Conditions -> What OT Considers First

COPD - Key Issues

• Dyspnea (shortness of breath)

• Chronic cough

• Fatigue

• Impaired activity tolerance

• Frequent exacerbations

COPD - Impacts on Occupation

Difficulty with bathing, dressing, household tasks, and community mobility due to dear of breathlessness and high rates of anxiety/depression

COPD - OT Considerations

ADLs/IADLs

Activity tolerance

Endurance and fatigue

Psychosocial factors (anxiety, fear, stigma)

COPD - Tools

COPM

Borg Rating of Perceived Experience

CHF - Key Issues

Inability of the heart to pump efficiently

• Reduced blood flow

Fatigue, dyspnea with exertion, fluid retention, reduced endurance, frequent hospitalizations

CHF - Impact on Occupation

• Difficulty sustaining daily routines

• Increased rest breaks

• Reduced participation in meaningful activities

• Risk of deconditioning

• Large psychological impact (20-30% depression; 50% anxiety)

CHF - OT Considerations

• Functional mobility

• ADLs/IALs

• Activity Tolerance

• Cognitive changes related to fatigue or hypoxia

• Monitoring exertion and symptoms

CHF - Tools

COMP

Borg Rating of Perceived Experience

Arthritis/Joint Replacements - Arthritis: Key Issues

Chronic pain and activity limitation. Stiffness, swelling, and reduced ROM.  

• Inflammatory (Acute-sudden) or Degenerative (Chronic – Gradual).

Arthritis/Joint Replacements - Arthritis: Impact on Occupations

• Independence

• ADLs

• IADLs

• Work

• Leisure

• Joint Replacement

Arthritis/Joint Replacements - Arthritis: OT Considerations

• Joint protection strategies (use larger/stronger joints, proper position, distribute the load).

• Activity pacing activities (break down the task into small manageable tasks, regular rest breaks, and prioritize and plan)

• Adaptive equipment (built up handles, reachers, jar openers, electric can opener)

• Orthoses (splinting & bracing)

• Strengthening vs overloading (moderate controlled resistance training)

Arthritis/Joint Replacements - Joint Replacement: Key Issues

• Severe Osteoarthritis

• Failed Conservative treatment

• Joint Injury

Arthritis/Joint Replacements - Joint Replacement: Impact on Occupations

• Independence

• ADLs

• IADLs

• Work

• Leisure

Arthritis/Joint Replacements - Joint Replacement: OT Considerations

Post op contact surgeons for tips

Movement

Sensory Functions (Low Vision, Hearing, Diabetes) - Low Vision: Key Issues

First system to decline with age, increased need for lighting, contrast, and size, and near vision more likely to decline.

• Loss not correctable by medical treatment

• Includes usable vision

• Occupational Impact

• Some Ots specialize in this.

• Cataracts, age-related macular degeneration, glaucoma

Sensory Functions (Low Vision, Hearing, Diabetes) - Low Vision: Impact on Occupations

Reading, driving, medication management, increased fall risk, hazard detection, often misattribute to cognition.

Sensory Functions (Low Vision, Hearing, Diabetes) - Low Vision: OT Considerations

• Environmental modifications (lighting, contrast, organization)

• Task adaption (simplification, positioning, pacing)

• Assistive devices (magnification, large print)

• Client and caregiver education

Sensory Functions (Low Vision, Hearing, Diabetes) - Hearing: Key Issues

More profoundly affects men than women, Presbycusis-age associated loss of hearing, loss of high frequently perception occurs, difficulty turning out background noise and localizing sounds.

• Sensorineural hearing loss

• Conductive hearing loss

• Tinnitus

Sensory Functions (Low Vision, Hearing, Diabetes) - Hearing: Impact on Occupations

Social participation, safety, communication breakdowns, fatigue,

Sensory Functions (Low Vision, Hearing, Diabetes): Hearing - OT Considerations

• Environmental strategies (reduce noise, improve visibility)

• Communication strategies (face-to-face, pacing, cues)

• Task Modifications and rode adaption

• Habits and Routines

• Collaboration with audiology and family.  

Sensory Functions (Low Vision, Hearing, Diabetes) - Diabetes: Key Issues

• Most common is type II

• Diabetic retinopathy

• Peripheral neuropathy

• Reduced protective sensations

• Balance implication

• High blood sugar damages nerve fibers and small blood vessels.

Vision: Diabetic Retinopathy

• Microvascular damage

• Blurred vision

• Floaters

• Fluctuating acuity

• Risk Factors (Long term Diabetes, HTN, ethnicity, poor sleep)

Sensory Functions (Low Vision, Hearing, Diabetes) - Diabetes: Impact on Occupation

Medication management, foot care, cooking, community mobility, caregiving roles, ADLs/IADLs

Sensory Functions (Low Vision, Hearing, Diabetes) - Diabetes: OT Consideration

• Environmental modifications

• Fall prevention

• Routine restructuring

• Diabetes self-management education

• Energy conservation and pacing

• Compensatory scanning strategies

• Psychological supports.

Dementia - Key Issues

Changes in the brain that cause loss of memory, language, problem-solving, and other cognitive abilities severe enough to interfere with daily life.

• Greater than normal aging cognitive decline

• Changes in memory, planning, decision-making, or other cognitive functions

• Progressive

• Impacts daily functioning

• Affects participation, identity, and relationship.

Alzheimer’s is the most common.

Dementia - Impact on Occupations

Social/Mental Health:

• Anxiety, depression, apathy

• Social withdrawal

• Stigma & loss of confidence

Cycle of disengagement leading to worsening of symptoms.

Dementia - OT Considerations: General

• Addresses participation, safety, and meaning

• Helps individuals and their families cope and adapt as the disease progresses

• Occupation is used as both the assessment and the intervention.

Dementia - OT Considerations: Environmental & Task Modifications

• Simplifying task setup (reduce steps, reduce clutter)

• Using visual cues and contrast

• Modifying environments to reduce cognitive load

• Adjusting task demands rather than expectations

• Supporting familiar routines and spaces

Dementia - OT Considerations: Care Partner Support & Education

• Coaching cueing strategies (verbal, visual gestural cues)

• Teaching communication approaches (simplified language, pacing, tone, calm, demeanor)

• Support routine development (Consistency, predictability, timing)

• Supporting care partner confidence, stress management, and role adaptation

Dysphagia - Key Issues

• Aspiration pneumonia

• Malnutrition

• Dehydration

• Reduced quality of life

• Increased mortality

Dysphagia - Impact on Occupation

Hemiparesis

Cognitive Deficits

Dysphagia - OT Considerations: Diet Texture Management

-              Diet modification using international dysphagia diet standardization initiative framework (thin liquids, thickened liquids, pureed, soft and bite-sized foods, pills/meds

Dysphagia - OT Considerations: Compensatory, Med, Surgical

• Restorative – incorporate neuroplastic principles and motor learning

• Swallowing therapy should focus on swallowing foods/liquid

Dysphagia - OT Considerations: Other

• Safe feeding

• Positioning

• Adaptive equipment

• Feeding independence

• Strategies to optimize cognition