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Enabling across liifespan OA

What are 5 major life transitions for Older Adults? Productivity, Home downsizing, Health, Financial, Social
Before you perform a congitive assessment you should do what 6 things? Explain the assessment, Explain the length and what is expected Ask consent Make sure they have the glasses, hearing aids, ect..
When reporting the results of a cognitive assessment what should you do? connect results to functional implications and daily impact on performance. Convey the message to the key person.
Cargivers need what kind of support? Education, coaching, emotional support
What is Capacity? A legal decision. The ability to understand relevant information and the consequences
What are the three types of Capacity? Global, Domain Specific, Decision Specific
What is global capacity? Domain specific capacity? Can they make decisions. Can they make decisions about an area.
What are the 7 Domains in domain specific capacity? Healthcare, Accommodation, Associates, Socail Activities, Education Activities, Employment Activities, Legal Matters
What is Decision Specific Capacity? Simple decisions within a domain
What are the Guiding Legal Principles of Capacity? Assumed capacity until proven otherwise A risky decision is not necessarily incompetent it is the process of lack of process that calls into question capacity
What are the 4 most common mistake of capacity testing? Assuming the result is global Failing to provide the client with the relevant info Lack of problem solving before capacity testing Lack of investigate temporary cause of impaired decision making
Reasons for Capacity assessment? Discharge, Hazards/Vulnerability, Specific Insight into doing AIDLs
What is the role of OT in assessing capacity? Deterimine ADLS Determine IADLS Home management/Safety
What are 7 possible Cognitive assessment we might use? The MMSE, The Moca, The FAB, the clock drawing test, the Cognistat, The Exit, The ILS
What cognitive testing limitations should be kept in mind? Level of conciousness, Education, Cultural background, language, vision, hearing, comorbidities
What is a personal derective? A plan for when a person can no longer make decisions for themselves
What are affective issues? mental illnesses which predominantly affect mood and also have an effect on thoughts, behaviors and emotions
What example os affective disorders? •Major depressive disorder •Bipolar disorder •Dysthymia •Anxiety disorders including •Panic disorder
What makes Lewy Body disorders distinct? They have hallucinations they know are not real
What distinguishes vascular dementia? Fluctuating, Varied symptoms
What is the hallmark of Kosocoff's dementia? Loss of executive function Substance abuse history
What is the hallmark of Frontal temporal (Pics) dementia? Rapid Younger individuals Behave inappropriate-Innapropriate behavior Language problems
What is the hallmark of Crutzfeldt Jacob's disease? 6 month to live progression Rapid dementia
What is Delerium? An acute medical emergency syndrome, A cluster of symptoms Inattention Confusion Fluctuates over 24hrs
What is the difference between dementia and delerium? Dementia they focus, even if innappropriate Delerium they can't focus
What are the two types of Delerium and signs? Hypoactive-drowsy, blunted, depression Hyperactive-aggitation, hypermotor, excitable
How long can recovery from a delerium take? up to 1 month for each week
What tool is used to assess delerium? CAM. Confusion Assment Meathod
What is the most common problem of delerium? Hypoactive delerium goes unrecognized and the person dies
In acute setting what do you want to do before a cognitive assement? Perform a delerium assessment
What are common treatments for depression?
What is a danger of psycho therapy? they don't have the resources to deal with issue They can't understand/have insight Delerium
What percentage of the senior population have low literacy? 80%
What is level 1 and 2 for literacy? barely can read and understand
What is level 3 for literacy? Minimum level that they can function
What is level 4/5 for literacy? Higher order reading
Litteracy is a skill T or F? True, it deteriates with age unless practice.
What is the effect of health literacy? Reduce cost of disease Reduce demand of health system Make informed decision
What needs to be done to improve the literacy of an individual? Improve the literacy of the family
What is a way to ensure a healthcare facility is literacy friendly? A literacy audit
What kinds of things must an ot consider in an enviromental assessment? The model or frame of reference, age related changes, strategies, universal design
What is the enviroment? the external CONTEXT that individual interacts with
What is a social groups? Interests Values Attitudes Social Beliefs Citizenship Relationship (friends, family)
What is the single greatest determinate of if a person will die in long term care? Family context (values, ect)
What is culture? Ethnic (racial, ceremonial roines) Proxemics (doors, sleep arrangements
What is a personal reaction bubble? The comfort zones around a person.
What is the institutional enviroment? Socail instututions and practices Political, economic, legal
what is the physical enviroment? The physical structures and spaces
what is Lawtons Ecological Model of Aging? The Function of the person in the enviroment
What is in the PEF model? Sense of competence Enviromental stress Addaptive Behavior occurs with the right amount of competence and stress
What percent of seniors have vision problems? 80%
What vision problems are common? Cataracts, Macular degeneration, Descrimination of Blue, Green, Violet, shades High light
What is the most important idea for lighting? Provide curtains, lighting options, dimmers and defussers
What precautions should be kept in mind for seniors? High contrast Dark patterns or lines look like a hole Lines on steps, Floor colors that merge with the wall Large Font, Multiple cues pictures High or amount signage Homelike features Allow safe pacing
What are the three current features of visitability? Minimum one bathroom main floor, Minimum one non step enterance One extra wide door for the main floor
What approache is used for end of life care? The supportive approach-acceptance, adjustment, comfort, prevention and quality of life
What is Hospice care? Team, collaborative, comfort of family and client adressing issues of dying
What percent of canadians will need pallative care? 90%
What percentage have access to end of life services? 15-30%
what is end of life care? Prevention of suffering Palliation-ease without curing
What is palliation? Relief of physical, emotional, spiritual, and social symptoms
What can make pallative care easier? Listen, Discuss feelings, Collaborate on steps, Let them help themselves, don't make a decision for them.
Who is the client in pallative care? The entire family
What role might OT have in prevention and physical relief? Simplification of tasks Maintenence of skin integrity Supportive counselling Provide resources Relaxation managment
How might roles be simplified? Equipement Environment modification Energy conservation Caregiver training Prioritization
How might maintenance of skin integrity? Pressure relief/Possitioning Mobilization Treatment/Accomiodation for edema
What kind of resources can help client with end of life care? Support groups Respite care Transportation Funding and equipment Referrals
How might pallative children clients be different? More emotional Unable to give informed consent Remember to involve ENTIRE family even kids
What precautions need to be maintained in OT pallative care? Be aware of the system Maintain boundaries Debrief with the team and reflect
What are sources of adaptive equipment? Homecare loan AADL Organizations such as ALS
What are repite options? Home care Self organized (eg. family) Facility
What are determinates for transfer to Hospice? Home accessibility Family Support Finances Symptom control
What are the three key ethical views of the treatmetment for clients Respect, Integrity, Competence
What are the 5 factors of Respect? Upholding dignity/context, Provide unbiased service, Callaboration in setting goals Accepting client's choice, Provide information for decision making, Respecting confidentiality,
What are 2 parts of competence? Reviewing practice and engaging in professional developement, Improve knowledge,
(L8) What are the 4 properties of cognition? Descrimination, aquisition, understanding, retention and appropriate application of information
(L8) What are the 9 Spheres of cognition? Memory, Attention, Orientation, Language, Perception, Praxis (planning), Mental Processing, Emotional awareness, Executive function
(L8) What is executive function? Complex, goal directed behaviors
(L8) What are the 6 key types of executive function? Planning, Sequencing, Working memory, Inhibition, Initiation, Attention
(L8) What is the key symptom of depression? Decrease in mood (attention fine)
(L8) What is the key symptom of Delerium? Inability to attend to reality
(L8) What is the key symptom of Dementia? Memory impairment, with change in exectutive function (attention fine)
(L8) What is a Neurocognitive disorder? A decrease in cognition & IADL >2SD
(L8) What are the 6 most common types of dementia?
(L8) Why is it important to recognize minor cognitive decline early? The earlier the intervention the greater the outcome
(L8) How can congnition be assessed (3)? Which is better when time is critical? abilities to infer function, funtion to infer abilities, Informally Infer function from abilities
(L8) How does a therapist select a good cognitive assessment tool? Examines the person, enviroment and occupations
(L9) How is the domain of memory usually assessed? Word recall
(L9) How is the domain of attention usually assessed? Digit order
(L9) How is the domain of orientation usually assessed? Location and date
(L9) How is the domain of language usually assessed? comprehsion and naming
(L9) How is the domain of perception usually assessed? Copying
(L9) How is domain of praxis usually assessed? Multi-step commands
(L9) How is the domain of mental processing usually assessed? Calculation, proplem solving
(L9) How is the domain of jugment usually assessed? Hypothetical situations
(L9) How is the domain of abstraction usually assessed? Simularities/Opposites
(L9)What five factors influence cognitive assessment tool selection? Cognitive sphere to assess, Cost, Utility, Location, Pt. factors
(L9) name 3 tools to assess cognitive abilities that allow function interpreted? MMSE, 3MS, TICS, Cognistat, Clock Drawing, MoCA, Exit, FAB
(L9) Name 3 tests of function that can allow an interpretation of cognitive ability? SAFER, ILS, KELS, KitchenTA, SAS, ACLS
(L9) What 5 interventions can enable a client with cognitive declines to maintain function? Practice tasks, Simplify tasks, Memory aids, Caregiver support, Environmental adaptation
(L9) What score on the MMSE is a sign of cognitive decline? <26
(L9) What score on the MoCA is a sign of cognitive decline? <26
(L5) What are 5 common age related declines? decreases in musculoskeletal health, cardio pulmonary function, neuronal function, sensory abilities, bladder control
(L5) What are 6 functional implications for age related decline in the major systems? decreased balance, coordination, sensory abilities, strength and ROM, ability to do ADLs and IADLs
(L5) What is the number one effect of arthritis? An eventual inability to perform ADLs
(L5) What are the 2 common effects of a broken hip? Restrictions in movements, decreased engagment,
(L5) What are the 3 common effects of a stroke? Change in physical, cognitive or affect
(L5) What is the danger with diabetes? Hyperglycemia-high blood pressure, Hypoglycemia-low blood sugar
(L5) What are 4 warning signs of unregulated diabetic blood sugar? Changes in attention, changes in speech, frequent thirst or voiding, change in sensation, impaired healing
(L5) What are three common precautions for congestive heart failure/angioplasty? Activity as tolerated (fatigue), no lifting above the shoulder, no lifting weight
(L5) What are the 3 main OT treatments for incontinence? Behavioral (when voiding and taking liquids) Training (pelvic exercises) Functional (clothing, mobility)
(L5) What are the 4 common problem areas with nutrition? Shopping, Preparation, Feeding, Appetite
(L5) What are the 4 major movement precautions for a hip replacement? Bending the hip past 90 degrees, bending forward, crossing the legs, twisting the leg
(L5) What is the major movement precaution for a knee replacement? Twisting
What is Dysphagia? Difficulty swallowing
What is apraxia? In ability to initiate the correct movement including correct word for speech
What is Agnosia? Inability to know/name objects
What is hemianopsia? Loss of a visual field
(L5) What one single factor in seniors effects participation, IADLs and leisure more than any other? The ability to Drive
(L5)What is the name of an OT driving program? DriveAble
(L5) What is the best assessment of driving? A road test
(L5)Leisure is a neglected domain for what percentage of seniors? 60%
(L5) What are 5 common barriers to seniors enjoying leisure? Task demands, Behavioral issues, Accessibility, Finance, Cargivers
(L6)What is the most common injury for seniors? Falls
(L6) What 4 things does a fall impact? Emotions, ADLs, IADLs, Fear/Mobility
(L6) What are the 4 risk factors of falls? It's multifactorial: Biological, Behavioral, Socail/Economic, Enviormental
(L6) What is Best Practice for fall intervention? A multifactorial, individual, interdisciplinary approach
(L6) What interventions are part of the BEEEACH model of fall prevention? Behavioral, Educational, Enviromental, Equipment, Activity, Clothing/footwear, Health managment.
(L6) What is the primary focus of the BEEEACH model of fall prevention? Changing behavior
(L6) What motivates fall safety? Client/family buy in, You consider the socail enviroment, They believe it will increase ADL function
(L6)What are the two biggest risk factors associated with falls? Inactive lifestyle and bladder control.
(L9) What is capacity? the ability to understand the info. relevant to making a decision and the consequences
(L9) What are the three types of capacity and what does OT concern itself with? Global, Domain specific, and Decision specific. OT is concerned with decision specific
(L9) What are the 3 caveats to assessing cognition? they are capable until proven contrary, Risky decisions can still be competent, It's the process of decision making not the decision that determines competence
(L9) What should be considered before judgement of incapacity? Reversible causes (delerium) Client informed, Client sensory limitations
(L9) What two types of assessment do OT's do to determine capacity? Cognitive assessments ADL Functional assessments
(L9)What are the 6 major compontents of executive function? Behavior, Reasoning, Selective attention, Inhibition, Problem solving, Ability to adapt to the enviroment
(L9) What are the basic cognitive abilities OTs can measure ? Attention, Orientation, Memory, Concentration
(L9) What is a personal directive? A legal tool to ensure wishes are met after met when unable
(L9) What are the 3 parts of the Adult Guardianship act? Falls on a continuum, Immediate danger, Reviewed after 90 days
(L9) What is the Trusteeship act? A agreement allowing someone else to make financial decisions
(L9) What should always be remembered about cognitive assessment? Done with their functional enviromental needs, Cognition does not necessarily reflect abilities, Cognitive assessment includes functional assessement
(L9) What are the 7 test limitations? Level conciousness, Education can skew Cultural background Language Vision Hearing Co-morbid conditions Enviroment assistance
(L9) 4 Reasons to do formal capacity assessment? Problem solving not enough Risk Guardian may reduce harm Problem persist or worsten
(L9) To declare incapacity an assessor must report an opinion on what 5 things? Comprehension Retention of information Consequences The ability to communicate decision, The ability to follow through/act
Created by: swcherry
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