OT IN ACUTE CARE

Question 1

ACUTE CARE

Answer 1

• CLIENT IS MEDICALLY UNSTABLE
• GOALS
  
  • increase medical stability, initiate rehabilitation, and determine discharge setting (disposition)

Question 2

HOSPICE

Answer 2

• FOR TERMINALLY ILL
• GOALS
  - comfort measures, minimal or NO rehabilitation, and family education to ensure needs are being met.

Question 3

NURSING HOME

Answer 3

• Little to no goals for rehabilitation and unable to return home (client will D/C to a SNF if they came from a SNF)
• GOALS
  - patient safety and assistance with ADL’s

Question 4

Long Term Acute Care (LTAC)

Answer 4

• CLIENTS WHO ARE HOSPITAL LEVEL AND REQUIRE EXTENDED STAY
• HAVE MEDICAL COMPLEXITY BUT NOT CRITICALLY UNSTABLE
• ventilator dependent,complex wounds, or on more than 2 antibiotics

GOALS
- maximize functioning using an interdisciplinary approach. They may discharge home, hospice,SNF, inpatient, subacute, or outpatient

Question 5

HOME HEALTH

Answer 5

• MULTIDISCPLINARY APPROACH
• CLIENT IS HOMEBOUND

GOALS
- maximize patient/caregiver carryover of therapeutic intervention, support family, beneficial for those with dementia because of familiarity

Question 6

SUBACUTE/SNF

Answer 6

• THERAPY FOR LESS THAN 3 HOURS A DAY
• GOAL ORIENTED AND SLOWER PROGRESS

Question 7

INPATIENT

Answer 7

• MEDICALLY STABLE
• MUST TOLERATE 3+ HOURS OF THERAPY
• DISCHARGE TO home, family’s home, or assisted living facility (ALF)

GOALS
- functional improvement in a reasonable time frame.

Question 8

DAY TREATMENT

Answer 8

• CLIENT WHO CAN BE MANAGED AT HOME
• INTERDISCIPLINARY TEAM

Question 9

OUTPATIENT

Answer 9

• MED STABLE
• LIVE AT HOME
• REQUIRES 1-3 THERAPIES

GOALS
- educate patient/family for final discharge home

Question 10

EVALUATION FOR DISCHARGE FROM ACUTE CARE

Answer 10

• If the client shows resistance to the OT’s recommendation, seek to understand the reason for resistance. Then collaborate with the client or family to come up with the needs and capabilities and clearly list options
• ASSESS EXECUTIVE FUNCTIONING
  - Provide the client with functional and realistic tasks such as: provide two tasks with the materials for only one of the task available. See if they forget about the second task. This will identify distractibility. Take them out of the room and throughout the halls. Identify if they can find their way back to their room. This identifies recall
• Identify if the patient has the ‘decision-making’ ability or if they have lost the capacity to make decisions
  - When clients are deemed incompetent the attention shifts from the client to the family members who will advocate for their loved ones. STILL INVOLVE THE CLIENT IN THE DECISION-MAKING TO PRESERVE THEIR DIGNITY AND PURPOSE. Allow the client to participate in areas that they may be able to such as the location of the facility and possessions to bring

FRAIL OR DEBILITATED OLDER ADULTS
- may benefit from day treatment programs, meals on wheels, DME, or home health services when discharging home alone.

Question 11

TRENDELENBURG BED POSITION

Answer 11

• WHEN FOOT OF BED IS HIGHER THAN HEAD OF BED
• USED FOR HYPOTENSION
• RISK OF ASPIRATION

Question 12

AIR MATTRESS

Answer 12

• FOR SKIN INTEGRITY MAINTENANCE AND HEALING