occupational therapy Archives - LDOT - O.T.SERVICES INC.

Best Practices in Fall Prevention

Best Practices in Fall Prevention

Best Practices in Fall Prevention – When you want to make a change for your health, you want to know about best practices. Best practices are strong recommendations that clinicians (doctors, occupational therapists, etc.) use to provide their patients with an effective intervention (treatment or modification).

The clinicians base these recommendations on evidence in the clinical unbiased literature.  Evidence found that the intervention improved the health outcome, and the conclusion is that the benefits outweigh the harm.

This is a big deal. The evidence is what should guide all good practice. It is why you buy a car with safety ratings that are independently researched, and not just the word of the company that is trying to sell you a car.

Fall Prevention is a big thing. Here are a few startling statistics:

  • 1 in 3 older adults in Canada fall each year (over 65)
  • 50% of falls which resulted in hospital admissions occurred in those 65 and older
  • Falls cause more than 90% of hip fractures in seniors and 20% die within a year of the fracture

(Public Health Agency of Canada, Report on Seniors’ Falls in Canada, 2005)

So, when our team at LDOT Services were looking at Best Practices for Fall Prevention; we looked at the literature and found what the American and British Geriatric Society recommended as best practice.

With respect to ‘Assessment’ – the following is recommended:

A multifactorial fall risk assessment should be performed by clinicians with appropriate skills and training, (Occupational Therapists have this training) including a focused history, physical examination, functional assessment (watching clients actually do things) and an assessment of their environment.

With respect to ‘interventions’ or ‘treatment’ – the following should be “Best Practice”.

  • Assessment should include identifying hazards in the home, making recommendations to eliminate the hazards, and providing options to promote the safe performance of daily activities
  • Adaptation or modification of the home environment based on the assessment criteria above
  • Exercise, particularly balance, strength, and gait training

More importantly – the following was NOT recommended in that there was fair evidence found that the intervention is ineffective, or that harm outweighs benefits.

  • Education should not be provided as a single intervention to reduce falls in older persons living in the community

Other evidence that was strong was that vitamin D supplements should be taken by persons proven to have insufficient vitamin D intake. The only way to know whether this is an issue is to consult a doctor – and this is our recommendation.

Our practice is best practice. We provide a multi factorial assessment. We provide recommendations to eliminate hazards within the home and provide options to promote the safe performance of daily activities.

We can provide a list of vetted contracting companies that specialize in home adaptations.

We can work with the contractors to ensure you get what you need to make the living safer, and avoid what may put you in harm’s way.

We provide in home and pool exercise programs though our team of Occupational Therapy Assistants. And by using Occupational Therapy Assistants we ensure these programs are accessible and financially feasible for the participants. For information on these programs or any of our Occupational Services; please contact us directly; you will reach a live knowledge representative at either our  Hamilton Office: 905-481-1122 or our Toronto Office: 416-907-6287.

Alternatively, you can email us directly anytime and one of our helpful representatives will respond very quickly.

 

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Hamilton Brain Injury Association Dinner 2016

Hamilton Brain Injury Association Dinner 2016

hamilton brain injury associationHamilton Brain Injury Association

Once again we are happy to be supporting the 2016 Hamilton Brain Injury Association (HBIA) Dinner being held at the Liuna Station in Hamilton on November 17th, 2016. This will be the 10th annual fundraising dinner for Hamilton Brain Injury Association. LDOT is excited to be a centre piece sponsor this year and happy to show our support by purchasing a full table and will be attending as a team to show our support.

HBIA is an asset to our community providing support, education and advocacy for brain injury survivors and their families.

ABILITY – the correct skills and/or mental and physical fitness to perform in a competent way.
ABNORMAL – different from the average; inappropriate with regard to the standards of society, social role or the existing set of circumstances.
ABSTRACT ATTITUDE- an objective, detached, impersonal state of mind.
ABSTRACT CONCEPT – a concept or idea not related to any specific instance or object and which potentially can be applied to many different situations or objects. People with cognitive deficits often have difficulty understanding abstract concepts.
ABSTRACT THINKING – the ability to apply abstract concepts to situations and surroundings. It is characterized by adaptability in the use of ideas and generalization.
ACTING OUT – impulsive; anti-social behavior.
ACALCULIA – the inability to perform simple problems of arithmetic.
ACUITY – sharpness or quality of a sensation. Keenness of perception.
ACUTE – sharp, severe. 2. Having rapid onset, severe symptoms and a short course. The early stages of an injury (as opposed to chronic, which is long term).
ADAPTIVE / ASSISTIVE EQUIPMENT – a special device which assists in the performance of self care, work, play or leisure activities.
ADL – activities of daily living. Routine activities carried out for personal hygiene and health such as eating, dressing, grooming, shaving, etc. Nurses, occupational and physical therapists are the main coaches for ADL, which is sometimes called DLS or daily living skills.
ADVOCACY – support; help, promoting a cause.
AFFECT – feeling tones; emotions; the outward signs of individual emotions.
AFFECTIVE – having to do with emotions.
AGITATION – a state of restless activity such as pacing, crying or laughing without apparent reason.
AGGRESSIVENESS – a state of irritability; combativeness.
AGNOSIA – failure to recognize familiar objects although the sensory mechanism is intact. May occur for any sensory modality.
AMBIVALENCE – contradictory feelings about an object, person or action, emotion, idea, situation, etc. .
AMBULATION – to walk.
AMNESIA – lack of memory about events occurring during a particular period of time.
ANEURYSM – a balloon-like deformity in the wall of a blood vessel. The wall weakens as the balloon grows larger, and may eventually burst, causing a hemorrhage.
ANOMIA – inability to recall names of objects. Persons with this problem often can speak fluently but have to use other words to describe familiar objects.
ANOSMIA – loss of the sense of smell. SYN: anodmia
ANOXIA – a lack of oxygen. Cells of the brain need oxygen to stay alive. When blood flow to the brain is reduced or when oxygen in the blood is too low, brain cells are damaged.
ANTERIOR INJURY – front.
ANTEROGRADE AMNESIA – inability to consolidate information about ongoing events. Difficulty forming new memories. Shrot- term annesia.
ANTERO-LATERAL INJURY- front and to the side.
ANTERO-POSTERIOR INJURY- gront and to the back.
ANTICONVULSANT – meditation used to decrease the possibility of a seizure (e.g., Dilantin, Phenobarbital, Mysoline, Tegrtol).
ANTI-SOCIAL BEHAVIOR – behavior which is contrary to the customs, standards and moral principles accepted by society.
ANXIETY – feelings of apprehension, uneasiness, agitation, uncertainty and fear because of threat or danger.
APATHY – indifference. Lack of emotiom, concern or interest.
APHASIA – the change in language function due to an injury to the cerebral cortex of brain. It causes partial or total loss of ability to express oneself and/or to understand language.
APRAXIA – the inability to produce voluntary speech due to a deficit in motor (muscle) programming caused by brain damage.
ARACHNOID MEMBRANE – the middle of three membranes protecting the brain and spinal cord.
AROUSAL – being awake. Primitive state of alertness managed by the reticular activating system (extending from medulla to the thalamus in the core of the brainstem) activating the cortex. Cognition is not possible without some degree of arousal.
ARTERIAL LINE – a very thin tube (catheter) inserted into an artery to allow direct measurement of the blood pressure, the oxygen and carbon dioxide concentrations in arterial blood.
ARTICULATION – movement of the lips, tongue, teeth and palate into specific patterns for purposes of speech. Also, a movable joint.
ASSESSMENT – an evaluation of a patient based on the following information: 1. the subjective report of the symptoms by the patient. 2. the progress of the illness or condition. 3. the objective findings of the examiner based on tests, physical examination and medical history.
ATAXIA- a problem of muscle coordination not due to apraxia, weakness, rigidity, spasticity or sensory loss. Caused by lesion of the cerebellum or basal ganglia. Can interfere with a person’s ability to walk, talk, eat and to perform other self care tasks.
ATTENTION – the ability to focus on given task or set of stimuli for an appropriate period of time.
ATTENTION DEFICITS – impaired ability to concentrate.
AUDIOLOGIST – one who evaluates hearing defects and who aids in the rehabilitation of those who have such defects.
AUTOMATIC – spontaneous; involuntary
AUTOMATISM – automatic actions or behavior without conscious volition or knowledge. Such episodes might last for a few minutes or a few days. During such episodes, the person appears normal but, is actually in a trance like state. While in such a state the person is not responsible for his acts and should not be left alone. He may carry out complicated acts without remembering having done so. Such episodes have been associated with severe emotional distress and temporal motor epilepsy.
AUTONOMIC NERVOUS SYSTEM – the part of the nervous system that controls involuntary activities, including heart muscle, glands, and smooth muscle tissue. The autonomic nervous system is subdivided into the sympathetic and parasympathetic systems. Sympathetic activities are marked by the flight or fight emergency response, initiated by way of the transmitter norepinephrine (adrenaline). Parasympathetic activities are known by lowered blood pressure, pupil contradiction and slowing of
the heart.
REDUCED AWARENESS – insight; understanding is not clear.
AXON – the nerve fiber that carries an impulse from the nerve cell to a target, and also carries materials from the nerve terminals back to the nerve cell. When an axon is cut, proteins required for
its regeneration are made available by the nerve cell body. A growth cone forms at the tip of the axon. In the spinal cord, a damaged axon is often prepared to re-grow, and often has available a supply of materials to do so. Scientists believe it is the toxic environment that surrounds the axon, and not the genetic programming of the axon itself, that prevents regeneration.

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How are Occupational Therapists trained?

How are Occupational Therapists trained?

occupational-therapy-training_largeOccupational Therapist-OTs training in Ontario are now educated through Universities, either at a bachelors or masters level.  For therapist trained outside Canada, their credentials are screened to ensure they meet the minimum standard required in the province of Ontario. After finishing their course of study whether here or abroad, all Occupational Therapists in the province of Ontario must pass an exam that is set by the Canadian Association of Occupational Therapists (CAOT) in order to be considered a Registered Occupational Therapist.

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What can I expect during my first meeting?

What can I expect during my first meeting?

meeting-occupational-therapist_largeIn your first meeting with your Occupational Therapist, she or he will introduce themselves and provide you with their business card. You will then know their credentials and how to contact them in the future if you need to.  The therapist will then explain the purpose of the assessment, and what will happen during the assessment. Usually, the assessment will include an interview portion, and assessment of the home or work environment, a brief physical assessment, and if necessary, some other assessments that might require answering questions or writing. This process is called obtaining informed consent, so you know what you agreeing to in your assessment.

After the assessment is complete, you will be given information as to the report, and who it will be sent to. Also, your therapist may ask for your permission to contact your family doctor or other health professionals. They will ask you to sign a consent form that given them permission to release information or contact specific professionals or both.

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