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Eval and Intervention for Areas of Occupation

Terms in this set (63)

Focus: the assessment of the severity of a disability as determined by what the individual actually does and the amount of assistance needed by the individual to complete each task. Six performance areas are assessed
1) Self-care: toileting, bowel and bladder management, grooming, bathing, dressing, and eating
2) Sphincter management: bowel and bladder control
3) Mobility: bed/chair/w/c, toilet, tub/shower transfers
4) Locomotion: walking, using stairs, and using a w/c
5) Communication: expression and comprehension
6) Social cognition: social interaction, memory, and problem solving

Method: observation of activity performance with or without the assistance of a helper as determined by the person's ability to do a task.

Scoring and Interpretation
1) Each item on the FIM for adults and 3-7 year olds is scored on a 1-7 scale graded from dependent to independent and the amount of assistance needed for task performance (WeeFIM for less than 3 yo is scored on 1-3 scale)
2) A score of one indicates the person could not be evaluated performing the task or he/she required total assistance in task performance
3) Scores of 2-5 indicate increasing levels of assistance required from a helper for the individual to do the task
4) Scores of 6 or 7 indicate that the person is independent in task performance and does not require a helper
5) Behavior criteria are provided for each scoring level for all test items
6) Documentation of demographics, diagnoses, impairment groups, length of stay and costs of hospitalization are also included on the FIMs to provide data on the social and economic costs of disability
7) Results of the FIM can provide relevant information about an individual's level of independence and severity of disability

Population: adults with disabilities who are not functionally independent. six months to 7 years for the WeeFIM
-Assessment for evaluation of activities of daily living
-The evaluation of the ADL skill of sexual expression/activity does not have a published OT assessment available for clinical use
-The OT practitioner should assess this ADL during routine screenings and interviews, as appropriate.
-Determine if sexual expression/activity is valued
-Identify potential obstacles for the attainment and maintenance of safe, satisfying sexual expression/activity (pathophysiological changes related to disease, disability, and/or aging process; psychological and/or cognitive changes related to disease, disability, and/or the aging process - judgement, impulse control and decision-making skills must be assessed to ensure safety; limited partner availability due to social demographics and/or sociocultural attitudes
-Determine is a person's knowledge of his/her sexuality is adequate and appropriate for his/her age, developmental level, expected roles, and environmental contexts
-If an individual is reticent about discussing his/her sexuality during the OT evaluation, the therapist must respect and accept this preference (sexual concerns that are unexpressed during initial OT sessions are often brought forth during later session as a therapeutic relationship develops between the individual and his/her OT; sessions focused on intimate self-care issues frequently precipitate questions regarding sexuality; an atmosphere of continuing permission to discuss sexual expression should be maintained throughout the person's engagement in OT)
-The potential realities of sexual abuse, protective legislation, and our professional code ethics to report any suspected incidents of child, adult, or elder abuse or assault to the appropriate agency and/or local law enforcement