ADLs and iADLs

Question 1

definition of independence

Answer 1

• a self-directed state of being characterized by an individual’s ability to participate in necessary and preferred occupations in a satisfying manner, irrespective of the amount or kind of external assistance desired or required
• the individual’s independence is not related to whether they perform the activity or not or in a modified fashion or with assistance

Question 2

how to report the results

Answer 2

• remember the purpose of the assessment
• be concise
• provide background of the patient (age, pathology, occupation, where in OT process the patient is, etc..)
• use measurable descriptions
• summarize your findings
• list implications
• recommendations?

Question 3

name and explain descriptors of independence

Answer 3

1. independent:
   - client can independently perform the activity without cueing, supervision, or assistance, with or without assistive devices, at normal or near normal speeds
   - task is completed safely
   - if the client requires assistive device or performs the activity at a slower than customary speed, the term modified independence may be used
2. supervised:
   - client requires general supervision (not hands on) and may require verbal cues for safety
   - the OT feels comfortable being greater than an arm’s length away at all times
3. standby assistance (SBA/contact guard assistance CGA)
   - client requires caregiver or someone to provide hands on guarding to perform a task safely
4. minimal assistance
   - client requires 25% physical or verbal assistance of one person to complete a task safely
   - client performs 75% or more of the task
5. moderate assistance
   - client requires 50% physical or verbal assistance of one person to complete a task safely
   - client performs 50-74% of the task
6. maximal assistance:
   - client requires physical or verbal assistance for 51-75% of an activity by one person
   - client performs 25-49% of the task
   - the helper is doing more than half the work or task, while client is performing less than half
7. dependent:
   - client requires more than 755 physical or verbal assistance
   - client does less than 25% of the task
   - for example, she or he can perform only one or two steps of the activity or very few steps of the activity

Question 4

what deductions and recommendations can be made from results

Answer 4

• measure baseline’- indicate if treatment is needed
• if so, it informs treatment planning
• is treatment effective? adapt treatment
• what adaptations (methods, assistive devices) are required
• what other OPAs are affected?
  + work, social participation, health management, rest and sleep, play, education

Question 5

name basic therapist ethics

Answer 5

• introduce yourself
• explain prose of assessment
• clarify value of personal independence
• explain process of assessment
• include the patient in the decision-making process

Question 6

general approach to assessments

Answer 6

• know the patient and be client centered
• understand the client’s perceptions and value of personal independence
• know the pathology’s presentation and precautions
• note the way the client performs the activity
• know previous circumstances
• activity analysis of each component