What is Occupational Therapy? Introduction to Occupational Therapy. World Federation of Occupational Therapists 2012

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1 World Federation of Occupational Therapists 2012 Introduction to Occupational Therapy Suki HUI Occupational Therapist I Statement on Occupational Therapy Occupational therapy is a client-centred health profession concerned with promoting health & well-being through occupation. The primary goal of OT is to enable people to participate in the activities of everyday life. Definition of Occupational Therapy A kind of therapy for people with temporary, permanent or development disabilities We enhance both physical and psychological functions, prevent illness, facilitate independent living, improve quality of life of people with disabilities or special needs, and promote their reintegration into home, work and society Occupational Performance Model What is Occupational Therapy? ADL & IADL WORK LEISURE ayer_detailpage&v=tkhzr4rfmoo Maximize Independence Return to Community Improve Quality of Life

2 Major Specialties Areas of Practice in O.T. Specialty Scope of Service Physical Disability Mental Illness Developmental Disability Medical & Geriatric (M&G) Orthopaedic &Traumatic Paediatrics Stroke, Pulmonary, Cardiac, Renal, Palliative, Parkinson s disease, Geriatric Care, Intensive care unit, Infirmary/extended care, Integrated Care Model, Geriatric Day Hospital, Allied Health Clinic (e.g. Fall, Respiratory clinic, Dementia Care Clinic), Community Geriatric Assessment Team Fall & Fracture, Traumatic injuries, Musculoskeletal Management, Work Rehabilitation Neonatal care, Development delay, Autism etc. Surgical Psychiatrics Burns, Neurosurgery, Varicose Vein Oncology etc. Psycho-geriatrics, Adult, Children & Adolescent, Psychiatric Day Hospital etc. Multi-disciplinary Team Approach Scope of services Example in a local hospital Medical Officer, Nurse, Physiotherapist, Occupational Therapist, Medical Social Worker, Speech Therapist, Dietitian, P&O, Clinical Psychologist and Podiatrist etc. 1. In-patient phases (Physical & Psychiatric) Medical & Geriatrics Stroke Unit Pulmonary Rehabilitation Cardiac Rehabilitation Palliative Care Intensive Care Unit Renal Service Integrated Care Model (ICM) for high risk elderly Scope of services Example in a local hospital Scope of services Example in a local hospital Orthopaedic & Traumatic Hip Fracture Rehabilitation Low Back Pain Traumatic Injuries Psychiatrics Psychogeriatric Adult, Child & Adolescent Special Program on Autistic Spectrum Disorder Surgical Neuro-surgical Rehabilitation Burns Varicose Vein Paediatric, Neonatal Care

3 Scope of services Example in a local hospital Scope of services Example in a local hospital 2. Out-patients Phase (on special program basis) Work Assessment & Rehabilitation Functional Training Program Ergonomic Consultation Chronic Pain Management Cognitive Rehabilitation for MCI Assistive Devices consultation Pressure Relieving Program Seating & Positioning Program etc 3. Ambulatory & Community Services Geriatric/ Psychiatric Day Hospital Community Geriatric Assessment Team (CGAT) Integrated Care Model ICM Allied Health Clinic: Fall Clinic, Memory Clinic Attention deficit Hyperactive Disorder (ADHD) Personalized Community Program PCP (for mental illness clients) Occupational Therapy Intervention Process Rehabilitation Goals: SMART Specific Measurable Achievable Realistic Tailor-made treatment Common Evaluation Tools (1) Barthel Index (BI) Functional Performance: Barthel Index (BI) Lawton Instrumental Activity of Daily Living (Lawton IADL) Functional Independence Index (FIM) To measure performance in basic activities of daily living (ADL) It covers 10 domains: Feeding, Bathing, Grooming, Dressing, Bowel & Bladder Control, Toilet use, Bed/chair transfer, mobility on level surfaces & stairs Scoring , Independent 60-79, needs minimal help with ADL 40-59, Partial Dependent 20-39, Heavy Dependent < 20, Totally Dependent

4 Functional Independence Measures (FIM) Contains 18 items, composed of 13 motor tasks & 5 cognitive asks (cognitive comprehensive, Expression, Social Expression, problem & Memory) Rated on a 7 point ordinal scale Scores range from 18 (lowest) to 126 (highest) Common Evaluation Tool (2) Cognitive & Perceptual Function: Mini-mental State Examination (MMSE) Montreal Cognitive Assessment HK-MoCA Albert s Test Star Cancellation Test Reivermead Behavioural Memory Test Mini-mental State Examination (MMSE) Montreal Cognitive Assessment (MoCA-HK) Consists of 11 questions grouped into 7 cognitive domains Total Score 30 Orientation (time & Place Registration Attention & Calculation, Recall Memory Language Visual Construction Common Evaluation Tools (3) Psychosocial Function: Geriatric Depression Scale (GDS) Hospital Anxiety & Depression Scale (HADS) State Trait Anxiety Test Interest Checklist Work: Valpar Work Samples Career Explorer OT Interventions Quality of Life: WHO-5 Short Form 36.

5 Occupational Therapy Interventions Occupational Therapy Interventions Activity of Daily Living (ADL) Training Instrumental Activity of Daily Living Skills Training (IADL) Hand Function Training Functional Skills Training Design & Fabrication of Splints Scar Management & Pressure Therapy Prescription of Assistive Devices / Aids Home/Community Assessment, Home Modifications & Community Skills Training Care-giver Training Cognitive Training Wheelchair Prescription & Seating Program Prescription of Oxygen Therapy Therapeutic Groups & Leisure Therapy Special Program: Fall Prevention, Health Qigong Activity of Daily Living Training (ADL) ADL training Real tasks practice e.g. bed/chair transfer, dressing garments, toilet transfer, bathing, grooming etc. Introduce assistive devices Care-giver Training Special techniques Dressing Trouser Use long handle reacher Toilet Transfer 2 Toilet Raiser & Toilet Frame Bathing Bath-board Instrumental ADL Training (IADL) Foundation Skills Training Standing Tolerance Stability / Postural Control Training Upper Limbs & Hand Function Training Lower Limb Function Training Cooking Assessment

6 Standing Tolerance Activity Endurance Training Interactive Postural Control Training Upper Limb & Hand Function Training Interactive Hand Function Training Robotic Upper Function Training

7 Virtual Reality Training for Upper Limb OT Interactive Training Design & Fabrication of Splints Scar Management & Pressure Therapy Assistive Devices Prescription Home Assessment & Modifications

8 Home Assessment & Modifications Home Assessment & Modifications Wheelchair Prescription & Training Pressure Mapping & Seating Adaptation Seating Adaptation Cognitive Training- ipad apps

9 Cognitive Training Special Program.. Fall Prevention Program Fall Prevention Program Art Program Photo Therapy Health Qigong Lifestyle Redesign Program The Miracle of Art: Promoting Mood & Quality of Life for long stay residents OBJECTIVES Pilot program collaborate with Occupational Therapists (OT) & Art Instructors (AI) Aims to promote Mood & QoL for long stay residents with diverse physical disabilities

10 The Miracles of Art: boost up the Mood & QoL for the long stay residents in Cheshire Home by Occupational Therapy Department RESULTS SPSS significant improvement Mood (p<.003) QoL (p<.002) Significant Improvement: Mood Score increased 39 % (p< 0.003) WHO-5 (QoL) increased 31 % (p<0.002) Questionnaire : 100% enjoyment in the art program We love Art! Collaboration of Art Instructor & OTs Acrylic on Canvas Happy Moment We Add Colors to Lives Gives Meaning with Pride! Circle Painting Photo Therapy Program

11 (Ba Duan Jin) Eight Excellent ent Movements Lifestyle Redesign Program