The document discusses home and community occupations, specifically the home modifications process undertaken by occupational therapists in Australia. It covers client groups that may receive modifications, common barriers to home modifications, factors to consider in the assessment and modification process, and models and tools used in assessing the home environment. Key considerations for occupational therapists include applicable building codes and regulations, modifying the physical and social environment to enable occupational performance, and ensuring modifications are client-centered and address individual goals.
Occupational Therapy Theory & Practice Models and Frame of ReferenceStephan Van Breenen
Occupational therapy uses models and frames of reference to guide practice. Models provide overarching perspectives on health, well-being, and participation in occupations. Frames of reference are founded on models and focus on specific elements of occupational performance to guide the evaluation and treatment process. Occupational therapy practitioners use models and frames of reference together to plan and implement client-centered interventions.
1. An amputation care team should take an interdisciplinary approach to managing patients with upper extremity amputations. This includes regular communication to develop a comprehensive treatment plan.
2. Comprehensive assessments should be completed during the perioperative, pre-prosthetic, and prosthetic training phases, as well as annual screenings, to document outcomes and monitor rehabilitation efficacy.
3. Rehabilitation should have a patient-centered approach, incorporating patient goals and providing education, from the perioperative phase through lifelong care.
Cognition refers to various mental processes such as attention, memory, executive functions, comprehension, and perception. Occupational therapists use a dynamic interactional approach to evaluate and treat cognitive impairments. This approach views cognition as the dynamic interaction between a person, their tasks, and their environments. Occupational therapists evaluate clients through standardized and dynamic assessments to understand their cognitive strengths and limitations. Therapists then develop individualized interventions focused on building awareness, teaching strategies, and modifying tasks and environments to improve clients' cognitive performance and participation in daily activities.
Occupational Therapy Theory, Models, Reference and PracticeStephan Van Breenen
This document summarizes several theories and models that are relevant to occupational therapy practice, including Piaget's cognitive development theory, Freudian psychodynamic theory, Bronfenbrenner's ecological system theory, Skinner's behavior theory, and cognitive behavior theory. It discusses conceptual practice models like the Occupational Performance Model of Australia and frames of reference such as the Neuro-Developmental Treatment frame of reference, which is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. Conceptual practice models provide frameworks to explain important aspects of occupational therapy and offer guidelines for clinical assessments and interventions.
This presentation was prepared for educating the patients with stroke and their caregivers about the role of Occupational Therapy in stroke. It gives a very BRIEF over view about OT in stroke rehabilitation
Application of Affolter approach to occupational therapy intervention. The presentation ended with a case study of a patient management using affolter techniques.
Accessible Living Through Home Modificationsginaarroyo
Learn how home modifications can enhance independent living for individuals with disabilities and individuals aging in place. Occupational therapy promotes home safety and greater independence for caregivers and their loved ones.
The International Classification of Functioning, Disability and Health, provides a standard language and framework for classification of health and health-related domains
It throws light on certain points-
What changes in body function and structure have occurred in a person with a health condition?
What a person with a health condition can do in a standard environment -their level of function
What can be done to maximize function?
Occupational Therapy Theory & Practice Models and Frame of ReferenceStephan Van Breenen
Occupational therapy uses models and frames of reference to guide practice. Models provide overarching perspectives on health, well-being, and participation in occupations. Frames of reference are founded on models and focus on specific elements of occupational performance to guide the evaluation and treatment process. Occupational therapy practitioners use models and frames of reference together to plan and implement client-centered interventions.
1. An amputation care team should take an interdisciplinary approach to managing patients with upper extremity amputations. This includes regular communication to develop a comprehensive treatment plan.
2. Comprehensive assessments should be completed during the perioperative, pre-prosthetic, and prosthetic training phases, as well as annual screenings, to document outcomes and monitor rehabilitation efficacy.
3. Rehabilitation should have a patient-centered approach, incorporating patient goals and providing education, from the perioperative phase through lifelong care.
Cognition refers to various mental processes such as attention, memory, executive functions, comprehension, and perception. Occupational therapists use a dynamic interactional approach to evaluate and treat cognitive impairments. This approach views cognition as the dynamic interaction between a person, their tasks, and their environments. Occupational therapists evaluate clients through standardized and dynamic assessments to understand their cognitive strengths and limitations. Therapists then develop individualized interventions focused on building awareness, teaching strategies, and modifying tasks and environments to improve clients' cognitive performance and participation in daily activities.
Occupational Therapy Theory, Models, Reference and PracticeStephan Van Breenen
This document summarizes several theories and models that are relevant to occupational therapy practice, including Piaget's cognitive development theory, Freudian psychodynamic theory, Bronfenbrenner's ecological system theory, Skinner's behavior theory, and cognitive behavior theory. It discusses conceptual practice models like the Occupational Performance Model of Australia and frames of reference such as the Neuro-Developmental Treatment frame of reference, which is used to analyze and treat posture and movement impairments based on kinesiology and biomechanics. Conceptual practice models provide frameworks to explain important aspects of occupational therapy and offer guidelines for clinical assessments and interventions.
This presentation was prepared for educating the patients with stroke and their caregivers about the role of Occupational Therapy in stroke. It gives a very BRIEF over view about OT in stroke rehabilitation
Application of Affolter approach to occupational therapy intervention. The presentation ended with a case study of a patient management using affolter techniques.
Accessible Living Through Home Modificationsginaarroyo
Learn how home modifications can enhance independent living for individuals with disabilities and individuals aging in place. Occupational therapy promotes home safety and greater independence for caregivers and their loved ones.
The International Classification of Functioning, Disability and Health, provides a standard language and framework for classification of health and health-related domains
It throws light on certain points-
What changes in body function and structure have occurred in a person with a health condition?
What a person with a health condition can do in a standard environment -their level of function
What can be done to maximize function?
The Model of Human Occupation (MOHO) is an occupation-focused framework developed in the 1980s to explain how engaging in occupations occurs and problems can arise from illness or disability. MOHO views humans as dynamic systems influenced by volition (motivation), habituation (routines), performance capacity, and environment. Through participating in meaningful occupations, people can reshape their occupational abilities and identities to become more adaptive. MOHO provides resources for occupational therapists to engage clients in therapeutic occupations to restore, reorganize, or maintain their occupational performance.
The Ecology of Human Performance framework was developed by occupational therapists to emphasize the role of context in occupational performance. It views the person and environment as interdependent and examines how their interaction impacts tasks and performance. The framework's core components are the person, context, tasks, and performance. It provides five intervention strategies - establish/restore, adapt, alter, prevent, and create - to facilitate optimal occupational performance through modifying features of the person, context, and/or task.
Occupational therapy can help people with dementia by engaging them in meaningful activities to improve their quality of life and functioning. Therapists evaluate clients' abilities and tailor interventions and adaptations to maximize independence in daily living skills. The goal is to enhance well-being and compensate for cognitive and functional impairments through customized non-pharmacological approaches.
Occupational therapy at SIRC aims to prevent disability and restore functional independence through various services. OT services include upper limb exercises, splinting, assisting with activities of daily living, wheelchair skills training, home and workplace modifications, and community reintegration support. The OT process involves assessment, intervention, and evaluation to address patients' rehabilitation needs following a spinal cord injury. Key areas of OT focus are hand therapy, mobility training, self-care skills, and providing assistive devices to improve independence and quality of life.
This document provides examples of different types of occupational therapy interventions including the use of occupations and activities, preparatory methods and tasks, education and training, advocacy, and group interventions. Occupations and activities are client-directed daily tasks selected to meet therapeutic goals. Preparatory methods prepare clients for occupations and include modalities, splinting, assistive technology. Education imparts knowledge to clients and training facilitates skill acquisition. Advocacy promotes occupational justice. The examples illustrate but do not encompass all intervention types.
Applying the Person Environment Occupation Model to PracticeStephan Van Breenen
The document discusses applying the Person-Environment-Occupation (PEO) model to occupational therapy practice. The PEO model considers the dynamic relationship between a person, their occupations or tasks, and the environments in which they perform those occupations. The model can be used to understand clients and guide intervention by evaluating how features of the person, environment, and occupation interact and influence occupational performance.
Occupational performance refers to the ability to carry out day-to-day activities that are meaningful and purposeful to one's life and identity. It encompasses activities related to self-care, productivity, and leisure that allow individuals to participate in desired life situations. Factors such as physical and mental health, motivation, environment, and habits can influence a person's occupational performance.
Occupational Adaptation Theory describes the link between occupation and adaptation. It focuses on improving a person's adaptiveness through occupation. The theory postulates that adaptation is a lifelong process of responding to demands through one's sensorimotor, cognitive and psychosocial systems. The occupational adaptation process involves interactions between the person, their environment, and the occupational challenges they face. The goal is achieving mastery through an adaptive response involving planning, evaluating and integrating one's response. When challenges exceed one's adaptive capacity, dysfunction occurs. The theory guides occupational therapy to focus on clients' adaptive capacities and use occupation to promote adaptation.
Prompt client to use the strategy of chunking
information into smaller steps
Realistic? Relevant?
How long will it take to achieve this? (Time frame)
Performance Assessed:
Stage Three:
Environmental supports and barriers impacting
occupational performance
Scoring:
Rate impact of each environmental feature on
performance
Interpretation:
Summarize environmental supports and barriers
impacting OP
Goal-setting: Environmental Adaptation
Client will prepare a meal in their home kitchen
This document discusses vocational rehabilitation, independent living, and consumerism for people with disabilities. It covers several topics:
Vocational rehabilitation programs help prepare and employ people with various disabilities. The government has set up 20 vocational rehabilitation centers with objectives like assessment, rehabilitation planning, and job placement assistance.
The vocational rehabilitation process involves evaluation, job skills training, job analysis, job placement and accommodations, and follow up.
Independent living centers are consumer-controlled and aim to maximize self-sufficiency through services like housing assistance, transportation, peer counseling and advocacy. They differ from vocational rehabilitation in focusing on independence rather than employment.
The document also outlines various livelihood opportunities, government schemes
Traumatic brain injury (TBI) rehabilitation aims to restore function and minimize disability through a comprehensive, team-based approach. The rehabilitation process varies based on injury severity but generally involves early intervention to prevent complications, followed by therapy to improve mobility, activities of daily living, cognition, and communication. Outcomes depend on the nature and severity of injury, though most improvement occurs within the first year through coordinated acute and post-acute rehabilitation.
Occupational Therapy Theory and Practice Person-Environment-Occupation-Perfor...Stephan Van Breenen
Occupational therapy focuses on the dynamic relationship between a person, their environment, the occupations they engage in, and their performance of those occupations. This theory emphasizes how a person's skills and abilities interact with environmental demands and supports to either facilitate or impede their ability to perform daily tasks and activities. The goal of occupational therapy is to enable patients to engage as fully as possible in meaningful daily activities by modifying the environment or tasks to better match the person's abilities.
The Person-Environment-Occupation (PEO) model was developed to describe the interaction between a person, their environment, and occupations. It provides a framework to guide clinical reasoning and analysis of how these components interact and influence occupational performance. The model consists of the person, environment, and occupation and how their transactional relationship results in performance. It allows flexibility in assessment and intervention tools to apply in practice.
Model of Human Occupation, Cole & Tuffano (2007)Kirsten Buhr
The Model of Human Occupation (MOHO) is a conceptual model that views people as open systems that are influenced by internal factors like motivation, habits, and skills as well as the external environment. It describes three subsystems that comprise the internal factors: volition (source of motivation), habituation (habits and roles), and performance capacity (underlying skills). MOHO views occupational participation and competence as important to developing one's identity and adapting to different contexts. The model emphasizes the dynamic interaction between the person and their environment and can be used to understand occupational performance and dysfunction.
The document provides guidelines for home and community occupational therapists regarding home modification assessments and prescriptions. It outlines factors to consider in the assessment including client needs, property details, and funding. It also describes steps for preparing funding applications, overseeing construction, and signing off on completed modifications. Specific modification options like ramps, handrails, and doorways are defined with technical specifications. Compliance with standards and special client needs are also addressed.
Occupational Therapy- Biomechanical dysfunction and analysisStephan Van Breenen
Occupational therapists assess biomechanical function to determine limitations, required improvements, and the focus and effectiveness of treatment. Range of motion, muscle strength, endurance, contractures, and the effects of immobility are evaluated. Prolonged lack of movement can lead to deconditioning, weakness, and skeletal or psychological issues. Wound healing involves hemostasis, inflammation, proliferation of new tissue, and maturation of collagen over time as the wound gains strength.
Sensory integration is a neurological process that allows individuals to make sense of sensations from their body and environment. Sensory integration disorder occurs when this process is not functioning properly, making it difficult for individuals to respond appropriately. Sensory integration therapy aims to stimulate the senses through activities involving movement, touch, sound, and vision to help brains better process sensory information. Research suggests this therapy can help brains of children with sensory integration disorder change and develop through rich sensory experiences.
The document discusses the Occupational Performance Model (OPM). It defines a model as a statement that organizes knowledge about the relationships between elements in theory and practice. The OPM was developed in 1986 to illustrate factors involved in human occupational performance and the domain of occupational therapy. It describes occupations, occupational roles and performance areas, and identifies the physical, cognitive, and psychosocial components and contexts that influence a person's ability to engage in occupations.
An incomplete spinal cord injury results in partial damage to the spinal cord, leaving some motor and sensory function remaining below the level of injury. The effects depend on the area of the cord damaged, such as the anterior, central, or posterior regions. Common types of incomplete injury include anterior cord syndrome, central cord syndrome, and Brown-Séquard syndrome. Recovery from incomplete injuries can vary greatly between individuals based on the specific nerves impacted.
Timothy Dodd is seeking a position utilizing his operations, supervisory, and organizational skills. He has over 10 years of experience managing residential group homes for individuals with developmental disabilities. His responsibilities included managing staff, overseeing clients' medical care and goals, conducting performance evaluations, and ensuring regulatory compliance. He is skilled in areas like case management, developing behavior plans, and advocating for clients.
The Model of Human Occupation (MOHO) is an occupation-focused framework developed in the 1980s to explain how engaging in occupations occurs and problems can arise from illness or disability. MOHO views humans as dynamic systems influenced by volition (motivation), habituation (routines), performance capacity, and environment. Through participating in meaningful occupations, people can reshape their occupational abilities and identities to become more adaptive. MOHO provides resources for occupational therapists to engage clients in therapeutic occupations to restore, reorganize, or maintain their occupational performance.
The Ecology of Human Performance framework was developed by occupational therapists to emphasize the role of context in occupational performance. It views the person and environment as interdependent and examines how their interaction impacts tasks and performance. The framework's core components are the person, context, tasks, and performance. It provides five intervention strategies - establish/restore, adapt, alter, prevent, and create - to facilitate optimal occupational performance through modifying features of the person, context, and/or task.
Occupational therapy can help people with dementia by engaging them in meaningful activities to improve their quality of life and functioning. Therapists evaluate clients' abilities and tailor interventions and adaptations to maximize independence in daily living skills. The goal is to enhance well-being and compensate for cognitive and functional impairments through customized non-pharmacological approaches.
Occupational therapy at SIRC aims to prevent disability and restore functional independence through various services. OT services include upper limb exercises, splinting, assisting with activities of daily living, wheelchair skills training, home and workplace modifications, and community reintegration support. The OT process involves assessment, intervention, and evaluation to address patients' rehabilitation needs following a spinal cord injury. Key areas of OT focus are hand therapy, mobility training, self-care skills, and providing assistive devices to improve independence and quality of life.
This document provides examples of different types of occupational therapy interventions including the use of occupations and activities, preparatory methods and tasks, education and training, advocacy, and group interventions. Occupations and activities are client-directed daily tasks selected to meet therapeutic goals. Preparatory methods prepare clients for occupations and include modalities, splinting, assistive technology. Education imparts knowledge to clients and training facilitates skill acquisition. Advocacy promotes occupational justice. The examples illustrate but do not encompass all intervention types.
Applying the Person Environment Occupation Model to PracticeStephan Van Breenen
The document discusses applying the Person-Environment-Occupation (PEO) model to occupational therapy practice. The PEO model considers the dynamic relationship between a person, their occupations or tasks, and the environments in which they perform those occupations. The model can be used to understand clients and guide intervention by evaluating how features of the person, environment, and occupation interact and influence occupational performance.
Occupational performance refers to the ability to carry out day-to-day activities that are meaningful and purposeful to one's life and identity. It encompasses activities related to self-care, productivity, and leisure that allow individuals to participate in desired life situations. Factors such as physical and mental health, motivation, environment, and habits can influence a person's occupational performance.
Occupational Adaptation Theory describes the link between occupation and adaptation. It focuses on improving a person's adaptiveness through occupation. The theory postulates that adaptation is a lifelong process of responding to demands through one's sensorimotor, cognitive and psychosocial systems. The occupational adaptation process involves interactions between the person, their environment, and the occupational challenges they face. The goal is achieving mastery through an adaptive response involving planning, evaluating and integrating one's response. When challenges exceed one's adaptive capacity, dysfunction occurs. The theory guides occupational therapy to focus on clients' adaptive capacities and use occupation to promote adaptation.
Prompt client to use the strategy of chunking
information into smaller steps
Realistic? Relevant?
How long will it take to achieve this? (Time frame)
Performance Assessed:
Stage Three:
Environmental supports and barriers impacting
occupational performance
Scoring:
Rate impact of each environmental feature on
performance
Interpretation:
Summarize environmental supports and barriers
impacting OP
Goal-setting: Environmental Adaptation
Client will prepare a meal in their home kitchen
This document discusses vocational rehabilitation, independent living, and consumerism for people with disabilities. It covers several topics:
Vocational rehabilitation programs help prepare and employ people with various disabilities. The government has set up 20 vocational rehabilitation centers with objectives like assessment, rehabilitation planning, and job placement assistance.
The vocational rehabilitation process involves evaluation, job skills training, job analysis, job placement and accommodations, and follow up.
Independent living centers are consumer-controlled and aim to maximize self-sufficiency through services like housing assistance, transportation, peer counseling and advocacy. They differ from vocational rehabilitation in focusing on independence rather than employment.
The document also outlines various livelihood opportunities, government schemes
Traumatic brain injury (TBI) rehabilitation aims to restore function and minimize disability through a comprehensive, team-based approach. The rehabilitation process varies based on injury severity but generally involves early intervention to prevent complications, followed by therapy to improve mobility, activities of daily living, cognition, and communication. Outcomes depend on the nature and severity of injury, though most improvement occurs within the first year through coordinated acute and post-acute rehabilitation.
Occupational Therapy Theory and Practice Person-Environment-Occupation-Perfor...Stephan Van Breenen
Occupational therapy focuses on the dynamic relationship between a person, their environment, the occupations they engage in, and their performance of those occupations. This theory emphasizes how a person's skills and abilities interact with environmental demands and supports to either facilitate or impede their ability to perform daily tasks and activities. The goal of occupational therapy is to enable patients to engage as fully as possible in meaningful daily activities by modifying the environment or tasks to better match the person's abilities.
The Person-Environment-Occupation (PEO) model was developed to describe the interaction between a person, their environment, and occupations. It provides a framework to guide clinical reasoning and analysis of how these components interact and influence occupational performance. The model consists of the person, environment, and occupation and how their transactional relationship results in performance. It allows flexibility in assessment and intervention tools to apply in practice.
Model of Human Occupation, Cole & Tuffano (2007)Kirsten Buhr
The Model of Human Occupation (MOHO) is a conceptual model that views people as open systems that are influenced by internal factors like motivation, habits, and skills as well as the external environment. It describes three subsystems that comprise the internal factors: volition (source of motivation), habituation (habits and roles), and performance capacity (underlying skills). MOHO views occupational participation and competence as important to developing one's identity and adapting to different contexts. The model emphasizes the dynamic interaction between the person and their environment and can be used to understand occupational performance and dysfunction.
The document provides guidelines for home and community occupational therapists regarding home modification assessments and prescriptions. It outlines factors to consider in the assessment including client needs, property details, and funding. It also describes steps for preparing funding applications, overseeing construction, and signing off on completed modifications. Specific modification options like ramps, handrails, and doorways are defined with technical specifications. Compliance with standards and special client needs are also addressed.
Occupational Therapy- Biomechanical dysfunction and analysisStephan Van Breenen
Occupational therapists assess biomechanical function to determine limitations, required improvements, and the focus and effectiveness of treatment. Range of motion, muscle strength, endurance, contractures, and the effects of immobility are evaluated. Prolonged lack of movement can lead to deconditioning, weakness, and skeletal or psychological issues. Wound healing involves hemostasis, inflammation, proliferation of new tissue, and maturation of collagen over time as the wound gains strength.
Sensory integration is a neurological process that allows individuals to make sense of sensations from their body and environment. Sensory integration disorder occurs when this process is not functioning properly, making it difficult for individuals to respond appropriately. Sensory integration therapy aims to stimulate the senses through activities involving movement, touch, sound, and vision to help brains better process sensory information. Research suggests this therapy can help brains of children with sensory integration disorder change and develop through rich sensory experiences.
The document discusses the Occupational Performance Model (OPM). It defines a model as a statement that organizes knowledge about the relationships between elements in theory and practice. The OPM was developed in 1986 to illustrate factors involved in human occupational performance and the domain of occupational therapy. It describes occupations, occupational roles and performance areas, and identifies the physical, cognitive, and psychosocial components and contexts that influence a person's ability to engage in occupations.
An incomplete spinal cord injury results in partial damage to the spinal cord, leaving some motor and sensory function remaining below the level of injury. The effects depend on the area of the cord damaged, such as the anterior, central, or posterior regions. Common types of incomplete injury include anterior cord syndrome, central cord syndrome, and Brown-Séquard syndrome. Recovery from incomplete injuries can vary greatly between individuals based on the specific nerves impacted.
Timothy Dodd is seeking a position utilizing his operations, supervisory, and organizational skills. He has over 10 years of experience managing residential group homes for individuals with developmental disabilities. His responsibilities included managing staff, overseeing clients' medical care and goals, conducting performance evaluations, and ensuring regulatory compliance. He is skilled in areas like case management, developing behavior plans, and advocating for clients.
Organization development (OD) is a planned process aimed at enhancing congruence between an organization's structure, strategy, culture and people. It is a long-term effort led by top management to develop solutions and self-renewing capacity through collaborative problem solving. Key approaches to OD include laboratory training like sensitivity training, survey feedback, and action research which involves problem diagnosis, data collection, feedback, and action planning. The client-consultant relationship is important, requiring entry and contracting, maintaining confidentiality, and ensuring the consultant acts as a facilitator rather than content expert.
This document provides an overview and agenda for a presentation on change management in project environments. The presentation covers topics such as the relationship between project and change management, how change impacts individuals and organizations, communications and stakeholder engagement strategies, approaches to change management practice, and frameworks for managing change like those developed by Lewin and Kotter. The goal is to help participants understand change management and how to enable successful change.
Miriam Cho, a 35-year-old systems analyst, experiences pain and loss of mobility in her forearm, wrist, and fingers. She is undergoing occupational therapy to prevent symptoms from recurring, including taking breaks every hour, limiting keyboard work to 4 hours per day, using wrist splints and supports, and ensuring proper body alignment. Occupational therapists use systematic instruction based on applied behavior analysis to help clients acquire skills for their occupational goals, drawing on various levels of theory to guide evaluation and intervention selection in a way that integrates theory and practice.
PSY 636 Final Project Guidelines and Grading Guide O.docxpotmanandrea
PSY 636: Final Project Guidelines and Grading Guide
Overview
The final project for this course is an intervention plan with recommendations for the treatment of a child/adolescent who has been affected by the legal system
and now is showing signs of a mental and/or behavioral disorder. The final product requires students to fully define and operationalize a treatment intervention
plan.
The finished product will incorporate the application of theories and concepts taught in the course to substantiate the following criteria:
1. An examination of the factors that would specifically affect treatment in the case (familial, environmental, etc.)
2. A substantiated evaluation of various treatment options outlining their appropriateness
3. A recommendation of one or more intervention strategies with justification as to why they selected the one(s) that they did
4. An evaluation of potential ethical issues that should be considered or guarded against and how their plan does so
The project is divided into five milestones, which will be submitted at various points throughout the course to scaffold learning and ensure quality final
submissions. These milestones will be submitted in Modules Two, Three, Four, Six and Ten.
This assessment will assess your mastery with respect to the following course outcomes:
PSY-636.1: Develop effective evaluation strategies drawing upon the different types of evaluations used for children impacted by the legal system.
PSY-636.2: Evaluate the influence of cultural, familial, and environmental factors on the effectiveness of intervention and treatment strategies.
PSY-636.3: Analyze the effectiveness and appropriateness of treatment options available for various common behavioral/psychological issues affecting
children and adolescents.
PSY-636.4: Recommend family therapy treatment options that take into account the multi-dimensionality of the family unit.
PSY-636.5: Assess the ethical implications of various intervention strategies.
Prompt
Specifically, the following critical elements must be addressed:
1. Preparing for Effective Intervention: Outside Factors and Effective Treatment
a. Describe the potential impact of culture on treatment
b. Describe the potential environmental factors that may influence the treatment
c. Examine the potential role that family plays on the effectiveness of intervention and treatment strategies
2. Treatment Options and Family Therapy Evaluation
a. Evaluate appropriate treatment options available for family therapy treatment and individual treatment for various behavioral/ psychological
issues affecting children and adolescents who have been affected the legal system
3. Intervention Strategies
a. Recommend intervention strategies for behavioral/psychological issues affecting the child and/or adolescent chosen. Include justification for the
effectiveness of the recommended intervention strategies. ...
1. The document provides guidance on developing and implementing an effective behavioral intervention plan (BIP) that focuses on replacing problematic behaviors with desired behaviors.
2. It outlines key components of a BIP including linking interventions to the function of behaviors, developing therapeutic approaches, ensuring plan integrity, and evaluating effectiveness.
3. Guidelines are provided for making intervention decisions based on objective data collection and monitoring of the student's behavior over time.
The document provides an introduction to educational research. It discusses that research is important to understand educational processes, improve practices, and address policy issues. The research process involves identifying a problem, conducting an empirical study, replicating studies, and synthesizing results. Research aims to improve education through a scientific inquiry approach using methods like the scientific method. It can have quantitative or qualitative orientations depending on the approach and purpose.
ECO 605 Final Project DocumentOverviewThe final project.docxSALU18
The document provides instructions for a final project in an environmental economics course. Students must research and analyze an environmental issue in a 10-12 page paper. It outlines 5 critical elements that must be addressed: 1) describing the environmental problem, impacted groups, and affected resources, 2) analyzing public/private aspects of good usage, 3) assessing resource sustainability, 4) evaluating economic valuation methods used, and 5) providing recommendations based on economic analysis and efficient resource use. The project is divided into milestones and will be evaluated on comprehension of course concepts and the quality of the response.
Assessing students and giving feedbackSean_Polreis
The document discusses various methods for assessing students, including formative and summative assessment. It describes tools for direct observation, rubrics, and portfolios that can be used to assess students. Direct observation allows for authentic assessment in clinical settings but has issues with standardization. Rubrics provide guidance to learners on improving and reinforce learning outcomes. Portfolios demonstrate competencies through case histories and other materials. The document emphasizes choosing an appropriate assessment method and providing effective feedback to improve learner performance.
This document provides an overview of assessment and evaluation approaches. It discusses educational evaluation standards from organizations in the United States and Philippines. Evaluation approaches are classified based on epistemology, perspective, and orientation. Objectivist approaches use empirical inquiry while subjectivist approaches consider personal experiences. True evaluation determines value, quasi-evaluation may or may not, and pseudo-evaluation promotes views. Various evaluation methods are described like experimental research, testing programs, and accountability studies.
This document discusses auditory enablement and a teleaudiology model based on the Goldstein and Stephens management model of audiological rehabilitation. It advocates for a client-centered approach that enhances activities, quality of life, and minimizes effects on others. A teleaudiology model should attract and empower clients with choice through online testing, tailored solutions, self-management, and a continuum of care approach. The model is based on assessing client attitudes and barriers in order to personalize the servicing approach across online, telehealth, clinic, and other channels.
The document discusses evaluation methods used in pediatric occupational therapy. It describes standardized tests, ecological assessments, skilled observation, interviews, inventories and scales, and arena assessments. Standardized tests provide uniform administration and scoring but may not reflect real-world performance. Ecological assessments consider the child's environment. Skilled observation involves objective recording of behavior. Interviews gather information from the child, parents, and teachers. Inventories and scales evaluate functional capabilities. Arena assessments use a transdisciplinary approach in natural settings.
Jerry Agyei Mensah has over 3 years of experience in environmental science with a focus on RCRA hazardous waste programs and cleanups. He has a Master's degree in Environmental Science from NJIT and a Bachelor's degree from NJCU. His experience includes roles as a lab technician, facility supervisor, and sorting agent for hazardous waste cleanups. He is trained in CPR/First Aid and 40-hour HAZWOPER. Currently he works as a lab technician performing tests, maintaining equipment, and ensuring strict safety procedures are followed.
Challenging management situations in managing OHSSari Tappura
This document summarizes a study on challenging occupational health and safety management situations faced by managers. The study interviewed 75 managers from three Finnish public sector organizations. The most challenging situations related to administration of work, support for managerial work, feedback, social interaction, and conflicts. Managers sought ad hoc help to deal with these situations. They required more competence and organizational support procedures. The document argues that actively addressing these challenges is important for occupational health, quality of work, and organizational performance, but managers lack adequate resources and support from their organizations.
Beginning Functional Assessments and Behavior Intervention PlansSteve Vitto
The document outlines components of user friendly functional assessments and behavioral intervention plans. It discusses conducting functional assessments to identify the function or cause of problematic behaviors. Key steps include defining the behavior, collecting and analyzing data on antecedents and consequences. Functional assessments are then used to develop positive behavioral intervention plans that teach alternative behaviors and reinforce appropriate behavior through environmental modifications.
Strategies to prevent psychological injury at workKautilya Tiwari
This document outlines strategies to prevent psychological injury in the workplace. It recommends promoting safe workplaces, identifying potential harms, assessing risks, and developing and implementing primary, secondary, and tertiary intervention plans in consultation with employees and managers. Key strategies include supportive leadership, managing workloads and pace, effective communication, addressing occupational violence, and promoting work-life balance. The document provides specific suggestions for addressing different risk factors like repetitive work, shift work, change management, and performance management.
This document outlines the key aspects of decision making and problem solving in nursing administration. It discusses decision making as a complex cognitive process that involves identifying alternatives and choosing a course of action. Problem solving is defined as a process that focuses on analyzing difficult situations and includes a decision making step. The relationship between decision making and problem solving is explored, noting they are not synonymous but related processes. Types of decisions, levels of decisions, and factors affecting decision making are also summarized. Decision making models and techniques like analytical hierarchy matrices are presented to aid in evaluating alternatives and selecting the best solution.
Assessment of Adaptive Behavior in Special EducationAnn Vitug
This document provides an overview of adaptive behavior assessment. It defines adaptive behavior as the skills needed to function independently. Assessing adaptive behavior is important for eligibility for special education and developing effective interventions. It involves evaluating independent living skills in multiple domains. Assessment requires input from various sources and should account for changing expectations as students age. The document discusses commonly used assessment tools and the goal of understanding how to support individuals' everyday functioning.
Similar to Home and Community Occupations - Home Modification Process (20)
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities. Therapists design customized activity plans tailored to each patient's abilities and interests to maintain skills and encourage independence. Occupations are used as therapy to improve quality of life and support individuals as dementia progresses.
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities to support independence. Therapists evaluate each patient's abilities and design customized programs, choosing interventions that are enjoyable, purposeful and match the person's interests and skills. The goal is to use familiar tasks and routines to enhance quality of life and function through the stages of dementia.
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities to support independence. Therapists evaluate each patient's abilities and design customized programs, choosing interventions that are enjoyable, purposeful and match the person's interests and skills. The goal is to use familiar tasks and routines to enhance quality of life and function through the stages of dementia.
Occupational therapy can help people with dementia by providing cognitive stimulation and engagement in meaningful activities to support independence. Therapists evaluate each patient's abilities and design customized programs focused on remaining skills rather than deficits. The goal is improving quality of life and functioning through non-pharmacological interventions that reduce behavioral issues and maximize comfort.
Parkinson's disease is a progressive neurological disorder that causes motor symptoms like tremors and rigidity. Occupational therapy can help people with Parkinson's maintain independence through customized treatment plans. Therapists focus on improving mobility, balance, coordination, dexterity and other motor skills compromised by the disease to make daily activities and tasks easier.
Pain is a complex experience influenced by sensory, emotional, cognitive, and social factors. Physical therapists address pain by focusing on movement and function rather than just symptoms. Treatment may include manual therapy, therapeutic exercise, education, and strategies to help patients cope with and self-manage their pain.
The document discusses pain management in aged care facilities. It focuses on the importance of properly assessing and treating pain in elderly patients, as untreated pain can decrease quality of life. It also stresses the need for facilities to have strong pain management policies and train staff on identifying and responding to pain effectively in residents.
Neurocognitive domains refer to specific cognitive abilities like memory, language, and executive function. Dementia is linked to decline across multiple domains, with memory typically the first and most severe. Early detection of declines in neurocognitive domains can help diagnose dementia and allow for earlier treatment and support planning.
Falls are a serious risk for older adults, resulting in injuries, loss of independence, and even death. Proper lighting, removal of tripping hazards, and exercise can help seniors stay mobile and prevent falls. Regular vision exams, medication reviews, and home safety checks are also recommended to address common risk factors and keep seniors safe in their homes.
Falls are a serious risk for older adults, resulting in injuries, loss of independence, and even death. Common risk factors for falls include poor vision or balance, use of medications, and home hazards. Implementing prevention strategies like exercise programs, home safety checks, and medical reviews of medications can help reduce risks and keep seniors safe in their homes.
Motor skills naturally decline with age as the body slows down and becomes less coordinated over time. Older adults also take longer to learn and remember new motor skills due to typical age-related declines in cognitive processing speed and working memory. However, regular physical activity and exercise can help offset some of these effects of aging on motor performance and learning by maintaining muscle strength, flexibility, balance, and cognitive abilities into older adulthood.
Functional movement is essential for healthy aging. As we age, our mobility and flexibility naturally decline if not maintained through regular movement and exercise. Exercises that improve balance, coordination, and range of motion can help offset age-related declines and maintain independence later in life.
The document discusses the role of a community care worker. As a community care worker, typical responsibilities include assisting clients with daily living activities like bathing, dressing, and meal preparation. Community care workers also provide companionship, monitor clients' well-being, and help coordinate care with other medical professionals.
Community Care Workers provide in-home care and assistance to elderly, disabled, or otherwise vulnerable individuals in order to help them live independently in their own homes and communities. Their responsibilities include helping with activities of daily living like bathing, dressing, and meal preparation as well as providing companionship, transportation to appointments, and light housekeeping. The goal of their work is to support individuals' health, safety, and well-being so they can maintain maximum independence.
The document discusses the physiological changes that occur with aging and their impact. As people age, they experience changes in various body systems like sensory, cardiovascular, musculoskeletal, and neurological systems. These changes can affect functional abilities and independence with daily activities unless addressed through occupational therapy interventions.
Occupational therapy can help the elderly population with daily living activities. Therapists assist seniors with tasks like cooking, cleaning, and personal care. The goal is to improve independence and quality of life for older adults through customized interventions and exercises.
Occupational therapy can help elderly patients maintain independence and quality of life. Therapists assist seniors with daily activities like bathing, cooking, cleaning, and more through customized treatment plans. The goal is to adapt tasks and environments to an individual's physical and cognitive abilities so they can live as autonomously as possible for longer.
Occupational therapy is a client-centered health profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Occupational therapists use their knowledge of the transactional relationship between clients and their contexts and environments to improve clients' ability to engage in the occupations that they want to, need to, or are expected to do or engage in. Occupational therapists provide services to help clients promote health, prevent injury or disability, and achieve maximum functional independence in daily living skills.
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
Emotional and Behavioural Problems in Children - Counselling and Family Thera...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Mental Health and well-being Presentation. Exploring innovative approaches and strategies for enhancing mental well-being. Discover cutting-edge research, effective strategies, and practical methods for fostering mental well-being.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
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End-tidal carbon dioxide (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
Non-invasive methods for ETCO2 measurement include capnometry and capnography. Capnometry provides a numerical value for ETCO2. In contrast, capnography delivers a more comprehensive measurement that is displayed in both graphical (waveform) and numerical form.
Sidestream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
CHAPTER 1 SEMESTER V COMMUNICATION TECHNIQUES FOR CHILDREN.pdfSachin Sharma
Here are some key objectives of communication with children:
Build Trust and Security:
Establish a safe and supportive environment where children feel comfortable expressing themselves.
Encourage Expression:
Enable children to articulate their thoughts, feelings, and experiences.
Promote Emotional Understanding:
Help children identify and understand their own emotions and the emotions of others.
Enhance Listening Skills:
Develop children’s ability to listen attentively and respond appropriately.
Foster Positive Relationships:
Strengthen the bond between children and caregivers, peers, and other adults.
Support Learning and Development:
Aid cognitive and language development through engaging and meaningful conversations.
Teach Social Skills:
Encourage polite, respectful, and empathetic interactions with others.
Resolve Conflicts:
Provide tools and guidance for children to handle disagreements constructively.
Encourage Independence:
Support children in making decisions and solving problems on their own.
Provide Reassurance and Comfort:
Offer comfort and understanding during times of distress or uncertainty.
Reinforce Positive Behavior:
Acknowledge and encourage positive actions and behaviors.
Guide and Educate:
Offer clear instructions and explanations to help children understand expectations and learn new concepts.
By focusing on these objectives, communication with children can be both effective and nurturing, supporting their overall growth and well-being.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
2. The built environment includes structures such as
- Public buildings
- Schools
- Hospitals
- Private dwellings
- Parks and playgrounds
- Streets and footpaths that have been designed and constructed by
and for people
In Australia environmental modifications undertaken by occupational
therapists are mainly in domestic dwellings
Client groups generally fall within on of the following
- Privately funded clients
- Compensable clients
- State based publicly funded organizations
- Community Housing
- Public Housing
3. Barriers to home modifications
Psychological
- Concern about stigma
- Lack of social support
- Perception of them not being needed
- Denial of disability
Practical
- Cost
- Aesthetics/desirability
- Lack of secure tenure
- Lack of home-modification knowledge
Person who are depressed and or cognitively impaired are less likely
to value environmental changes
4. The Client
A transactional approach considers that the interaction between the
client and their environment is a dynamic entity and that the
person and the context at that point in time can only be understood
and assessed together, as a unified system and not in isolation of
each other (Tanner, 2011). This is the concept that underpins the
preferred method of a home assessment – with the client present.
An occupational therapist may be requested to undertake an
assessment without the client present and this is often a necessity to
ensure that the home environment can support the visit itself
(particularly in the case of severely injured or debilitated clients)
however it is difficult to determine function / environmental press
inherent in the person-environment-occupation relationship
without the client being at the assessment.
5. Assessment is an active process that requires selective attention and
assists human reasoners to make sense of complex and sometimes
contradictory data.
The development of the ability to notice and attend cues
appropriately in the home-modification scenario is crucial in
learning discrimination.
In Intervention, the focus shifts to overt action in extending and
testing understanding.
Observing and/or measuring humans in their physical environment
in terms of features and their component attributes provide the data
needed for occupationally successful outcomes
Occupational reasoning means that the shower-hob’s water-
containment structure need to be evaluated in terms of their
location, height, surrounding and shape
6. Evaluation of a building problem from a home-modification
perspective judges the qualities of all relevant components by their
features relative to the intervention goal
Modification may be motivated by desire to improve safety by
reducing or eliminating the building components that require good
dynamic balance.
Consideration of alternative requires a wider analysis
- Consideration of the impact on available circulation space
- Existing wall support structures
- Existing floor treatments
Modification reasoning requires movement from a specific building
component out to its wider contextual situation
7. Consideration of the wider implications allows a better
understanding of the problem and makes possible a more explicit
statement of modification goals
The feasibility of modification as an activity depends on being able
to evaluate and appropriately communicate the extent and scope of
the changes required.
8. Occupational Therapist Knowledge and Skills acquired to
effectively determine the fit between individual and their home
environments include:
- A health care perspective
- Assessment of performance
- Knowledge of modification interventions and assistive technology
- Knowledge of specific diseases and disability
- Knowledge of life span development
Difficulty in moving from sitting to standing could be due to one or
all of the following
- Stiff joints
- Poor endurance
- Unsuitable footwear
- Slippery or unstable surfaces
9. Home Assessment Components
Interview
- Provide overall profile of the client’s abilities
- Understand client’s priorities in relation to task performance
- Target tasks requiring further in-depth evaluation
Observation of task performance
- Assess the performance of components of tasks identified as being
difficult for the client to perform
- Identify possible intervention strategies
- Ascertain whether a change in the environment would enable ease
of task performance
Examination of the home environment
Assess for environmental hazards
Suitability of environment for client
Understanding of culture and values of client
Assess structural and maintenance issues
10. Home Modification competencies relevant to Occupational Therapists
- Respects the individuality and worth of each client within their
environment
- Establishes and maintains collaborative working arrangements
with other disciplines
- Assesses the occupational environment(s) of the individual or
group
- Prescribes specialized adaptive equipment and techniques
- Provides consultation regarding modification to the workplace,
home and leisure environments
- Understands the role of the client’s caregiver
- Utilizes available community resources and facilities
11. Home Assessment Tools
Occupational therapists need effective assessments to help evaluate
the physical, social, and psychological aspects of the home
environment when planning home modification interventions.
Assessment tools need to have a client-centered focus, emphasis on
occupation or occupational performance, comprehensive
evaluation of the environment, strong psychometric properties, and
clinical utility.
When selecting an assessment tool, occupational therapists also
need to take into an account the type of home modification
interventions that they will be able to complete in a given treatment
context.
Because of the unique needs of each home modification
intervention, there is no one-fits-all assessment; the best tool will
depend on the context of care.
12. SAFER
Home assessment by occupational therapist
Covers 97 items within 14 sections (living situation, mobility,
kitchen, fire hazards, eating, household, dressing, grooming,
bathroom, medication, communication, wandering, memory aids
and general
Based on IADL categorization (i.e. mobility, medication, etc.) with
inclusion of aspects of living situation (trip hazards) and fire
hazards. Little or no theoretical base and associated issues with
content and construct validity
Assesses an individual's abilities to safely manage functional
activities within their home
This assessment considers both the environmental feature along
with client's capabilities
13. SAFER
Evolved out of occupational therapy home visit proforma’s
currently in use in Canada. Concept of person and environment
unclear
Designed for older adults (who may or may not have cognitive
impairments) but can be used for other age groups
Unclear, behaviors implicit with exception of cognitive impairment
markers such as wandering
Manual contains suggestions for home modification-interventions
45 - 90 minutes to complete
The SAFER tool provides 95th and 99th percentile scores for each
category, allowing comparison of the client's score
14. SAFER
Strength
- Familiar and commonsensical
- No prior training required if used by an occupational therapist
- Problem identification linked directly to helpful hits about potential
solutions
- Evidence of psychometric review particularly in terms of reliability
Weaknesses
- Limited information on sample size, selection methods and
population demographics
- No cautions or limitations listed
- Summary score based on ordinal level data
- Insufficient space to record recommendations
15. Westmead Home Safety Inventory
Home hazard identification by occupational therapist
72 item checklist of fall hazards in the following categories:
internal/ external trafficways, general/ indoors, living area, seating,
bedroom, bathroom, kitchen, laundry, footwear, medication
management (60 minutes to complete (1 home visit)
Limited to housing environmental data associated with fails and
successful fall-related interventions
Evolved out of international environmental review of fall factors.
Concept of environment related to environmental settings. Concept
of person unclear
Unclear, scoring is based on environmental hazards. The
relationship to diagnosis, mobility, fall history and anthropometric
dimensions implicit
16. Westmead Home Safety Inventory
Items are rated as relevant/ not relevant for the client, then the
items rated as relevant are deemed as a hazard/ not a hazard
Strength
- Excellent training tool
- Comprehensive
- Evidence of psychometric review (i.e. attention paid to issues or
reliability and validity)
- Designed to be used in conjunction with the inventory prompt thus
not bulky or difficult to apply
Weaknesses
- Takes considerable time to process manual and integrate concepts
- Some aspect not always valid for the environment of concern
- No detail provided about potential solution
- Insufficient space to record recommendations
17. HOMEFAST
Home hazard utility screening, identify seniors at increased risk of
falls help facilitate referral for more detailed assessment and
recommend interventions.
25 items in total
Includes data about function and environment. Little or no
theoretical base and associated issues with content and construct
validity
Evolved out of NSW Home falls safety checklist. Concept of person
and environment unclear
Unclear, scoring is based on observation of a combination of
environmental factors and human performance in environment
factors
18. HOMEFAST
The assessment focuses on functional tasks and mobility within the
home
This screening tool looks at environmental hazards which may
contribute to falls
Allows problem identification but no explicit ink to modifications
Higher scores are predictive of falls risk
Construct validity : HOME FAST can be used to identify relative
risk for falls
19. HOMEFAST
Strengths
- No prior training required
- Evidence of psychometric review of inter-rater reliability and
content validity
- Good reliability for showering and bathing
- Evolved out of NSW Home falls safety checklist
- Intended for rural application
- Designed for speed of administration
Weaknesses
- Reliability assessed with occupational therapist, occupational
assistants and social worker
- Significant reliability difference with expertise
- Poor reliability for outdoor paths
20. Home Enabler
- Home accessibility assessment by occupational therapist, and as a
social participation and planning tool
- 198 items in full version (also shorter version possible). Four parts,
outdoor environment, entrances, indoor environment and
communication
- Includes data about functional limitations and environment. Based
on the enabler model developed from a 1979 review of the literature
on accessibly
- Evolved out of the enabler accessibility matrix and Swedish
handicap codes. Concept of person similar to WHO impairment
levels. Concept of environment related to environmental settings
21. Home Enabler
Interaction between person and environment
- Relationships are predetermined and weighted according to
observed severity of impairment generally
Relation to home modification
- Problems are summarized across the four sections but no explicit
link to modifications
22. Home Enabler
Strength
- Having two separate profiles increases flexibility allowing one
functional profile to be compared across several environmental
profiles and vice versa
- Evidence of psychometric review including content and external
validity based on Swedish handicap codes. Inter-rater reliability
good.
- Predictive environmental score is based on presence and severity of
functional impairments
Weaknesses
- Does not address hazards per se (i.e. omits smoke detectors and fire
egress)
- Requires education and training to apply appropriately
- Consensus about functional limitations and degree of dependency
on equipment unstable
23. Occupational Performance Model (Australia)
In the center of the OPM(A) is occupational performance. Five
main components constitute occupational performance:
- Biomechanical performance
- Sensory-motor performance
- Cognitive performance
- Intrapersonal performance
- Interpersonal performance.
The external environment is divided into the physical, sensory,
cultural and social environments.
24. Occupational Performance Model (Australia)
Core elements of occupational performance are the body element,
the mind element and the spirit element.
Occupational performance is embedded in space and time.
Space refers to physical matter (physical space) and the person's
experience of space (felt space).
Time refers to the temporal ordering of physical events (physical
time) as well the meaning that is attributed to time by the person
(felt time)
25. Model of Human Occupation
The center of the MoHO is the human system.
A system refers to any complex of elements that interact and
together constitute a logical whole with a purpose of function.
Occupational behavior is a result of the human system, the task
and the environment.
The human system has three subsystems:
- The volition subsystem (for making occupational choices; consists
of values, interests and personal causation)
- The habituation subsystem (consists of habits of occupational
behavior)
- Mind-brain-body performance subsystem (describes the
performance capacity).
26. Model of Human Occupation
In addition, the environment influences human occupational
behavior: physical, social and cultural environments constitute
occupational behavior settings such as in the home, school or
workplace and recreation sites
27. Canadian Model of Occupational Performance
In the center of the CMOP is occupational performance.
Occupational performance is defined as the overlap of three key
terms: occupation, environment and a person.
The result of the dynamic relationship between occupation,
environment and a person is occupational performance.
The key elements of the environment are cultural, institutional,
physical and social.
Purposes of occupations can either be leisure, productivity or self-
care.
The CMOP presents the person as an integrated whole who
incorporates spiritual and affective, cognitive and physical needs
28. Individuals carrying out occupations have a human body with
particular performance potentials and human measurements (i.e.
anthropometric) in conjunction with socially acquired activity-
relevant skill and knowledge
An individual’s ability to perform is shaped, on the one hand by
their health status and their performance of preferred
habit/routines; while on the other hand, an environmental setting
shapes the occupations afforded by defining the activity spaces and
the equipment available.
It is the interaction between the individuals and their
environmental settings that enables the development, practice and
fulfilment of personally valued activities.
29. Factors on decision-making outcomes
- Knowledge of environmental risks
- Having an injury history
- Personal perspective (i.e. preventative versus immediate functional
outcome)
- Acceptance of risk
- Attachment to objects (i.e. symbolic meaning and vessel of
memories)
- Exploration of alternatives
- Valuing the recommended change
- Feasibility (i.e. ability and opportunity) for change
- Beliefs (i.e. that risk could be effectively averted via behavioral
change alone)
- Degree of perceived personal freedom in decision-making affecting
the home
30. The built environment includes structures such as
- Public buildings
- Schools
- Hospitals
- Private dwellings
- Parks and playgrounds
- Streets and footpaths that have been designed and constructed by
and for people
31. In Australia environmental modifications undertaken by occupational
therapists are mainly in domestic dwellings
Client groups generally fall within on of the following
- Privately funded clients
- Compensable clients
- State based publicly funded organizations
- Community Housing
- Public Housing
Other areas where modifications can take place are
- Independent Living Units
- Retirement villages
- Boarding houses whose residents may be included in any of the
above groups
32. Occupational therapist who work in the area of home modifications,
must have:
- Knowledge of basic accessibility guidelines
- Local and national building codes
- Other relevant legislation ( i.e. negligence, product liability,
trespass, etc.)
- When planning to modify a home, it must be compliant with all
necessary building codes, standards and regulations.
- Environmental legislation and regulations need to be check
(especially as zoning laws and/or development legislation may
directly impact on home modification options)
33. - Building codes stipulate the minimum necessary standards (e.g.
health, safety, amenity, and sustainability of the buildings)
- Accessibility standards provide guidance on aspects of physical
accessibility relevant to design outcomes.
- The degree to which accessibility standards are implemented
depends on whether they are called up in legislation or regulation.
34. Home Modification that Enable Occupational Performance
Changes to the Physical Environment:
- Modify the layout (remove a door to make the opening wider)
- Provide adaptive equipment (provide a tub bench)
- Architectural modifications (provide a ramp, bathroom
modifications)
Modification of the occupation
- Educate the user in how to use the environment in a different way
- Use of everyday items for a different purpose or to achieve goals
Supports from people
- Caregiver education (such as transfer techniques)
- Engaging in person based services (such as meal delivery).
35. Key concepts of client-centered practice:
- Individual autonomy and choice
- Partnership
- Therapist and client responsibility
- Enablement
- Contextual congruence
- Accessibility
- Respect for diversity
Home modification team:
- Insurance agents
- Occupational therapists
- Project Managers
- Designers, Builders etc.
- People with disability and their families
36. Assessment of the Home Environment
- Access (front, back, side)
- Bathroom
- Toilet
- Lounge or sitting room
- Laundry
- Bedroom
- Kitchen
37. Home Modifications can:
- Reduce institutionalization and promote participation and
community inclusion
- Significantly reduce the number of falls in older people
- Delay performance loss and dependency
- Reduce the overall cost of care by decreasing the risk of injury and
hospitalization or institutionalization
- Improve occupational performance, safety or accessibility
- Greater independence
- Heightened confidence
- Greater security
- Increased sense of wellbeing
38. Home modifications must:
- Be reasonable and necessary.
- Be appropriate for funding by the insurer.
- Maximize client control, choice and participation in decision-
making.
- Address individual goals and needs which are articulated in
participant plans, including participation in occupational activities,
social and economic life.
- Represent value for money (by project and in comparison with
alternatives.)
- Be effective and beneficial with regard to the existing structure and
site of the home.
- Be of good quality and compliant with building codes and
regulations.
39. Complexity of decisions process in home modification
(example associated with toilet rail placements)
Length
- Minimum length is 300 mm and increments are usually in 150 mm
units
- Person’s height and height of any co-habitants ability to flex and
extend hips and knees and competency of this ability
Profile
- Circular, square, oval
- Person’s hand size, degree of muscle tone and dynamic grip
strength
Diameter
- Minimum is 20 mm but can go up to 50mm
- Person’s hand size, degree of muscle tone and dynamic grip
strength
40. Shape
- Straight, angled, curved
- Number of persons utilizing a grab rail and their ability to shift
center of balance in a normal sit-to-stand maneuver
Location of fixings
- Wall, ceiling, floor
- Person’s upper-limb segment length and preferred transfer
procedure
Distance from pan to proximal projection point
- Can vary widely
- Person’s arm segment length
Distance from floor to distal projection point
- Can vary widely
- Person’s height and limb segment lengths
41. Material
- Wood, plastic, galvanized iron, chrome, aluminum, brass
- Person’s ability to exert dynamic grasp, torso and upper-limb
muscle strength and the possibility of contact with water
Fixing
- Screws, loxins, dynabolt
- Persons weight, wall fabric
Surface texture
- Degree of slip resistance
- Possibility of contact with water, excessive sweating in hands or
contaminants such as soap
Angle of insertion
- Vertical, horizontal, variety of angles in between
- Number and height of all users utilizing the same rail, person’s
stated transfer method
42. Projection from wall surface
- Can vary, minimum is considered to be 25 mm
- Size of hand and chance of arm becoming entrapped should slip
occur
Obstructions and protrusions that might prevent usage
- Pipes, wires, toilet roll holders
- Ability of an individual to gain grip purchase
43. Specialist knowledge and skills include:
- Responsive to the needs of people with different experience of
disability
- Solutions-focus to deliver home modifications that result in
improvement in safety and independence for the participant, their
family and carers
- Fluent in the application of universal design principles
- National Construction Code and standards related to access in the
residential setting
- Project management skills
- Design and construction knowledge and practice
- Applied understanding of insurance principles
44. Insurance principles
- Reasonable and necessary
- Appropriate for funding by the insurer
- Maximize client control, choice and participation in decision-
making
- Address individual goals and needs which are articulated in
participant plans, including participation in occupational activities,
social and economic life
- Represent value for money(by project and in comparison with
alternatives.)
- Effective and beneficial with regard to the existing structure and
site of the home
- Good quality and compliant with building codes and regulations
45. Privately funded clients:
- Generally the occupational therapist (whether public or private)
will advise the client of the modifications they recommend and the
client will choose to arrange a private builder or tradesperson at
their own expense to undertake these recommendations.
- It is considered prudent for the occupational therapist to let the
client source their own builder, or if the OT does have a list of
builders they have used provide the list and let the client make their
own decision about which provider to use.
46. Compensable clients
- Various kinds of compensation exist in the Australian context,
depending on the management of the client’s injury and how it
occurred.
- The main focus is personal injury claims through WorkCover,
Motor Vehicle Accident insurance, public liability claims and civil
and medico legal claims.
- Different states and territories have different compensation
schemes (e.g. Life Time Care and Support in NSW, and TAC in
Victoria), as well as case law and liability legislation.
- While the Occupational Health & Safety Act (2000) is a federal
piece of legislation the application for the WorkCover
compensation process is generally run at a local level by the
various insurers that cover the region.
47. Department of Veterans’Affairs (DVA)
- This Commonwealth department provides and funds a number of
services to veterans and their dependents (under programs such as
HomeFront) including home modifications.
- The level of service from an occupational therapist is dependent on
the Veterans’ level of claim (White or Gold).
48. If the client has a Repatriation Health Card
- For All Conditions (Gold Card), DVA will pay for occupational
therapy services available through DVA arrangements that meet the
client’s clinical needs.
If the client has a Repatriation Health Card
- For Specific Conditions (White Card), DVA will pay for
occupational therapy services if provided under DVA arrangements,
that are required because of an accepted war or service caused
injury or disease.
Where a White Card has been issued for:
• Malignant cancer;
• Pulmonary tuberculosis
• Post traumatic stress disorder (PTSD)
• Anxiety and/or depression whether war caused or not,
DVA will fund treatment for clinical needs related to these conditions
(The Department of Veteran's Affairs, 2011)
49. Government funded organizations
The Home and Community Care (HACC) Program is a joint
Australian, State and Territory Government Initiative.
The HACC Program provides services such as domestic assistance,
personal care as well as professional allied health care and nursing
services, in order to support older Australians, younger people with a
disability and their carers to be more independent at home and in the
community and to reduce the potential or inappropriate need for
admission to residential care
50. Community Housing (such as The Community Housing Federation of
Victoria)
There are 3 main types of community housing: housing associations,
co-operatives and church owned housing.
Housing associations manage the vast majority of community
housing tenancies, the others play a crucial part in making
community housing the vital and diverse sector that it is (NSW
Federation of Community Housing Inc., 2011).
- Housing associations are specific professional not-for-profit housing
providers. While they mainly manage rental housing, they may
provide other services as well.
- Co-operative housing is subsidized by government, but is fully
managed by the tenants themselves, providing real control and
‘ownership’ of their housing.
51. - Church-based agencies have responded to need in their local
communities and bring church resources to the table.
Generally community housing is delivered by funded community
organizations and tenancy will be managed by that community
housing organization.
In that vein, when planning modifications it is essential to contact
the Community Housing Provider (CHP) with regard to their policy
and/or procedures in this regard.
In some cases, particularly if the client is HACC eligible, the CHP
may only be required to supply the “Authority to Install” document.
In others case, the CHP may choose to offer relocation to a more
suitable property within their range of available housing stock.
52. Aboriginal Community Housing
There is a distinct, Indigenous-controlled, housing system. While
much of this housing is managed through the relevant state
department that manages public housing, there is also significant
number Aboriginal community based housing providers
Public Housing (such as The Department of Housing, Western
Australia).
Each state and territory in Australia has its own public housing
program and each have programs within it to modify/retrofit existing
housing to suit their tenants abilities, to purpose build specific
properties for people with different abilities and disabilities, and to
support tenants with specific environment needs access the private
rental marker if nothing is available in their geographical area.
Each States body has a different name and policy on this.
53. Most occupational therapy departments will have information on the
practices of their local public housing body and the best way to
communicate with their modifications program.
Unlike other funded services, eligibility is usually focused on the fact
that the client is already in public housing. The request for
modifications usually only needs to state the functional reason for
the person need the modification, not an in depth medical
background.
Client privacy and confidentiality is relevant here and the clinical
senior in the area will probably have an example of a report that will
demonstrate the level of information that is required in order to have
modifications undertaken.
In some cases the relevant body may decide that the cost of
modifications is untenable and will recommend that the client
relocate to a more suitable property.
54. There is a caveat in housing tenancy documents that covers this
eventuality and it may be prudent to advise your client of this prior to
lodging a request for major modifications.
The client can decline the recommendation to relocate and accept
the agency’s decision to decline the modifications for that particular
property.
If there are particular reasons as to why the client relocating is
untenable (such as carer availability or proximity to relevant
locations) these should be documented and reported on if a response
to the modification decline is prepared.
For example if a client’s primary carer does not drive and walks to
the client each day, relocation may cause significant impact on the
client’s well being and ability to manage in the community
55. Legislation and Regulations
Access standards and building codes, while useful for general
guidance, cannot account for individual needs.
All therapist-determined recommendations (relevant to client
anthropometrics and subsequent function) should be identified and
documented and then put to test against any relevant legislation /
regulations and codes by the installing tradesperson
In some cases, where the Australian Standard 1428 is used as part of
a home modification service delivery guideline for example, a
client’s anthropometrical data can determine that the AS1428 is not
relevant for that person and it should then be used as a guide only.
The therapist will need to document this and any negotiation with
the relevant tradesperson / home modifications coordinator
56. Legislation and Regulations
Other Standards, for example the Electrical Standards Act, the
requirements are legislated and cannot be altered. Although
occupational therapists are not trained in these specific areas and
should not profess expertise with regard to building, plumbing etc.,
occupational therapists need to be aware of specific, relevant
legislative requirements and regulations/codes.
Not all these are directly related to the built environment but may
have indirect relevance when their purpose is examined more
closely.
Areas such as Privacy, and Discrimination are also relevant to the
practicing occupational therapist
57. Commonwealth legislation and regulations AS 1428
Australia’s primary legislated guidelines for Accessibility, AS 1428
Part 1 (Standards Australia, 2001) and Part 2 (Standards Australia,
1992b) do not include accessible front entrance solutions, primarily
because the Standards were developed with commercial entrances in
mind; consequently the AS1428 suite focuses on urban, commercial
entrances requiring ramps or lifts, not domestic responses for
individuals.
It is worth noting that scooters are not considered in the A90
footprint sizing and that many wheelchairs are also larger than this
specification. There has been a recent amendment to this standard
58. Access to Premises
The Access to Premises Standards (commonly referred to as the
‘Premises Standards”) is intended to clarify how designers,
developers, managers and building certifiers can meet their
responsibilities under discrimination law to ensure that buildings are
accessible to people with a disability
The Standards apply to ‘public buildings’, which includes hotels,
tourist accommodation, and retail premises, commercial and
industrial buildings, government buildings, theatres and cinemas as
well as the common areas of strata apartments
59. Building Code of Australia (2011)
The Building Code of Australia (BCA) is produced and maintained
by the Australian Building Codes Board (ABCB) on behalf of the
Australian Government and all State and Territory Governments.
The BCA has been given the status of building regulations by all
States and Territories. The BCA is updated on a regular basis
(usually each year).
The goal of the BCA is to “enable the achievement of nationally
consistent, minimum necessary standards of relevant, health, safety
(including structural safety and safety from fire), and amenity and
sustainability objectives efficiently.”
Electrical Standards Australia/Standards New Zealand. (2007).
Australian/New Zealand Standard, Electrical Installations: Wiring Rules
(3000:2007, Amendment Nos 1, 2 & 3 ed.): Standards Australia/Standards New
Zealand.
60. Disability Discrimination
The Disability Discrimination Act (DDA) 1992 provides protection
for everyone in Australia against discrimination based on disability.
It encourages everyone to be involved in implementing the Act and
to share in the overall benefits to the community and the economy
that flow from participation by the widest range of people.
Disability discrimination happens when people with a disability are
treated less fairly than people without a disability.
Disability discrimination also occurs when people are treated less
fairly because they are relatives, friends, carers, co-workers or
associates of a person with a disability (HREOC, 2011).
61. Privacy
The Privacy Act regulates 'information privacy'. It covers a number
of different activities and sectors.
The type of privacy covered by the Privacy Act is the protection of
people's personal information, where personal information is
defined as information that identifies a person or could identify a
person.
Personal information, such as a client name or address. Personal
information can also include medical records, bank account details,
photos, videos, and even information about what someone likes,
their opinions and where they work - basically, any information
where someone is reasonably identifiable. Information does not have
to include a name to be personal information.
62. Privacy
The Privacy Act definition of personal information is:
"... information or an opinion (including information or an opinion
forming part of a database), whether true or not, and whether recorded
in a material form or not, about an individual whose identity is
apparent, or can reasonably be ascertained, from the information or
opinion" (Office of the Australian Information Commissioner, 2010)