Week 14 Flashcards
name 2 common aspects of long term care residents.
- primarily women
- largely widowed/divorced older adults
approx. what percent of LTC residents have dementia?
40%
what % of LTC residents need assistance with 2 or more ADLs?
82%
name a major predictor of placement in a LTC facility.
absence of caregiver or partner
name 6 OT practice examples in a LTC facility.
- seating and positioning
- ADL programs
- contracture management
- activity programs
- restorative therapy following functional decline
- wound care
- comprehensive assessment of residents in all Medicare and Medicaid certified facilities
- mandated by federal law
- used to identify potential problems - ex: care triggered areas such as delirium, falls, nutrition status, mood state, etc. and directs care provider to care plan
- helps to identify resident’s strengths and preferences
- reimbursement tool for medicare
MDS
which parts of the MDS do OTs often complete?
functional status and evaluation complexity codes
name 4 qualities of the typical assisted living resident.
- 80 years old
- female
- independent in functional mobility
- requires assistance with 1-2 ADLs/IADLs per day
name 4 roles of the OT in assisted living.
- facilitate transition to new living environment
- ADL, IADL, leisure, and lifelong learning
- health and wellness programs
- community mobility and community reentry
LTC residents have a high level of ___ ___.
functional decline
name a specific condition with multiple causes that could lead to LTC.
incontinence
retain some level of independence
ADL retraining
what is the last ADL ability we typically lose?
ability to feed themselves
name 3 examples of LTC programs.
- falls prevention
- dementia symptom management - activity-based programming
- helping people stay active
name 2 purposes of a wedge.
-positioning - to keep head elevated, to keep people in side-lying
name the purpose of a hand roll.
-contracture management - if they can’t tolerate a splint, keeps a space within palm/arch of hand without skin macerating or becoming moist
what is the purpose of a tilt in space w/c?
can’t shift weight, repositioning
how can we help manage contractures?
ROM promotion
short course of rehab to get them back to where they need to be
restorative therapy following functional decline
tool that helps us pick up issues we need to address and provide a care plan
MDS
quick screening for cognition - looks at word recognition, orientation, and word recall
bims questionnaire (MDS)
name 3 components that can determine evaluation complexity codes.
- number of comorbidities a person has
- complexity of decision-making
- evolving or stable presentation
for assisted living, some places will not accept who?
individuals in W/Cs
is IADL always the goal at assisted living facilities?
no, sometimes IADL is not the goal - the reason why they may be there is that they are unable or don’t want to participate in those activities anymore
why is mid-wheel drive for w/cs good for indoors and LTC residents?
smaller turning space
- begins with a diagnosis of a progressive illness for which there is no cure
- combines active and compassionate therapies to support individuals and their families who are living with life threatening illness
- strives to meet physical, psychological, social, and spiritual needs
palliative care
- last 6 months of life
- focus is on compassionate care rather than treatment to extend life
hospice
name 7 common symptoms at end of life.
- dyspnea
- anxiety and altered mental state
- fatigue
- terminal dehydration
- nausea and vomiting
- restlessness
- pain
name 5 roles of the OT in end of life care.
- relief from pain and other symptoms
- improve QOL:
- support engagement in meaningful daily life occupations
- prevent loss of roles and independence
- help clients to maintain sense of control
- focus is on quality of life
- addresses disability and lifestyle patterns to enhance quality of life
- harmony between domains:
- interpersonal relatedness
- intrinsic gratification
- societal contributions
- self care and self maintenance
lifestyle performance model
name the 4 domains of the lifestyle performance model.
- interpersonal relatedness
- intrinsic gratification
- societal contributions
- self care and self maintenance
describe assessments for end of life and palliative care.
- consider non-standardized, informal assessments, interview family members
- pain assessments, coping strategies, fatigue, social relationships, spirituality
- goal setting considerations
- 4-week program led by OT and PT
- clients with a cancer diagnosis, different stages of the disease
- resources available from health professionals
- individual assessment of personal difficulties
managing fatigue
name 4 aspects of the managing fatigue program.
- planning, prioritizing and pacing activities, delegating or discarding activities
- increasing activities levels with simple exercises
- relaxation exercises
- how to make easy, nutritious meals, sharing personal energy saving ideas and tips for better sleep
name 3 strategies for managing shortness of breath.
- pursed lip breathing
- raised the head of the bed
- use of a fan
name 3 ways to help manage pain.
- education
- physical - massage, cold, heat, positioning
- psychological - distraction, relaxation, guided imagery, progressive muscle relaxation
minute you’re diagnosed with a progressive illness for which there is no cure
palliative care
name an example of an illness with a short period of decline leading up to death.
covid-19
name an example of a condition with long-term limitations with intermittent serious episodes.
MS
name an example of a condition with fatigue (can be physical, mental, emotional).
cancer
not getting in enough fluids - nutrition and hydration, natural process at end of life, can be distressing for families
terminal dehydration
why does terminal dehydration occur?
spike in endorphins at end of life (natural anesthetics) - won’t feel like they are so hungry or so thirsty
a lot of movement or restlessness at the last days of their lives
terminal restlessness
relationships with other people
interpersonal relatedness
leisure, enjoyment
intrinsic gratification
volunteering, helping your own family
societal contributions
- 13 items
- looks at level of fatigue and its effects on function
FACET fatigue scale
- meaning in life questionnaire
- looks at presence of meaning of life
MLQ
describe goal setting in this type of care.
-comfort-focused, pain management, adaptive strategies
name 3 energy conservation strategies.
- pacing, using less energy
- delegating things
- discarding activities
what is the most comfortable position to sit in with metastasized cancer with spinal involvement?
recline - less downward forces - didn’t sit there for long but it helped a little
when do we feel pain the most?
when you’re paying attention to it - lying in bed at night
