How to be a better OT

How to do a self-care assessment

• Season 1 • Episode 9

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Do you need to complete an OT self-care assessment for your client, but you’re not sure where to start or what needs to be covered? Discover how to use a non-standardised self-care assessment to uncover your client's true capacity and support needs.

Episode Summary: In this episode of the How to Be a Better OT podcast, host Clare Batkin breaks down one of the absolute pillars of adult occupational therapy: the non-standardised self-care assessment. Focusing on showering, toileting, dressing, and grooming, Clare explains how observing these routines provides invaluable insights into how a client's physical, cognitive, sensory, and psychological impairments impact their overall functioning. She shares her strategic planning process, tips for navigating hospital ward and community logistics, the "Pause, Prompt, Praise" framework, and how to translate your observations into solid recommendations for home equipment, support packages, or rehabilitation.

 

Key Takeaways:

  • The "Why": Learn why a self-care assessment is about much more than just whether a person can wash; it's a powerful tool to understand baseline function, safety for discharge, and functional cognition.
  • Strategic Planning: Discover why you should assess tasks in the way the client normally performs them, and how to choose the right amount of tasks to assess depending on your client’s capacity.
  • Hospital vs. Community Logistics: Learn how to book assessments with ward nurses to avoid scheduling clashes, and how community OTs can manage limited funding by using "dry runs" or simulations.
  • The Pause, Prompt, Praise Framework: How holding back and allowing safe mistakes reveals true cognitive capacity, and how to deliver graded prompts (from non-specific to direct) to keep the assessment going.
  • Tips from the Field: Why you always need at least four towels for a hospital assessment, and how to stay dry when you dare to give the patient full control of a handheld shower hose.
  • Standardised vs. Non-Standardised: Why popular tools like the FIM or Modified Barthel Index are actually scored using your non-standardised observations, rather than being completely separate tests.

 

Links & Resources Mentioned:

  • Deep Dive: Access the full recorded webinars on self-care assessments, functional cognitive assessments and functional mobility assessments, along with clinical reasoning guides, and documentation examples by joining the Connector Membership.
  • Freebie: Access more than 100 clinical resources in the Free Learning Library.

 

If you found this step-by-step guide to self-care assessments helpful, please subscribe, leave a review, and share this episode with a colleague! Be sure to tune in next time for the final episode of Series 1, where we will cover how to work collaboratively with support workers.

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Because of her delirium and fatigue, we wouldn't throw her into a massive shower, toileting, and dressing assessment all at once. We'd maybe even just start with a bedside grooming activity to test her physical endurance and cognitive focus. And if she managed that well, then we could move on to planning a shower assessment. Once we decide that that's what we want to do, we need to explain to Mrs. Smith our reasoning and gain her consent. We speak to the nurse looking after her and get her to add the shower assessment to her handover, but then we also ask her for any insights that she can share about how much help Mrs. Smith needed with her shower that morning. Welcome to the How to Be a Better OT podcast. I'm Claire Batkin, an OT and clinical educator who is on a mission to make professional development simple, practical, and worth it for OTs. If you're ready to step back from the overworld and bring core frameworks to life, join me for step-by-step guides and practical solutions that will build your confidence and confidence so you can deliver the best outcomes for your clients and truly love what you do. Hello, thanks for joining me for another podcast episode. Today we are focusing on one of the absolute pillars of adult occupational therapy, the non-standardized self-care assessment. When we talk about self-care assessments in this context, we're focusing on observation-based assessments of daily routines that typically take place within a bathroom setting. Specifically, we're looking at showering, toileting, dressing, and grooming. Now there are many other tasks that can constitute self-care tasks, but for the purposes of this podcast episode, it's those four activities that I'll be focusing on. And I'll be looking at it through the lens of when we're doing a self-care assessment for somebody who has a physical or cognitive impairment. Now, this is a core skill whether you are a hospital OT on a busy acute ward or a community-based OT visiting an NDIS client in their home. My plan for this episode is to explain why we complete self-care assessments, help you understand how to choose the right activity to assess, what setup and preparation you need to think about, how you actually run the assessment itself so you give the right amount and type of prompts to see your client's full potential, what goes into our documentation and what the results actually mean in terms of real world impacts. So lots to get through. I'm probably being a bit ambitious about getting through all of this in 30 minutes, but we'll see how we go. To do this though, there will be a few shortcuts where I won't fully unpack every one of those topics I mentioned, but never fear, if you would like the extended version, that is available as part of one of my paid memberships, including the EuroTutor Connector membership. So I'll drop the link in the show notes for where you can access that recording and all the resources that come along with it, including a clinical reasoning guide and some documentation examples. But let's just see how we go with getting through the whirlwind version first. So let's start with the why. Why do we do non-standardized self-care assessments in the first place? The main reason is that it allows us to assess the real-world impact of our clients' physical, cognitive, sensory, and psychological impairments on their overall functioning. So while it can give us clear information about somebody's ability to put on a shirt or to apply makeup, self-care assessments can provide much more information than just exactly what we're seeing. We can use these observations to help us understand and predict how the client might perform in other daily activities based on how the impairments are showing up in these functional tasks. We can then take this information and use it to understand things like our clients' baseline level of function, what support they might need to be safe within their homes, their safety for hospital discharge, their readiness for some active rehab, or maybe how their functional cognition translates to day-to-day safety. But to get this valuable information, we need to be strategic about how we approach self-care assessments. And the first step of the process needs to be good preparation and planning. So, first things first, don't just walk into a ward or into a house and think that you'll be able to wing it. Maybe if you're an experienced OT who's been doing this for a while, you might be able to work it out as you go, but only because your OT brain has gone through this planning process many, many times before. The first step is deciding exactly which tasks you're going to include. And it's important to know that you don't necessarily have to assess showering, toileting, dressing, and grooming all in one massive session. In fact, in many caseloads, trying to do that can be incredibly overwhelming and exhausting for your client. There's a few questions you can ask yourself to help you choose the right activity. Firstly, what is your client's current physical and cognitive capacity? Also consider how much time you have available. And then consider what tasks are relevant to your client and what they'll be needing to do in their immediate future. So let's go through each of these in more detail. Firstly, what is your client's current capacity? So are they in high levels of pain? Are they incredibly fatigued? If they've just had major surgery or they're recovering from an acute illness, they might not have the stamina for a full shower and dressing trial, so you might need to focus on just one of those tasks at a time. Also just keep in mind that in a hospital setting especially, if you complete a self-care assessment involving showering and the patient needs help with any aspect of that task, you will be the person providing that assistance, as you generally won't have a nurse doing the task and you're just sitting back and observing. In a community setting, it might be a bit different where there's a familiar support worker who's doing the assistance and you are just observing or prompting. But in a hospital you're in, so just keep in mind any of your own limitations to provide physical help. Or if the person actually needs two people to assist with showering, make sure that second person is available. Also consider how much time you have available. A full self-care assessment with a slow, complex client can easily take over an hour. Do you have that time right now, or is it better to focus on one high priority task today and assess the rest later? In situations where your time is limited or your client's capacity is stretched, even a full shower by itself is too much. So consider starting smaller with a bedside grooming task with a washball and a mirror first. It still gives you a wealth of information about the person's fine motor skills, their reach and their cognitive sequencing without draining all of their energy. But most importantly, always remember what's going to be relevant for your client. You should be assessing a task that they would typically be doing as part of their normal routine and something that they're likely to do in the near future. And you should be assessing it in the way that they would typically do it. So if they always use an electric razor, a grooming assessment with a manual razor and soap is not really going to provide a true indication of how much help the client will need with this task in the future. Once you've decided what tasks you're going to assess and when you're going to do it, communication and planning is essential. If you're in a hospital setting, you'll need to work well with the nursing staff to be able to successfully book in a self-care assessment. So don't assume you'll just be able to make a time in your diary and then rock up to the ward and the patient will be there ready to go. Unexpected things will always come up. You don't want to have them undressed and ready to start their shower only to have the porter turn up to take them for an x-ray. You also don't want to block out an hour in your diary to do the full morning routine with your patient, only to find upon arrival that the patient had forgotten the plan and the efficient nurse had already gotten them showered and dressed. So you need to go and talk to the nurses. Tell them your plan and check that there isn't anything else scheduled for the patient that day. Make sure that that plan makes it into the nurse's handover document or on the ward whiteboard that lists whatever appointments are coming up for each patient that day. And remember that these conversations aren't just about logistics, so it's a perfect opportunity to find out more about the patient's current function. So what difficulties have the nurses observed so far? Are there any specific precautions that you need to be aware of when you're running the assessment? Preparation also applies in a community setting and you could probably even argue that the stakes are higher. So in this case, if the client isn't ready and waiting for you, you can't often just re-book them for the next morning. You may have traveled 30 minutes to get there, with nothing else that you can action now until that assessment takes place. But it's not just about having your client ready for you. Also consider if a carer needs to be present, whether it's a family member or a paid support worker. If there is a regular support worker who knows the client's routine, talk to them to get collateral history. If you need that support worker there to be present to assist with the manual handling or the care during the visit, be highly proactive. Call the provider or the worker the afternoon before or the very morning to double check that they're still attending. There's nothing worse than driving all the way out to a home visit only to find that the support worker actually called in sick and you can't complete the assessment. Another essential part of the preparation phase is to find out what's normal for your client. The way you shower or you get dress is probably completely different to how your client does it. So ask the client or their family. What time of day do they normally bathe? Are there any specific cultural preferences around hygiene or dress that you need to respect? And how long do the task normally take? We need to know whether a 15-minute shower is normal for the client or whether it's a potential sign that they're having difficulty moving between steps or rewashing body parts that they've already washed just because they've forgotten what they've done. You also need to make sure that the client knows exactly what you plan to do and why you plan to do it. Make sure they understand that you'll be the one helping them with their shower the next morning, and the expectation is that they will do as much as they can themselves so that you can plan what sort of supports will be helpful for them going forward. They need to consent to the process, so make sure that you've had that discussion and document that as well. And my final tip for the preparation phase is to build in a bit of a meaning memory test. So if you're a phospholotee planning to see your patient for a showering assessment the next morning, when you see your client the afternoon before, explain exactly what you're going to be doing and why. So say something like, Tomorrow morning I'll be coming back so that we can have a look at how you're currently managing your showering. And the plan will be that you do as much as you can yourself and I'll just be there to help with anything that you need help with. But when I come back tomorrow, I want to see if you can remember who I am and what my name is and what I'm there to do. Is that alright? And then you just need to remember when you come back the next morning to check that information. So when you walk in you say, Hi, do you remember what my name is and what I'm here to do today? This simple interaction gives you an immediate and practical baseline of what their short-term recall and cognitive retention is like before you get into the physical assessment itself. So this is something that I'd always include when I'm expecting to see cognitive impairments, and it's something I go into more detail about in another podcast episode and in the connector webinar on functional cognitive assessments. So now that you've done all that planning, you'll have a clearer idea of what tasks you're going to have your client or patient complete during the assessment. If you plan to do a whole self-care routine, you'll typically include these tasks functional mobility, toileting, dressing, showering, and grooming. Now in a moment we'll go through some of these specific things that you might want to look out for for each of the activities. But first let's just recap the preparation phase that we've covered so far using a case study. So let's say we're working with Mrs. Smith, who is an 83-year-old hospital inpatient. She was admitted with lethargy, confusion, and a UTI. She normally lives alone, is normally quite independent, but on the ward she's deconditioned, she has a mild delirium that is resolving, and she needs assistance from the nurses with her self-care routine. So first, let's choose the activity. Because of her delirium and fatigue, we wouldn't throw her into a massive shower, toileting, and dressing assessment all at once. We maybe even just start with a bedside grooming activity to test her physical endurance and cognitive focus. And if she managed that well, then we could move on to planning a shower assessment. Once we decide that that's what we want to do, we need to explain to Mrs. Smith our reasoning and gain her consent. And we might even plant that little memory test scene where we ask her to remember our face and name and what we'll be doing when we come back the next day. We speak to the nurse looking after her and get her to add the shower assessment to her handover, but then we also ask her for any insights that she can share about how much help Mrs. Smith needed with her shower that morning. Okay, so now we're up to the day of the assessment, and there's one small final bit of preparation that we need to cover. Before you bring the client to the bathroom, you need to check the environment yourself. Now in a busy hospital ward, bathrooms will frequently become the dumping ground for spare walking frames, commodes, and hoistlings. You must clear that clutter out first. It's really not a fair or safe test of an elderly patient's function to expect them to navigate an obstacle course, and it's probably not what they'll be coming up against once they're home either. But when you're setting up the space, you do have to make a clinical decision. So do you want to keep the space completely clear and simple so that you don't set them up for failure? Or do you want to deliberately plant some safe challenges to test their real-world problem solving and hazard awareness? So for example, you might intentionally leave the towels on their hospital bed rather than bringing them into the bathroom to check their ability to plan and bring them with them. Okay, now we're up to doing the actual assessment. We'll start by breaking down some of the key things that you'll be looking at for each of the tasks that I mentioned before. Firstly, functional mobility. So pay attention to how far they walk, what aids they use, and whether you needed to provide any assistance. How do they manage their transfers? Did they use a grab rail beside the toilet, or did they use their upper limbs for support when they were standing from the shower chair? For more details about how to do a functional mobility assessment, including some tips for what interventions might be helpful if somebody does have difficulty with functional mobility, there's a full webinar within the EuroT Tutor Connector membership, and again I'll drop the link to that in the show notes. The next task is toileting, so it's not just the transfer that we're interested in, but their ability to manage their clothing, to wipe and to flush. For showering, this includes the drying part too, so pay attention to how long it takes, whether they skip or repeat steps such as washing the same body part multiple times, how they manage to problem solve the tricky hospital lever taps, or their phone motor ability to get the shampoo out of the bottle. Remember, know what is normal for your client before assuming that there's a deficit or impairment. When it comes to dressing, we're looking at how much help they need overall, but then looking for varying levels of performance for different types of dressing tasks as well. So physical aspects include the ability to do buttons and zips or to pull a shirt over their head. But there's also cognitive aspects such as choosing the right outfit based on the weather and what they've got planned for the day. And finally, grooming. So what tasks are relevant to your client? This could involve shaving, applying makeup, brushing their hair, brushing their teeth. They could all apply or they could all be completely irrelevant depending on your patient or client. Now, while they are completing all of these tasks, your brain needs to be scanning across four main potential categories where they may be experiencing impairments. So for physical, things like what's their balance, endurance, upper limb function, including range of motion and dexterity. In terms of cognitive function, we're thinking are they sequencing the steps in a logical order, or are they putting their pants on before their underwear? Are they neglecting one side of their body, for example, only washing or shaving one half of their face? Are they demonstrating safe judgment? Or are they trying to stand on one leg on a slippery tiled floor to dry their toes? In terms of sensory impairments, it could be can they actually feel if the water temperature is too hot? Or are they at risk of burning themselves? And the other side of it could be can they see clearly? Or are they tripping over items because everything is white in the bathroom? And finally, psychological. So thinking about is there an intense fear of falling because they've had a previous accident in the bathroom, and how is this impacting their performance during the assessment? A tip for this part is that you can take a few minutes in your preparation phase to pull out a PEO model and map out what impairments you're expecting to see based on what you know about the client already, such as their diagnosis. So for example, if you're working with an adult with multiple sclerosis, we would be anticipating that we could see deficits related to balance, fine motodexterity, fatigue, and potentially cognitive impairments. Now it doesn't mean that all these deficits will necessarily show up, but going through this process will help you feel more prepared for what you should be looking out for. If during the assessment itself you are worried that you'll forget about all of these aspects, you can consider if it is possible to take notes as you go, such as by having a printout with the task steps listed, and then you can just record comments or tally up the errors made at each step. The only difficulty is that often it's logistically tricky to not only keep yourself dry, but to keep a piece of paper dry. So while you're learning, investing more time in the preparation phase, and then also making sure that you've blocked out time immediately after the assessment so that you can do that brain dump of your observations, maybe against a predefined list of task steps, or help you remember exactly what it was that you saw, even if you don't get to write it up into the progress notes straight away. For some extra details around this sort of preparation and recording your observations, take a listen to the podcast episode on how to do a functional cognitive assessment, or join the Connector membership to find the full webinar recording. I also covered this next tip in the Functional Cognitive Assessment Podcast and webinar, and that's how to use the pause prompt praise framework when doing the assessment. Let me give you the in a nutshell version. So firstly the pause. And this is often the hardest part for OTs. We're natural helpers, we want to jump in and fix things, but during an assessment, you have to hold yourself back. If your client makes a mistake, like forgetting to rinse the soap off their arm, you need to pause. Give them a moment to see if they register the error and self-correct. As long as they're physically safe, let those safe mistakes happen so you can see their true cognitive limitations. Next is the prompt. If they draw a complete blank or they get stuck, don't just give them the answer or do the task for them. Give them the minimum amount of help needed to take the next step. Start with something broad or non-specific. So it could be if they've sat on the shower chair but they haven't brought their towel, ask, what else might you need for after you finish washing? If they still can't figure it out, move to something more direct, such as don't forget to grab your towel from the bed. This graded prompting tells you exactly where their executive processing might be breaking down. And finally, the praise part. So when they've successfully solved a problem or maybe worked through a tough sequence, give them the subtle nod of encouragement. So acknowledge their success to keep their confidence up, but just don't overdo it. If we take this structured approach where we're pausing and providing the right amount of prompts at the right time, we'll have a clearer understanding of what your client is capable of. Now before we move on to what to do with the findings of a self-care assessment, let me share some tips from the field learnt from many, many years of completing self-care assessments on the front line as an acute hospital OT. Number one, don't underestimate how many towels you need. Now, don't be conservative, bring at least four towels to a phosphoryl shower assessment. You'll need one for drying the patient, one for the floor, one dry towel to put over the shower chair seat. So if your client stands up to dry themselves and then sits back down on a freezing, soaking wet plastic chair to get dressed, no one's going to be happy. And then the final towel is just in case, but potentially could be for you, which leads to the next tip, the hose of chaos. Handheld shower poses can be fantastic, but to a patient who's only ever used a fixed shower head, they're a completely new skill set to master. So if you let them use it unsupervised, they can easily spray you, the ceiling, and the entire hallway. So keep the bathroom doors shut and stay alert. It's also worth having a spare pair of socks, some dry shoes, or even a backup uniform in your office. If you do enough self-care assessments, you will get splashed or stepped on by wet feet eventually. And without going into too much detail, splashes from water may be the least of your problems. Next up we'll briefly talk through some potential solutions for impairments that are observed in self-care assessments. But first let's go back to Mrs. Smith. On the day of the assessment, we need to remember to ask her, do you remember who I am and what I'm here to do? Rather than telling her, as this will give us some details that we can write about in terms of that longer term memory and recall. We need to check the bathroom itself to ensure that it's free from obvious hazards, but then also make a conscious choice to not carry everything into the bathroom for her, and instead let her identify what she needs and what she might need help with to carry. During the assessment itself, we'll jump in and help only when there's a safety concern or when she seems to have been stuck for a while, or when Mrs. Smith asks for help, and only after we've tried a few more generic prompts first. We're looking out for potential impairments in terms of her physical function, such as her standing balance and endurance, her cognition, such as whether she sequences the steps appropriately, and also any sensory and psychological aspects if that's something that comes up as a potential concern during the planning process. And also some sensory and psychological aspects, particularly if that comes up as a potential concern during the planning process. And then finally we're prepared with plenty of towels and a backup uniform if that shower hose does get out of control. Okay, so now what do we do with our observations from a self-care assessment? We use it to inform our recommendations for things like assistive technology, the need for support services, the need for inpatient rehab, or to confirm our recommendations about safety for discharge. So let's go through those things in a bit more detail and we'll stick with Mrs. Smith to help illustrate it for you a bit more clearly. So firstly, equipment options. If she showed reduced balance or endurance, we'd be looking at prescribing some sort of shower chair or stool. If it was more cognitive deficits, the AT could be in the form of visual prompts that guide her through the steps of the process. If we found that she was normally independent with showering at home but really needed ongoing supervision to be safe while she was recovering due to her deconditioning, it doesn't necessarily mean that she wouldn't be safe for discharge, but it would mean that she isn't safe to go back to her previous home setup and support structure. Now this is where we may make recommendations for support services. If she was otherwise independent with mobility, toileting, and making herself a snack and could go home alone safely for those things, we would still need to have a plan for how she's going to get help with showering. So she could be safe for discharge if the hospital social worker could find a package of services that would be able to help fill that support need upon discharge. If the findings of the self care assessment showed that she required minimal assistance with all aspects from chair transfers to managing her clothes after toileting, she's likely to need more time to recover. So we could consider a referral to inpatient rehab instead, clearly outlining what tasks she still needs. To build independence in to be safe for discharge. Once we're clear on what we'll be recommending, how do we record it in the notes? My first tip is to check with your manager or supervisor to see if there are any resources that already exist, because there may be some specific self-care assessment forms or performers that you need to be filling in and filing in your clients' records. Or there could even be some examples of documentation in progress notes. We could just serve as inspiration for how you're going to document your own session. You can take the approach of documenting your observations on a step-by-step basis, outlining the deficits observed at each step, or you could use the subheadings of the impairments you observed and provide examples of how they showed up during the assessment. Now there's no right or wrong answer, and the key part is that your observations are clear and that they're then followed up by a section that outlines your recommendations and your plan for further input. Now, if you do need some help with visualising how all this information might go together in a progress note, there are some documentation examples available in the Connector membership. And finally, you need to communicate your recommendations to others and how you do this will depend on your setting. In a hospital, it may involve summarising the findings in a case conference discussion or in a clinical handover to a social worker where you're letting them know the patient will need services for showering upon discharge. In a community setting, it can involve liaison with a support coordinator so they know to juggle the client's support roster to make sure that support will be available for that self-care task. Sometimes the communication can also come via a formal report, and this is definitely the case in an NDIS caseload. Now, in this case, we might need to succinctly outline our findings from a self-care assessment in something like a functional capacity assessment. And the key here is to make sure that there's a clear connection between how we describe our client's function and the recommendations that we'll be making for ongoing support. And that's it, so we've gone through the self-care assessment process, but before we finish up the podcast, I've got a couple more things to discuss. Firstly, I'll point out some tips for how completing a self-care assessment in a community setting can be a little bit different because many of the examples that I've focused on so far have been used in the hospital example of Mrs. Smith. And then I'll also touch on how non-standardized self-care assessments may be used in conjunction with the standardized self-care assessments, like a FIM or a modified Barthell Index. Firstly, the community example. So some potential limitations are time and funding. You may have limited funding to be able to go and see and assess the client, and while going through a full morning self-care routine could provide some valuable information, it may not be possible to fund you to do this. Sometimes there's also more hesitation around completing the task as normal, such as showering in the nude, when you're in a community setting compared to a hospital. I think in a hospital setting, many people have been assisted by nurses and it just feels a little bit more expected or normal, but this definitely might not be the case in a community. And I find that community OTs tend to do more of a dry run instead, which is more of a simulation, where they'll get the client to do a walkthrough of their shower transfer, demonstrate how they reach your body parts or how they reach the taps, and pretend to dry themselves off with a towel without actually having to do it in real life. So this saves time if funding is limited, and it may be more comfortable for the client. But we just need to be aware of any potential limitations that this could introduce, such as how it may make things a little bit more confusing and abstract and impact the performance for someone who's primarily experiencing cognitive impairments. Also, if we know that the person's performance does change when it's cold, when it's wet, and that's why they need extra help, then within a community setting, we may still need to see the full task as it is normally performed, so that we can strengthen the evidence if we were doing something like requesting increased support worker assistance from an NDIS plan. For more straightforward self-care assessments, though, simulations can provide adequate detail. So if you did need some ideas for what sort of simulations you could complete, again, that's covered in my self-care webinar in the Connector membership. And then my final point is around standardized and non-standardized self-care assessments, as I find that this is often really confusing for students and new grads. Now, more often than not, the standardized assessments that we're using for self-care, such as the functional independence measure or the modified Barthel index, are based on observations that we've gathered by completing a non-standardized self-care assessment. The FIM and the Barthel aren't completely separate assessments that require us to conduct the task in a certain way. They just allow us to score our observations more objectively. So instead of just saying that they need help and equipment with toilet transfers, the FIM would actually allocate a specific score to that level of function. Allocating scores then opens up opportunities to track change and progress, or sometimes it's needed to get somebody access to a rehab or support package service because the eligibility to that will depend on reaching a specific score on one of those standardized tools. The exception to this may be something like if you're using the AMPS or the PRPP formally as an assessment tool, because that does provide more guidance around the actual administration of the assessment task and recording our observations in a certain way. But otherwise for things like the FEM or the Barthell, it's the non-standardized self-care assessment that gives you the information to allocate a score in the first place. Now, whether or not a standardized assessment adds value in this case depends on the purpose of that score. Like I said, if it's needed to gain entry to rehab or if it's going to serve as a baseline that will then be re-measured, or say for an NGIS client is going to highlight their need for funded supports, then it's worth including. But if that score doesn't add any value or change your recommendations, you probably don't need to be doing it, except for if you were completely new to self-care assessments and you wanted a bit of guidance about what tasks to check on and comment on. Then a standardized tool could provide you with a bit of a list to then guide your non-standardized assessment process. Okay, now we have reached the end of the episode. Hopefully it's helped you understand that a self-care assessment is not just about working through a checklist of what your client can or can't do in certain self-care activities. It provides you with an opportunity to really understand how your client's physical, cognitive, sensory, or psychological impairments may be impacting function. And it can provide you with a starting point for what type of OT intervention will eventually be needed. Next up in the How to Be a Better OT podcast, it's actually the last episode of series one, which has been focused on the how-to guides for OT. We'll be finishing off with one that will definitely be of relevance to OTs working in a community setting. We'll be talking about how to work collaboratively with support workers. We'll talk about how to identify the right support worker, timing and activity, so that you don't automatically place the idea of working with a support worker into the too hard basket. Thanks for listening and I'll talk to you again soon. The information shared on this podcast is for general educational use only, so please always use your own clinical reasoning and seek appropriate professional supervision for any individual client situations. If you'd like to learn more with your OT Tutor so that you can be a better OT who loves what you do, check out the EuroT Tutor website. The links will be in the show notes. There are free resources in the Learning Library, paid CPD memberships, online courses, supervision and mentoring opportunities, and options for your team to all learn together with me.