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OT And stroke case study

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Hyesha Medley

on 18 November 2015

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Transcript of OT And stroke case study

Governing Care
National Service frameworks

White paper: Caring for our future: reforming care and support (2012)
Frameworks
Compensatory
Other Approaches
Theory and Practice
Defining Occupational Therapy (OT)
Function in occupation
reduce disability

Stroke
' Rapidly delivered clinical signs of focal or global disturbances of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin' (WHO, Aho et al 1980)
Ischaemic
Haemorrhagic
A patient's Stroke Journey
(CRH)
A&E Brain scan ? Thrombolysis
By: Hyesha Medley
Brief Introduction
Specialist treatment
Physiotherapy
Occupational Therapy
Speech & Language Therapy
Discharge
Referral
Information
gathering
Initial Ax
Formal Ax

Problem formation
Goal setting
Action planning
O
n
g
o
i
n
g

A
s
s
e
s
s
m
e
n
t
Action
Outcome (measurement)
Review
Male
78 yrs old
Farm work
Sheffield Wednesday
Retired
Frame of reference
Approach
Remedial
Enable a person to achieve maximum function in performance of daily activities (seidel 2003)
References

College of Occupational Therapists (2006c) Post qualifying framework: a resource for occupational therapists. London: COT

College of Occupational Therapists (2007c) Professional standards for occupational therapy practice. 2nd ed. London: COT

College of Occupational Therapists (2015) Code of ethics and professional conduct. London: COT.

Department of Health (2012)
White paper: Caring for our future: reforming care and support


Duncan, E (2011) Foundations for practice in occupational therapy 5th ed. Churchill Livingstone Elsevier: Edinburgh

Haywood KL (2006). Patient-reported outcome: Measuring what matters or just another paper exercise? Musculoskeletal Care 4(2): 63–6.

Levens, M (1989)‘Working with Defence Mechanisms in Art Therapy’ in Gilroy, A & Dalley, T eds (1989) Pictures at an Exhibition: Selected essays on Art and Art Therapy. Routledge, London

Lincoln, NB (2000) Five year follow up of a randomised controlled trial of a stroke rehab unit,
British medical journal
, pp320-359.

Seidel, A.C., 2003. Theories derived from rehabilitation perspectives. In : Crepeau, E.B., Cohn, E., and Schell, B.A.B., eds. Willard and
Spackman’s Occupational Therapy. Tenth Edition. Philadelphia: Lippincott Williams and Wilkins, 238-240.

Ward M (1994). Are patient self-report measures of arthritis activity confounded by mood? A longitudinal study of patients with rheumatoid arthritis. British Journal of Rheumatology 21: 1046–50

Aho, K., Harmsen, P., Hatano, S., Marquardsen, J., Smirnov, V. E., & Strasser, T. (1980). Cerebrovascular disease in the community: results of a WHO collaborative study. Bulletin of the World Health Organization, 58(1), 113.
Compensation Is:
Allowing patients to live and cope with their remaining capabilities
Compensation is not:
Meant to cure an illness
Compensation is:
The use of assistive devices,
environmental adaptations,
Compensatory strategies
Compensation is not:
Focusing on disability,
it is about emphasizing the clients strengths
and abilities
Cognitive behavioural
Biomechanical
Psychodynamic
Neurodevelopmental
Changing client variables to restore a skill or ability that has been impaired
Encouraging maintainance

Allowing practice (without which could lead to a decline in performance)
Humanistic
Models
Thoughts have an impact on outward behaviour

Encourages awareness of thoughts and a change in thinking to change behaviour


Motion during occupation

Muscle strength

Endurance
Behaviour is determined by unconscious drives, past experiences and feelings


Defence mechanisms
employed against the external world
Guide
Structure
Provide formal Assessment

College of Occupational Therapists

Code of conduct
Values

Bobath

Sensory
integration
How a person constructs the meaning of events to understand the person
Pre admission
Independent
glasses
No eqipment
Initial Ax
Vision
Tracking
Confrontation
Extinction
R
L
Upper Limb
Kitchen Ax
Scanning H's
Copying
Reading
Re-assess
Oxford Cognitive Ax
Sentence reading
Hearts
Mirroring
Kitchen Ax
Scanning to L
still difficult seeing cups on L
Discharge
ESD; Not alone, compensating, resolving, MDT decision
Model of human occupation MOHO
Volition
Habituation
Environment
Performance capacity

Ease of use?
Who uses them most?
Dynamic relationship
Full transcript