Environment & WC

Question 1

Environment

Answer 1

The aggregate of phenomena that surrounds the individual and influences their development and existence

Question 2

Sensory Environment

Answer 2

Visual: lighting, color, clutter; Auditory; Tactile: room temp, seating textures; Olfactory; Gustatory

Question 3

Socio-cultural/human environment

Answer 3

Social roles; Social Network: web of voluntary relations; Cultural: soc norms accepted by a group of people; Psychological: mood/stress level

Question 4

Context

Answer 4

A variety of interrelated conditions that are within/surrounding the pt.
Less tangible than phys/soc
Include: Cultural, personal, temporal & virtual

Question 5

Cultural Context

Answer 5

Includes customs, beliefs, activity patterns, behavior standards and expectations accepted by the pts society

Question 6

Personal Context

Answer 6

Demographic features of individual: age, gender, socioecon status and educational level that are not part of the health condition

Question 7

Temporal Context

Answer 7

Stages of life, time of year/day, and duration of activity/hx

Question 8

Virtual Context

Answer 8

Environment in which communication occurs thru airways/comps
Absence of phys contact

Question 9

ADA

Answer 9

Americans with Disabilities Act: A civil rights law aimed at allowing full participation in society for people with disabilities
(Public service, employment, public accommodations)

Question 10

OBRA

Answer 10

Omnibus Budget Reconciliation Act: Mandates restraints cannot be ised without proper justification/agreement/documentation

Question 11

IDEA

Answer 11

Individuals with Disabilities Edu Act: Mandates that all children with disabilities are entitled to a free public education in the most least restrictive (natural) environment; uses inclusive models
Child must be edu on living independently, employment, soc participation

Question 12

Comprehensive environmental eval should assess

Answer 12

Sensory, visual-perceptual processing, musculoskeletal, neuromuscular, cognitive and psychosocial skills

Question 13

The Safety Assessment of Function and the Environment for Rehab (SAFER) focus

Answer 13

ID possible safety concerns in home environment/assesses if person is able to respond to safety situations
Interview/observation covering 128 safety items conducted in home

Question 14

SAFER scoring and population

Answer 14

Scored using percent (addressed, not applicable, problem)

Originally for psychogeratrics - but now used for home-residing pts of all ages

Question 15

Safety Assessment Scale (SAS) foucs

Answer 15

Assesses potential safety risks of people with dementia who live at home
Observation and caregiver interview (19-32 Q’s)

Question 16

SAS scoring and population

Answer 16

Rating scale of most of the time, occasionally and never

Older adults with cog impairments but also community dwelling elders w/o impairments

Question 17

Presbyopia

Answer 17

Decreased acuity: farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age

Question 18

Fall Efficacy Scale (FES) focus

Answer 18

Measure a persons FOF during non hazardous ADLs - asking about FOF while pt completes

Question 19

FES scoring and population

Answer 19

Likert scale (1 not concerned and 4 very)
Comm-dwelling older adults w or w/o hx of FOF

Question 20

Average w/c width
Average w/c length
W/c height from seat to floor

Answer 20

24”-26” rim to rim
42-43”
19-19.5”

Question 21

Min/ideal clearance for w/c use with door widths

Answer 21

32” & 36”

26” is needed beside the door for door swing

Question 22

Hallways should be _____ “ wide

Answer 22

36”

Question 23

W/c height to push handles from floor

W/c height from floor to armrest

Answer 23

36”

29-30”

Question 24

A 360 degree turning space req clearance space of

Answer 24

60” x 60”

Question 25

Max reach height forward/sideways from sitting

Answer 25

48” and at least 15”(min) is needed to prevent tipping

46” sideways when obstruction present

Question 26

Max w/c user countertop

Answer 26

31”

Question 27

Space for w/c maneuver at parking spot

Answer 27

4 feet

Question 28

Pathways/walkways ______ wide

Answer 28

48’

Question 29

Ramps ______ wide

Slope to rise and railings

Answer 29

36” with non skid surface on U and L levels
Slope to rise = 1:12 which means 1” of vertical rise for ever 12”
Railings: between 29”-36” - 32” = average

Question 30

Ramp curbs and turns

Answer 30

4” high min
90 degree turn = 4’ x 4’
180 degree turn = 4’ x 6’

Question 31

If ramps lead to a door there must be

Answer 31

5’ X 5’ platform b4 door that extends at least 12” (preferably 18”) along the side of the door to allow for door swing w/o backing up

Question 32

Intrinsic factors contributing to need for fall evalq

Answer 32

Vision difficulties: presbyopia/impaired depth perception, reduced night vision
Vestibular difficulties: vertigo, postural sway
Neuromuscular age related changes 
Pathological conditions
Meds/Side effects
Delirium/Dementia
Anxiety/Depression
Prior fall hx  or FOF

Question 33

Restraint reduction is needed to ensure ______ and as a result is mandated by______

Answer 33

Ensure a persons dignity, health and safety

Omnibus Budget Reconciliation Act (OBRA)