Interventions for Activities of Daily Living PDF

INTERVENTIONS FOR ACTIVITIES OF DAILY LIVING  The ultimate objective of any rehabilitation program is to return the individual to a lifestyle, to live independently. Activities of daily living (ADL) :are tasks concerned with daily self care as feeding, dressing, hygiene and physical mobil...

INTERVENTIONS FOR ACTIVITIES OF DAILY LIVING  The ultimate objective of any rehabilitation program is to return the individual to a lifestyle, to live independently. Activities of daily living (ADL) :are tasks concerned with daily self care as feeding, dressing, hygiene and physical mobility. Most self care tasks are performed routinely by able bodied persons, but they can become extraordinary challenges for persons with cognitive, motor or sensory impairment and disability. Role of family A stable and supportive family unit can be of great assistance during rehabilitation process. Poor outcomes result from lack of family involvement.  Whereas too much support can encourage depending of patient. The family should be involved in all aspects of rehabilitation including evaluation, setting of rehabilitation goals, and treatment strategies before and after discharge. Management of self care tasks: (A) Assessment Functional assessment is a method for describing abilities and limitations and to measure an individual's use of the variety of skills included in performing tasks necessary to daily living, leisure activities vocational, social interactions and other required behaviors. Evaluations of ADL depends on: Value of the activity to the client. Level of independence in performing task (initiation of a task, continuation of a task, completion). Safety of activity performance. Adequacy of task performance involved difficulty, pain, fatigue, dyspnea, efficiency, social standards, satisfaction, and experience (comprehensive evaluation added all these parameters). Several basic considerations must be kept during assessment: 1. The setting chosen must be conductive to the type of testing and free of distractions. 2. The setting should be similar as possible to the actual environment in which the patient usually performs the tasks and activities assessed. Principles of functional assessment of ADL: Analysis of function focuses on the measurement and classification of functional activities and an individual's ability to successfully engage in them. Functional assessment measures how a person does certain tasks or fulfills certain roles in the various dimensions of living. Types of assessment: A performance- based assessment: Functional assessment may be administered by a therapist who observes the patient during the performance of activity. Self assessment: Survey or series of questions constructed to be answered directly by the respondent without additional input or direction. 1. Instructions should be precise. 2. Assessments may be biased by fatigue (if patient performs best in the morning, but tires by afternoon, an accurate assessment of functional ability must consider the variations of performance. 3. The patient should be told if testing will take several sessions. B) Physical therapy intervention for some of ADL: 1- Compensatory: To accommodate or compensate for impairment that hinder task performance a. Alter the task: Tasks are done with 2 hands, practice is necessary for learning with one hand (dressing). b. Adapt the task or prescribe assistive devices: Simple adaptations for tables, desks or using assistive devices. c. Modify the task environment: Modification of the environment itself may be used to facilitate task performance. Modification of the environment needs learning and practice less than that required for learning an alternative method or adapted task objects. 2. Restoration: Intervention may be used to restore capacities as strength, endurance, ROM exercises. 3. Education: Methods should be selected that best meet the needs of the person. Group instruction can be an effective and efficient for providing basic education for homogenous client population. Teaching a group is cost effective when well structured. Videocassette recorder are widely used in client's homes. Individual training is more appropriate for many clients and caregivers because the personal nature of the tasks (e.g. bathing). Factors influencing performance outcome are: 1. The client ability to learn. 2. The client prognosis. 3. The time allocated for intervention. 4. The client's discharge disposition. 5. The client's ability to follow new techniques. Physical therapy intervention for some of ADL: a. Hygiene: Compensatory approach: The usual hygiene activities may require adapted equipment, so the patient can hold, control or reach e.g. use splints for wrist stability and functional hand position. Store task items on counter or shelf in a basket or plastic container that can be transported to task site easily. Restoration: ROM exercises. Splinting. Prosthetic training. Motor learning. Inhibitory and facilitatory treatment. Sensory reeducation Education: Demonstrate proper use of adapted task. Provide handout with drawings, pictures. Provide video of suggested strategies. Thank You