OT 504 Week 2 LG2: Interventions for Mild NCD Flashcards

What are the four major steps of the OT process?

Referral/Intake, Evaluation, Treatment, Re-evaluation/Update POC/Discharge.

What documentation concepts were emphasized in OT Process Part 1?

Templates, SMART and COAST goals, levels of assistance, CPT codes, evaluation levels, re-evaluation, and treatment.

What is the purpose of treatment planning?

To determine which interventions/treatments will address the client's occupational performance problems.

With whom should treatment plans be developed?

Clients, families, and care partners.

Why are treatment plans important?

They direct OT actions and describe intervention approaches and types used to achieve desired outcomes.

What should guide a treatment plan?

Goals.

What factors should be considered when developing a treatment plan?

Client goals, values, beliefs, occupational needs, occupational profile, performance analysis, environmental context, personal context, best evidence, and practice setting requirements.

What are the four steps for connecting evaluation to treatment?

1. Identify WHAT the problem is.

2. Determine WHY it is happening.

3. Determine WHICH interventions address the problem.

4. WRITE goals and a treatment plan.

What should be considered when identifying WHAT the problem is?

Occupational profile findings, performance analysis findings, and other team members' documentation

Why is determining the WHY important?

It helps determine the most appropriate intervention approaches and intervention types.

What should be considered when selecting interventions?

Best evidence, client preferences, context, practice setting requirements, insurance requirements, and therapist competence.

In the medication management example, what was the occupation-based problem?

Difficulty managing medications.

What cognitive deficits contributed to medication management difficulties?

Prospective memory, working memory, executive functioning, task management, planning, scheduling, and following dosing instructions.

What emotional factors contributed to the medication management difficulties?

Anxiety and depression.

What is habilitation?

Developing a new skill or a skill that did not previously exist.

What is health promotion?

Encouraging wellness and independence.

What is prevention?

Reducing risk of injury, disease, or disorder.

What is compensation/adaptation?

Modifying the task or environment to work around limitations.

What is maintenance?

Maintaining the current level of performance.

What is rehabilitation/remediation?

Regaining a lost or diminished skill.

Name common OT interventions discussed in class.

Disease self-management, daily routine management, cognitive training, ADL retraining, IADL retraining, adaptive equipment training, and assistive device training

What intervention approach was recommended for medication management difficulties due to MCI?

Compensation/adaptation.

What interventions support compensation/adaptation for medication management?

Memory aids, medication tracking systems, assistive devices, and routine management.

What intervention approach supports reducing risks associated with MCI?

Prevention.

What prevention-focused interventions were suggested?

Disease self-management and cognitive training.

What habilitation intervention was suggested?

Learning self-advocacy skills such as communicating medication concerns to physicians and pharmacists.

What does SMART stand for?

Specific, Measurable, Achievable, Realistic, Time-Based.

What does COAST stand for?

Client, Occupation, Assistance level, Specific Conditions, Timeline.

What is a long-term goal?

What the client should accomplish by the end of the plan of care.

What is a short-term goal?

A goal or an action step that relates to the long term goal that can be achieved in a short time frame

What is essential for all goals?

They must be objective, measurable, and include time frames.

What are common ways to measure progress in OT?

Assistance level, cueing, complexity, quality of performance, frequency/consistency, and time.

What types of cueing may be measured?

Verbal, tactile, and visual cueing.

What aspects of quality of performance can be measured?

Errors, pain level, and adherence to precautions.

What are the levels of assistance from most independent to most dependent?

1. Independent (I)

2. Modified Independent (Mod I)

3. Standby Assistance (SBA)

4. Contact Guard Assistance (CGA)

5. Minimal Assistance (Min A)

6. Moderate Assistance (Mod A)

7. Maximal Assistance (Max A)

8. Dependent (Dep)

what does independent (I)mean?

Independent (I) refers to a situation where an individual can perform a task or activity without any assistance or supervision.

what does Modified Independent (Mod I) mean?

Modified Independent (Mod I) means that an individual requires extra time or adaptive equipment to perform a task unaided but does not need physical assistance or supervision.

what does Standby Assistance (SBA) mean?

Standby Assistance (SBA) means that an individual can perform a task independently but requires someone to be present to provide immediate help if needed.

what does Contact Guard Assistance (CGA) mean?

Contact Guard Assistance (CGA) means that an individual requires physical contact or support from another person while performing a task to ensure safety and prevent falls, even though they can perform most of the task independently.

what does Minimal Assistance (Min A) mean?

Minimal Assistance (Min A) means that an individual can perform most of a task independently but requires help with a small part of the task, usually with physical contact or verbal cues for safety and guidance.

what does Moderate Assistance (Mod A) mean?

Moderate Assistance (Mod A) means that an individual can perform some components of a task independently but requires significantly more help than minimal assistance, including physical support or guidance for safety and completion of the task.

what does Maximal Assistance (Max A) mean?

Maximal Assistance (Max A) means that an individual is unable to perform most components of a task independently and requires substantial help, including physical support and guidance throughout the entire task to ensure safety and completion.

what does Dependent (Dep) mean?

Dependent (Dep) means that an individual is unable to perform any components of a task independently and requires total assistance from another person for safety and completion of the task.

What level may sometimes be used similarly to SBA?

Supervision (S).

What is the COAST goal template?

Client will perform [occupation] with [assistance level] under [specific conditions] within [timeline] in order to [functional outcome].

What are examples of specific conditions in a COAST goal?

Use of adaptive equipment, cueing, sitting/standing position, environmental modifications.

Give the medication management COAST goal example.

Client will manage medication with modified independence using external memory aids within 6 weeks to reduce safety risks and improve health management performance with MCI.

What questions should you ask when reviewing a goal?

• Is it timely?

• Is it measurable?

• Is it reimbursable?

• Is it occupation-centered?

• Is it client-centered?

what does it mean when they say a goal is reimbursable?

it means the goal aligns with payer requirements for reimbursement, ensuring that the interventions are covered by insurance or funding entities.

Why is it important to assess ADLs and IADLs when evaluating cognition?

They reveal how cognitive changes affect everyday functioning.

Can ADL and IADL assessment be formal or informal?

Yes. It can involve standardized assessments or observation.

What does the Katz Index measure?

Independence in ADLs.

How long does the Katz Index take?

About 5 minutes.

What six ADLs are assessed in the Katz Index?

Bathing, dressing, toileting, transferring, continence, and feeding.

What does a score of 1 mean on the Katz Index?

Independent.

What does a score of 0 mean on the Katz Index?

Dependent

What Katz score indicates high independence?

6

What Katz ADL score indicates moderate impairment?

4–5.

What Katz ADL score indicates severe functional impairment?

2–3.

What Katz score indicates high dependence?

0

What does the Lawton IADL Scale measure?

Independent functioning in IADLs.

Who is the Lawton Scale especially useful for?

community-dwelling older adults, admitted to hospital, short-term SNF, or rehab facility

how long does Lawton IADL take?

10-15 minutes..

What eight IADLs are assessed?

Telephone use, shopping, food preparation, housekeeping, laundry, transportation, medication management, and finances.

What score indicates independence on the Lawton Scale?

1.

What score indicates dependence on the Lawton Scale?

0.

What Lawton score indicates high function?

8.

What Lawton score indicates low function?

0.

Why should OTs avoid making older adults feel tested?

It may negatively affect performance and participation.

Should clients be forced to complete cognitive testing?

No.

Why should OTs be cautious about diagnosing cognitive impairment?

Other factors may influence performance.

What factors may affect cognitive assessment results besides cognition?

Testing anxiety, language, hearing, vision, environment, noise, pain, dysregulation, sleep, medications, and substances

What factors should be considered when selecting a cognitive assessment?

Access, competence, testing format, concerns being investigated, time available, abilities of the client, and purpose of testing.

name non-paper cognitive assessments discussed.

Short Blessed Test, Telephone Interview, EFPT, Cognitive Self-Efficacy, Daily Living Test, Kettle Test, and E-ADL.

Name paper-and-pencil cognitive assessments discussed.

SLUMS, MoCA, MMSE, and BIMS.

what does SLUMS stand for?

Saint Louis University Mental Status Exam

How many items are on the SLUMS?

11 items.

Why must alertness be documented during SLUMS?

Alertness affects performance and interpretation.

What accommodation may be used during SLUMS?

Large-print materials.

What does SLUMS scoring provide?

Three categories of cognitive functioning.

For someone with a high school education, what SLUMS score is considered normal?

27–30.

For someone with a high school education, what SLUMS score suggests Mild Cognitive Impairment (MCI)?

21–26.

For someone with a high school education, what SLUMS score suggests dementia?

0–20.

For someone with less than a high school education, what SLUMS score is considered normal?

25–30.

For someone with less than a high school education, what SLUMS score suggests Mild Cognitive Impairment (MCI)?

20–24.

For someone with less than a high school education, what SLUMS score suggests dementia?

0–19.

what does MoCA stand for?

Montreal Cognitive Assessment

What is the primary purpose of the MoCA?

To screen for mild cognitive impairment (MCI) and early dementia.

What cognitive domains are assessed by the MoCA?

Memory, attention, language, executive function, visuospatial skills, abstraction, delayed recall, and orientation.

How many cognitive areas does the MoCA examine?

Eight.

Why should naming items be covered during earlier MoCA sections?

To prevent visual cueing.

What timing tool is required during the MoCA?

A timer for verbal fluency.

What does MoCA scoring provide?

Two categories of cognitive functioning.

What is the total score range for the MoCA?

0–30 points.

What MoCA score is considered normal?

26–30.

What MoCA score suggests mild cognitive impairment (MCI)?

18–25.

What MoCA score suggests moderate cognitive impairment?

10–17.

What MoCA score suggests severe cognitive impairment?

Less than 10.

Which cognitive screening tool is more sensitive to mild cognitive impairment: MMSE or MoCA?

MoCA.

what does BIMS stand for?

Board Intent to Monitor Status