NAJMA ADAM DOW UNIVERSITY OF HEALTH SCIENCES LECTURER OCCUPATIONAL THERAPY Institute of Physical Medicine and Rehabilitation School of Occupational Therapy DOW UNIVERSITY OF HEALTH SCIENCES

HELPING PEOPLE TO HELP THEMSELVES Occupational Therapy HELPING PEOPLE TO HELP THEMSELVES

Occupational Therapy Interventions Increase and maintain independence in activities of daily living (ADL’s) Increase mobility & co-ordination Caregiver education Organized environment Energy conservation Adaptive Equipment Increase dexterity & fine motor coordination

Activities of Daily Living (ADL’s) Basic ADL’s Instrumental ADL’s Self care Feeding Grooming Dressing Bathing Personal hygiene Toileting Interaction with physical environment Putting things away & getting things out of the closet Telephoning Written communication Using paper money, checks or coins Using books, newspapers & entertainment equipments Using public/private transportation Leisure activities

Dressing: Warm & light room. Firm seat with both feet on the floor with back supported Clothing: Easy to handle. Light weight warm /stretchy fabrics Easily laundered Cotton – or cotton – polyester Wide openings Non-iron and dip-dry fabrics. Aids: Elastic laces Shoe horn Slipper – socks

Eating : Eating : Begin meal slightly ahead of the rest of his family Eat little and often One course of main meal at midday 2nd course on the evening Half filled mug(tremor Aids: Padded /light weight cutlery Plate guards Non slip mats Weighted bracelets (not too heavy) Mugs & cups with two enlarged handles

Bathing:

Correct positioning. Correct positioning. It may be useful to reduce the distance between the hands and mouth e.g. raising the table or plate, or by positioning the patient so that his elbows can be used as a pivot in order to assist hand movement

Home Safety and Management Beds: Firm mattress Grab rail by the bed Night light luminous Alarm clock Light left on in the hallway

Home Safety and Management Even floor. Non-slip polishes Grab rails e.g. bath, toilet, steps. Plan but flexible routine will help to conserve energy. Carrying aids: Net bag clipped to the walking frame. Trolley or an apron with large pockets all reduce the danger of tripping Alarm system Telephone

Writing:

Writing aids: Padded pens Writing board Roller ball pen (easier than fountain or ball point pen).

Family support for the patient Social Activities work

Physical Therapy Interventions Exercises ROM Stretching Active Weight shifting Transfer Posture & Balance Treadmill training Cycling Walking Strength & Flexibility

Mobility & Co-ordination Aim Gait Balance Transfers

1. Gait: Gait: Rx Aim: To improve size & rhythm of the walking pattern Large; rhythmical bilateral non-resisted movements Walking Practice using foot outlines lines marked on the floor at paced intervals are all suitable. Activities which encourage walking should be under supervision.

Initiating Movement Rocking motion with verbal stimulus “one, two, three go!” Counting, Marching, Music, or rhythmic encouragement ‘step and step and ….’ One step backward before attempting to walk forward. Auditory & visual stimuli (received when climbing up stairs often makes this activity easier than walking on level ground).

2. Balance:- Balance:- Initially Work at a balance table. Mirror Later Encourage side flexion and rotation. Encouraged to bend and stoop, such as gardening and skittles. Wedged shoes Leather soled shoes Weighted clothing. Raised chairs /beds. Inclined seats reduces the risk of over balancing when rising.

3.Transfers: 3.Transfers: Stable & firm surface. A firm wedged cushion or rocking motion for rising from sitting. Raise the back legs of a chair slightly. Steady high chair with arm rest.

Speech Therapy Intervention Swallowing disorders Cognitive changes

Alternative Therapies Music Therapy Dance Tai Chi Cognitive Challenges Daily Exercise Vitamin/Mineral Supplements ALWAYS CHECK WITH YOUR DOCTOR BEFORE BEGINNING

TAKE HOME MESSAGE Be a fighter and never lose hope

Thank you