class test two (wk 4-8) Flashcards
1
Q
what are types of risks in mental health?
A
- self harm
- harm to others
- aggression/violence
- absconding
- suicide
2
Q
what are the aims of a risk assessment?
A
Identify those at risk
Identify clinical management
3
Q
what are static risk factors for someone suicidal?
A
fixed and historical
4
Q
what are types of static risk factors for someone suicidal?
A
- previous self harm
- diagnosis of mental illness
- past substance abuse
- family history
- recent stressors or loss
- age, gender and marital status
5
Q
what are dynamic risk factors for someone suicidal?
A
changeable and fluctuate
6
Q
what are types of dynamic risk factors for someone who is suicidal?
A
- active suicidal ideation
- prone to impulsivity
- hopelessness, guilt or dramatic change in mood
- current substance use
- psychosocial stressors
- social withdrawal, unstable supports
- increased agitation, anxiety, sleep disturbance
- available means to suicide
- feeling alone, trapped or burden on others
7
Q
what are protective factors for someone who is suicidal?
A
- availability of healthcare
- restrictions on lethal means
- safe and supportive community enviro
- connectedness
- supportive relationship with healthcare providers
- coping and problem solving skills
- reasons for living
- moral objections
8
Q
what are questions to ask about ideation in relation to suicide?
A
do you have frequent thoughts of suicide- how strong, intrusive and frequent?
9
Q
what are questions to ask about the plan in relation to suicide?
A
what, where and when?
10
Q
what is intent in relation to suicide?
A
attempt in progress, plan to skill self (method known), predatory behaviour, expressed intent to die
11
Q
what is CPR in regards to suicide assessment?
A
C- current plan
P- previous exposure to suicide
R- resources- what the person has or can use thats helpful
12
Q
what are some questions to ask in regards to an individual’s current plan in a suicide risk assessment?
A
> may be vague or specific
> what?- how and access to means
> where?
> when?
13
Q
what is the current plan in relation to suicide risk assessment?
A
elements of a person’s plan, the more concrete the greater the risk
14
Q
what are some questions to ask in regards to an individual’s previous exposure in a suicide risk assessment?
A
- previous attempt- when? What was the care after?
- someone close to them has killed themselves
15
Q
what are resources in regards to suicide risk assessment?
A
what the person has or can use that is helpful
16
Q
what are types of resources that an individual has in regards to suicide assessments?
A
> positive, protective factors to reduce risk
> resources person finds useful
> three types- internal, external and peripheral
17
Q
what are the three types of resources in a suicide assessment?
A
internal, external and peripheral
18
Q
what are examples of internal resources in a suicide assessment?
A
> coping strategies
> distraction
> safety plan
> engaging in meaningful occupation
> values
19
Q
what are examples of external resources in a suicide assessment?
A
> family/friends/pets/significant other
20
Q
what are examples of peripheral resources in a suicide assessment?
A
> helplines
> therapists etc.
> teachers
> clergy
21
Q
what are examples of risk assessment questions for CPR?
A
-do you want to kill yourself/do you have suicidal thoughts?
Current Plan: 1. How would you kill yourself? 2. Do you have access to…? 3. When do you plan to kill yourself?
Previous Exposure: 1. Have you tried to kill yourself before? 2. If so how long ago was that? 3. Do you know anyone who has killed themselves?
Resources: 1. Who in your life do you turn to when you need someone to talk to? 2. What stops you from killing yourself or what keeps you alive? 3. Do you have any other supports?
22
Q
what are some risk management actions you could take?
A
- rapport, active listening
- involve family, caregivers and support networks
- if required inform supervisor and refer to other professionals
- consider substance use disorders, mental illness and personality disorders
- management plan needs to be individualised and informed by risk assessment
- conduct MSE
- provide resources
- address dynamic risk factors
- document
23
Q
what is low risk in risk management for suicide?
A
-depressed, no social ideation, no plan/intent
24
Q
what should occur if an individual is a medium risk in risk management for suicide?
A
- engaged in more collaborative approach, help with access to info/resources but ultimately leaving things up to individual
- seek manager input and refer on if any suicidal ideation/plan/intent
25
what should occur if an individual is a high risk in risk management for suicide?
- engaged directively, with helper taking steps to ensure immediate and ling-term safety and connecting them to resources
- seek manager immediate and direct input
26
how should an individual with low risk for suicide be treated?
with empathy and respect and empowered to make decision for themselves
27
what are some resources for suicide risk patients?
- safety plans
- helplines
- follow up appointments/calls
- online resources
- enlist family/support persons
- referrals
- local hospital triage
- CATT- crisis and assessments treatment teams
- call 000 or go ED
28
what is PTSD?
is a type of anxiety disorder that can occur at any age after witnessing or experiencing a traumatic event that involved the threat of injury or death
29
what can PTSD follow?
```
> natural disaster
> life threatening illness
> assault
> domestic abuse
> prison stay
> rape
> terrorism
> war
```
30
what does procedural memory formation relate to?
motor skills that are learnt, automatic
31
what does declarative memory formation relate to?
life events
32
what does the hypothalamus-suprachiasmatic nucleus affect with sleep?
- circadian rhythm area
| - receives sensory info about light/dark cycle ‘entrains’ sleep rhythm
33
how is the brainstem involved with sleep?
- communicates with SCN and reduces activity of the ARAS
| - GABA
34
how is the thalamus involved with sleep?
- relay of external sensory info to the cortex decreases
| - in REM sleep it is active relaying info from within the brain
35
how is the pineal gland involved in sleep?
- secretes melatonin in response to signals from the SCN and visual system
- melatonin synchronises
36
how is the basal forebrain involved with sleep?
-helps regulate sleep cycles by increasing drive to sleep
37
how is the amygdala involved with sleep?
-becomes active during REM sleep
38
what is the purpose of sleep?
- homeostatic need for sleep regulated centrally
- metabolic role- NREM- rise in ATP- increased protein synthesis
- growth hormone release
- immune system
- neurotrophic factors released- synaptic consolidation and generation
> synaptic plasticity and learning
39
how does PTSD influence sleep?
- hyperarousal > problems with sleep transition
- REM arousal due to intrusive dreams
- REM behaviour disorder due in older sufferers
- evidence of increased activation of amygdala in REM
40
what occurs in the neurobiology of chronic PTSD?
- increased circulating levels of noradrenalin
- increased reactivity of a2- adrenergic receptors
> blood vessel reactivity
- increased thyroid hormone levels
- explains some of the somatic symptoms
- increased catecholamine levels potentiate threat response of amygdala
41
does the hippocampus have a higher for lower volume for PTSD sufferers?
lower
42
what occurs in the 1st stage of stress?
shock
43
what occurs in the 2nd stage of stress?
resistance, body fights back > adrenaline and cortisol release
44
what occurs in the 3rd stage of stress?
```
if too much cortisol for too long:
> exhaustion
> impaired immune function
> chronic hypertension
> obesity
> atherosclerosis
```
45
what are some possible treatments for PTSD?
```
> CBT
> eye movement desensitisation reprocessing (EMDR)
> brief psychodynamic psychotherapy
> stress management
> supportive counselling/therapy
> narrative exposure therapy
> group therapy
> expressive therapies- art/drama
```
46
what are some pharmacological treatments for PTSD?
> antidepressants
> TCAs, MAOIs, SSRI
> benzodiazepines and other sleeping meds
> B blockers- anxiolytic
> antihistamines- for sedative effect
> antihypertensives
> experimental- Acetylcholinesterase inhibitors
47
what are some physical treatments for PTSD?
> ECT
| > transcranial magnetic stimulation- dorsolateral prefrontal cortex
48
what are some adjunctive therapies for PTSD?
> engagement in meaningful individual/group occupation
> healthy behaviours
> exercise
> sleep hygiene
49
what is involved in trauma informed care?
1. safe/supportive enviro that protects against physical harm and re-traumatisation
2. Understand clients and symptoms, background, experiences and culture
3. Collaboration between service provider and client throughout
4. Understanding of symptoms and survival responses required to cope
5. View of trauma as a fundamental experience that influences identity rather than a discrete event
50
what are treatment principles for OTs working disasters?
> multi level- individual, families, groups, community- dynamic
> appreciate each individual/communities have their way of coping
> can’t be prescriptive
51
what should be provided immediately after exposure to trauma at immediate intervention?
> info
> emotional support
> practical assistance
52
what is involved in psychological first aid for those experiencing acute stress responses or risk of impaired function?
1. Contact and engagement
2. Safety and comfort
3. Stabilisation
4. Info gathering
5. Practical assistance
6. Connection with social supports
7. Info on coping
8. Linkage with collaborative services
53
what are five post disaster early intervention principles?
Promote:
- sense of safety
- calm
- social connectedness
- self-efficacy
- hope
54
what are some early interventions in the immediate days/weeks out disaster?
- basic practical support, set up familiar routines- reengage in daily activity
- need sense of belonging
- occupational balance
- engage in some positive occupations to balance difficult experiences
- psychoeducation
55
what are some treatment principles in PTSD?
- psychoeducation
- skills- how to cope
- therapy
56
what are some occupational issues associated with PTSD/disasters?
- sleep issues, decreased self care
- avoid/limited leisure and productive activity
- isolated from social enviro impacting everyday function
- difficulty initiating participation in community activity
- poor time management- occupational imbalance
- social skill difficulty impacting relationships
57
what are some models that can be utilised when dealing with PTSD or disaster?
- biopsychosocial model
- recovery model
- systems theory
58
what are some interventions that can be used for PTSD?
- graded exposure
| - CBT
59
what are some assessments that can be apart of a PTSD program?
- initial
- CAPS (clinician administered PTSD scale)
- other scales such as DASS
60
what does psychoeducation about PTSD involve education about?
> trauma memory network
> problems commonly associated with PTSD
> impact on families and relationships
> neuropsychology
> medications used
61
what does skills treatment/training for PTSD involve?
> substance use issues
> relaxation training
> communication skills
> anxiety/anger management
62
what are some lifestyle based treatments for PTSD?
```
> exercise
> outing group
> managing change
> occupational issues
> sleep
> gender issues
```
63
what are some types of therapy that can be beneficial for PTSD sufferers?
```
> group therapy
> individual therapy
> couples therapy
> creative expression
> children’s group
```
64
what is traumatic stress?
human response to traumatic, catastrophic or adverse events
65
what is trauma?
deeply distressing experience, emotional shock following stressful event
66
what are the different types phenomena that can be referred to as trauma?
> physical- injury to body
> emotional- psychological and emotional injury
> physical and emotional- traumatised both physically, psychologically and emotionally
> psychic- trauma to the psyche (soul, mind, spirit)
> psychosocial- Psychological and social (community) response to event
67
when does a crisis response occur?
few days immediately after experience
68
when does an acute stress response occur?
few months after
69
what awesome trauma and stressor related disorders identified by the DSM-V?
- reactive attachment disorder- children
- disinhibition social engagement disorder- children
- PTSD- symptoms more than 1 month in adults, adolescents and children older than 6 years
- PTSD for children 6 and under- symptoms more than 1 month
- acute stress disorder (3 days-1month)
- adjustment disorder- no traumatic event but response to an identifiable stressor within 3 months
70
what PTSD diagnoses are no longer in the DSM?
- acute PTSD- less than 3 months
- chronic PTSD- longer than 6 months
- delayed onset PTSD
- complex PTSD- disorders of extreme stress not otherwise specified
71
how does the American Psychiatric Association define events as being traumatic?
if there has been exposure to actual or threatened death, serious injury, or sexual violence in 1 or more of the following ways:
- directly witnessing
- witnessing in person the events as it occurred to others
- learning that traumatic events occurred to close family/friend, event must have been violent or accidental
- experiencing repeated or extreme exposure to aversive details of traumatic events (paramedic, police, therapists)
72
how is a traumatic event categorised by type?
- human/nonhuman (war vs natural)
- sudden onset (accident)
- short duration
- repeated over time
73
how is a traumatic event categorised by type of experience?
- primary (direct experiencing)
- secondary (witnessing)
- tertiary (learning about event occurring to close family/friend)
74
what is psychic (emotional) trauma?
- an inescapably stressful event that overwhelms peoples exisiting coping mechanisms
- the experience of hopelessness, powerlessness, a threat to one’s life and sense of control
75
what are some types of post traumatic responses?
- existential impact- profound emptiness, loss of connection with one’s spirituality, disruption of ability to hope, trust, or care about oneself or others
- depression
- complicated or traumatic grief
- anxiety
- stress disorders
- dissociation
76
what is criteria A on the symptoms and diagnosis of PTSD on the DSM-V?
Exposure to actual or threatened death, serious injury or sexual violence
77
what is criteria B on the symptoms and diagnosis of PTSD on the DSM-V?
Presence of 1 or more intrusion symptoms associated with traumatic events beginning after the event
78
what is criteria C on the symptoms and diagnosis of PTSD on the DSM-V?
Persistent avoidance of stimuli associated with traumatic events beginning after the event
79
what is criteria D on the symptoms and diagnosis of PTSD on the DSM-V?
Negative alterations in cognition and mood associated with traumatic events beginning after the event evidenced by 2 or more of…
80
what is criteria E on the symptoms and diagnosis of PTSD on the DSM-V?
Marked alteration in arousal and reactivity associated with the trauma beginning after the event or worsening after
81
what is criteria F on the symptoms and diagnosis of PTSD on the DSM-V?
Duration of the disturbance (Criteria BCDE) more than 1 month
82
how long must criteria BCDE on the PTSD DSM-V last for?
more than a month
83
what is criteria G on the symptoms and diagnosis of PTSD on the DSM-V?
The disturbance causes clinically significant distress or impairment in social, occupational or important areas of functioning
84
what is criteria H on the symptoms and diagnosis of PTSD on the DSM-V?
The disturbance is not attributable to the physiological effects of substance or other medical condition
85
what is somatic symptom disorder as a traumatic response in DSM-V?
somatization disorder (unexplained physical symptoms such as pain) and conversion reaction (symptoms or deficits affecting voluntary motor or sensory function which cannot be fully explained and are associated with conflict or stressor)
86
what is brief psychotic disorder as a traumatic response in DSM-V?
(brief reactive psychosis) associated with marked stress event
87
what is dissociative identity disorder as a traumatic response in DSM-V?
disruption of identity, discontinuity of sense of self and sense of agency
88
what is borderline personality disorder as a traumatic response in DSM-V?
pervasive patterns if instability of interpersonal relationships, self image, and affects, and marked impulsivity beginning by early adulthood
89
what are some personal variables associated with the development go post-traumatic symptoms?
> genetic
> biological
> coping abilities, adaptive strategies
> previous experiences
90
what are some event variables associated with the development go post-traumatic symptoms?
> intentional act of violence
> presence of life threat/physical injury
> extent of exposure
> witnessing death
> loss of friend/family/loved one due to trauma
> unpredictability and uncontrollability
> sexual victimisation
91
what are some social response variables associated with the development go post-traumatic symptoms?
```
> family/friends
> community leaders
> emergency and support workers
> health professionals
> society
```
92
what are some of the recovery enviro response variables associated with the development go post-traumatic symptoms?
> reduced demands initially- social, occupational, emotional and psychological
> absence of stressors
> engagement in healthy behaviours and occupation
> encouragement of resilience, constructive thinking and activities
93
what is identified in the working model?
factors identified that affect processing of a traumatic event
94
what is the working model used to do?
plan assessment and intervention to enable recovery, adoption, growth and destabilisation and not pathology
95
what are some factors in the working model?
> nature of experience
> individual characteristics
> recovery enviro
> post traumatic processing
96
what is the nature of experience as a factor in the working model?
life threat, warning, exposure to grotesque, role of survivor
97
what is the individual characteristics as a factor in the working model?
pre-trauma personality, coping behaviour, defensive styles etc.
98
what is the recovery enviro as a factor in the working model?
social support, intactness of community, demographics, culture etc.
99
what is post traumatic processing as a factor in the working model?
psychic overload vs gradual assimilation of event
99
what is post traumatic processing as a factor in the working model?
psychic overload vs gradual assimilation of event
100
what is the corrections act 1986?
- people indention have right to health and mental health treatment comparable to community care
- cannot be compelled to accept treatment
101
what is the mental health act 2014?
-patients who meet criteria for compulsory treatment under MHA must be transferred to a designated mental health service (Thomas Embling Hospital) under secure treatment order
102
what is involved in the crimes (mental impairment) act 1997 under section 20?
-person charged with offence if at time of engaging in conduct constituting the offence, the person was suffering from a mental impairment that has the effect that:
> he/she did not know nature and quality of conduct
> he/she did not know conduct was wrong (could not reason is perceived as wrong)
103
what is seclusion defined under?
MHA (2014) and clear purpose for use
-aim for least restrictive option
104
what is the diagnosis in forensic patient profiles?
- 95% schizophrenia
| - 76% have dual diagnosis (substance use)
105
what is the psychosocial aspect of forensic patient profiles?
- average IQ is 80
- average education level is year 9
- less than 30% were working prior to admission
106
what is the often the offence of forensic patient profiles?
- 70% have committed murder (others: attempted murder, serious violence
- 25% have prior offending
107
what is the often the health of patients on their forensic patient profiles?
- secure hospital patients have a shorter life expectancy (by 10 years)
- average BMI: 35 (healthy= 18.5-24.9)
108
what are some clinical support and intervention programs in forensic setting?
- vocational training via TAFE
- recreation and leisure
- dietician/physio/dentist/GP/practice nurse
- therapeutic programs- WHO pillars of care
- creative arts
- spiritual care coordinator
- consumer and carer programs
109
what are some assessments apart from MOHO that can be used in forensic setting?
- adult sensory profile (ASP)/sensory cards
- cognitive assessments
- ongoing observations of occupation
- literacy/numeracy assessment
- digital literacy/skills assessment (informal)
110
what are some individual interventions in the forensic setting?
- providing individual therapy on bed-based units and within outpatient settings
- supporting community re-integration including developing skills for community living
111
what are some group interventions in the forensic setting?
- providing group based treatment on bed-based units and within outpatient settings
- modules and series to address a range of occupational needs
112
what are some service wide (population) interventions in the forensic setting?
- liaising and providing treatment options with wider MDT and other key stakeholders (education, programs staff, correctional staff etc.)
- educating and enhancing clinical and non-clinical team’s understanding of the role of OT in each setting
- project work
113
what is step 1 recovery pyramid?
paralysis, denial
114
what is step 2 recovery pyramid?
hopelessness, confusion, giving up
115
what is step three of the recovery pyramid?
initial motivation
116
what is step 4 of the recovery pyramid?
understanding, adaptability
117
what is step 5 of the recovery pyramid?
eager to move forward
118
what is step 6 of the recovery pyramid?
accountability for action, initiate actions
119
what is step 7 of the recovery pyramid?
ongoing journey with/without symptoms, being apart/contributing to community
120
how do we evaluate individual patient progress in the forensic setting?
MOHOST as an outcome measure
121
how do we evaluate programs in the forensic setting?
observations and reviews, feedback, pre and post surveys
122
how do we evaluate runs in the forensic setting?
using reflection, supervision, and peer support too evaluate and improve practice
123
what is multiple sclerosis?
a condition of the CNS that interferes with nerve impulses within the brain, spinal cord, and optic nerves. Scars occur within the CNS and symptoms depend on where they develop
124
what are symptoms of MS?
- impaired motor control
- fatigue- heat sensitivity and MS fatigue
- other neurological: vertigo, pins and needles, neuralgia, and visual disturbance
- continence issues- bladder incontinence and constipation
- neuropsychological- depression, cognitive difficulty, memory loss
125
what are the types of MS?
```
Relapsing-remitting (RRMS)
Secondary progressive (SPMS)
Primary progressive (PPMS)
```
126
what is relapsing-remitting MS characterised by?
-characterised exacerbations, relapses, or flares
127
what is the % of relapsing-remitting MS of MS sufferers?
70-75% of MS diagnosed
128
what is secondary progressive MS?
starts with RRMS and then becomes steadily progressive
129
what % of people with MS have secondary progressive MS?
- greater than 50% of people with RRMS will develop within ten years
- 90% within 25 years
130
what is primary progressive MS?
-conditions progressively worse than onset
131
what % of people with MS develop PPMS?
15%
132
what is MND?
affects nerves (motor neurones) that communicate between brain and muscles that enable movement, speech, swallowing, breathing. People with MND have gradually degenerating to dying motor neurones, causes muscles to weaken and waste
133
what is the life expectancy of MND?
terminal with average life expectancy 2-3 years
134
what are types of MND?
- amyotrophic lateral sclerosis (ALS)
- progressive bulbar palsy (PBP)
- flail limb
- primary lateral sclerosis
- MND/FTD
135
what are the initial symptoms of MND?
- stumbling due to leg muscle weakness
- difficulty holding objects caused by weakness of hand muscles
- slurring of speech or swallowing difficulty due to tongue and throat muscle weakness
- cramps and muscle twitching
136
what are the ongoing symptoms of MND?
- breathing difficulty
- fatigue
- insomnia
- cognitive changes
- emotional regulation issues
- pain
137
what is a prognosis?
term for predicting likely or expected development of a disease, including whether signs/symptoms will improve or worsen (and how quickly) or remain stable over time; expectations of QoL, potential for complications; and likelihood of survival (life expectancy)
138
what is prognosis made based on?
asis of the normal course of diagnosed disease and individuals physical and mental condition, treatments available, and additional factors
139
what is the OTs role in the community in palliative care?
- holistic assessment
- collaborative goals
- client centred treatment
- monitor and adjust goals/treatment which deterioration
- discharge
140
what is involved in assessment at end of life stage?
- fatigue/pain/stress levels
- pressure care issues
- carer/family supports
- preparedness for death
- joint assessment with multidisciplinary team
141
what are some focuses of end of life stage intervention?
- continuing routine valued occupations
- long held wishes
- new pursuits
- preparing for death
- ADL strategies to assist with participation in valued occupations
- minor home mod
142
what can we do when working with caregivers of palliative patients?
- education with specific support skills
- attending to care givers own needs
- balancing demands with their own occupations
- support grief and bereavement needs
143
what are the three types of palliative care services delivered?
Palliative approach
Specialised palliative service approach
End of life (terminal) care
144
what is trajectory 1 in functional decline in palliative care?
rapid decline in last 14 days, AKPS 40
145
what is trajectory 2 in functional decline in palliative care?
flatter, prolonged decline over 120 days, AKPS 40
146
what is the rapid assist home visit service?
- rapid response team
- OT, doctor, nurse
- fast track discharge
- keep people at home
147
what are assessment tools for patients in palliative care?
```
> symptom Ax- BFI
> goal attainment- COPM, GAS
> discharge destination
> QoL
> performance status
```
148
what are assessment tools for carers in palliative care?
> CSNAT
| > carer burden scale
149
what are some coping strategies in palliative care?
- may be adaptive or maladaptive
| - collusion, denial/anger, depression and anxiety
150
what is palliative care?
approach that improves QoL of patients/families facing problems associated with life threatening illness, through prevention and relief of suffering by means of early identification and assessment, and treatment of pain and other problems, physical, psychosocial and spiritual
151
what is the goal and aim of palliative care?
- provide relief from pain and other stressors
- affirms life
- intends to neither hasten or postpone death
- integrates psychological and spiritual aspects of care
- offers support system to help patients live as actively as possible, and to families
152
when was the voluntary assisted dying act passed in VIC?
19th Nov 2017
153
what is the voluntary assisted dying act?
provides regulations, establishes criteria steps through detailed request and assessment process, including requirements for medical professionals. Provides safeguards including medication monitoring, practitioner protections, offences, and a five year review
154
what is the eligibility criteria for the voluntary assisted dying act?
- over 18 years
- Aus citizen or permanent resident for at least 12 months
- have decision making capacity
- be diagnosed with a disease, illness that:
> incurable and advanced, progressive and will cause death
> expected to cause death within weeks/months not exceeding 6 months ( 12 for people with neurodegenerative)
> is causing suffering that cannot be relieved in tolerable manner
-request and assessment x3
155
what is the OTs role in end of life care?
- directed to maximise potential for sale and independent living
- main roles is assessment of capacity for independent living, planning improvements to household, and supporting carers
- assist people to live at home for as long as possible
156
what are some OPI's being experienced by Elza?
- occupational imbalance
- lack of occupational participation in self care (sleep)/leisure
- lack of occupational roles
- managing finances
157
what is some info about Elza's situation?
- homeless since 16
- beaten multiple times by partner
- unstable living situation
- previous experience as barista
- prior psychiatric admission following OD
158
what symptoms is Elza still experiencing?
- headaches and double vision when tired
| - loss of sensation on ulnar side if right hand
159
what are some OPI's that could occur following disaster?
- grief
- loss
- loss of occupational roles
- occupational imbalance
- lack of occupational participation
160
what is some info about Pete's previous interests?
video games and music and watching DVDs and tv about this
161
what has Pete been diagnosed with?
- ASD
- paranoid schizophrenia
- substance dependency- Hep C
162
what is Pete's presentation?
- intrusive
- thought disordered and acutely psychotic
- non compliant with meds
163
what are some OPIs Pete is experiencing?
- medication management
- socially appropriate behaviour
- managing finances
- not being able to maintain a job
- PADLs sporadically
- limited CADLs/DADLs
- minimal ADLs especially food prep
164
what is the ages of the young people in residential aged care?
25,31,36, 40
165
what have the young people in residential aged care been diagnosed with?
ABI all HHH (high ADL, behaviour, and complex needs)
166
what equipment is being used by young residents in aged care?
- 3 have customised wheelchairs, 1 can use independently
- 1 mobile hoist
- transport for two at a time
- light writer and alphabet board
167
what are some strengths of the young people living in residential aged care?
- can communicate basic needs
- generally orientated to time
- good level of awareness
168
what are some secondary issues experienced by some of the young people in residential aged care?
- for 1 stage 2 pressure care
- recurrent chest infection
- 2 dysarthric speech
169
what are some OPIs experienced by the young people in residential aged care?
- age-appropriate occupation, lack of occupational balance/participation
- pressure care
- limited occupational roles
- lack of social engagement
170
what is some info about Jenny's situation?
- 48 yo
- husband and two kids
- wants to go home
171
what is Jenny's current and previous diangosis?
currently has left frontal parietal brain tumour
previously had grade 2 astrocytoma brain tumour 10 years ago
172
what symptoms is Jenny currently experiencing with her tumour?
- headaches
- seizures
- muscle weakness
173
what are some OPI's Jenny is experiencing?
- fatigue
- transfers
- house accessibility/getting into backyard for leisure (smoking)
- DADLs
- social engagement
- community access
- weight gain
174
what are some models and frameworks used in palliative care?
- biomechanical
- biopsychosocial
- ICF
- MOHO
- CMOP-E
- models of grief and loss
- stress-vulnerability
- QoL
- CPPF
