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YR 3, SEM 1 enabling occupation > class test two (wk 4-8) > Flashcards

class test two (wk 4-8) Flashcards

1
Q

what are types of risks in mental health?

A
  • self harm
  • harm to others
  • aggression/violence
  • absconding
  • suicide
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2
Q

what are the aims of a risk assessment?

A

Identify those at risk

Identify clinical management

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3
Q

what are static risk factors for someone suicidal?

A

fixed and historical

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4
Q

what are types of static risk factors for someone suicidal?

A
  • previous self harm
  • diagnosis of mental illness
  • past substance abuse
  • family history
  • recent stressors or loss
  • age, gender and marital status
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5
Q

what are dynamic risk factors for someone suicidal?

A

changeable and fluctuate

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6
Q

what are types of dynamic risk factors for someone who is suicidal?

A
  • active suicidal ideation
  • prone to impulsivity
  • hopelessness, guilt or dramatic change in mood
  • current substance use
  • psychosocial stressors
  • social withdrawal, unstable supports
  • increased agitation, anxiety, sleep disturbance
  • available means to suicide
  • feeling alone, trapped or burden on others
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7
Q

what are protective factors for someone who is suicidal?

A
  • availability of healthcare
  • restrictions on lethal means
  • safe and supportive community enviro
  • connectedness
  • supportive relationship with healthcare providers
  • coping and problem solving skills
  • reasons for living
  • moral objections
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8
Q

what are questions to ask about ideation in relation to suicide?

A

do you have frequent thoughts of suicide- how strong, intrusive and frequent?

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9
Q

what are questions to ask about the plan in relation to suicide?

A

what, where and when?

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10
Q

what is intent in relation to suicide?

A

attempt in progress, plan to skill self (method known), predatory behaviour, expressed intent to die

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11
Q

what is CPR in regards to suicide assessment?

A

C- current plan
P- previous exposure to suicide
R- resources- what the person has or can use thats helpful

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12
Q

what are some questions to ask in regards to an individual’s current plan in a suicide risk assessment?

A

> may be vague or specific
> what?- how and access to means
> where?
> when?

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13
Q

what is the current plan in relation to suicide risk assessment?

A

elements of a person’s plan, the more concrete the greater the risk

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14
Q

what are some questions to ask in regards to an individual’s previous exposure in a suicide risk assessment?

A
  • previous attempt- when? What was the care after?

- someone close to them has killed themselves

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15
Q

what are resources in regards to suicide risk assessment?

A

what the person has or can use that is helpful

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16
Q

what are types of resources that an individual has in regards to suicide assessments?

A

> positive, protective factors to reduce risk
> resources person finds useful
> three types- internal, external and peripheral

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17
Q

what are the three types of resources in a suicide assessment?

A

internal, external and peripheral

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18
Q

what are examples of internal resources in a suicide assessment?

A 
> coping strategies
     > distraction 
     > safety plan
     > engaging in meaningful occupation 
     > values
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19
Q

what are examples of external resources in a suicide assessment?

A

> family/friends/pets/significant other

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20
Q

what are examples of peripheral resources in a suicide assessment?

A

> helplines
> therapists etc.
> teachers
> clergy

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21
Q

what are examples of risk assessment questions for CPR?

A

-do you want to kill yourself/do you have suicidal thoughts?

Current Plan: 1. How would you kill yourself? 2. Do you have access to…? 3. When do you plan to kill yourself?

Previous Exposure: 1. Have you tried to kill yourself before? 2. If so how long ago was that? 3. Do you know anyone who has killed themselves?

Resources: 1. Who in your life do you turn to when you need someone to talk to? 2. What stops you from killing yourself or what keeps you alive? 3. Do you have any other supports?

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22
Q

what are some risk management actions you could take?

A
  • rapport, active listening
  • involve family, caregivers and support networks
  • if required inform supervisor and refer to other professionals
  • consider substance use disorders, mental illness and personality disorders
  • management plan needs to be individualised and informed by risk assessment
  • conduct MSE
  • provide resources
  • address dynamic risk factors
  • document
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23
Q

what is low risk in risk management for suicide?

A

-depressed, no social ideation, no plan/intent

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24
Q

what should occur if an individual is a medium risk in risk management for suicide?

A
  • engaged in more collaborative approach, help with access to info/resources but ultimately leaving things up to individual
  • seek manager input and refer on if any suicidal ideation/plan/intent
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25
Q

what should occur if an individual is a high risk in risk management for suicide?

A
  • engaged directively, with helper taking steps to ensure immediate and ling-term safety and connecting them to resources
  • seek manager immediate and direct input
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26
Q

how should an individual with low risk for suicide be treated?

A

with empathy and respect and empowered to make decision for themselves

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27
Q

what are some resources for suicide risk patients?

A
  • safety plans
  • helplines
  • follow up appointments/calls
  • online resources
  • enlist family/support persons
  • referrals
  • local hospital triage
  • CATT- crisis and assessments treatment teams
  • call 000 or go ED
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28
Q

what is PTSD?

A

is a type of anxiety disorder that can occur at any age after witnessing or experiencing a traumatic event that involved the threat of injury or death

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29
Q

what can PTSD follow?

A 
> natural disaster 
     > life threatening illness
     > assault 
     > domestic abuse 
     > prison stay 
     > rape 
     > terrorism 
     > war
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30
Q

what does procedural memory formation relate to?

A

motor skills that are learnt, automatic

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31
Q

what does declarative memory formation relate to?

A

life events

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32
Q

what does the hypothalamus-suprachiasmatic nucleus affect with sleep?

A
  • circadian rhythm area

- receives sensory info about light/dark cycle ‘entrains’ sleep rhythm

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33
Q

how is the brainstem involved with sleep?

A
  • communicates with SCN and reduces activity of the ARAS

- GABA

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34
Q

how is the thalamus involved with sleep?

A
  • relay of external sensory info to the cortex decreases

- in REM sleep it is active relaying info from within the brain

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35
Q

how is the pineal gland involved in sleep?

A
  • secretes melatonin in response to signals from the SCN and visual system
  • melatonin synchronises
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36
Q

how is the basal forebrain involved with sleep?

A

-helps regulate sleep cycles by increasing drive to sleep

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37
Q

how is the amygdala involved with sleep?

A

-becomes active during REM sleep

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38
Q

what is the purpose of sleep?

A
  • homeostatic need for sleep regulated centrally
  • metabolic role- NREM- rise in ATP- increased protein synthesis
  • growth hormone release
  • immune system
  • neurotrophic factors released- synaptic consolidation and generation> synaptic plasticity and learning
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39
Q

how does PTSD influence sleep?

A
  • hyperarousal > problems with sleep transition
  • REM arousal due to intrusive dreams
  • REM behaviour disorder due in older sufferers
  • evidence of increased activation of amygdala in REM
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40
Q

what occurs in the neurobiology of chronic PTSD?

A
  • increased circulating levels of noradrenalin
  • increased reactivity of a2- adrenergic receptors> blood vessel reactivity
  • increased thyroid hormone levels
  • explains some of the somatic symptoms
  • increased catecholamine levels potentiate threat response of amygdala
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41
Q

does the hippocampus have a higher for lower volume for PTSD sufferers?

A

lower

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42
Q

what occurs in the 1st stage of stress?

A

shock

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43
Q

what occurs in the 2nd stage of stress?

A

resistance, body fights back > adrenaline and cortisol release

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44
Q

what occurs in the 3rd stage of stress?

A 
if too much cortisol for too long: 
    > exhaustion 
    > impaired immune function 
    > chronic hypertension 
    > obesity 
    > atherosclerosis
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45
Q

what are some possible treatments for PTSD?

A 
> CBT 
     > eye movement desensitisation reprocessing (EMDR)
     > brief psychodynamic psychotherapy 
     > stress management 
     > supportive counselling/therapy 
     > narrative exposure therapy 
     > group therapy 
     > expressive therapies- art/drama
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46
Q

what are some pharmacological treatments for PTSD?

A

> antidepressants
> TCAs, MAOIs, SSRI
> benzodiazepines and other sleeping meds
> B blockers- anxiolytic
> antihistamines- for sedative effect
> antihypertensives
> experimental- Acetylcholinesterase inhibitors

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47
Q

what are some physical treatments for PTSD?

A

> ECT

> transcranial magnetic stimulation- dorsolateral prefrontal cortex

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48
Q

what are some adjunctive therapies for PTSD?

A

> engagement in meaningful individual/group occupation
> healthy behaviours
> exercise
> sleep hygiene

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49
Q

what is involved in trauma informed care?

A
  1. safe/supportive enviro that protects against physical harm and re-traumatisation
  2. Understand clients and symptoms, background, experiences and culture
  3. Collaboration between service provider and client throughout
  4. Understanding of symptoms and survival responses required to cope
  5. View of trauma as a fundamental experience that influences identity rather than a discrete event
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50
Q

what are treatment principles for OTs working disasters?

A

> multi level- individual, families, groups, community- dynamic
> appreciate each individual/communities have their way of coping
> can’t be prescriptive

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51
Q

what should be provided immediately after exposure to trauma at immediate intervention?

A

> info
> emotional support
> practical assistance

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52
Q

what is involved in psychological first aid for those experiencing acute stress responses or risk of impaired function?

A
  1. Contact and engagement
  2. Safety and comfort
  3. Stabilisation
  4. Info gathering
  5. Practical assistance
  6. Connection with social supports
  7. Info on coping
  8. Linkage with collaborative services
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53
Q

what are five post disaster early intervention principles?

A

Promote:

  • sense of safety
  • calm
  • social connectedness
  • self-efficacy
  • hope
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54
Q

what are some early interventions in the immediate days/weeks out disaster?

A
  • basic practical support, set up familiar routines- reengage in daily activity
  • need sense of belonging
  • occupational balance
  • engage in some positive occupations to balance difficult experiences
  • psychoeducation
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55
Q

what are some treatment principles in PTSD?

A
  • psychoeducation
  • skills- how to cope
  • therapy
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56
Q

what are some occupational issues associated with PTSD/disasters?

A
  • sleep issues, decreased self care
  • avoid/limited leisure and productive activity
  • isolated from social enviro impacting everyday function
  • difficulty initiating participation in community activity
  • poor time management- occupational imbalance
  • social skill difficulty impacting relationships
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57
Q

what are some models that can be utilised when dealing with PTSD or disaster?

A
  • biopsychosocial model
  • recovery model
  • systems theory
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58
Q

what are some interventions that can be used for PTSD?

A
  • graded exposure

- CBT

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59
Q

what are some assessments that can be apart of a PTSD program?

A
  • initial
  • CAPS (clinician administered PTSD scale)
  • other scales such as DASS
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60
Q

what does psychoeducation about PTSD involve education about?

A

> trauma memory network
> problems commonly associated with PTSD
> impact on families and relationships
> neuropsychology
> medications used

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61
Q

what does skills treatment/training for PTSD involve?

A

> substance use issues
> relaxation training
> communication skills
> anxiety/anger management

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62
Q

what are some lifestyle based treatments for PTSD?

A 
> exercise 
    > outing group
    > managing change 
    > occupational issues 
    > sleep 
    > gender issues
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63
Q

what are some types of therapy that can be beneficial for PTSD sufferers?

A 
> group therapy 
    > individual therapy 
    > couples therapy 
    > creative expression 
    > children’s group
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64
Q

what is traumatic stress?

A

human response to traumatic, catastrophic or adverse events

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65
Q

what is trauma?

A

deeply distressing experience, emotional shock following stressful event

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66
Q

what are the different types phenomena that can be referred to as trauma?

A

> physical- injury to body
> emotional- psychological and emotional injury
> physical and emotional- traumatised both physically, psychologically and emotionally
> psychic- trauma to the psyche (soul, mind, spirit)
> psychosocial- Psychological and social (community) response to event

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67
Q

when does a crisis response occur?

A

few days immediately after experience

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68
Q

when does an acute stress response occur?

A

few months after

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69
Q

what awesome trauma and stressor related disorders identified by the DSM-V?

A
  • reactive attachment disorder- children
  • disinhibition social engagement disorder- children
  • PTSD- symptoms more than 1 month in adults, adolescents and children older than 6 years
  • PTSD for children 6 and under- symptoms more than 1 month
  • acute stress disorder (3 days-1month)
  • adjustment disorder- no traumatic event but response to an identifiable stressor within 3 months
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70
Q

what PTSD diagnoses are no longer in the DSM?

A
  • acute PTSD- less than 3 months
  • chronic PTSD- longer than 6 months
  • delayed onset PTSD
  • complex PTSD- disorders of extreme stress not otherwise specified
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71
Q

how does the American Psychiatric Association define events as being traumatic?

A

if there has been exposure to actual or threatened death, serious injury, or sexual violence in 1 or more of the following ways:

  • directly witnessing
  • witnessing in person the events as it occurred to others
  • learning that traumatic events occurred to close family/friend, event must have been violent or accidental
  • experiencing repeated or extreme exposure to aversive details of traumatic events (paramedic, police, therapists)
72
Q

how is a traumatic event categorised by type?

A
  • human/nonhuman (war vs natural)
  • sudden onset (accident)
  • short duration
  • repeated over time
73
Q

how is a traumatic event categorised by type of experience?

A
  • primary (direct experiencing)
  • secondary (witnessing)
  • tertiary (learning about event occurring to close family/friend)
74
Q

what is psychic (emotional) trauma?

A
  • an inescapably stressful event that overwhelms peoples exisiting coping mechanisms
  • the experience of hopelessness, powerlessness, a threat to one’s life and sense of control
75
Q

what are some types of post traumatic responses?

A
  • existential impact- profound emptiness, loss of connection with one’s spirituality, disruption of ability to hope, trust, or care about oneself or others
  • depression
  • complicated or traumatic grief
  • anxiety
  • stress disorders
  • dissociation
76
Q

what is criteria A on the symptoms and diagnosis of PTSD on the DSM-V?

A

Exposure to actual or threatened death, serious injury or sexual violence

77
Q

what is criteria B on the symptoms and diagnosis of PTSD on the DSM-V?

A

Presence of 1 or more intrusion symptoms associated with traumatic events beginning after the event

78
Q

what is criteria C on the symptoms and diagnosis of PTSD on the DSM-V?

A

Persistent avoidance of stimuli associated with traumatic events beginning after the event

79
Q

what is criteria D on the symptoms and diagnosis of PTSD on the DSM-V?

A

Negative alterations in cognition and mood associated with traumatic events beginning after the event evidenced by 2 or more of…

80
Q

what is criteria E on the symptoms and diagnosis of PTSD on the DSM-V?

A

Marked alteration in arousal and reactivity associated with the trauma beginning after the event or worsening after

81
Q

what is criteria F on the symptoms and diagnosis of PTSD on the DSM-V?

A

Duration of the disturbance (Criteria BCDE) more than 1 month

82
Q

how long must criteria BCDE on the PTSD DSM-V last for?

A

more than a month

83
Q

what is criteria G on the symptoms and diagnosis of PTSD on the DSM-V?

A

The disturbance causes clinically significant distress or impairment in social, occupational or important areas of functioning

84
Q

what is criteria H on the symptoms and diagnosis of PTSD on the DSM-V?

A

The disturbance is not attributable to the physiological effects of substance or other medical condition

85
Q

what is somatic symptom disorder as a traumatic response in DSM-V?

A

somatization disorder (unexplained physical symptoms such as pain) and conversion reaction (symptoms or deficits affecting voluntary motor or sensory function which cannot be fully explained and are associated with conflict or stressor)

86
Q

what is brief psychotic disorder as a traumatic response in DSM-V?

A

(brief reactive psychosis) associated with marked stress event

87
Q

what is dissociative identity disorder as a traumatic response in DSM-V?

A

disruption of identity, discontinuity of sense of self and sense of agency

88
Q

what is borderline personality disorder as a traumatic response in DSM-V?

A

pervasive patterns if instability of interpersonal relationships, self image, and affects, and marked impulsivity beginning by early adulthood

89
Q

what are some personal variables associated with the development go post-traumatic symptoms?

A

> genetic
> biological
> coping abilities, adaptive strategies
> previous experiences

90
Q

what are some event variables associated with the development go post-traumatic symptoms?

A

> intentional act of violence
> presence of life threat/physical injury
> extent of exposure
> witnessing death
> loss of friend/family/loved one due to trauma
> unpredictability and uncontrollability
> sexual victimisation

91
Q

what are some social response variables associated with the development go post-traumatic symptoms?

A 
> family/friends
     > community leaders 
     > emergency and support workers
     > health professionals 
     > society
92
Q

what are some of the recovery enviro response variables associated with the development go post-traumatic symptoms?

A

> reduced demands initially- social, occupational, emotional and psychological
> absence of stressors
> engagement in healthy behaviours and occupation
> encouragement of resilience, constructive thinking and activities

93
Q

what is identified in the working model?

A

factors identified that affect processing of a traumatic event

94
Q

what is the working model used to do?

A

plan assessment and intervention to enable recovery, adoption, growth and destabilisation and not pathology

95
Q

what are some factors in the working model?

A

> nature of experience
> individual characteristics
> recovery enviro
> post traumatic processing

96
Q

what is the nature of experience as a factor in the working model?

A

life threat, warning, exposure to grotesque, role of survivor

97
Q

what is the individual characteristics as a factor in the working model?

A

pre-trauma personality, coping behaviour, defensive styles etc.

98
Q

what is the recovery enviro as a factor in the working model?

A

social support, intactness of community, demographics, culture etc.

99
Q

what is post traumatic processing as a factor in the working model?

A

psychic overload vs gradual assimilation of event

99
Q

what is post traumatic processing as a factor in the working model?

A

psychic overload vs gradual assimilation of event

100
Q

what is the corrections act 1986?

A
  • people indention have right to health and mental health treatment comparable to community care
  • cannot be compelled to accept treatment
101
Q

what is the mental health act 2014?

A

-patients who meet criteria for compulsory treatment under MHA must be transferred to a designated mental health service (Thomas Embling Hospital) under secure treatment order

102
Q

what is involved in the crimes (mental impairment) act 1997 under section 20?

A

-person charged with offence if at time of engaging in conduct constituting the offence, the person was suffering from a mental impairment that has the effect that:

 > he/she did not know nature and quality of conduct 
 > he/she did not know conduct was wrong (could not reason is perceived as wrong)
103
Q

what is seclusion defined under?

A

MHA (2014) and clear purpose for use

-aim for least restrictive option

104
Q

what is the diagnosis in forensic patient profiles?

A
  • 95% schizophrenia

- 76% have dual diagnosis (substance use)

105
Q

what is the psychosocial aspect of forensic patient profiles?

A
  • average IQ is 80
  • average education level is year 9
  • less than 30% were working prior to admission
106
Q

what is the often the offence of forensic patient profiles?

A
  • 70% have committed murder (others: attempted murder, serious violence
  • 25% have prior offending
107
Q

what is the often the health of patients on their forensic patient profiles?

A
  • secure hospital patients have a shorter life expectancy (by 10 years)
  • average BMI: 35 (healthy= 18.5-24.9)
108
Q

what are some clinical support and intervention programs in forensic setting?

A
  • vocational training via TAFE
  • recreation and leisure
  • dietician/physio/dentist/GP/practice nurse
  • therapeutic programs- WHO pillars of care
  • creative arts
  • spiritual care coordinator
  • consumer and carer programs
109
Q

what are some assessments apart from MOHO that can be used in forensic setting?

A
  • adult sensory profile (ASP)/sensory cards
  • cognitive assessments
  • ongoing observations of occupation
  • literacy/numeracy assessment
  • digital literacy/skills assessment (informal)
110
Q

what are some individual interventions in the forensic setting?

A
  • providing individual therapy on bed-based units and within outpatient settings
  • supporting community re-integration including developing skills for community living
111
Q

what are some group interventions in the forensic setting?

A
  • providing group based treatment on bed-based units and within outpatient settings
  • modules and series to address a range of occupational needs
112
Q

what are some service wide (population) interventions in the forensic setting?

A
  • liaising and providing treatment options with wider MDT and other key stakeholders (education, programs staff, correctional staff etc.)
  • educating and enhancing clinical and non-clinical team’s understanding of the role of OT in each setting
  • project work
113
Q

what is step 1 recovery pyramid?

A

paralysis, denial

114
Q

what is step 2 recovery pyramid?

A

hopelessness, confusion, giving up

115
Q

what is step three of the recovery pyramid?

A

initial motivation

116
Q

what is step 4 of the recovery pyramid?

A

understanding, adaptability

117
Q

what is step 5 of the recovery pyramid?

A

eager to move forward

118
Q

what is step 6 of the recovery pyramid?

A

accountability for action, initiate actions

119
Q

what is step 7 of the recovery pyramid?

A

ongoing journey with/without symptoms, being apart/contributing to community

120
Q

how do we evaluate individual patient progress in the forensic setting?

A

MOHOST as an outcome measure

121
Q

how do we evaluate programs in the forensic setting?

A

observations and reviews, feedback, pre and post surveys

122
Q

how do we evaluate runs in the forensic setting?

A

using reflection, supervision, and peer support too evaluate and improve practice

123
Q

what is multiple sclerosis?

A

a condition of the CNS that interferes with nerve impulses within the brain, spinal cord, and optic nerves. Scars occur within the CNS and symptoms depend on where they develop

124
Q

what are symptoms of MS?

A
  • impaired motor control
  • fatigue- heat sensitivity and MS fatigue
  • other neurological: vertigo, pins and needles, neuralgia, and visual disturbance
  • continence issues- bladder incontinence and constipation
  • neuropsychological- depression, cognitive difficulty, memory loss
125
Q

what are the types of MS?

A 
Relapsing-remitting (RRMS)
Secondary progressive (SPMS)
Primary progressive (PPMS)
126
Q

what is relapsing-remitting MS characterised by?

A

-characterised exacerbations, relapses, or flares

127
Q

what is the % of relapsing-remitting MS of MS sufferers?

A

70-75% of MS diagnosed

128
Q

what is secondary progressive MS?

A

starts with RRMS and then becomes steadily progressive

129
Q

what % of people with MS have secondary progressive MS?

A
  • greater than 50% of people with RRMS will develop within ten years
  • 90% within 25 years
130
Q

what is primary progressive MS?

A

-conditions progressively worse than onset

131
Q

what % of people with MS develop PPMS?

132
Q

what is MND?

A

affects nerves (motor neurones) that communicate between brain and muscles that enable movement, speech, swallowing, breathing. People with MND have gradually degenerating to dying motor neurones, causes muscles to weaken and waste

133
Q

what is the life expectancy of MND?

A

terminal with average life expectancy 2-3 years

134
Q

what are types of MND?

A
  • amyotrophic lateral sclerosis (ALS)
  • progressive bulbar palsy (PBP)
  • flail limb
  • primary lateral sclerosis
  • MND/FTD
135
Q

what are the initial symptoms of MND?

A
  • stumbling due to leg muscle weakness
  • difficulty holding objects caused by weakness of hand muscles
  • slurring of speech or swallowing difficulty due to tongue and throat muscle weakness
  • cramps and muscle twitching
136
Q

what are the ongoing symptoms of MND?

A
  • breathing difficulty
  • fatigue
  • insomnia
  • cognitive changes
  • emotional regulation issues
  • pain
137
Q

what is a prognosis?

A

term for predicting likely or expected development of a disease, including whether signs/symptoms will improve or worsen (and how quickly) or remain stable over time; expectations of QoL, potential for complications; and likelihood of survival (life expectancy)

138
Q

what is prognosis made based on?

A

asis of the normal course of diagnosed disease and individuals physical and mental condition, treatments available, and additional factors

139
Q

what is the OTs role in the community in palliative care?

A
  • holistic assessment
  • collaborative goals
  • client centred treatment
  • monitor and adjust goals/treatment which deterioration
  • discharge
140
Q

what is involved in assessment at end of life stage?

A
  • fatigue/pain/stress levels
  • pressure care issues
  • carer/family supports
  • preparedness for death
  • joint assessment with multidisciplinary team
141
Q

what are some focuses of end of life stage intervention?

A
  • continuing routine valued occupations
  • long held wishes
  • new pursuits
  • preparing for death
  • ADL strategies to assist with participation in valued occupations
  • minor home mod
142
Q

what can we do when working with caregivers of palliative patients?

A
  • education with specific support skills
  • attending to care givers own needs
  • balancing demands with their own occupations
  • support grief and bereavement needs
143
Q

what are the three types of palliative care services delivered?

A

Palliative approach
Specialised palliative service approach
End of life (terminal) care

144
Q

what is trajectory 1 in functional decline in palliative care?

A

rapid decline in last 14 days, AKPS 40

145
Q

what is trajectory 2 in functional decline in palliative care?

A

flatter, prolonged decline over 120 days, AKPS 40

146
Q

what is the rapid assist home visit service?

A
  • rapid response team
  • OT, doctor, nurse
  • fast track discharge
  • keep people at home
147
Q

what are assessment tools for patients in palliative care?

A 
> symptom Ax- BFI 
     > goal attainment- COPM, GAS
     > discharge destination 
     > QoL
     > performance status
148
Q

what are assessment tools for carers in palliative care?

A

> CSNAT

> carer burden scale

149
Q

what are some coping strategies in palliative care?

A
  • may be adaptive or maladaptive

- collusion, denial/anger, depression and anxiety

150
Q

what is palliative care?

A

approach that improves QoL of patients/families facing problems associated with life threatening illness, through prevention and relief of suffering by means of early identification and assessment, and treatment of pain and other problems, physical, psychosocial and spiritual

151
Q

what is the goal and aim of palliative care?

A
  • provide relief from pain and other stressors
  • affirms life
  • intends to neither hasten or postpone death
  • integrates psychological and spiritual aspects of care
  • offers support system to help patients live as actively as possible, and to families
152
Q

when was the voluntary assisted dying act passed in VIC?

A

19th Nov 2017

153
Q

what is the voluntary assisted dying act?

A

provides regulations, establishes criteria steps through detailed request and assessment process, including requirements for medical professionals. Provides safeguards including medication monitoring, practitioner protections, offences, and a five year review

154
Q

what is the eligibility criteria for the voluntary assisted dying act?

A
  • over 18 years
  • Aus citizen or permanent resident for at least 12 months
  • have decision making capacity
  • be diagnosed with a disease, illness that:> incurable and advanced, progressive and will cause death
    expected to cause death within weeks/months not exceeding 6 months ( 12 for people with neurodegenerative)
    is causing suffering that cannot be relieved in tolerable manner

-request and assessment x3

155
Q

what is the OTs role in end of life care?

A
  • directed to maximise potential for sale and independent living
  • main roles is assessment of capacity for independent living, planning improvements to household, and supporting carers
  • assist people to live at home for as long as possible
156
Q

what are some OPI’s being experienced by Elza?

A
  • occupational imbalance
  • lack of occupational participation in self care (sleep)/leisure
  • lack of occupational roles
  • managing finances
157
Q

what is some info about Elza’s situation?

A
  • homeless since 16
  • beaten multiple times by partner
  • unstable living situation
  • previous experience as barista
  • prior psychiatric admission following OD
158
Q

what symptoms is Elza still experiencing?

A
  • headaches and double vision when tired

- loss of sensation on ulnar side if right hand

159
Q

what are some OPI’s that could occur following disaster?

A
  • grief
  • loss
  • loss of occupational roles
  • occupational imbalance
  • lack of occupational participation
160
Q

what is some info about Pete’s previous interests?

A

video games and music and watching DVDs and tv about this

161
Q

what has Pete been diagnosed with?

A
  • ASD
  • paranoid schizophrenia
  • substance dependency- Hep C
162
Q

what is Pete’s presentation?

A
  • intrusive
  • thought disordered and acutely psychotic
  • non compliant with meds
163
Q

what are some OPIs Pete is experiencing?

A
  • medication management
  • socially appropriate behaviour
  • managing finances
  • not being able to maintain a job
  • PADLs sporadically
  • limited CADLs/DADLs
  • minimal ADLs especially food prep
164
Q

what is the ages of the young people in residential aged care?

A

25,31,36, 40

165
Q

what have the young people in residential aged care been diagnosed with?

A

ABI all HHH (high ADL, behaviour, and complex needs)

166
Q

what equipment is being used by young residents in aged care?

A
  • 3 have customised wheelchairs, 1 can use independently
  • 1 mobile hoist
  • transport for two at a time
  • light writer and alphabet board
167
Q

what are some strengths of the young people living in residential aged care?

A
  • can communicate basic needs
  • generally orientated to time
  • good level of awareness
168
Q

what are some secondary issues experienced by some of the young people in residential aged care?

A
  • for 1 stage 2 pressure care
  • recurrent chest infection
  • 2 dysarthric speech
169
Q

what are some OPIs experienced by the young people in residential aged care?

A
  • age-appropriate occupation, lack of occupational balance/participation
  • pressure care
  • limited occupational roles
  • lack of social engagement
170
Q

what is some info about Jenny’s situation?

A
  • 48 yo
  • husband and two kids
  • wants to go home
171
Q

what is Jenny’s current and previous diangosis?

A

currently has left frontal parietal brain tumour

previously had grade 2 astrocytoma brain tumour 10 years ago

172
Q

what symptoms is Jenny currently experiencing with her tumour?

A
  • headaches
  • seizures
  • muscle weakness
173
Q

what are some OPI’s Jenny is experiencing?

A
  • fatigue
  • transfers
  • house accessibility/getting into backyard for leisure (smoking)
  • DADLs
  • social engagement
  • community access
  • weight gain
174
Q

what are some models and frameworks used in palliative care?

A
  • biomechanical
  • biopsychosocial
  • ICF
  • MOHO
  • CMOP-E
  • models of grief and loss
  • stress-vulnerability
  • QoL
  • CPPF

YR 3, SEM 1 enabling occupation (2 decks)

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