Beyond Mats & Poor Lighting: The Occupational Therapists role - - PowerPoint PPT Presentation

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Dec 21, 2023 316 likes •500 views

Beyond Mats & Poor Lighting: The Occupational Therapists role in Falls Management Anne Pressley, Senior Occupational Therapist Rehabilitation & Aged Care, Osborne Park Hospital Falls 1 in 3 community dwelling people over 65 fall

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Beyond Mats & Poor Lighting: The Occupational Therapist’s role in Falls Management

Anne Pressley, Senior Occupational Therapist Rehabilitation & Aged Care, Osborne Park Hospital

SLIDE 2

Falls

1 in 3 community dwelling

people over 65 fall each year.

Falls are multi-factorial.
Environment is a likely

trigger.

Behaviour, cognition,

culture & experience shape client attitudes.

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Occupational Therapists, Environment and Falls

An occupational therapy home visit,

as part of a multifactorial strategy, is strongly recommended based on high quality evidence (NHMRC level A) when considering hazard reduction, training and education.

Patients who will particularly benefit

are those who are at high risk such as those with vision impairment and recent hospitalisation. Waldron, N., Hill, A. & Barker, A. (2012)

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What Skills Does the OT Offer in the Home Environment?

Specialist assessment of function in unique environmental contexts.
Knowledge of the functional impact of a range of medical conditions

& disabilities.

Specialist skills in activity analysis, task gradation and adaption.
Knowledge of cognitive and perceptual issues relating to function.
Skills in applying goal setting, self management and behaviour

change strategies.

Extensive knowledge in a range of environmental modifications,

functional strategies and creative solutions to address limitations and hazards.

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Detailed observation of a client’s performance of functional activities

and transfers within their home and community.

Consider function over 24 hours.
Consider culture and values.
Determine range of risk factors.
No ‘one size fits all’ approach.
Consider resources already in place.

Specialist Assessment of Function in Unique Environmental Contexts

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Knowledge of the Functional Impact of a Range of Medical Conditions & Disabilities

Stroke
Diabetes
Parkinson’s Disease
Arthritis
Dementia

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Specialist Skills in Activity Analysis, Task Gradation and Adaption

Tap into usual methods where possible.
Consider task demand and cognitive load.
Dual tasking is important.
New, safer methods rather than ‘undoing’ ineffective

habits.

Rehabilitation versus Compensation.
Least intrusive interventions.

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Knowledge of Cognitive and Perceptual Issues Relating to Function at Home

Planning, awareness,

attention, memory and

rientation.
Visuospatial skills
Anxiety & depression

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Fear of Falling Cycle

Acknowledgement: Falls Specialist Service, SCGH

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Goal Setting, Self Management and Behaviour Change Strategies

Set goals.
Ownership of the

environmental and functional strategies.

Sense of self efficacy.
Education.
Intervention takes time to have

an effect. Pick the three most important factors and tailor.

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Behaviour Change

Prochaska & DiClemente, 1983

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In Summary

Physical changes to the home environment are only one

aspect of the Occupational Therapist’s role.

Analysis of functional activities give a unique

understanding of the client’s behaviour and values.

Client must be receptive to change for any falls

intervention to be effective in their home.

Some risk is beneficial.
Don’t underestimate fear of falling.

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Environmental Modifications / Functional Strategies

Before After

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Falls Sensors / Alarms

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Monitoring

Infrared, sound modalities.
Baseline data on usual routines & activities is used to determine

unusual changes which may be indicative of a fall.

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