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Barriers that slow progress Progress in therapy is hindered by pt's cognitive deficits, which limit his/her ability to comprehend and retain instructions.l Pt's dementia-related cognitive impairments contribute to slower gains in occupational therapy activities, particularly in tasks requiring new learning/complex sequences. Due to challenges in memory and attention associated w/ dementia, pt experiences delays in achieving therapy goals related to motor coordination and fxnl find. Cognitive limitations significantly impact the patient's ability to follow through with therapeutic exercises and strategies, thus affecting the pace of progress.
Caregiver ed on improving communication w/ direct eyle contact w/ pt and approaching pt from the front to start a conversation in order to increase participation in social act.
case Example for fall 1.who was present 2.environment fall occurred 3.time of day 4.circumstances around the fall 5.pt response to fall 6.therapist actions
Communication w/ pt on progress toward ST and LT goals. Progress Note due. Barthel Index -/100.
EC Discussion on energy conservation by completing ADLs and IADLs in the seated position.
Ed on energy conservation and breathing strategies to improve endurance for home management tasks.
Education to maximize energy reserves by pacing during tasks and taking rest breaks throughout day when feeling fatigued.
ENDURANCE SPO monitored at . HR at . RPE at . BP reading at .
Energy conservation techniques w/ sitting to dress and taking breaks in between tasks.
Facilitation in seated act w/ reaching toward LE unilaterally/bilaterally to promote flexibility, UE ROM, and sitting balance for LB dressing. Clothes pins provided as visual targets for pt to reach toward.
incident report muzar@rehabriskconsultingllc.com
Increased time required due to perseveration on unrelated topics required cues for redirection to task. Session required increased time for all exercises and activites secondary to redirection.
Joint protection strategies to reduce pain and discomfort by minimizing joint stress. Improve mobility and flexibility. Prevention of further injury/damage. Enhance ability to perform everyday activities. Increased independence and confidence. Use of larger joints (forearm vs fingers). Education on proper body mechanics to reduce joint strain. Implement assistive devices to complete task w/ less joint pain. Encourage activity modification by breaking task into smaller steps/frequent breaks. Prioritize good posture during activities to prevent additional strain on weight-bearing joints (spine, hips, knees). Use pain as a guide and stop activities that cause joint pain.
Joint Protection Strategies By integrating joint protection techniques into daily routines to manage pain and prevent injury more effectively.
Pierced lip breathing exercise to decrease shortness of breath and elicit use of energy conservation techniques. * to maximize fxnl tolerance.
Provide education and visual handouts on pursed lip breathing to complete as needed.
Pt caregiver education on HEP. Able to verbalize understanding and demonstrate and repeat proper technique/cues.
Pt and CG education on AD for independence w/ dressing.
Pt declined therapy. Education on benefits of therapy. Communication on pt's autonomy. Causation: did what you do hurt the pt? Duty Breech damage
Pt ed on energy conservation techniques to minimize muscle fatigue, joint stress, and pain.
Pt ed on energy conservation techniques to maximize energy reserves. pacing during tasks and taking rest breaks throughout day when feeling fatigued. plan and prioritizing day around completing most important tasks first, as well as the importance of not over-planning the day. modifying/simplifying difficult tasks. Discussion with pt on delegating tasks to family members/ friends/caregiver. on the use of adaptive equipment during ADLs. Discuss completing ADLs and IADLs in the seated position. and visual handouts on pursed lip breathing to complete as needed.
Recommendation on use of AD reacher to promote I in picking object from floor to reduce fall risks and enhance participation in ADLs.
Recommendations on proper fit footwear, lighting adjustment, and medication side effects to address fall prevention.
RRecommendations on modifications to improve accessibility and safety such as installing grab bars in the bathroom or rearranging furniture to increase safety and ease of movement.
Safety cards Pt was introduced to a series of visual safety cards depicting common environmental hazards, including slippery floors, uneven surfaces, and electrical cords. Educated on hazard recognition and strategies for creating a safe living environment. Pt participated in a safety assessment in home environment, identifying potential hazards and implementing corrective measures. Utilized visual safety cards to identify safety risks and propose solutions with minimal visual cues to increase awareness.
Training on nasal cannula and tub management.
Training on sit-to-stand sequence to improve safe fxnl txf. 1. Move bottom to the edge 2. Feet shoulder-width apart 3. Arms on armrest 4. Nose over toes 5. Momentum
VCC Verbal cues for pacing to prevent fatigue.

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