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OCCTH557B
Enabling across liifespan OA
| Question | Answer |
|---|---|
| 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 |
| (L7) |
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swcherry
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