Mod 2 Special Topics

Money management training/ activities for neuro/ cog disorders: common neurocognitive disorders

Mild

• Mild cognitive impairment

  • Applying to older adults

  • At risk of developing dementia

Major

• Alzheimer’s disease (AD)

• Lewy body disease

• Traumatic brain injury (TBI)

• Parkinson’s disease

• Huntington’s disease

• Substance or medication use

Money management training/ activities for neuro/ cog disorders

focuses on iadl of financial management and shopping

• simulates online shopping

• online bill play

• practice writing checks/ balancing checkbook

• assist in creating monthly budget planner

• budgeting - spending tracker

• budgeting planner

Fugl-Meyer

assesses motor function after a stroke in the following 5 domains:

1. motor function

2. sensory function

3. balance/ coordination

4. joint range of motion

5. joint pain

how to administer the fugl-meyer

• collect patient history

• complete the 5 subtests

• score the assessment

  • 0-2 scale

    • 0 unable to perform movement

    • 1 partial movement/ significant limitation

    • 2 full movement/ no significant limitations

• interpret the scores

one handed dressing techniques: tips

• allow for rest breaks and adequate time

• set up the task for success

• don with affected limb first and doff with unaffected limb first

• positioning:

  • ensure the client is in a stable chair with both feet on the ground

  • have the head of bed elevates or in seated potion

  • if client has poor trunk balance, support them against the chair

one handed dressing techniques: adaptive clothing and equipment for UB

• Rings or strings added to zipper pulls

• Velcro

• Snaps and grippers

• Button hooks

• Clip-on tie

• Pullover or front-closure bras

• Large buttons

• For zippers – once closed place a large safety pin at the bottom of the zipper to prevent it from detaching

• Magnetic fasteners

• *consult with a doctor if the client has a pacemaker

• Easy coat fabrics to put on: satin, silk, nylon

• Use loose-fitting tops

• Dressing hooks

one handed dressing techniques: adaptive clothing and equipment for LB

• Elastic waistbands

• Use a reacher or clothing hook to pull the clothing item up to the knees/hips

• Use loose-fitting pants

• Skirts may be easier to put on rather than pants

• Tear away pant

Chedoke-McMaster Stroke Assessment (CMSA)

assessment that measures from 2 inventories, impairments and activities to determine physical impairments and severity in patients post stroke

impairment relates to the recovery stage of the arm, leg, trunk, etc… (?)

activity: 15 items

3 main objectives:

1. add stage to current motor recovery (brunnstrom)

2. predict rehab outcomes

3. measure important change at end of rehab stay

Scoring:

1-7 scale for impairment and activity; higher score meaning better function

Kettle Test

• performance-based assessment to measure cognitive abilities during IADLs

  • working memory, concentration, attention, problem solving, safety judgement, praxis, executive function, problem solving

• used for clients with a cognitive impairment 13+ years old, mainly stroke

• task: prepare 2 different cups of hot beverage

• scoring: 4 point scale (0 is intact performance, 4 is physical assistance)… high score of 52

Activity Measure for Post Acute Care (AM-PAC) 6 click short form

• Measures and tracks functional status across care settings

• Role in predicting discharge destination

• Used for a variety of diagnoses and patient populations

• Patient-reported outcomes OR therapist observation

  • Administered on computer OR paper and pencil

• Full version has 15 domains

• 6 Click consists of basic mobility, daily activity and applied cognitive domains

• 6 Click is a short form of the AM-PAC

  • 6 questions

• Scoring (total score corresponds to approximate degree of functional impairment:

  • 1 unable to complete

  • 2 need a lot of assistance

  • 3 need a little assistance

  • 4 do not need assistance

texas functional living scale (TFLS)

• observant based rating of independence with iADLs in 4 functional areas: time, money & calculation, communication, memory (24 items total)

• used with 16-90 year olds with neurodegenerative disorders, mental illness, and TBIs

• how to administer: read over menual, set up environment, explain purpose to client, move through each subtest

wolf motor function test (WMFT)

• measures upper extremity motor abilities: times single or multi-joint movements and functional tasks, tasks ordered by complexity and move proximally to distally

• population: individuals with stroke or brain injury with mild to moderate functional deficits in UE movements