Test 1 (Units 1 and 2) Flashcards
Young Adulthood (Lela Llorens)
20-35 years
Middle Adulthood (Lela Llorens)
35-50 years
Later Adulthood (Lela Llorens)
50-65 years
What did Levinson say was the age range for early adulthood?
17-45 years
What did Levinson say was the age range for early adulthood transition?
17-22 years
What did Levinson say was the age range for entering the adult world?
22-28 years
What did Levinson say was the age range for age thirty transition?
28-33 years
What did Levinson say was the age range for settling down in early adulthood?
33-40 years
What did Levinson say was the age range for middle adulthood?
40-60 years
What did Levinson say was the age range for late adulthood?
60+ years
What was the issue with Levinson’s perspective on adulthood?
Sample size of only 40, all were males
Most contemporary theorists consider what perspective?
Life-span perspective
What makes up the lifespan perspective?
Early phase development (childhood and adolescence) and later phase development (young adulthood, middle age, old age)
Human development across the lifespan is views as a ___________ and _________ process?
Dynamic, complex
Human development across the lifespan views humans as wanting what?
Competence and role mastery
OT views development across the lifespan as what approach?
Bottom-up
What is the first assumption of the OFM?
Adults strive to have feelings of satisfaction, self-efficacy, and self-esteem
According to the OFM, where are the feelings of satisfaction, self-efficacy, and self-esteem derived from?
Being able to perform something successfully, control of own life, being competent in life roles
Belief you can do something
Self-efficacy
Examples of self-maintenance roles
ADLs, IADLs, home management, caregiver, exercise
Examples of self-advancement roles
enabling/betterment of self
Examples of self-enhancement roles
leisure, club member, social participation
Second assumption of the OFM?
Adults’ performance ability to carry out one’s roles, tasks, and activities based upon: abilities, skills, and capacities, habits
Remediation vs adaptation
Remediation= rebuild, restore, adaptation= compensatory ideas
Third assumption of OFM?
Adults’ satisfactory performance ability in life is based upon context and environment
Difference between context and environment?
Context is bigger
Changes in vision with age
decreased tissue elasticity, decreased strength in eye, nearsightedness, dry eyes, macular degeneration, decreased night vision, driving
Prevention for age related vision changes?
Adequate lighting, get rid of tripping hazards, large print, driving eval
Age related changes with hearing
Decreased, safety issues, hard to hear high frequency
Age related hearing changes prevention?
Cancel out harmful sounds
Tactile age related changes
Decreased response to stimuli
Prevention tactile age related changes
Make habit to examine skin, remove sharp objects
Vestibular changes with age
decreases with age, decreased righting reactions, decreased balance
Prevention vestibular age related changes?
Rugs removed, other trip hazzards
Age related changes PNS and CNS?
neuron loss, decrease axons, slower nerve conduction
Prevention CNS/PNS degeneration
Keep mind active
Age related changes taste/smell/tactile
increase threshold, inability to detect aromas, food may seem tasteless
Prevention age related changes taste/smell/tactile
Large label with food expiration dates, gas detectors in home
Age related changes in muscles
decrease in size, increase fatigue, decrease strength
Prevention muscle degeneration
Staying active
Age related changes in joints/bones
Ligaments and tendons less elastic, decrease in synovial fluid, hardened cartilage, decreased bone density
Prevention in joints/bones age related changes
Activity to keep blood flowing to bones
Age related cognitive changes
fluid intelligence is more difficult, memory and recall more difficult
Age related cognitive changes
decrease in pace maker cells, changes in artery elasticity, stiffening joints
4 most common interruptions during adulthood
Neurologic conditions, cardiovascular conditions, musculoskeletal disorders, systemic illnesses
Examples of common neurological conditions
CVA, MS, TBI, Guillain Barre, Parkinson’s, SCIs, Alzheimer’s, ALS
Cardiovascular condition examples
MI, COPD
Common musculoskeletal disorders in adulthood
repetitive trauma disorders, various hand injuries, arthritis, polymyositis/dermatomyositis, myasthenia gravis
Typical stay TCU?
10 days or less
Typical stay rehab?
2 weeks +
Examples of systemic illnesses
T2 diabetes, AIDS, cancer, scleroderma, systemic lupus erythematosis
Where is biomedical model used?
Hospitals, neuro, acute care, cardiac, ICU
What would an OT do within the biomedical model?
Preparatory methods, positioning, ROM, splinting, universal cuff, ADLs (grooming, transfers, toileting, dressing)
Where is the rehabilitative model used?
TCU, simulated occupations (actually showering/dressing/walking)
Where are community based models used?
Residential, outpatient settings, school, respite
Where are prevention and health promotion models used?
Nursing home
Complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity
Health
The process of enabling people to increase control over, and to improve, their health
Health promotion
Modification of risk factors prior to onset
Primary prevention
Early detection and strategies to slow progression
Secondary prevention
Interventions to stop progression of a condition and limit disability
Tertiary prevention
Which prevention tier is considered at risk?
secondary
Health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illness in a variety of health care settings
Health promotion and maintenance
There is a ____% annual increase in those with chronic conditions
1
The ability of the individual, i conjunction with family, community, and health care professionals, to manage symptoms, treatments, lifestyle changes, and psychosocial, cultural, and spiritual consequences of health conditions
Self Management (DeRosa)
Outlines methods for coordinated healthcare and improved outcomes for individuals with chronic conditions
Chronic Care Model (DeRosa)
OT process
referral, evaluation
What should be in the medical history/occupational profile?
prior functional level, occupational history, interests, values, needs
What are the 2 parts of an evaluation?
Med history/occ profile, analysis of occupational performance
What goes into an analysis of occupational performance?
Identification and observation of present performance level in areas of occupation, identify and measure underlying performance skills patterns, contextual factors, client factors that affect performance
Overall, evaluation occurs through what?
Interview, skilled observation, testing
Evaluation leads to what?
A “working hypothesis”
Presents a picture of a person’s status at one moment in time and can compare it with another person’s status
Descriptive ADL evaluation
Sets criteria against which a person’s status is compared
predictive ADL evaluation
Measures a person’s status over time
Evaluative ADL evaluation
Does it measure what it states it will?
Validity
Is the parameter measured consistently no matter who administers test?
Reliability
Can small increments of client change be detected?
Responsiveness
FIM can be scored through what?
Interview or observation
Shortened version of the FIM, 6 items (eating, grooming, bowel management, toilet transfer, expression, memory)
Alphafim
From FIM for orthopedic and cardiopulmonary practice and outcome measurement
Lifeware
Evaluation of motor skills
Functional UE ROM, Modified Ashworth Scale, Functional MMT, POG and pinch
The combined activity of many muscles into smooth patterns and sequences of motion. Automatic response monitored primarily through proprioceptive sensory feedback
Coordination
The ability to make skillful, controlled arm-hand manipulations or larger objects
Manual/gross dexterity
Ability to make rapid, skillful, controlled manipulative movements of small objects, using primarily the fingers
Finger or fine motor dexterity
Vision should be tested how?
First with vision then vision occluded
Stimuli should be applied how?
On in-tact area prior to sensory impaired area
PNS injury stimuli applied how?
Distal to proximal
CNS injury stimuli applied how?
Proximal to distal
What does BiVaBa stand for?
Brain injury visual assessment battery for adults
What is on the bottom of Mary Warren’s Hierarchy of Visual perception?
Attention, oculomotor control, visual fields, visual acuity
2nd to bottom on hierarchy of visual perception?
Scanning
3rd from bottom on hierarchy of visual perception?
Pattern recognition
3rd from top on hierarchy of visual perception?
visual memory
2nd from top on hierarchy of visual perception?
visuocognition
Top of hierarchy of visual perception?
adaptation through vision
The ability to interpret or attach meaning to sensory information from the external and internal environments
Perception
Perceptual skills are very closely tied to what 3 things?
Sensory experience, cognitive functions, and emotions
Foundational to all other cognitive skills
Attention
5 types of attention
Focused, sustained, selective, alternating, divided
Name, date, place, personal information
Orientation
Involves input, storage, and retrieval processes
Memory
Types of memory
visual, auditory, recognition, procedural
Types of higher level thinking
Problem solving, reasoning, concept formation
2 types of metacognition/metaprocessing
executive functions, self-awareness
Types of executive functions
initiation, planning, execution, monitoring, self-reflection
appreciation of own attributes an initiation of compensatory strategies
Self-awareness
Bottom of cognitive hierarchy
attention
2nd to bottom of cognitive hierarchy
orientation
3rd from bottom of cognitive hierarchy
memory
2nd from top cognitive hierarchy
problem-solving
Top of cognitive hierarchy
Meta-processing
Examples of IADL evaluations
Kitchen task assessment, EFPT, AMPS
Features of the built environment that optimize function for everyone regardless of ability
Universal design
Features of build environment that remove physical barriers to allow for full and equal accessibility for all people with disabilities
Barrier-free design
7 principles of universal design
equitable use by individuals with diverse abilities, flexibility in usage to accommodate many preferences, simple and intuitive use, information is perceptible and understood by all audiences, error is minimized and safety is enhanced, low physical effort is required, size and space is appropriately designated for use for individuals with a variety of disabilities
How wide should hallways be?
48 inches
Ramps should rise ______ inch of height for every ________ inches of length
1, 12
Doorways should be at least _______________ inches in width
32-36
Door pressure should be ____ lbs or less
5
Wheelchair turning space should be _______ inches or ______ square feet in diameter
60, 5
Another person is not required for the activity
Independent
Client safely performs all the tasks described as making up the activity within a reasonable amount of time, and does so without modification, assistive devices or aids
FIM 7, complete independence
One or more of the following may be true: the activity requires an assistive device or aid, the activity takes more than reasonable time, or the activity involves safety (risk) considerations
FIM 6, modified independence
Patient requires another person for either supervision or physical assistance in order to perform the activity, or it is not performed- REQUIRES HELPER
Dependent
The patient expends 50% or more of the effort
Modified dependence
Patient requires no more help than standby, cuing or coaxing, without physical contact; alternately, the helper sets up needed items or supplies orthoses or assistive/adaptive devices
FIM 5, modified dep, supervision or setup
Patient requires no more help than touching, and expends 75% or more of the effort
FIM 4, modified dep, minimal contact assistance
FIM level independent but use sock aid?
6, mod ind
FIM levels contact guard assist?
4 and/or 5
Just verbal assist necessary
FIM 5, supervision or setup
Can do all dressing but buttons
FIM 4, minimal contact assistance
The patient requires more help than touching, or expends between 50 or 74% of the effort
FIM 3, mod dep, moderate assistance
The patient expends less than half the effort. Maximal or total assistance is required.
Complete dependence
Patient expends between 25 to 49% of the effort
Maximal assistance, FIM 2
Patient expends less than 25% of the effort
Total assistance, FIM 1
Activity does not occur
FIM 0
