During the summer 2002, Marianne Lorraine took a close
look at the many stages in meal preparation by a man suffering
from the after-effects of a cerebral vascular accident.
The objective was to determine whether he succeeded or
failed at each action he attempted was due to his environment
and, eventually, propose targeted intervention strategies. “Failure
at any function, such as not finding an object, may be
due to more than one cause: the subject did not visually “explore” the
room enough, he simply did not recognize the object, or
he was unable to see it because it was located outside
his field of vision. You have to break the action down
into minute details to understand all these phenomena,” notes
the master’s student in the School of Rehabilitation
at Université de Montréal.
The activity was filmed with a video camera in the presence
of a neuropsychologist and an occupational therapist, in
order to code and analyze each movement. This method can
identify even the smallest element. It is worth noting
that preparing a meal involves quite a number of individual
tasks, all connected to specific cognitive and perceptual
functions: memory, recognition of objects, orientation
in space, ability to plan an action. An interview with
the patient's spouse was also conducted. “Those closest
to these people are our greatest experts! Their testimonies
are indispensable in helping us understand what happens
every day.”
According to the graduate student, people suffering cognitive
deficiencies can become more autonomous if they are allowed
to carry out everyday activities at home. “The idea
is to adapt the environment to help them carry out certain
tasks as best they can. This takes some of the load off
those around them, so it’s really satisfactory for
everybody,” she explains. Sometimes, it takes very
little effort to make something doable: change the arrangement
of furniture, measure out food in advance or use pictograms
to help in locating objects. “This principle is being
used more and more in homes for the elderly, but until
now nobody had studied how to make concrete improvements
in patients’ homes.”
Although the researcher still has plenty of data to analyze,
she already has a general idea of the difficulties her
subject had to contend with: “The man’s actions
were very disorganized. For example, he washed the dishes
systematically every time he used a utensil instead of
waiting for the end of the meal. In addition, he forgot
to use the soap and merely rinsed the dishes without washing
them.” Insignificant details? Not if you consider
that these trifles too often lead loved ones to take over
doing these tasks for the patient, and thus, in spite of
themselves, restrict his autonomy.
Researcher: Marianne Lorrain
Direction: Bernadette Ska, bernadette.ska@umontreal.ca
Telephone: (514) 343-6111, extension 1070
Email: marianne.lorrain@umontreal.ca
Funding: Faculty of Graduate Studies, Université de
Montréal (scholarship)
