L3.1 Intervention Planning Flashcards
in terms of ADL performance, difficulties can arise as a consequence of…
- Changes in a person’s functional capacities as a result of ageing, injury, impairment or a health condition
- Variations in occupational demands or the way activities are undertaken
- Barriers or challenges presented by the environment
what is the intervention focus?
- Person: skill development, preparatory methods and purposeful activity
- Occupation: grading, adapting task, use of assistive devices
- Environment: structure and modify physical and social environment and interactions between each and all of the above
in terms of person-based interventions, engagement in occupation can be established or restored by…
- restoring or maintaining performance components such as muscle strength, range of movement, endurance, and attention: Preparatory Methods, Purposeful Activities, Meaningful Occupations.
- managing issues such fatigue, pain, attention and short-term memory difficulties: Training and education
- establish habits and routines for activities that need to be undertaken regularly: Training, education and structuring.
in terms of occupation-based intervention, explain occupation as ‘means’ and ‘ends’.
- Means - Occupation as a medium of change - occupational therapy intervention may involve the therapeutic use of occupation as a “means” or method of changing performance.
- Ends - Humans as occupational beings – goal (and outcome) of occupational therapy intervention is the client’s improved engagement in meaningful occupation and patterns of engagement.
in terms of occupation-based intervention, explain grading and adapting activities with examples.
Grading = Changing the complexity of the activity to decrease/increase demand.
o Duration – allow more time, break task into smaller units with frequent rests
o Complexity – simplify the activity
o Resistance – the weight of the objects
o Reach – where objects are placed
o Repetition – number of times action/performance is required
Adapting = Modifying or substituting techniques or objects to be used in performing the activity.
o Adapting activities may impact on the way the activity is performed. This may have as much meaning to the person as the outcome
o Using alternative methods/strategies to complete activities
o Using assistive devices – to enable participation in activities
in terms of environment-based intervention, what is the intervention’s concern/goal.
Concerned with structuring or modifying the environment to support/promote occupational performance
Specifically: safety, independence, efficiency, effectiveness (of performance)
Ensuring that the method used is acceptable and the meaning of the activity is retained for the individual
in terms of environment-based intervention, what are environmental modification approaches?
- Reorganising – restructuring the existing environment
- Repositioning –relocating objects, features, resources
- Enhancing – improving aspects of the environment e.g. changing lighting
- Adding – providing additional resources e.g. grab rails, nonslip mats
- Removing – taking away challenges
in terms of environment-based intervention, explain how to enable occupation.
- Focused on supporting occupational engagement
- Utilises alternative strategies, assistive devices, environmental design and social supports
- Used with people with acute, chronic & stabilized conditions
- Suited to acute, discharge and community settings
- Requires only intermittent contact with OT
- Relies on funding resources for devices, environmental design and care supports
in terms of environment-based intervention, what are the four ways of addressing occupational performance issues
- alternative strategy
- tool/assistive device
- social support (formal or informal)
- environmental modification
(see notes for further explanation of each)
developing good interventions requires…
understanding of process + sound knowledge base and effective application
in terms of the topic of ‘quality of outcome depends on quality of process’, good solutions rely on…
- Systematic analysis of the issues
- Sensitive and respectful negotiation with the client
- Careful and discriminating selection of the intervention
what are things to consider when deciding on the best option for the client?
- Clinical evaluation of issues and options - evaluating P, E and O
- Person’s goals and preferences
- Relative costs
- Available evidence
- Impact on the household
- Long term benefits
- Available services and resources
- Policies of the service provider
what are things to consider regarding a persons capacities?
- Weight considerations — to determine whether the load capacity of the grab bar needs to be increased
- Height when seated and standing— to determine the required height of the bar above the floor
- Arm length, reach range, and length of forearm— to establish the best location for the rail and the preferred length
- Hand size —to guide the size of the diameter of the grab bar
- Grip strength —to guide the size of the diameter of the grab bar and the finish on the surface of the bar
- Dominance—to determine the side of the toilet on which the bar should be placed
in terms of documentation, reports must include…
- Statement of client goals
- Description of function & risks
- Evaluation of proposed options
- Client’s preferences and where these differ from therapist’s recommendations, discussion of concerns
- Any training provided or risks discussed
- Validation of recommended option
- Record of decision making NOT just the outcome
