Adults Exam 3

what is assistive technology?

devices, services, strategies, and policies that are conceived and applied to ameliorate the problems faced by individuals who have disabilities

assistive technology legislation

public law the assistive technology act

an assistive technology service is any service that directly assists an individual with a disability in the …

selection, acquisition, or use of an AT device

examples of what kind of tech: built-up utensils, non-slip mats, reachers, pencil grips, velcro fasteners, post it notes

low tech

examples of what kind of tech: speech generating devices, eye-gaze communication systems, robotic exoskeleton, smart home technologies, mobile apps for task management

high tech

OT’s unique contribution to AT

holistic assessment (PEO), client-centered planning, use of activity analysis

theoretical foundations inform AT - and -

selection and use

theoretical foundations (3)

HAAT, PEO, MOHO

Human activity assistive technology (HAAT) model

framework for understanding the place of AT in the lives of a person with disabilities, guiding both clinical applications and research investigation

the HAAT model also takes into consideration the

context (social, setting, physical)

what are the four primary components for the HAAT model?

human, activity, AT, context

the human aspects (HAAT model)

skills and abilities, novice vs expert users

the context aspects (HAAT model)

physical context, social context, cultural context, instructional context

occupational performance is the outcome of the dynamic interaction between the …

person, environment and occupation

PEO model: addressing ___, modifying the ___, enabling ____

person factors, environment, occupations

the ____ provides a framework for understanding how individuals engage in occupations, and AT can be a key component in facilitating that engagement (volition, habituation, performance capacity, environment, occupational participation)

MOHO

areas of occupation and AT

supports IADLS, supports ADLs, health management, rest and sleep, work, play, leisure, social participation

OT process with AT- evaluation

identify client goals and needs, assess skills and limitations, analyze environment and context

OT process with AT- intervention

match AT to person, task and environment, train client and caregivers, monitor and adjust interventions

clinical outcomes for AT use

improved independence, enhanced safety, better quality of life, increased participation

barriers to AT access

cost and funding limitations, lack of awareness or training, environmental barriers, stigma or resistance to use

87% of Americans over age 65 want to remain

in their current homes

95% of Americans over age 75 want to remain

in their current homes

home modification involves the use of

processess and products

the home mods process is the confluence of ___ and delivery __, including assessing needs, identifying solutions, implementing solutions, training in the use of solutions and evaluating outcomes that contribute to any alteration, adjustment, or addition to the home environment through the use of specialized, customized, or universally designed technologies, equipment, products, hardware, finsihed, cues, controls, furnishing and other features that affet the layout and structure to improve functional capability

activities, services

home modification process step 1

assessing needs

home mods process step 2

identifying solutions

home mods process step 3

implementing solutions

home mods process step 4

training in the use of solutions

home mods process step 5

evaluating outcomes

any alteration adjustment, or addition to the home environment through the use of specialized, customized, off the shelf, or universally designed technologies, equipment, products, hardware, controls or cues, finishes, furnishings, and any other features that affect the layout and structure to improve functional capability of or minimize environmental demands on individuals and their caregivers to meet the situational needs for promoting performance of daily activities as independently and safely as possible

home mods products

internal and external physical adaptations to the home, which are necessary to ensure the health, welfare and safety of the user

environmental modifications

single-family or owner-occupied housing designed in such a way that it can be lived in or visited by people who have trouble with steps or who use wheelchairs or walkers

visitability

three requirements for visitable homes

one zero-step entrance, doors with 32 inches of clear passage space, and one bathroom on the main floor you can get into in a wheelchair

refers to broad spectrum ideas meant to produce buildings, products, and environments that are inherently accessible to older people, people without disabilties, and people with disabilities

universal design

inclusive design does not mean you are designing one thing for

all people

in inclusive design, you are designing a diversity of ways to ___ so that everyone has a sense of ___

participate, belonging

accessibility is strongly related to ___ which is the ___ of creating products that are usable by people with the widest possible range of abilities, operating within the widest possible range of situations

universal design, process

accessibility is about making things accessible by ___ to all people

design

is there any area of clinical practice that does not have to think about home and/or environmental modification concerns?

no

how do you assess needs? types of ____: informal interview, structured interview, skilled observation, standardized assessments

evaluations

what is the purpose of assessments (AT)?

to determine an individuals level of:

occupational performance, functional capacity, level of independence

COPM, OSA, OPHI-II, OCAIRS are examples of what kind of assessments for AT

occupational performance

lighthouse near acuity chart, auditory screening tool, TUG test, functional reach test, short blessed test, MMSE, GDS, caregiver strain index, zarit burden interview are examples of what kind of assessments for AT

functional capacity

barthel (FIM), katz index of independence in ADL are examples of what kind of assessments for AT

level of independence

organizations that support home modifications

AARP, national association of home builders, rebuilding together

an interruption in the blood flow to the brain from a blocked or ruptured blood vessel

stroke

type of stroke that is a blockage

ischemic

includes a hemorrhage (intracerebral or subcarachnoid)

hemorrhagic

most common type of CVA, 85% of cases

ischemic

classified as either thrombotic, emboic or lacunar

ischemic stroke

membrane surrounded by affected neuron in ischemic stroke leaks what

potassium and ATP

with ischemic stroke, irreversible cell death occurs in __ minutes if oxygen and nutrients are unable to reach from the bloodstream

5-10

dead cells form a zone of ___ that will not regenerate (ischemic stroke)

infarction

downstream from the infarct zone is the zone of ___

injury

the zone of injury may be capable of returning to normal function, if intervention occurs ___

early to prevent further stroke progression

_ of the stroke is of utmost importance

early diagnosis

the most common cause of cva

atherosclerosis

cerebral thrombosis: a ___ forms in one of the arteries supplying the brain, causing vascular obstruction

blood clot

thrombosis occurs most frequently in blood vessels that have already been damaged by

atherosclerosis

a patholoical process when rough fatty deposits form within the arteries and often leads to development of a thrombus

atherosclerosis

_____ atherosclerosis accounts for 60% of ischemic strokes

large vessel

ischemic strokes typically do not occur until the vessel is ___ blocked

2/3

atherosclerosis and thrombus formation are most likely to occur in areas where blood vessels

turn or divide

causes progressive symptoms, occur over several hours or days, onset during sleep is common, often middle arm numbness, awakens with paralysis

cerebral thrombosis

temporary blockages of an artery

transient ischemic attacks

TIAs precede actual infarctions about __ the time

half

risk factors for TIAs are the same as

other types of strokes

small infarcts, usually in deep brain structures

lacunar strokes

20-25% of ischemic strokes are the result of damage to deep brain structures

lacunar stroke

15-20% of CVA are

hemorrhagic

caused by a rupture in a blood vessel or aneurysm, with resultant bleeding into or around cerebral tissue

hemorrhagic stroke

two types of hemorrhagic stroke

intracerebral and subarachnoid

intracerebral stroke is bleeding directly into

brain substance

subarachnoid stroke is occurring within the brain’s

surrounding membranes and CSF

stroke risk factors: smoking, obesity, hypertension, DM, oral contraceptives, hyperlipidemia, cardiovascular conditions, alcohol and drug abuse, sleep apnea

modifiable

stroke risk factors: age, gender, ethnicity, family history, previous stroke or TIA

nonmodifiable

motor control is the ability to

regulate or direct the mechanisms essential to movement

motor control includes the ___ role in organizing muscle and joints into function and integrating ___ input necessary for the movement

CNS, sensory

motor control 3 aspects

individual, task and environment

movement is a result of an

integration of skills (action, perception and cognition)

performance of a controlled movement, to accomplish something

action