Quiz 2 Flashcards
(28 cards)
History (patient) what to do/what not to do?
- avoid childish talk
- provide pictures of what you are talking about
- use touch or soothing voice
Examination - history (moderate and severe dementia) what to do/what not to do?
- caregiver will provide info
- assess relationship btw caregiver and patient
- look for signs of burden or stress
Common communication missteps
- assuming behaviors due to dementia
- using “elderspeak”
- relying on only verbal communication
- thinking that new learning cant occur
- providing patient with too much info
What to examine?
Functional ROM Strength Pain Balance/coordination Muscle tone Sensation Integ Cardiopulmonary Mobility/transfer/amb
What are examples of functional assessments?
TUG FIM - functional independence measure Performance oriented mobility assessment (Tineti) Gait speed Berg balance
Performance oriented mobility assessment?
Tests balance and gait
Static/dynamic balance
Step length equal?
Need AD?
Gait speed - how to encourage them?
Taping/markings on floor (bright colors)
Music
Manual cues
Putting things on ground for them to step over
What does the assessment of gait provide?
Predict ST fall risk in nursing home patients with mod/severe dementia
Gait and balance abnormalities?
Apraxia
Loss of proprioception
Decreased step length, step height, speed
Wide BOS, shuffling gait, decreased arm swing, hands in high guard
Doesnt initiate gait correctly - body before feet
Problems associated with loss of cognitive function?
Overestimation of mobility safety
Communication and behavior problems
Inability to understand correct use of AD
Visual problems associated with AD?
Loss of peripheral vision
Decreased depth perception and visuospatial function
Inability to recognize familar objects and places
What is gait speed influenced by?
Fitness
Cognition
Mood
What is the primary role of PT?
- activities to maximize functional mobility of the patient
- maintain strength, balance, mobility
- simplify environment to maintain function
- assist caregiver in functional meaningful safe activities
- help them understand what to do, why, and the outcomes are (soreness)
Physical therapy goals?
Maintain physcial health and fitness
Prevent falls
Increase mobility and safety in home
Prevent caregiver-related injuries
How to give validation to a patient?
Use empathy to build trust = safety = strength
Tune into feelings and listen
Observe nonverbal behavior
What should PT’s do for the therapeutic environment?
Minimize clutter Decrease distractions Have family member there if possible Provide rest breaks Use multiple cures (tactile, verbal - short, visual)
Intervention strategies from literature?
Bed mobility, transfers, gait training
Exercise
Home safety
Caregiver edu
What to do during bed mobility and transfer training?
Simple instructions
Relate to something familiar
Know when to employ mechanical assistance
Caregiver training
What to do for gait training?
AD or no? (Avoid complex ADs)
Rolling walker > canes
Maintain walking AS LONG AS POSSIBLE
How should exercise programs be based?
Individual or group works well
FAMILIAR Functional and automatic activities
Meaningful activities
What are meaningful activities?
Goals?
Patient’s hx/personal life
Match target muscle group with activity
What are physical signs of caregiver burnout?
Back pain
Fatigue
What are emotional signs of caregiver burnout?
Frustration
Anxiety
What are social indications of caregiver burnout?
Confined to house
Decreased social activities
