Self Care Workshop EO101 2006

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Self Care WorkshopEO101 2006

• Introduction to self care
• Understanding occupational performance of self
  care
• Assessment of self care
• Intervention strategies
• Conclusion

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For your assessment Skills Demonstration
Video You may choose to introduce and teach a
person how to use a compensatory self care
technique or use assistive equipment for dressing
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Categorization of occupations

• Rest/sleep
• Leisure /play
• Productivity/work
• Self maintenance / self care
• Categorization depends upon the purpose assigned
  by the person doing the occupation

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A definition of self care the decisions and
actions individuals take in the interest in their
own health and for the health of family
members (Letts, Fraser, Finlayson and Walls
(1993) )
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• Self care tasks are considered
• a necessity for health and survival
• a basis for existence and acceptance in a social
  world
• (Christiansen 2003)
• Photo of man from Wodaabe tribe

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• Self maintenance occupations can be divided into
  
• Self Care / Basic Activities of Daily Living
• Eg bathing, dressing, grooming, mobility etc
• Instrumental Activities of Daily Living
• Eg managing money, using the telephone, shopping,
  laundry, house keeping

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It is only when performance of self-maintenance
(and self care) occupations become difficult or
impossible, that its importance becomes
evident. (Christiansen 2000)
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Exercise

• What occupations do you classify as self care
  within your cultural and social frameworks?
• Consider whether nurturing yourself is part of
  self care justify your answer

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Within the contexts of everyday life, bodily
impairments and limitations in ability may
interact with social attitudes and environmental
barriers to restrict participation and diminish
opportunities for the expression of personal
identity. (Christiansen 2000)
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Occupational therapy practitioners can perform a
valuable service by helping their patients
explore and consider different views of self that
are acceptable and offer reasonable prospects for
personal fulfilment. Understanding how the
patient is experiencing and interpreting the
challenges of disablement will assist in this
process. (Christiansen 2000, p10)
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(Christiansen Baum 2005)
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Exercise

• Dressing Activity Analysis

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Why assess self-care occupations?

• Christiansen (2000) suggests four main reasons
• To describe self-care status
• To measure change and monitor progress
• To facilitate communication and decision-making
• To evaluate programs and conduct research

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Standardised assessments are tests and
evaluations with

• specific norms (a typical score for a member of
  a comparison group)
• standards and protocols (manner in which it is
  conducted)
• (Christiansen and Baum , 1997 pg 604)

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Sample of Assessments

• Barthel Index
• Functional Independence Measure (FIM)
• Canadian Occupational Performance Measure (COPM)

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Barthel Index

• Measures changes in functional status (ADL) for
  hospital/rehab clients
• Physical focus

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Functional Independence Measure (FIM)

• Designed to measure
• the impact/degree of disability on functional
  status
• changes over time
• what person can actually do not capability

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Canadian Occupational Performance Measure (COPM)

• Measures clients perception of own occupational
  performance over time
• (Crepeau, Cohn. Schell 2003 pg 985)

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Exercise

• In your own time, read to become familiar with
  various self care/maintenance tests and consider
  the limitations and benefits for standardised
  assessment (ie standardised tools), including
  client-centredness and evidence based practice

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Considerations of standardised tests

• Cultural bias of instrument ?
• Requirements of test specific environment and
  questions ?
• physical focus ? (cognitive , behavioural
  perspectives?)
• Time to conduct
• Observation V interview (ability V capability)
• Reassessment time limitations?

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Intervention Strategies for Self Care

• Remediation changing a persons capabilities by
  impacting upon performance components
• Adaptation an internal process within a person
  a response to change, through repetition and
  practice
• Compensation changing the activity and the
  environment to match client
• Use of adaptive techniques, routines or
  equipment/devices
• Environmental modifications
• Use of family members/personal care attendants to
  assist with or carry out the self-care activities

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• Intervention Strategies (contd)
• Prevention identify and reduce risk factors,
  anticipatory action
• Health promotion enable person to identify
  resources (time, energy)
• Education ways to manage occupation
• Consultation providing expert advise and
  information
• (Christiansen 2005)

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Exercise

• Dressing with a simulated disability

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Exercise

• Environmental and Assistive Technology
  considerations

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Conclusion

• Self care as means of survival, identity, as an
  occupation
• Reviewed PEO model, activity analysis
• How OTs use strategy for s-c engagement (cultural
  context)
• Familiar with compensation adaptive methods,
  technology, environment
• Used reasoning, occupational performance issues,
  client centred practice

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Reference List Refer to Self Care Workshop
Workbook
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