ADL and Universal Design Flashcards by Alex Stein

Activities of Daily Living are

those things done each day which sustain and enhance life

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It is an assumption that daily activities

play a central part in everyone’s life

These activities have been identified as occupation

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ADL are oriented toward

taking care of one’s own body

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ADL include

functional mobility
self-care
personal care devices
sexual activity
sleep/rest

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Functional mobility includes

movement in bed
transfers
wheelchair mobility
indoor and outdoor ambulation

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Self care includes

Dressing
Eating and feeding
Toileting (including BB management)
Bathing
Personal hygiene and grooming

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Self care - performance level

1 the ability to perform self care tasks ind.
2 assistive devices may be developed to aid in physically impaired
3 other people in environment can be trained to assist

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Personal Care Devices - examples

Using their hearing aids, changing the batteries

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Sexual activity, sleep/rest

needs to be addressed at some point with the patient even if they don’t bring it up

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IADL are activities that are oriented toward

interacting with the environment and that are often complex

Generally optional in nature (can be delegated to someone else)

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Examples of IADL

Care for others/pets
Child rearing
Communication device use
Community mobility (driving)
Financial management
Health management
Meal preparation/clean up
Safety procedures 
Emergency response
Shopping
Work activities

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IADL - environmental hardware and devices

telephones
keys
faucets
light switches
windows
doors
scissors

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IADL - communication skills

ability to write
operate a computer
read
type
use the telephone

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Components of an ADL examination

SAME! Hx, strength, ROM, coordination, sensation, balance, perceptual skills, cognition, mobility, endurance, cultural values

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ADL evaluation - assessment of the environment(s) the person will be returning to and the available resources - what do these types include

Home
Work/School
Leisure

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ADL evaluation - environments - purpose

1 prevent injury
2 ability to return home and level of assistance needed
3 will they be returning to work and do they need modifications
4 leisure?
5 financial resources

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Work assessment process - usually done by who

Referral for it
Usually done by OT or PT
Worksite visit with the employer/supervisor present

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Work assessment - report of findings and recommendations

Reassign workspace and associated areas
Identification of assistive and adaptive equip
Purchase and install equipment
Redesign of work duties

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Goals

Think function
Level of independence
Use of assistive devices and adaptive equipment

ADL interventions

ROM, strengthening
Mobility trainings
Balance training
Assistive aids
Adaptive equipment
Cognition
Work simplification
Energy conservation
Effective time management
Positioning
Designs to eliminate barriers
Job analysis and placement

Assistive devices and adaptive equipment

Any tool used to make a task easier
May include special medical supplies, tools, or appliances that are widely available or something we have adapted ourselves

Assistive and adaptive equipment - what to consider

cost
use - can and will client use it
design
maintenance

Benefits of assistive and adaptive equipment

Safety
Make tasks easier and more efficient 
Conserve energy
Increase/maintain independence 
Joint protection
Self - esteem

Energy conservation

what is the most efficient way to complete a task or series of tasks

Energy conservation - priorities should be set so that

those activities that are the most important can be accomplished first

Energy conservation - technique to it

organize activities into smaller tasks allows the person to stop activity at any point when the pain or fatigue develops

Increase/Maintain independence

for most this is their goal - need to determine whether this is client's goal or not determine what is and what is not feasible

Universal Design is what

the design of products and environments to be usable by all people, to the greatest possibility, without the need for adaptation or specialized design

American National Standards Institution - published when? | established guidelines for what?

1961 For barrier free design Based on disability based ergonomic principles Reviewed and updated every 5 yrs

Architectural Barriers Act

Enacted 1968 | Stipulated that all federal buildings be accessible to the public including to individuals with disabilities

Public law 94-142 IDEA

enacted 1975 All states receiving federal funding must develop and adhere to policies that provide a free appropriate public education to all children with disabilities

Fair housing act

enacted 1968 prohibits discrimination relative to the sale, rental, and financing of housing based on race, religion, national origin, gender, and disability (latter was added in 1988)

Americans with disabilities act

enacted 1990 Employers cant discriminate based on disability or perceived disability reasonable accommodations cant cause undue hardship

Universal design principles

``` 1 equitable use 2 flexibility in use 3 simple and intuitive 4 perceptible info 5 tolerance for error 6 low physical effort 7 size and space for approach and use ```

Application of universal design for PT and OT

home and work assessments

Universal design - home assessment and adaptation is what

identification of barriers within the home that have the potential to lead to injury and/or decrease function

Universal design - home assessment and adaptation - purpose

1 prevention of injury 2 increase function 3 facilitate return to home environment

Universal design - home assessment process

- referral for home assessment - typically done by OT or PT - client and caregiver present

Universal design - home assessment process - report of findings and recommendations

1 reassign rooms 2 movement or removal of furniture/appliances 3 purchase and installation of equipment 4 identification of outside services

Universal design - recommendations - lighting

Sufficient brightness Limit glare Use of contrasting colors

Universal design - entrances

``` Nonskid surfaces Stairs have railings and step markings Appropriate lighting Easy to use door handles and locks Distance from house to garage and to curb Location of mailbox ```

Universal design - common living space

``` Limited furniture Functional furniture Open walkways Absence of throw rugs Floor surfaces appropriate for mobility devices Appropriate width of doorways/hallways ```

Universal design - kitchens

``` Safety features of stove Cabinets within easy reach Nonskid floor Location of dining room Anti-scald devices ```

Universal design - Bathroom

``` MOST DANGEROUS ROOM! Space btw vanity, tub, toilet Type of tub/shower Presence of adaptive equipment Nonskid floor Night light Anti-scald devices ```

Universal Design - bedroom

``` Lighting, night light Height of bed Location of bed Accessibility to items in closet and dresser Proximity to bathroom ```

Universal Design - Miscellaneous

Presence of pets and children Auditory and/or visual smoke detectors, telephone, door bell Safety devices Neighbors, friends, family Bill payment, transportation, medication management Presence of clutter