week 2 Flashcards
■ Referral ■ Screening ■ Evaluation ■ Intervention planning ■ Intervention implementation ■ Intervention review/outcomes
occupational therapy process
Brief process to determine need for skilled OT evaluation ■ Identify need for other services ■ Contains a brief occupational profile ■ Assessments to determine if further therapy is needed – Sensitive enough to identify performance problems ■ Recommendations about the appropriateness for an evaluation
screening
occupational profile ■ Identifies specific areas of occupation to be assessed ■ Assessments ■ Analysis of occupational performance ■ Identifies treatment plan and outcomes ■ Provides summary and recommendations
Evaluation
■ Documented in the evaluation (can be template of free form) ■ Includes specific txinterventions you are planning ■ Frequency of treatment ■ Goals ■ Length of OT treatment
Treatment plan
■ Intervention Plan ■ Intervention Implementation ■ Intervention Review
intervention process
What is the desired results? ■ Select intervention approach – Remediate, Modify ■ Consider discharge needs –depending on your place in the continuum of care your interventions and goals may vary – Is the patient going to a SNF, home, outpatient therapy ■ Monitor program – objectives, goals, outcomes
1st step in intervention implementation
Problem statement-Is developed by analyzing the assessments and the occupational profile. It should include the underlying factor (client factor, performance skill etc) and how it is impacting the area of occupation.
Intervention plan
Therapeutic use of self ■ Preparatory methods (PAMs, splinting, sensory stim, exercises) – Techniques that prepare the patient for occupational activities ■ Therapeutic use of Occupations – Purposeful and meaningful – Occupation as ends – Occupation as means ■ Consultation and Education
2nd step in intervention implementation
“A practitioner’s planned use of his or her personality, insights, perceptions, and judgments as part of the therapeutic process.” OTPF 2 – Showing empathy and compassion – Being self-reflective, self-aware – Communicating effectively – Client-centered perspective – Developing trust – Respecting the patients rights and differences
therapeutic use of self
Selecting therapeutic occupations that are both
Meaningful and P urposeful – Meaningful occupations-the task is motivating and significant – Purposeful occupations-help to enhance patients performance ■ The therapist can then grade the task to provide the “just right challenge” ■ “Occupation has the power to enable people to perform the actions they need and want to perform so that they can engage in and do the familiar, ordinary, goal directed activities of every day in a manner that brings meaning and personal satisfaction” Fisher (1998)
occupation as therapy
”Refers to engaging your client in occupations that constitute the end product of therapy” (W&S, 326)
– One handed shoe tying after CVA – Teaching handwriting skills to UE amputee who lost their dominate arm – Recommending adaptive equipment for a person with a brachial plexus avulsion to perform meal prep independently – Recommending/training a patient with a spinal cord injuries to use hand controls for driving
occupation as ends
“Occupation acting as the change agent to remediate impaired abilities” (W&S, 326)
– Engagement in putting together a Lego kit to develop reach and coordination skills that may transfer to ADL tasks for a patient using a UE myoelectric limb – Rolling out dough to increase UE strength so they can increase independence in home making tasks – Putting together a puzzle with all pieces placed on the left side to promote scanning techniques so a patient may be able to locate utensil placed on their left side
occupation as means
Enhances client factors (ROM, MMT, endurance, processing) to improve performance ■ Must link changes in abilities to changes in occupational performance ■ Increased strength and ROM should show improved occupational performance (if not is this the right intervention?) ■ Sensory integration ■ Constraint induced movement therapy ■ Therapeutic exercises
Remediate or restore
When disability is considered permanent ■ Client factors are not expected to improve ■ Limited access to therapy prevents remediation approach ■ Client prefers this approach ■ Environmental adaptions are often utilized ■ Focus is on modifying the tasks and use of adaptive equipment to maximize function and independence
Adapt/Modify
Health Promotion– Promote a health lifestyle in staff by starting a biking club ■ Maintain– Maintain upper extremity strength in wheelchair bound adults by providing a exercise program at a senior center ■ Prevent– Prevent low back injuries by instructing employees in proper lifting techniques
intervention approaches
