. He/she will have to take back responsibilities that were avoided while dependent onalcohol. He/she will also need to take responsibility for the behavior and consequencesof the past. Overall, he/she will have to learn to be an independent adult (Riley, 1998).In considering the expected level of independence for the person with alcoholdependency the occupational therapist will concentrate on OT domains of concern whichinclude performance areas, performance components, and performance contexts. Primarily, functional impairment are seen in leisure and work performance areas. Thealcoholic usually gives up leisure activities in order to spend more time acquiring andusing alcohol (Riley, 1998). They will need to explore and develop a variety of leisureactivities and skills (Reed, 1991). Work may be interrupted or jobs lost due to thephysiological and psychological effects of short and long term dependency. These effectsinclude decreased concentration, poor judgment, poor problem solving skills, increasedabsenteeism, and poor time management (Riley, 1998). Other performance areas wheredeficits appear are in activities of daily living and home management. They may neglectself-care and lack skills in money management (Reed, 1991). Performance componentsaffected include sensory and perceptual motor deficits, cognition, psychosocial, andpsychological issues. Sensory and perceptual motor impairments include a loss in tactileperception, figure ground perception, visual-spatial (greatest impairment), and fine motorcoordination (Riley, 1998). Motor deficits may include decreased physical tolerance,endurance, and peripheral neuropathy (Reed, 1991). Cognitive impairment includememory, attention span, concept formation, problem solving, and learning. Abstractreasoning, nonverbal problem solving, short term memory, and perceptual motorintegration may become permanent losses (Riley, 1998). The person may have cognitivedisorders associated w...
