Practice Guidelines for Home Modifications

Home modifications can benefit patients of all ages and health conditions. As the population of older adults continues to grow and “age in place”, home modification interventions are becoming more important to prevent injury in the home. Considerations: Fall risk reduction Functional performance Quality of life Caregiver burden Recommendations: Multicomponent interventions (home modifications and other … Read more

Prevention & Management of Pressure Injuries/Sores/Ulcers

Risks: Limited mobility (and inability to reposition) Loss of sensation Previous pressure injuries Cognitive impairment Nutritional deficiency Skin assessment: Skin integrity Color changes Variations in heat, firmness, moisture Prevention & Management: Pressure redistribution devices Repositioning Barrier creams Floating heels Patient education Caregiver education References: National Institute for Health and Care Excellence (NICE). 2014. https://www.guidelinecentral.com/share/summary/540f17649b325#section-date Bookmark

Stress Management Group Ideas

Social games Social bingo Jeopardy Family Feud Scattergories Apples to apples (be sure to take out inappropriate terms, e.g. “crazy”) Team based Pictionary Guess Who: have each participant anonymously write 3 interesting facts about themselves, shuffle the cards, and have everyone guess one card at a time. Ball pass: on a large table with participants … Read more

CBT-I: Sleep Hygiene

Sleep Hygiene Tips Screen time: Turn off TVs, computers, tablets, smartphones, and game consoles one hour before bedtime Caffeine: Avoid caffeine 6-8 hours before bedtime Nicotine: Avoid nicotine before bedtime Alcohol: Avoid alcohol after dinner Sleeping Pills: Use sleep medications sparingly, their long-term effects are still unknown Exercise: Get regular exercise Shower/Bath: Take a hot … Read more

Supporting Occupational Therapy in Medicare Home Health

Occupational therapy still has a long way to go compared to other disciplines. During a discharge planning meeting, I had a patient on my caseload who would have benefitted from home health occupational therapy services. I believe they were Medicare. However, they were walking more than 300′ with an assistive device and would have been … Read more

Cognitive Behavioral Therapy for Insomnia (CBT-I)

Occupational therapists can consider intervention for sleep disturbances with cognitive behavior therapy (CBT). CBT focuses on modifying unhealthy sleep habits, decreasing autonomic and cognitive arousals, altering negative beliefs and attitudes about sleep, and educating patients about sleep hygiene. Research has supported the use of CBT as a nonpharmacologic treatment to sleep disturbance. Cognitive Behavioral Therapy … Read more

Efficacy of Sleeping Aids (Melatonin) for Sleep Disturbances / Insomnia

  Melatonin May shorten the amount of time it takes to fall asleep by 12 minutes. Does not appear to improve the percentage of time that a person actually spends sleeping. Overall considered “safe”, side effects may include: headache, feelings of depression, daytime sleepiness, dizziness, stomach cramps, and irritability Risks: bleeding disorders, depression, diabetes (effect … Read more

Fracture Healing Times

Upper Extremity Callus formation: 2-3 weeks Union: 4-6 weeks Lower Extremity Callus formation: 2-3 weeks Union: 8-12 weeks Union has indications for weight bearing Check for MD orders prior to mobilizing Terms: Stable: clinical union vs. Unstable Displaced: long axis does not align Open vs. closed: whether bone breaks skin   Bookmark

Amputation Levels

Amputation is identified by which joint or long bone has been amputated. Above knee (AKA): transfemoral Below knee (BKA): transtibial Below ankle: transmetatarsal Above elbow: transhumeral Below elbow: transradial Below wrist: transmetacarpal Disarticulation: across a joint such as hip, wrist, elbow, or shoulder OT Dude Rant: A lot of old school doctors, nurses, therapists may … Read more

Colles’ Fracture (Distal Radius)

Etiology Most common mechanism of injury is a fall on an outstretched hand. The wrist usually lands in extension and the forearm in pronation. Facts Most common injury to the wrist May result in limited wrist flexion, extension, forearm pronation & supination External fixation may be used vs internal fixation Educate patient in active ROM … Read more