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88 Cards in this Set
- Front
- Back
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Model of Human Occupation (MOHO)
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Developed by Gary Kielhofner based on Occupational Behavior of Mary Reilly
Assumptions: Occupaiton is dynmaic and context-dependent -personal occupational choices and engagement in occupation shape the individual - 3 elements are inherent to humans: volition (thoughts and feelings that motivate people to act and is comprised of personal causation, values, and interest), havitation (organized recurring patterns of behavior and is comprised of roles and habits), performance capacity (physical and mental skills needed for performance and the subjective expereince of engaging in occupation) -Environmnet impacts on the individual through the opportunities, demands, resources and constratints it provides (environment is divided into physcial and social components, each component is influenced by the cultures in which it takes place) -Eval focuses on exploring the individual's occupational history, goals, voilition, habits, and occupational performance -Interention focuses on occupational engagement and inclues activities that are purposeful, relevant and meaningful to people and their social context |
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Life-Style Performance Model
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Developed by Gail Fidler
principles: lifestyle performance model seeks to identify and describe the nature and critical doing elements of an element that support and foster acheivement of a satistying, productive life-style -proposes a method for looking at the match between the enviornment and the individual's needs -eval focuses on obtaining an activity history and a life-style performance profile related to 4 domanins. Environmental factors are explored |
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Hypotheses are proposed from Life-Style Performance Model
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1. mastery and competence in activities that are valued and given priortity in one's society or soical gorup have greater meaning in defining social efficacy than competence in activites that carry less soical sig
2. A total activity and each its elements have symbolic as well as reality-based meanings that ntoably affect individual experiences and motivation 3. Mastery and competence are more readily acheived, and the sense of personal plasure and intrinsic gratification is more intense, in those activities tha are most cosely match to ones' neurobiology and psychological structure 4. compentence and achievement are most readily seen and verified in the end-produc t or outcome of an activity; thus, the qability to do to overcome, and to acheive becomes obvious to sef and others |
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10 fundamental human needs for performance and quality of life that enhanced by the environment per life-style performance model
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1. autonomy; self-determination
2. individuality: self-differentiation 3. affiliation: evidence of belonging 4 volition: the having of altneratives 5. consensual validation: acknowledgemnt of acheivement and verification of perspectives 6. predictability: discernment and evaluation of cause and effect 7 self-efficacy: evidence of competence 8. adventure: exploration of new and unknown 9 accomodation: freedom from physcial or mental harm and compensation for limitations 10 refelction: contemplation of events and meaning of things |
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Performance measurement domains of quality functioning per life-style perfomance model
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1. self-care and maintenance
3. intrinisc gratification 3 service to others 4 recriprocal relationships |
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Intervention of life-style performance model
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addresses 5 main questions to focus interention:
1. what does person need to be able to do 2. what is person able to do 3 what's the person unable to do 4 what interventions are needed and in what order 5 what are the characterisics and patterns of activity and of the environment that will enchnac the person's quality of life Use any interventions or activities that promote the performance in the four domains |
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Ecology of Human perfomrance Model (EHP)
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developed by Winnie Dunn and colleagues at University of Kansas Medical Center
principles: emphasizes role of individual's context and how the environment impacts a person and his/her task performance applicable to people across lifespan 4 main constructs of moedl are person, tasks, context & person-context-task transaction 11 assumptions of the model -eval ustilizes checklists |
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Assumptions of EHP model
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1. ecology refers to the interaction between a person and his/her enviornments
2. a person's performance is understood by looking at relationship between the person, context and the task 3. performance occurs when a person acts to engage in tasks within a context 4 each person is a unique individual with sensorimotor, cognitive and psychosocial skills and abilities 5 range of a person's performance is based on the transaction betwen the person and the context 6. skill that a person possesses can be increased or decresed due to illness and/or stress; person's interest and life experiences lead to continually changing variables 7. contexts are dynamic rather than satitc; there a reciprocal relationhsip between a person an his/her context where one incluences the other 8. roles that a person has in life is made up of tasks; transactional relationship between the person, task, and context makes up occupations and roles 9. theres a difference between a person's perfomance in his/her natual contexts and simulated expriences 10 occupational therapy process, people are empowered by increaseing self-determination 11. model defines independence as using the supports in a person's contex to meet his/her needs and wants |
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EHP intervention
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specific strategies designed to help person, context, task, or all three:
1. est and restore: enahncing a person's abiliites by teaching skills lost due to illness or disability or never learned 2. alter: assessing a person's context to determine which is the best match for the person's abilities 3. adapt/modify: chanign context or task in some way so that it leads the person to succesfu performance3 4. prevent: minimizing risks that might develop so the problem in perfomrance doesn; develop 5. create: assisting person by promoting enriching and complex performances in the person's context |
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Occupational Adaptation
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developed by Janette schkade and Sally Schultz
-principles: process individual goes through to adapt to his/her environment, cosists of three elements (person (consist of sensorimotor, cognititive & psychosocial), occupational enviornment (physcial, social & cultural systems) & interaction (occupational response) between the 2 -assumptions: occupation provides means to adapt to changing needs & conditions & desire to participate is intrinsic motivational drive to adapt; occupational adaptation is a normative process |
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Occupational Adaptation eval
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focuses on occupational environment, role expectation, and individual's potential for adpatations and the best means for adaptation to occur
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Occupational Adaptation intervention
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focuses on increasing skills needed for occupatioal adpatation addressing both individual and enviornment
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Role Acquisition
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Developed by Ann Mosey
-principles: intervention focsed on acquistion of specific skills needed to fxn in environment, individal employs task and social skills to meet demands of personally desired and necessary roles, performance is addressed through fxn/dysfunction continuums in 7 categories (task skills, interpersonal skills, family interaction, ADLs, school, work, play/leisure/recreation); temporal adaptation addresses the individual's temporal orientation and ability to organize his/her use of time in a need-satisfying manner |
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Role Acquisition eval & Intervention
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Eval: focuses on gathering data indicative of fxn/dysfunction in the above categories
intervention: principles of learning to promote skill development, general postuales for cahgne to guid tx process (LTG, can teaching interpesonal skills and tasks separately or within context initially, adequate repertoire of behavior is acuqired through ativities that are interesting to the client, intrasychic coentent is shared matter-of-factly with client and reality testing is provided, OT must know very specific behaviors desireing to promote/change). Some continuums have specific postulates to use any tx activitites that use teaching-learning principles |
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Cogntiive Disabilities
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Developed by Claudia Allen
-principles: based on Piaget & neurobiological stages of cognitive development; cognitive ability determined by biological factors and potential for improvement is dictated by those factors; once max level has been acheived, compensations must be made biologically, psychologically, or environmentally; cognitive performance is placed on a continuum divided into 6 levels that are further divided into modes |
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Automatic Actions, Level 1 of Cognitive Disabilities
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characterized by automatic motor responses and changes in the autonomic nervous system. Conscious response to the external environment is minimal
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Postural Actions Level 2 of Cognitive disabilities
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characgterized by movement that's associated with comfort. There's some awareness of lg objects in the environment and hte individual may assit the caregiver with simple tasks
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Manual Actions, Level 3 Cognitive Disabilities Model
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charcterizedc by beginning to use hands to manipulate objects. The individual may be able to perfomr a limited number of tasks with long-term repetitive traning
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Goal Directed Actions, Level IV Cognitive Disabilities
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charcterized by the ability to carry simple tasks through to completion. The individeaul relies heavily on visual cues. May be able to perform est routines but cannot cope with unexpected events
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Explatory Actions, Level 5 Cognitive Disabilities
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characterized by overt trial and error problem solving. New learning occurs. This may be the usual level of functioning for 20% of population
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Planned Actions, Level 6 Cognitive Disabiliteis
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charcterized by absence of disability; person can think of hypothetical situations and do mental trail-and-error problem solving
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Cognitive Disabilities Eval
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-focus on identifying individual's current cognitive abilites and their implications for perforamnce, indpendence & the need for assistance. The potential for improvement is also considered
-observation during fxnal tasks is emphasized -several eval tools have been developed (allen cognitive level screen-5 (ACLS-5), Routine Task Inventory, Cogntivie Performance Test (for Alzheimer's)) |
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Cognitive Disabilities Intervention
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-activities used to elicit the individual's highest cognitive level
-therapy focuses on maintaining the individual's highest level of fxn -environmental changes and activity adaptations are made to compensate for deficitis and allow the greatest degree of independence -the OT practitioner works with the team to develop an appropriate discharge plan -OT practitioner should meet with the family or other caregivers to develop understanding of the individual's abilities, deficits, and care needs |
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Cognitive Behavioral FOR/Cognitive Behavioral Therapy (CBT)
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developed by AAron Beck,
used with individuals with schizophrenia, anxiety, bipolar, panic, obsessive-compulsive, personality, somatoform, and eating disorders |
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Principles of CBT
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combines cognitive therapy and behavioral therapy,
3 components are didactic aspects (involve therapist explaining basic concepts and principles of CBT), cognitive techniques (eliciting automatic thoughts, testing automatic thoughts, identifying maladaptive underlying assumptions and testing validity of maladaptive assumptions) and behavioral techniques (used with cogntive techniques to test and challenge maladatpive and inaccurate cogntitions) cognitive triad: comprised of negative self evaluaiton, pessimistic view, sense of hopelessness development of insight necessary for growth and change: thinking influences behavior, changing the way a person thinks reduces symptoms, thinking can be self-regulated, change occurs through clients' involvement in learning and developing skills |
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CBT evaluation
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Beck Depression Inventory (BDI-II) is primary initial eval tool
eval of cognition is frequenctly completed by OTS variety of eval methods and assessments avalible |
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Beck Depression Inventory
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self-completed questionnaire that assess level of depression
no special traiing required to administer this client completed eval interpretation of results must be completed by metnal health professional that has completed required traning and acquired adequate knowledge abou the BDI-II and CBT |
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CBT Intervention
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assist client in identification of current problems and ptoential solutions
use active and collaborative therapist-client interaction as part of process help client learn how to identify distorted or unhelpful thinking patters, recognize and change inaccurate beliefs,a nd reltate to toerhs in more positive ways gain insight and acquire skills that max client functioing and quality of life thorugh the development of coping skills and meaningful healthy occupaitonal patterns facilitating the client's active role in the therapeutic process by frequently providing homework and sturctured assignments as part of the intervention process; scheduling activities; cognitive rehearsal, self-reliance training; role playing; diversion techniques and visual imagery; engaging in physcial, work, leisure/play, and/or social participation activities |
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Dialectical Behavior Therapy (DBT)
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form of CBT developed by Marsha Linehan
Focus: addresses suicidal thoughts and actions and self injurious behaviors, commonly used with indviduals with borderline personality disorder since a feature of this diagnosis is suicidal thinking and behavior, also used to treat individuals who have depression, substance abuse issues, and/or eating disorders eval: often begins with an accurate DSM-IV-TR dx by the psychiatrist; variety of OT eval may be used including those that address personality; OT assessments that focus on fxning performance areas and performance contexts can provide relevant info for intervention planning intervention: teaches assertiveness, coping and interpersonal skills, groups addressing acquisition of skills affecting occupational performance and opportunity to practice new skills, strong therapist-client relationship is essential (rapport used for validation and confrontation) |
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Sensory Models
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originally known as sensory integration (also called sensory processing, sensory motor model, sensory defensiveness, sensory moducalation and sensory based tx). Developed by Jean King
addresses movement patterns, calming and altering sensory input Sensory input processed in 1 of 4 patterns of neurological thresholds (sensory-seeking; sensory-avoiding; sensory sensitivity or low registration) assessments include Adolescent/adult sensory profile and allen cognitive level screen |
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sensory model interventions
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-use of snoezelen mulit-sensory environments to calm/alert individuals with psychiatric illness, autism, pervassive developmental disorders, and dementia
-use of therapeutic weighted blankets, dolls, and weighted stuffed animals as a modality ot assit in self-soothing and as an alternative to the use of restraints -use of comfort rooms in mental health settings as an alternative to restraints -pscyho-education -sensory diets including alterting/calming stimuli, and heavy work pattern |
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Narcisstic mechanisms
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Denail: failure to acknowledge existence of some aspect of reality that is apparent to others
projection: attributing attributes or unackowledged feelings, impulses or thoughts to others splitting: rigid separating of positive and negative thoughts and feelings |
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Immature mechanisms
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passive-aggressive: aggression towards others which is indirectly or unassertively expressed
regression: returning to an earlier stage of development to avoid the tension and conflict of the present one somatization: conversion of psychological symptoms into physical illness |
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neurotic mechanisms
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rationalization: creating self-justifying explanations to hide the rel reasons for one's own or another's behavior
repression: blocking from consciousness painful memories and anxiety-provoking thoughts displacement: redirecting an emotion or reaction from one object ot a similar but less threatening one reaction formation: switching of unacceptable impulses into its opposite |
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Mature mechanisms
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humor: using comedy to express feelings and thoughts without provoking discomfort in self and others
sublimation: redirecting engery from socially unacceptable impulses to socially acceptable activiteis suppression: conscioulsy or semi-consciously avoiding thinking about disturbing problems, thoughts or feelings |
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Areas addressed by Psychosocial Assessment
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1 performance skills and their impact on performance in areas of occupation
2 client factors and physical conditions or limitations that impact fxnal behaviors and performance in areas of occupation 3 the impact of individual's social, cultural, spiritual, and physical contexts 4 identification of the roles and behaviors tha are required of the individual either by society or for the acheivement of his/her desired goals 5. precautions and safety issues such as suicidal and/or aggressive behavior 6. history of behavior patterns 7 individual's goals, values, interests and attitudes |
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Psychosocial assessment methods
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interviews: structured and unstructured
std tests clinical observation and rating scales questionnaires self-report intevntories |
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Short Portable Mental Status Questionnaire
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focuses on intellectual fxn
short questionnaire asks 9 questions and a subtraction task each correct response gets a point, add point for education beyond high school or subtract a point if did not complete schooling beyond grade school. # of erros totaled with a potential error score of 10 -score of 0-2=intact intellectual fxn -3-4= mild intellectual fxn -5-7= moderate intellectual 8-10= severe intellectual impairement population: individuals with cognitve or psychiatric dysfunction |
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Adult/Adolescent Sensory Profile
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focus: allows clients to dientify their personal behavioral responses and develop strategies for enhanced participation
method: questionnaire measures individual's reactions to daily sensory experiences -scoring and interpretation: cutoff schores indicate typical performance and probable, definite and sig diffrences (which sensory system is hindering performance); can be used for interventino planning -population: 11-65 years old |
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Allen Cognitive Level Screen-5 (ACLS-5)
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focus: assesses the cognitive level of individual according to Alleg congitive levels
method: requires the performance of several leather lacing stitiches following instruction and/or demonstration, comparable tasks may be substitued, administration time varies Scoring: depends on stitches produced, ranges from 3.0-5.8: -level 3: running stitich -level 4: whipstitch -level 5: cordovan stitch population: adults with psychiatric or cognitive dysfunction |
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Beck Depression Inventory
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focus: measurement of the presence and depth of depression
method: adminstered by interviewer if needed, or person self completes interview; rates feelings on 21 characteristics associated with depression (mood, pessimism, sense of failure, lack of satisfaction, guilt, sense of punishment, self-dislike, self accusations, suicidal wishes, crying spells, irritability, soical withdrawal, indecisiveness, ditortion of body image, work inhibition, sleep disturbance, fatigability, loss of appetite, weight loss, somatic preoccupation, loss of libido) scoring: items are scored 0-3 (3 most severe) population: adolescent and adults |
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Elder Depression Scale
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focus: depression in elderly
method: completion of 30 item checklist that looks at presence of characterisitcs associated with depression scoring: items are scored yes or no, score of 10-11 is the threshold most often used to indicate depression population: elders |
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Hamilton Depression Rating Scale
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focus: measures severity of illness and changes over time in individuals dx with depressive illness
method: info gathered through interview with client, family & staff, rates info to 17 symptoms and characteristics (depressed mood, guilit, suicide, inital insomnia, middle insomina, delayed insomnia, work and interest, retardatin, agitatin, psychic anxiety, somatic anxiety, gastrointestinal somatic symptoms, general somatic symptoms, genital symptoms, hypochondriasis, insight, wt loss) and diurnal variation, depersonalizatin, paranoid symptoms and obessional symptoms scoring: items rated 0-2 (0 signifying absent, 1=tivial, 2- present); or rated 0-4 (absent, trivial, mild, moderate or severe). Note changes over time of individual's status population: individuals with dx of mood disorder |
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Bay Area Functional Performance Evaluation (BAFPE)
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focus: assesses cognitive, affective, performance, and social interaction skills required to perform ADLs
method: interview prior to assessmetn; task oriented assessment (TOA): measures cognition, performance, affect, qualitative signs and referrral indicators through completion of 5 std timed task; Social Interaction Scale (SIS): assess genreal ability to relate appropriately to other people within the enviornment through observations of the individual in 5 situations; optional self-report social interaction questionnaire; perceptual motor screening scoring: TOA (ten fxnal components of 5 tasks are rated, norms presented for compairson with specific adult psychiatric populations); SIS (7 categories are rated); combine scores of TOA & SIS for total BAFPE score which serves as indicators of overall fxnal performance, & provide info about person's congition, affective, social, and perceptual motor skills population: adults with psychiatric, neurological or developmental dx |
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Comphrehensive Occupational Therapy Evaluation Scale (COTE scale)
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focus: structured method for observing and rathing behaviors and changes in areas of general (7 items), interpersonaln(6 items), and task skills (12 items)
method: observe bheavior during session as completes task scoring: each item rated on scale of 0 (normal) to 4 (severe); use results to plan tx and assist with discharge planning population: adults with acute psychiatric dx |
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Activity Card Sort (ACS)
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focus: identification of person's level and amoutn of involvement in IADLs, leisure and social activities
method: present with 89 cards representing real people engaging in activity and asked to sor cards accoring to level of amount of involvement (never did, gave up doing, do less than in past, do same, do more than in past) scoring: total scores for each activity categories are obtained. complied into global scores for current activity, previous activity and percent retained population: orignially developed for older adults with demenia |
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Activities Health Assessment
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focus: time usage, patterns and configurations of activiteis, roles, and underlying skills & habits
method: completes an idosyncratic activities configuration schedule by constructing color-coded chart which depicts way time spent during a typical week, completees idiosyncratic activities configuration questionnaire administration time: 60 min to 2 hrs for questionnaire 45 min-60min for interview scoring: OT determines person's activity heath, sig placed on person's interprestation of level of balance, satisfaction, and comfort to which each activity contributes population: adults through elders |
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Adolescent Role Asessment
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focus: assesses development of internalized roles within family, school, and social settings
method: semi-sturctured interview scoring: indicates behavior that is appropriate, marginal or inappropriate population: adolescents aged 13-17 |
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Barth Time Construction (BTC)
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focus: time usage, roles and underlying skills and habits
method: construct color-coded chart, individually or in a gropu formant which depicts way time is spent during typical week (can use COTE scale during session) scoring: percentages of time calculated and significance of info is based on appropriate use of time and discussion population: adolescent through elder |
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Occupational Circumstances Assessment Interview Rating Scale (OCAIRS) version 4
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focus: nature and extent of occupational adaptation, bsed on MOHO model, 12 areas of occupational adaptation are explored (personal causation, self-perception of past circumstances and expereinces, social enviornment, physical environment, values, interests, roles, habits, skills, readiness for change, and LTG, STG
method: semi-structured invertivew with guided questions scoring: therapist rates each item on scale of 1-4 (4 being the highest) population: originally designed for adult through elder persons with psychiatric dx, now used in broader context. Has 3 interview forms for specific issues (physcial disabilities, mental health, forensic mental health) |
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Occupational Perforance History Interview-II (OPHI-II)
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focus: gathers info about individual's life history, past & present occupatioanl performance, and impact of incidence of disability, illness or other traumatic event
method: semi-sturcutred interview covers 5 areas (occupational roles, occupation/activity choices, critical life choices, occpuational behavior settings) scoring: therapist rates on sclae of 1-4 (1=extreme occupational dysfunction, 4=exceptionally occupational competent), write up results in narrative form population: indivdiuals who are able to participate in a comprehensive itnerview form adolescents to elders (not recommended to be used with children lesss than 12 yrs old) |
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Role Checklist
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focus: assesses self-rep0orted role participation adn value of specific roles to individual
method: checklist completed by individual along or with therapist (part 1 rate major roles, part 2 rates value of roles) scoring: used to get idea of disruption/changes to roles post event population: adolescent through elder individuals with physcial or psychosocial dysfunction |
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Indicators for one to one pyschosocial intervention
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refusal to attend groups
inability to toelrate group interaction presence of behaviors that would be disruptive to the goals of the group issues that must be addressed are specific to the patient only |
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Indicators for group psychosocial intervention
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more cost effective
effective at assisting members to learn to live in social environments takes advantage of group dynamics and therapeutic milieu |
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psychosocial intervention
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begin with basic skills, then progress to performance of fxnal activities specifically relevant to the individual
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Evaluation groups
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gathers info abou the individual's task and group interaction skills taht can be used to est goals and plan intervention, primary puspose is eval, however often therapeutic through process or content
bottom level of group in taxonomy |
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task-oriented groups
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purpose is to assit members in becoming aware of their needs, values, ideas, and feelings through the performance of a shared task
middle level of group in taxonomy |
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Developmental groups
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purpose is to assist members to acquire and develop group interaction skills (has 5 levels of interaction: parallel, project, egocentric cooperative, cooperative, and mature)
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thematic groups
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designed for the learning of specific skills
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topical groups
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focus on discussion of activities and issues outside group that are current or anticipated
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instrumental groups
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meeting health needs and maintaining fxn
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directive groups
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highly structured groups designed to assist low fxning pts in developing basic skills. Each session is divided into 5 parts followed by 15 min review of the session by the leaders
part 1: consists of orientation to purpose and goals fo the gorup (max of 5 min) part 2: review of everyone's name and intro of new members (5-10 min) part 3: consists of warm-up activities to make members comfortable adn engage them in the group (5-10 min) part 4: involves one or more activities desgined to address the goals of the group and the needs of its members (10-20 min) part 5: activities designed to give meaning to hte activities and closure to the group (10 min) |
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Mildred Ross' 5 stage groups
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Stage 1: orienttion of members to session and each other
stage 2: movement uses a variety of vigorous gross motor activities designed to be stimulating and alerting stage 3: perceptual-motor uses brief (30 min or less) activities that utillize perceptual-motor skills designed to be calming and to increase ability to focus stage 4: cognitive includes activities to provide cognitive stimulation to promote organized thinkng stage 5: closure consists of brief discussions to promote a sense of satisfaction and closure |
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modular groups
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focus of each session is rotated in a way that allows an individaul to join the group at any time and still cover each topic
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psychoeducational groups
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an intervention approach that uses a classroom format and the principles of learning to provide info to members to reach skills, teacher/student relathionship exists; use of homework assignments is encouraged to faciliate skill development and genralization of learning
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basic task skills groups
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include intervention activities desgined to develop basic cognitive skills necessary for hte completion of simple tasks. group uses a skill acquisition approach which differs from the psychodynamic approach used iin the taks-oriented group described by Fidler and Mosey
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social interaction groups
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include interventions to develop communication skills, socially acceptable behavior and interpersonal relationship skills, may be conducted in a modular and/or psychoeducational format
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ADL/IADL group
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focus on self-care and independent living skills such as cooking, money management, transportation, etc.
May be conducted in a modular and/or psychoeducational format |
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Community participation/reintegration
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focuses on identification and use of resources. May be conducted in a modular and/or psychoeducational format
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prevocational groups
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includes such topics as identification of skills, limitations, interests, work bheaviros, and job hunting skills
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Leisure
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may include identification of inerests, developmetn of activity specific skills, identification of resources, and recognition of the importance of healthy use of unstructured time
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Reminiscence groups
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activities are desgined to review past life experiences to poromote cognition and sense of personal workth
current memory is not necessary nor is it facilitated |
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Self-awarenes group
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includes such activities as values clarification, awareness of personal assest, limits and bheaviors; and the individual's impact on others
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Sensory awareness groups
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includes activiteis to promote sensory fxns and environmental awareness
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goal setting groups
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consists of activities designed to identify personal objectives and tx goals and steps to their achievement
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coping skills groups
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focuses on identifying hte problem-sovling and stress-management techniques needed to copoe with life stressors
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Discharge planning groups
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focuses on activities to problem-solve potential obstacles and identify resourdces for succesfful commmunity integration
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hallucination management
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create environment free of distractions that trigger hallucinatory thoughts and interfere with reality based activity
use highly structured simple, concrete activiteis that hold the individual's attn when the person appears to be focusing on a hallucinatory experience, attempt ot redirect him/her to reality-based thinking and actions |
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delusions management
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redirect individual's thought to reality-based thinking and actions
avoid discussion and other expriences that focus on and validate or reinforce delusional material |
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akathisia management
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allow person to move around as needed if it can be done w/o causing disruption to goals of gorup
keep in mind participation on many levels and in many forms can be beneficial to the individual whenever possible, select gm activities over fm or sedentray ones |
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offensive behavior (physical or verbal)
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set limits and immediately address the behavior during a session
reasons the behaviors aren't acceptable should be clearly presented in a manner that is not confrontational or judgemental consequences of continued offensive behavior should be clearly communicated required staff protects all pts from the threat of harm or abuse by another pts. Needs of entire unit and/or group membership must be kept in mind |
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Lack of initiation/participation
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together with the individual, identify reasons for lack of participation
motivation |
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Manic or monopolizing behavior
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select or design highly structured activities that hold the individual's attention and require a shift of focus from pt to pt
thank the individual for participation and redirect attn to another gorup member refer to limit-setting discussed above |
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escaliating behavior
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avoid what can be perceived as challenging bheavior
maintain a comfortable distance actively listen use a calm, but not patronzizing, tone speak simply, clarly and directly. Avoid miscommunication don't make or communicate vlaue judgements about he indivdiual's thoughts, feelings or bheaviors clearly present what you would like the person to do avoid positions where either you or pt feels trapped if above don't work remove other pts from area and get or send for other staff |
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Alzheimer's management
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make eye contact and show interest in person. Value and validate what's said by person
maintain a positive and friendly facial expression an dtone of voice during ll communications (don't order, use short, simple words adn sentences, don't argue or criticize) dont speak abou the individual as if not there use non-verbal communication create a routine that uses familiar and enjoyable activities note effects fo time of day on behavior and activity performance attend to safety issues at all times |
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RADAR
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use to approach screen for and respond to domestic abuse
R= routinely ask. Inquiring about potential abuse when inerviewing all clients can be the first step in intervention; this acknowledges that abuse is not an acceptable secret A= affirm and ask. Acknowledge and support the perosn who discloses abuse. Ask directquestions of all clients to dtermine risk D= document objective findings and record client statemetns in quotes A= assess and address the person's safety R= reveiw options and referrals. Refer the person to domestic violence hotlines, domestic violence shelters, and/or safe houses which have staff trained in family violence and safety planning |
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phases of adjustment
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1. shock (emotional numbness, depersonalization, and reduced speech and mobility)
2. anxiety (restlessness, confusion, racing thoughts and psychological symptoms associated with anxiety) 3. denial (minimalism, negation, aloofness, and unrealistic expectations) 4. depression (hopelessness, helplessness, isolation, and decreased self-esteem) 5. internalized anger (blaming of self for hte event, the extent of the loss, or the failure to recover) 6. externalized anger (aggression, antagonism, demanding and critical attitudes,a nd passive aggressive behavior) 7. acknowledgment (acceptance of new self concept and identification of values and goals) 8. adjustment (positive sense of self and potentialities and acheivement of meaningful goals) |
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Stages of response to death and dying & OT intervention
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1. Denial: allow person to ask questions and discuss the situation at his/her own pace
2. anger: allow individual to vent anger while identifying source and developing more effective coping strategies 3. bargaining: respond honestly to questions 4. depression: assists in providing physical and psychological comfort for both the individual and his/her loved ones 5. acceptance: provide ongoing support to the individual and family Don't push pt to progress to next stage, assist them to maintain control throughout all stages |
