Environment & WC Flashcards
Environment
The aggregate of phenomena that surrounds the individual and influences their development and existence
Sensory Environment
Visual: lighting, color, clutter; Auditory; Tactile: room temp, seating textures; Olfactory; Gustatory
Socio-cultural/human environment
Social roles; Social Network: web of voluntary relations; Cultural: soc norms accepted by a group of people; Psychological: mood/stress level
Context
A variety of interrelated conditions that are within/surrounding the pt.
Less tangible than phys/soc
Include: Cultural, personal, temporal & virtual
Cultural Context
Includes customs, beliefs, activity patterns, behavior standards and expectations accepted by the pts society
Personal Context
Demographic features of individual: age, gender, socioecon status and educational level that are not part of the health condition
Temporal Context
Stages of life, time of year/day, and duration of activity/hx
Virtual Context
Environment in which communication occurs thru airways/comps
Absence of phys contact
ADA
Americans with Disabilities Act: A civil rights law aimed at allowing full participation in society for people with disabilities
(Public service, employment, public accommodations)
OBRA
Omnibus Budget Reconciliation Act: Mandates restraints cannot be ised without proper justification/agreement/documentation
IDEA
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
Comprehensive environmental eval should assess
Sensory, visual-perceptual processing, musculoskeletal, neuromuscular, cognitive and psychosocial skills
The Safety Assessment of Function and the Environment for Rehab (SAFER) focus
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
SAFER scoring and population
Scored using percent (addressed, not applicable, problem)
Originally for psychogeratrics - but now used for home-residing pts of all ages
Safety Assessment Scale (SAS) foucs
Assesses potential safety risks of people with dementia who live at home
Observation and caregiver interview (19-32 Q’s)
SAS scoring and population
Rating scale of most of the time, occasionally and never
Older adults with cog impairments but also community dwelling elders w/o impairments
Presbyopia
Decreased acuity: farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age
Fall Efficacy Scale (FES) focus
Measure a persons FOF during non hazardous ADLs - asking about FOF while pt completes
FES scoring and population
Likert scale (1 not concerned and 4 very) Comm-dwelling older adults w or w/o hx of FOF
Average w/c width
Average w/c length
W/c height from seat to floor
24”-26” rim to rim
42-43”
19-19.5”
Min/ideal clearance for w/c use with door widths
32” & 36”
26” is needed beside the door for door swing
Hallways should be _____ “ wide
36”
W/c height to push handles from floor
W/c height from floor to armrest
36”
29-30”
A 360 degree turning space req clearance space of
60” x 60”
Max reach height forward/sideways from sitting
48” and at least 15”(min) is needed to prevent tipping
46” sideways when obstruction present
Max w/c user countertop
31”
Space for w/c maneuver at parking spot
4 feet
Pathways/walkways ______ wide
48’
Ramps ______ wide
Slope to rise and railings
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
Ramp curbs and turns
4” high min
90 degree turn = 4’ x 4’
180 degree turn = 4’ x 6’
If ramps lead to a door there must be
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
Intrinsic factors contributing to need for fall evalq
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
Restraint reduction is needed to ensure ______ and as a result is mandated by______
Ensure a persons dignity, health and safety
Omnibus Budget Reconciliation Act (OBRA)
