Introduction: Mitochondrial Encephalomyopathy, Lactic Acidosis, and Stroke-like Episodes (MELAS) syndrome is a rare, progressive disorder causing complex medical and functional impairments. Acute Medical Units provide rapid assessment and treatment for such patients, but fast-paced environments pose challenges, including disrupted continuity of care, overstimulation, and limited access to specialized rehabilitation. Occupational therapists in AMUs face additional barriers, such as fluctuating caseloads and unclear discharge pathways, complicating rehabilitation efforts.
Objective: This case study explores the application of the Model of Human Occupation (MOHO) in optimizing occupational performance, engagement, and discharge planning for a patient with MELAS in an acute medical setting.
Methods: A 45-year-old male with MELAS was initially admitted without therapy needs. Following a cardiac arrest and ICU transfer, occupational therapy was introduced to address functional deficits. MOHO-guided interventions focused on structured routines, ADL retraining, mobility restoration, and life role reinstatement. Strategies included errorless learning, habit training, family-inclusive therapy, and environmental adaptations. The AM-PAC “6 Clicks” tool measured functional progress.
Results: Structured rehabilitation using MOHO enhanced engagement despite challenges like seizures, fluctuating muscle tone, and exercise intolerance. Errorless learning and cognitive functional models facilitated participation in ADLs and mobility training. Interdisciplinary collaboration and family support established routines, ensuring a successful discharge to long term neuro-rehabilitation. MOHO contributes to complex discharge processes, supporting continuity of care and potentially improving long-term occupational performance and participation.
Conclusion: MOHO provides a valuable framework for occupation-centered care in acute medical settings, supporting meaningful engagement and individualized complex discharge planning. This case underscores the role of occupational therapists in advocating for specialized acute rehabilitation pathways and highlights the need for further research on MOHO’s scalability in acute medical units.