Term
|
Definition
| dysfunction in or loss of cognitive functions so that the acquisition, retention, and use of knowledge is impaired or lost (usually a result of delirium or dementia) |
|
|
Term
| Incidence and prevalence of cognitive disorders |
|
Definition
| 4-5 million americans (2% of all age groups, 15% of those over 65, increase incidence in terminal phases of cancer and AIDS) |
|
|
Term
|
Definition
| partial or total inability to recall past experiences too extensive to be explained by ordinary forgetfulness |
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Term
| Etiology of Amnestic Disorders |
|
Definition
| head trauma, cerebral degeneration, illness affecting the brain (CVA, inadequate intake or absorption of thiamine secondary to severe alcoholism, substance abuse, stress associated with tramatic experiences endured or witnessed; major life stresses, tremendous internal conflict) |
|
|
Term
| Signs and Sx of amnestic disorders |
|
Definition
| memory loss for a period of time, may affect recent and/or remote recall; may appear confused and depressed; may or may not be distressed by anmesia |
|
|
Term
| prognosis of Amnestic disorders |
|
Definition
if amnesia develops acutely and no underlying physical cause is present it will usually remist spontaeously within 24m of onset
underlying physical cause is present the amnesia will remit with treatment of the physical cause
severe, irreversibe memory loss will occur in the presence of degenerative dementias, severe brain trauma, brain anoxia or ischemia, alcoholic-nutritional disease, and various drug intoxications |
|
|
Term
| Risk factors of amnestic disorders |
|
Definition
| head injury, cva, substance abuse, traumatic life events |
|
|
Term
| What are Tx for amnestic disorders |
|
Definition
underlying physical case is present, treat the condition; thiamine supplements; adequate hydration
psychological cause provide a safe enbironment that establishes a sense of safety; use memory retrieval strategies, and help person clarify the trauma or conflicts resolving problems |
|
|
Term
| what are memory retrieval stragetgies |
|
Definition
| questioning under hypnosis or drug induced semihypnotic state |
|
|
Term
|
Definition
| acute, reversible, confusional state characterized by fluctuating disturbances in cognition, mood, attention, arousal, and self-awareness |
|
|
Term
|
Definition
metabolic, toxic, structural, or infectious disease processes that affect brain cells or neurotransmitters
|
|
|
Term
| most common cause of delirium |
|
Definition
| drug and alcohol withdrawl, medication side effects, infections, pain, surgery, trauma, hypoxia, electrolyte and acid base imbalance, sensory deprivation, sensory overload, and poor nutrition |
|
|
Term
| What are the Sx of Delirium |
|
Definition
| Disorientation without drowsiness, difficulty focusing attention, confusion about familiar events and routines, changes in personality, irritability, inappropriate behavior, fearfulness, delusions, hallucinations, withdrawn, agitated and hyperactive, contradictory emotional states presen within a brief period, dizziness, distorted sleeping and eating patterns |
|
|
Term
| Prognosis and progression of delirium |
|
Definition
| acute, rapid onset of Sx not more than a week, potentially reversible if underlying cause is identified and treated usually last not more thasn a week, recovery slow (days, weeks, months) particularly in the elderly |
|
|
Term
|
Definition
| discontinue unnecessary drugs, treat underlying case, provide fluids and nutrients, quiet, calm environment with low lighting, treat agitation symptomaticlly with medication or restraints |
|
|
Term
|
Definition
deterioration of intellectual function and other cognitive skills severe enough to interfere with the ability to perform daily life activities may be progressive, static, or remitting |
|
|
Term
| Incidence and prevalence of Dementia |
|
Definition
5-8% of individuals overage 65
15-20% over 75
25-50% over 85 |
|
|
Term
|
Definition
| metabolic, toxic, structural (alxheimers, vascular, other medical conditions affecting the brain) |
|
|
Term
|
Definition
| multiple interacting causes including genetic risk factors, down syndrome, environmental agents, preious head trauma, immunological factors; excessive number of senile plaques form in the cerebral cortex and ubcortical gray matter containing beta-amyloid and neurofibrilary tables consisting of tau protein |
|
|
Term
| etiology for vascular dementia |
|
Definition
| cerebrovscular disease (CVD), multiple brain infarcts, TIA's (transient ischemic attacks |
|
|
Term
| etiology for dementia for other medical conditions |
|
Definition
| AIDS, substance abuse, vi B12 defieciency, carbon monoxide poisoning, cerebral anoxia, hypothyroidism, parkinsons, hydrocephalus, intercranial masses etc |
|
|
Term
|
Definition
| Initially presents with short term memory impairment and at least one of the following: decreased ability for new learning, language disturbances, aphasia, agnosia, apraxi, significant decrease in previous level of social or occupational functioning |
|
|
Term
| prgression and prognosis of Dementia |
|
Definition
may be progressive, statisc, or remitting depending on etiology of the disease process
some will be non progressive (single TBI) others may be reversed or arrested if the underlying disease process is treated (vit deficiency, endocrine disorders etc) |
|
|
Term
| Primary dementia has 3 phases, name them |
|
Definition
early/forgetful phase
confusional phase
dementia phase |
|
|
Term
| What is the Ealy/forgetful phase of dementia |
|
Definition
difficulty with st and recent memory
intermittent/consistent confusion about time and place
concrete thinking
difficulty wiht problemsolving and new learning
declining ability to perform on the job or carry out IADL's |
|
|
Term
| what is the confusional phase of dementia |
|
Definition
increasing memory deficits
consisent confusion aout time place and person
poor concentration with an inability to make sense of incoming stimuli
requires help f caregiver for safety and financial maagement
declining ability to perform ADLs
decline in social interaction skills |
|
|
Term
| Dementia phase of dementia |
|
Definition
loss of awareness of familiar people, surrounding, and seasonal changes
declining ability to carry out familiar, repetitive actions
declining use of vocabulary
declining loss of voluntary movement for ambulation, eating, toileting, etc |
|
|
Term
| How to medical manage dementia |
|
Definition
early detection and diagnosis where possible treat underlying cause with medication or surgery for progressive, irreversible forms provide patient and family education aboutcommunity resources, advocacy, safety, drug therapies for depression whenpresent, physical exercise & social activity, proper nutrition supportive measures ( orientation, familiar environment, minimum of new stimulation, regular low-stress activities) safe, secure environment avoiding over or under stimulation avoiding isolation, confrontation, or intimidation maintaining activity level exercise OT, group therapy, family education simplification of daily routines elimination or strict limitation of drugs with CNS activity |
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|
Term
| What precautions woul OT take with dementia pt |
|
Definition
| monitor for safe use of tools, avoid overstimulation, provide a quiet space if agitation or signs of irritability occur; keep track of what tends to upset the pt, avoid arguing with the person if they are not telling the truth, and avoid giving false expectatons of the persons abilityto perform cognitive tasks. |
|
|
Term
| precautions OT should take during advanced stage of dementia |
|
Definition
| avoid stairs, or climbing when possible because of balance and gait problems |
|
|
Term
| precautions OT should take when in the terminal phase of dementia |
|
Definition
| avoid use of sharp objects, especially feeding utensils, to resuce the possiblity of injury. If splints are used, check the persons skin frequently for changes in circulation, as the person may be unaware of or not able to report sensory changes |
|
|
Term
| What areas of Occupation are involved with dementia |
|
Definition
| eventually allareas are affected; initially affects worker role, safety procedures,and emergency response; next social participation may be lost |
|
|
Term
| what performance skills are involved with Dementia |
|
Definition
| initially process then communication/interaction and lastly motor |
|
|
Term
| What body functions/performance components involved with progression of Dementia |
|
Definition
| initially congnitive (especially memory, problem solving, learning and generalization) then socally and finally neurmucular (especially postural control and motor planning) |
|
|
Term
| what does the eval asses for in dementia pt.'s |
|
Definition
| ADLs, self care, finanvial anagement, work skills and hx, leisure skills an dinterests, cognition, psychosocial, sensorimotor, social support network, accessibility and safety in the home, and approoriateness of living situation |
|
|
Term
| What are the goals for Dementia pt's |
|
Definition
| maintain ROM, mobility, physical activity level, social participation and leisure pursuits, prevent contractures and deformities, compensate for memory loss, maintain self-esteem, maintain max level of independence of ADL's |
|
|
Term
| What is the interventions for Dementia |
|
Definition
| Ther ex. mobility activities, environmental management, caregiver education, splinting, orientation activities, reminiscence activities, verbal and physical cuing for self-care activities as needed |
|
|
Term
| What are the basic emotional needs of people |
|
Definition
the need to belong and be accepted by other people
be loved
explore and master our environments |
|
|
Term
| Why are people with psychiatric problems often rejected |
|
Definition
| they have difficulty epressing their needs and other people cannot understand what they want. Those with problems often dont even know what they want and need |
|
|
Term
| Sx: behaviors or conditions which are abnormal |
|
Definition
| depression, anxiety, hostility, withdrawal |
|
|
Term
| In some situations, client may consciously or unconsciously use Sx to |
|
Definition
| cope with underlying problems |
|
|
Term
| what are the subjective or behavioral evidence of a disease |
|
Definition
|
|
Term
| Are there any mental diseases that we are able to cure |
|
Definition
|
|
Term
| A healthy individual develops what to get through daily life issues we all have |
|
Definition
| coping and prioritizing strategies |
|
|
Term
| Ultimately healthy individuals are able to |
|
Definition
| regain balance and fulfill our roles and occupations that make up our lives |
|
|
Term
| What results in bizarre behaviors and sx |
|
Definition
|
|
Term
| How we respond to those behaviors and sx will |
|
Definition
| ultimately create our outcomes |
|
|
Term
| How we intervene or treat sx and behaviors will determine |
|
Definition
| if we have implemented a successful treatment plan |
|
|
Term
| what must we always remember about our pt.s |
|
Definition
| the client is not just a bundle of sx, but a human being as well |
|
|
Term
| What is the definition of a group |
|
Definition
| 2 or more people who are together for some period to accomplish a common goal or share a common purpose |
|
|
Term
|
Definition
| a planned process for creating changes in individuals by bringing them together for this purpose |
|
|
Term
|
Definition
| a planned process for creating change so that the person can carry out their chosen daily life activity as independently and comfortably as possible |
|
|
Term
| what is group cohesiveness |
|
Definition
| the sense of solidarity the members feel towards each other and the group |
|
|
Term
| what creates a groups cohesiveness |
|
Definition
| closeness and identification of its members, same purpose, trust, rapport |
|
|
Term
| What is intermember similarity |
|
Definition
| the degree to which group memebers believe tey are like each other or share a sense of purpose or reason for being in a group together |
|
|
Term
|
Definition
purposes for which the group meets
establish a commonality |
|
|
Term
|
Definition
the rules and standards expected for the group
define the limits of permissible ad acceptable behavior |
|
|
Term
| The group will tell new members |
|
Definition
| what kind of behavior is acceptable |
|
|
Term
|
Definition
| to preserve their integrity a group may punish a member who violates the norms |
|
|
Term
| what are the task roles of group members |
|
Definition
initiator-contributor
opinion seeker
opinion giver
enegizer |
|
|
Term
| what are group maintenance roles |
|
Definition
encourager
gatekeeper
gollower |
|
|
Term
| What are the antigroup (egocentric) group member roles |
|
Definition
aggressor
blocker
dominator |
|
|
Term
| What are the group dynamics |
|
Definition
| expresses the constatnly evolving never static quality of groups |
|
|
Term
| what are some factors of the group dynamics |
|
Definition
individual members
reactions of the participants to each other
subgroups |
|
|
Term
|
Definition
when several group members divide into two or more smaller groups
form as members make alliances
may exlude others
may reinforce the status of members
may comete with other subgroups |
|
|
Term
|
Definition
entire group may "gang up" against one member
may blame the member for failure to meet group goals |
|
|
Term
| Who developed group interaction skills |
|
Definition
|
|
Term
|
Definition
18m-2yr
ability to work and play in the presence of others |
|
|
Term
| what is a project level group |
|
Definition
the ability to share a short term task with one or two other people
2-4yrs |
|
|
Term
| what is the egocentric-cooperative level group |
|
Definition
5-7 years
awareness of the groups goals and norms and willingness to abide by them |
|
|
Term
| what is the cooperative level group |
|
Definition
the ability to express feelings within a group and to be aware of and respond to the feelings of others
96-12yrs |
|
|
Term
|
Definition
|
|
Term
| what is a mature level group |
|
Definition
15-18 yrs +
the ability to take on a variety of group roles, both task role and group maintenance roles as needed in response to changing conditions in a group |
|
|
Term
| what can a COTA do with a group |
|
Definition
| structure groups to meet the needs of the peple at various levels by changing tasks and delegating or assuming functional group roles |
|
|
Term
|
Definition
designed to help patients acquire new skills or practice old ones
|
|
|
Term
| what is the role of the therapist with groups |
|
Definition
orient the group to the activities and the goals, promote new learning, spell out norms if necessry, promote interaction and interpersonal learning among group members
remain patient |
|
|
Term
| What are interactive groups |
|
Definition
| every member communicates with every other member and with the group leader |
|
|
Term
| what are leader mediated groups |
|
Definition
| members communicate only with or through the group leader |
|
|
Term
| how to prepare for a group |
|
Definition
| knowledge, set up the environment (space), materials, paperwork |
|
|
Term
| what steps need to be taken when developing a group activity |
|
Definition
identify the pts
assess their needs
identify rules and resources
narrow the focus and outline the main goals
write a goup protocol |
|
|
Term
| What is the group protocol |
|
Definition
description (purpose what will happen in the group)
structure (time place and size of the group)
goals/behavioral objective (set at a level that can achieve)
methodology (detail of how the time of the group will be used to achieve the stated objectives)
role of the leader
evaluation (measuring the achievement of the stated purpose of the group) |
|
|
Term
- What is the group session plan
|
|
Definition
activity analysis
state the goals
list supplies and materials
environment
intro of members
plan for conducint the activity
plan for ending your group
|
|
|
Term
| how to adapt a group to low functioning individuals |
|
Definition
short sessions (30 min)
group leader is very active
group leader provides momentum
leader may use touch, eye contact, hand over hand
5 stages are flexxible
|
|
|
Term
| what are the 5 stages of the group process (lower cognition) |
|
Definition
opening of the session
movement phase
visual motor perceptual activities
verbal ad symbolic activites
closing the session |
|
|
Term
| who developed the directive groups |
|
Definition
|
|
Term
| directive grups refers to the group leader doing what |
|
Definition
active involvement in nurturing, supporting, and facilitating behaviors
concnetrates on tolerance and participation |
|
|
Term
| people with severe psychiatric diagnosis may have |
|
Definition
| few choices than the rest, limit what they do and think, and have social and economic pressure |
|
|
Term
| what are the steps in treatment planning |
|
Definition
review the results of the evaluation
identify problems (deficits)
identify strengths (assets)
set goals
identify treatment priciples
select treatment methods
|
|
|
Term
| What are some general goals |
|
Definition
maintenance of function
rehabilitation
prevention
ltg, stg's |
|
|
Term
| how to write treatment goals |
|
Definition
| be specific, RUMBA, measurabl |
|
|
Term
|
Definition
relevant
understandable
measurable
behavioral
achievable |
|
|
Term
| what are the 3 important things to remember when selecting treatment methods |
|
Definition
activity
environment
therapeutic approach |
|
|
Term
| what does the therapist need to remember when concidering an activity |
|
Definition
| addresses the treatment goals, activity should always be the primary treatment tool, activity should enhance a sense of competency (reasonable challenge) |
|
|
Term
| what does the therapist need to remember about the environment when selecting treatment methods |
|
Definition
setting where the activity will take place
how the client responds to that environment
environmental demands and support
|
|
|
Term
| What does the therapist need to remember about the therapeutic approach when selecting treatment methods |
|
Definition
clients values, learning style, and motivation etc.
therapeutic use of self |
|
|
Term
| does the COTA implement and modify the treatment plan |
|
Definition
|
|
Term
| what is quality assurance in therapy |
|
Definition
measures the effectiveness of treatment
facility may have a quality assurance program
used to monitor and improve the effectiveness of patient care within a setting or service
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