nursing homes have quiet ambience with a primary goal of caring for its residents, focusing on completing basic ADLs like dressing, feeding and bathing of residents. The lack of avenues and chances for productive activities and completion of any instrumental ADLs like shopping often stifles the residents. Hence, excluding the productivity component, Tao’s overall occupational performance is good.

Reflection

Stroke is a common illness among older people and many have heard of it. Similarly, I knew about stroke but with a few misconceptions. I thought that all strokes derived from the same cause and had identical outcomes. However, stroke may be caused by a variety of reasons and the duration before treatment is received severely affects the treatment outcome. Mild cases might suffer from hemiplegia while extreme cases may not even survive. Some may fully recover like Tao while others remain partially paralyze forever. Through the movie, I have learnt the importance of social support. Tao got strong support from Roger and the residents at the nursing home backed each other. Tao’s main source of motivation to undergo physiotherapy was to relief burden off Roger’s shoulders. It was touching to see how the residents bonded in the early stages; establishing common grounds by sharing their disabilities, allowing them to empathize with one another. These strong bonds helped Tao feel welcomed in an unfamiliar environment. It was also endearing to see the Roger’s personality grow over time, from being indifferent and ignorant to showing caring and taking initiative.

Therefore, as an occupational therapist, I feel that it is best to involve family or friends in the treatment process as sources of motivation to ensure a more efficient recovery. Alternatives include support groups like Touch community for individuals with no family. In conclusion, this movie is good in helping people understand the emotional rollercoaster of not only the stroke patient but also the family members. In addition, it allows the audience to empathize and comprehend the thinking process and feelings of elderly patients.