What discharge arrangement would the COTA likely recommend for a client scoring an Allen Cognitive Level of 4.0?

The recommendation of discharging a client scoring an Allen Cognitive Level of 4.0 to a supported living arrangement reflects an understanding of cognitive capabilities at that level. Individuals at an Allen Level of 4.0 can typically perform basic self-care tasks and may require some assistance, particularly with more complex instrumental activities of daily living (IADLs). They can follow a simple 2- to 3-step sequence and may benefit from reminders and assistance for higher-level tasks.

A supported living arrangement strikes a balance between fostering independence and ensuring that the client has access to necessary support. This environment typically offers guidance while allowing the individual to practice and develop their skills, which is crucial for someone at this cognitive level. It encourages the growth of self-care routines while providing the safety net of available assistance.

Discharging home alone without support would likely pose challenges due to the potential difficulty in managing more complex tasks without assistance. Home discharge with family support for all IADLs and personal care may be excessive for a client who is capable of some independent functioning. Remaining in a psychiatric facility would not promote independence and recovery, which is often the goal for clients at this cognitive level.