Occupational Therpay Settings and D/C Requirements

What are the ‘who’, ‘why’, and ‘what’ of OT in acute care setting

Patients recently admitted to the hospital

Decline in function secondary to admitting diagnosis

Evaluation followed by d/c planning

What subjective information do you gather during your evaluation in an acute care setting?

Support systems

Home set-up

Prior level of function (PLOF)

What kind of objective information do you gather during your evaluation in an acute care setting?

Functional abilities and limitations

Evaluation tools

Measurable information

What are the different locations you can discharge a client to following their stay in an acute care setting?

INPT

SNF

OUTPT

HH

What are the requirements for d/c a client to inpatient?

Client must be able to tolerate up to 3 hours of therapy a day, 5-6 days/week

What is typically the most intense level of therapy an individual can receive?

IPR

What are common diagnosis you may see in inpatient rehab?

SCI

TBI

CVA

Poly-trauma

What are other factors that play a role in deciding if you are going to d/c a client to IPR?

Client reports high PLOF

Nature of client’s diagnosis and recovery

What are the requirements for d/c a client to a SNF?

Requires 24 hour nursing care and less intense therapy (less than IPR)

What are common diagnosis may you see in a SNF?

SCI

TBI

CVA

Poly trauma

CHF

MI

Fx

Generalized weakness

Orthopedic surgeries (TKA, THA, etc.)

What is the range of treatment time seen in a SNF? What does this time frame depend on?

40-60 mins, dependent on client’s tolerance levels and insurance

What are the requirements for d/c a client to outpatient?

Stable, appropriate and able to attend therapy in an outpatient client (aka has transportation)

Do you need to stay in the hospital to be referred to outpatient clinics?

No

Where is a client typically d/c to if they are at the highest practical level of function by d/c time?

Outpatient

What are different types of outpatient clinics?

Neuro

Orthopedics

Pediatric

What is the frequency of therapy sessions in an outpatient setting?

2-3x week

What are the requirements of d/c a client to HH?

Stable to return home however, unable to leave the home to receive therapy services

What typically precedes a referral to HH?

A stay in IPR and/or SNF

What is involved in HH?

Evaluation

Treatment: ADL training, home modifications, strengthening, functional activity tolerance, patient education, caregiver education, safety awareness, etc.

What is the role of OT in a independent living facility?

Similar to HH, focuses on home modifications, safety awareness, and education

What are the characteristics of an independent living facility?

Independent in all aspects of life, some IADLs are taken care of on an as needed basis

What are the characteristics of an assisted living facility?

More hands-on medical care, medication management, meals provided, and increased supervision for safety

What are the characteristics of a memory care facility?

Locked, all IADLs are typically taken care of, increased hands-of assistance for ADLs, near constant supervision

What is the role of OT in memory care?

Focus on ADL engagement, caregiver education and safety. No new learning, emphasis on muscle memory, decreasing fall risks, and improving overall QOL