The Role of Occupational Therapist

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NAJMA ADAM LECTURER OCCUPATIONAL THERAPY DOW
UNIVERSITY OF HEALTH SCIENCES/ PINE GROOVE
REHABILITATION CENTER HILAL-E-AHMER
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Occupational Therapy Help for people with
Parkinsons
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Take a moment to think of some of the things
(occupations) you have done today to attend this
lecture.

• Have you had a shower,
• Had breakfast with family,
• Driven a car?

Now imagine this...
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HOW WOULD YOU
HAVE A SHOWER IF

• You have rigidity in your muscles?
• You had poor balance?
• You couldnt reach your arms up to your hair?

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HOW WOULD YOU
HAVE BREAKFAST WITH FAMILY IF

• You couldnt hold a spoon/fork?
• You take a long time to finish your meal?
• You just couldnt cope with getting out of bed?

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HOW WOULD YOU
DRIVE A CAR IF

• You were paralyzed from the waist down?
• You were fearful leaving the garage?
• You lost the use of your right hand?

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HOW WOULD YOU
HAVE COME TO ATTEND THIS LECTURE IF

• You had pain in your back?
• You heard voices in your head?
• You had tremors in your hands?

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OCCUPATIONAL THERAPISTS

• have the knowledge and the skills to help
  people overcome these and other barriers they may
  face in doing their everyday occupations!

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What is anOccupational Therapist?

• Health Care Professionals who enable people to
  lead a more productive, satisfying, and
  independent life.

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Who do Occupational Therapists work with?

• Children

Adolescents
Seniors
Adults
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Where do Occupational Therapists work?

• Hospitals
• Schools/Special schools
• Mental Health Facilities
• Armed forces
• Old Homes
• Private Clinics

• Rehabilitation Centers
• Community Health Centers
• Insurance Companies
• Client Homes
• Client Work Places

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THE ROLE OF OCCUPATIONAL THERAPIST FOR PEOPLE
WITH PARKINSONS

• INCREASE AND MAINTAIN INDEPENDENCE IN ACTIVITIES
  OF DAILY LIVING (ADLs)
• INCREASE MOBILITY CO-ORDINATION

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Activities of Daily Living(ADLs)

• Basic ADLs

• Instrumental ADLs

• Self care
• Feeding
• Grooming
• Dressing
• Bathing
• Personal hygiene
• Toileting

• Interaction with physical environment
• Putting things away getting things out of the
  closet
• Telephoning
• Written communication
• Using paper money, checks or coins
• Using books, newspapers entertainment
  equipments
• Using public/private transportation
• Leisure activities

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Dressing

• Warm light room.
• Firm seat with both feet on the floor with back
  supported.
• Clothing
• Easy to handle.
• Light weight
• warm /stretchy fabrics
• Easily laundered
• Cotton or cotton polyester
• Wide openings
• Aids
• Elastic laces
• Shoe horn
• Slipper socks

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• Eating
• Begin meal slightly ahead
• of the rest of his family
• Eat little and often
• One course of main meal at
• midday
• 2nd course on the evening
• Half filled mug(tremor)
• Aids
• Padded /light weight cutlery
• Plate guards
• Non slip mats
• Weighted bracelets (not too heavy)
• Mugs cups with two enlarged handles

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• Correct positioning.
• It may be useful to reduce the distance between
  the hands and mouth e.g. raising the table or
  plate, or by positioning the patient so that his
  elbows can be used as a pivot in order to assist
  hand movement

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• Home Safety and Management
• Even floor.
• Non-slip polishes
• Grab rails e.g. bath, toilet, steps.
• Plan but flexible routine will help to conserve
  energy.
• Non-iron and dip-dry fabrics.
• Carrying aids
• Net bag clipped to the walking frame.
• Trolley or an apron with large pockets all reduce
  the danger of tripping
• Alarm system
• Telephone

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• Bathing
• Shower chair
• Non-slip bath mat
• Beds
• Firm mattress
• Grab rail by the bed
• Night light luminous
• Alarm clock
• Light left on in the hallway

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Mobility Co-ordination

• Aim
• Gait
• Balance
• Transfers

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• 1. Gait
• Rx Aim
• To improve size rhythm of the walking pattern
• Large rhythmical bilateral non-resisted
  movements Walking
• Practice using foot outlines lines marked on the
  floor at paced intervals are all suitable.
• Activities which encourage walking should be
  under supervision.

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• 2. Balance-
• Initially
• Work at a balance table.
• Mirror
• Later
• Encourage side flexion and rotation.
• Encouraged to bend and stoop, such as gardening
  and skittles.
• Wedged shoes
• Leather soled shoes
• Weighted clothing.
• Raised chairs /beds.
• Inclined seats reduces the risk of over balancing
  when rising.

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Initiating Movement

• Rocking motion with verbal stimulus
• one, two, three go!
• Counting,
• Marching,
• Music, or rhythmic encouragement
• step and step and .
• One step backward before attempting to walk
  forward.
• Auditory visual stimuli (received when climbing
  up stairs often makes this activity easier than
  walking on level ground).

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• 3.Transfers
• Stable firm surface.
• A firm wedged cushion or rocking motion for
  rising from sitting.
• Raise the back legs of a chair slightly.
• Steady high chair with arm rest.

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• Co-ordination
• large bilateral and rhythmic activities with
  little resistance.
• As co-ordination improves the time spent on each
  activity can be increased and the size of
  movement decreased.
• Regular practice of writing patterns.

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• Writing
• Initially
• Blackboard
• large poster-sized sheets of paper
• Later
• Rhythmical writing patterns using widely spaced
  lines.

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• Progressions to writing letters and words.

• Writing aids

• Padded pens
• Writing board
• Roller ball pen (easier than fountain or ball
  point pen).

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Support for the patient and his family

• Reassure
• Therapist should help the family to be realistic
  in their expectations.
• The family should not expect the patient to
  perform activities beyond his capacity, but
  emphasize those he can do.

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• Social Activities
• Work in small groups (to avoid isolation and to
  assist communication).
• Positive and purposeful.
• Familiar and interesting activities
• A wide variety of stimuli in the form of colour,
  sound and touch.
• The therapist should work within the
  concentration span of the patient.
• Maintain social contact through
• Hobbies
• Pastimes.
• Visits.
• Outings.

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work

• Part-time work.
• less responsibility at work may be considered.
• It is unwise for the patient to persist with work
  to the point where he becomes exhausted and
  possibly unsafe.

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REFERENCES

• THE PRACTICE OF OCCUPATIONAL THERAPY
• An introduction to the treatment of Physical
  Dysfunction (II EDITION-ANN TURNER)
• QUICK REFERENCE TO OCCUPATIONAL THERAPY ( KATHLYN
  L.REED)
• WILLARD AND SPACKMANS OCCUPATIONAL THERAPY (XI
  EDITION)

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Take Home Message

• ADD LIFE TO YEARS
• NOT
• YEARS TO LIFE

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