Adults/Older Adults module 6

health

physical, psychological, and occupational well-being

goal: maximize participation and quality of life

age-related cardiovascular changes

• decreased vessel elasticity

• reduced cardiac output reserve

• increased risk for dysrhythmias and clot formation

cardiac risk factors

• hypertension, smoking, diabetes

• high cholesterol

• obesity and inactivity

• stress, sleep apnea, alcohol use

sternal precautions

• no lifting > 8 lbs

• avoid pushing/pulling with arms

• avoid raising elbows about shoulders

• use pillow for splinting when coughing

• typically maintained ~8 weeks

monitoring response to activity

• HR, BP, RR

• O2 saturation

• monitor before, during, and after activity

MET levels

• 1 MET = resting metabolic rate

• used to estimate oxygen demand of activities

• guide safe activity progression

1-3 METs

dressing, grooming, eating

3-6 METs

gardening, sweeping, yoga

> 6 METs

climbing stairs rapidly, basketball

age-related pulmonary changes

• reduced elastic recoil

• air trapping and decreased vital capacity

• reduced gas exchange efficiency

pulmonary functional implications

• dyspnea and reduced endurance

• increased work of breathing

• activity limitations an participation restrictions

pulmonary OT Evaluation

• occupational profile

• vital signs and pulse oximetry

• 6-minute walk test

• Borg RPE scale

Signs of exercise intolerance

• shortness of breath

• abnormal HR/BP response

• dizziness, pallor, fatigue

• drop in O2 saturation

breathing techniques

• pursed-lip breathing

• diaphragmatic breathing

• breathing coordinated with activity

dyspnea control positions

• tripod sitting position

• leaning on countertop or shopping cart

• relaxation strategies

energy conservation principles

• plan, prioritize, pace

• balance activity and rest

• avoid rushing

• use proper body mechanics