OTA II

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OTA II

• Activities of Daily Living

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Class Outline

• ADLs basic ADLs vs. iADLs
• Evaluation of ADLs
• Case Study
• Teaching ADLs
• Dressing Lab

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Activities of Daily Living

• The skills needed to perform ADLs are required
  for basic survival and integration into the world
  around us.
• Can be subdivided into basic ADLs and iADLs
  (instrumental activities of daily living).
• Often taken for granted by the average person
• Dependence in these areas may provoke feelings of
  dependence and even infantilism
• Focus needs to be first on ADLs with iADLs
  being focused on later in the rehab process.

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ADLs

• Require basic skills
• ADLs categorized into types
• Mobility
• Self-Care
• Management of Environmental Hardware and Devices
• Communication
• Sexual Expression

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iADLs

• Skills that support personal independence
• Require more advanced problem-solving skills,
  social skills and complex environmental
  interactions then basic ADLs
• iADLs categorized into
• Home Management
• Community Living Skills (financial management,
  community mobility)
• Health Management
• Safety Preparedness

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Evaluation of ADLs

• Two major methods
• Top-Down Approach
• Focus is on clients occupational history and
  interests
• Bottom-Up Approach
• Focus on identifying problems in specific
  performance skills
• In practice a blend of both approaches is
  necessary
• Evaluation begins through
• Charting daily or weekly schedules
• Interest checklist
• Occupational role history
• Important to complete performance evaluation
• Must assess body structures and functions/
  consider environmental factors prior to beginning

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Recording Results

• The following are general categories used to
  describe ADL and iADL performance
• Independent
• Supervised
• Minimal Assistance ( supervision, cueing or lt20
  physical assist)
• Moderate Assistance (supervision, cueing and
  20-80 physical assist)
• Maximum Assistance (supervision, cueing 50-80
  physical assist, consider transfers)
• Dependent (gt80 physical assist)

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Discussion

• What does each category of iADLs include and
  whats important to consider in evaluation?
• Reminder
• Home Management
• Community Living Skills (financial management,
  community mobility)
• Health Management
• Safety Preparedness

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Sample Case Study

• See pg. 239 (Early) Figure 14-1
• Review COPM handout, Functional Indepence Measure
  and ADL evaluation page 240-241 (Early) Figure
  14-1 contd
• Discuss within small groups, when might the
  different tools provided be more useful?

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Teaching Activities of Daily Living

• Should identify appropriate short-term and
  long-term goals
• Grading in number and complexity of tasks
• Methods must be tailored to suit each client
• Use concrete, step-by-step instructions for
  clients with perceptual, memory deficits or
  difficulty understanding instructions
• Use of Tactile and Kinesthetic modes of
  instruction

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Tactile Kinesthetic modes of instruction

• Touching body parts to be moved, dressed, bathed
  or positioned
• Passively moving the part through the desired
  pattern to achieve a step or task
• Gently guiding the part manually through the task

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Todays Lab

• You (the OTA) have been asked to teach a client
  with some minor perceptual difficulties a
  one-handed dressing techniques.
• Please get into groups of 2 and you will be
  assigned a one-handed dressing technique (see pg
  257-260) Early) for
• Donning/doffing a shirt 4 methods (Choose 1)
• Taking pants on and off 2 Methods (Choose 1)
• Putting socks on and off
• Putting shoes on and off (one handed tying)
• Be prepared to demonstrate to the class the
  technique using some tactile/kinesthetic
  instruction.
• This will be your lab mark for this week