Pedretti Ch. 10 - ADLs

Question 1

ADLs include:

Answer 1

self-care tasks, bowel and bladder management, dressing/undressing, eating, feeding, functional mobility, sexual activity, toilet hygiene, and the care of personal devices such as hearings aids, orthotics, and splints

Question 2

IADLs include:

Answer 2

taking care of pets, child rearing, communication management, community mobility, financial management, and health management such as remembering therapy appointments and weight shifting in wheel chair

Question 3

Definition of “Client”

Answer 3

OT Practice Framework (OTPF-2) definition of client: refers to persons, organizations, and populations who receive OT services
(Organizations refer to businesses, industries, or agencies that may receive general consultation or referral by an OT on accessibility)

Definition includes client’s family, employers, and other significant relations

Question 4

Client Factors

Answer 4

Client factors: specific abilities, characteristics, or beliefs
-Includes strength, ROM, coordination, belief that one will improve, cognitive functions, emotional functioning etc.

Client factors are assessed to see the potential for remediation, the need for adaptive equipment, or other modifications

Question 5

Performance Skills

Answer 5

Abilities clients demonstrate in the actions they perform

Includes motor/praxis, sensory/perceptual, emotional regulation, cognitive skills, communication, and social skills

** Client factors reside within a person, performance skills are observable and demonstrable **

Question 6

Performance Patterns

Answer 6

Performance patterns: habits, routines, roles, and rituals

Habits: specific, automatic behaviors that can be useful, dominating, or impoverished
ADL habit example: shower routine
IADL habit ex.: routine of getting a child ready for school

Roles: expected by society, shaped by culture, may be further conceptualized and defined by the client
Ex.: student, worker, daughter

Rituals: symbolic actions with spiritual, cultural, or social meaning that contribute to the client’s identity and reinforce the client’s values and beliefs
ADL ritual examples: praying, holiday celebrations

Performance patterns allow OTs to ID performance deficits, set priorities with goal setting ,and help clients reestablish continuity in daily living

Question 7

Environment

Answer 7

EEnvironment: where the client will be discharged after treatment, the external physical and social environments that surround the client and in which their daily life occupations occur

Physical environment: the natural and built environments

Social environment: relationships by persons, groups, organizations

Question 8

Context

Answer 8

Situations or conditions within and around the client. Can by cultural, personal, temporal, virtual

Defined separately from “environments” in the OTPF-2

Question 9

Cultural context

Answer 9

Customs, beliefs, activity patterns, behaviors, and expectations accepted by the society in which one is a member

Cultures define independence differently. Clients also define independence differently

The potential for
independence depends on each client’s unique personal needs, values, capabilities, limitations, social and environmental resources

Question 10

Personal context

Answer 10

A person’s demographic features (age, gender, education)

Example: shaving legs may be important to people depending on age/gender

Question 11

Temporal context

Answer 11

Contexts that refer to time; time of year, day or stages of life
Ex.: when meals are eaten

Question 12

Virtual context

Answer 12

interactions in simulated, real-time, or near-time situations, absent of physical contact

Question 13

Occupational Justice

Answer 13

Occupational justice: describes OT’s concerns with the ability of all people to be given the opportunity to engage in occupations
(Including ADL/IADLs that are important to them)

OTs can assist in supporting social policies, actions, and laws that allow people to engage in meaningful occupations

Question 14

OTs can assist in supporting social policies, actions, and laws that allow people to engage in meaningful occupations

Answer 14

• OTPF-2: OT’s goal for the domain and process is “supporting health and participation in life through engagement in occupation”
• Evaluation of occupation performance involves collaborating with clients to determine what they need to do to support health and participation
• OTPF-2 says areas of occupation include: ADL, IADL, rest and sleep, education, work, play, leisure, and social participation
• OTPF-2 outlines how OT services are delivered to clients via evaluation, intervention, and outcomes
• This process is NOT linear, but dynamic. The OT can assess the process toward reaching goals
• Evaluations create an occupational profile, performance analysis of skills and patterns, and factors that influence performance
• occupational profiles describe client’s occupational history, patterns of daily living, interests, values, and needs

Question 15

Levels of Independence

Answer 15

Independent: client can independently perform activity without cueing, supervision, or assistance, with or without assistive devices at normal/near normal speeds

Modified independence: client requires assistive devices or performs the activity as slower than customary speed

Supervised: client requires general supervision (not hands on) and may require a verbal cue
OT can be greater than arms length away at all times

Standby Assistance (SBA)/ Contact guard assistance (CGA): client requires hands-on guarding

Minimal assistance: client needs 25% physical or verbal assistance (they perform 75% of the task)

Moderate assistance: client needs 50% physical or verbal assistance (they perform 50 - 74% of the task)

Maximal assistance: client needs 51% to 75% physical or verbal assistance (client performs 25 - 49% of task)

Dependent: client needs more than 75% physical or verbal assistance (client does less than 25% of the task)