OTAS 208 - Occupational Performance in Adult and Elder Care
PREREQUISITES: OTAS 206 Communication and Documentation Essentials in Occupational Therapy; OTAS 207 Fieldwork Level 1-B
COREQUISITES: OTAS 209 Assistive Technology and Modalities in Occupational Therapy; OTAS 210 Transitional Roles and Practice in Occupational Therapy; OTAS 211 Current Issues and Emerging Trends
CREDIT HOURS MIN: 4
LECTURE HOURS MIN: 2
LAB HOURS MIN: 4
TOTAL CONTACT HOURS MIN: 96
Addresses aspects of OT learned in previous courses related to legal, professional, and ethical care specific to OTA practice in an adult (age 21 to 65) and older adult (i.e., “elders,” age 65 plus) population. Reviews normal aging process as well as functional decline often experienced with aging. Explores principles and practice of assessing, reporting, developing, documenting, teaching, adapting, and grading occupations for adult and older adult clients with conditions/impairments that impact function. Focus on evidence-based interventions utilized to decrease occupational performance challenges due to disrupted client factors associated with acute, chronic, and/or degenerative conditions/injuries with or without resulting cognitive, motor, and processing dysfunction. Techniques, technology, and equipment that maximize participation in meaningful occupations, improve ADL independence, assure safety, encourage social participation, and prevent deformity, disease, and occupational disruption, as well as concepts of aging-in-place and lifestyle redesign, are emphasized. Students will develop and utilize ethical, critical-thinking, and clinical reasoning skills to evaluate, perform, and interpret common assessments, and to facilitate occupation-centered interventions for adults and older adults, including referrals for end-of-life care (i.e., hospice).
MAJOR COURSE LEARNING OBJECTIVES: MAJOR COURSE LEARNING OBJECTIVES: Upon successful completion of this course, the student will:
1. Demonstrate understanding of common theories, frames of references, and common models of practice used in OT within an adult/older adult population [B.2.1].
2. Understand how occupational performance is impacted and influenced by the effects of aging and various diseases, illnesses, conditions, and impairments [B.2.6]; review and identify developmental and lifespan milestones (i.e., childbirth age range, menopause, etc.) in adults and older adults [B.1.1].
3. Profile (i.e., include definitions, etiologies, incidences, signs and symptoms, prognosis, treatment implications, etc.) common later-onset diseases (including illnesses, conditions, impairments, injuries, etc.) and their effects on occupational performance in pediatric clients [B.2.6].
4. Demonstrate understanding of various common conditions (including neurological, cardiac, respiratory, mental/behavioral/psychosocial, environmentally induced, and orthopedic impairments, etc.) as well as common injuries, surgeries, and conditions in an adult/older adult population that can necessitate occupational therapy treatment by assistants; demonstrate understanding in the use of common sound assessments utilized [B.2.6; B.3.3].
5. Articulate and demonstrate understanding regarding the distinct nature of occupation [B.2.4] and OT’s role in health promotion and wellness, as well as disease and illness prevention within an adult/older adult population [B.2.5].
6. Identify work settings, practice areas, and workforce trends (new and emerging) in adult/older adult OT practice; and the impact of federal and state regulatory policies on OT practice for this population [B.4.1; B.4.7].
7. Research, analyze, synthesize, and implement evidence-based research into practice as it relates to occupational therapy screening, assessment, and intervention with adult/older adult clients [B.5.1; B.5.3].
8. Demonstrate professional communication methods for the occupational therapy assistant during interactions and supervision with an occupational therapist, as well as with caregivers and other professionals; be able to articulate OT’s distinct nature and role in healthcare using occupation within an adult/older adult population [B.3.21; B.2.3; B.2.4].
9. Demonstrate understanding and awareness regarding the roles of the OT/OTA and the principles of interprofessional and interprofessional team dynamics during treatment, emphasizing responsibilities of the OTA during treatment intervention that will promote wellness and disease prevention, restore, maintain, and/or modify occupational performance in this population [B.2.5; B.3.2; B.3.9; B.3.21; B.3.22; B.4.9].
10. Demonstrate understanding of the collaborative process and interprofessional team dynamics and professionalism that will promote a client-centered, holistic approach [B.3.10; B.3.21; B.3.22; B.4.6] in this population.
11. Demonstrate ability to contribute to the evaluation process of an adult/older adult client’s performance by completing an occupational profile and administering screening and assessment tools based on evidence-based practice research synthesized [B.3.3; B.5.1] and reporting data [B.3.5].
12. Demonstrate understanding and competency regarding patient safety of self and others [B.2.8], ethical and professional responsibilities [B.2.10], leadership styles when working with clients that are younger [B.2.11], and therapeutic use of self [B.3.1} during treatment with adults/older adults specifically.
13. When collaborating with an occupational therapist, demonstrate aspects of professional reasoning to inform occupation-based (or occupation-centered) interventions that consider adult/older adult client factors, performance patterns, and performance skills and demonstrate understanding and develop interventions that focus on creation, promotion, establishment, restoration, maintenance, modification, and/or prevention [B.3.2].
14. Demonstrate ability to provide direct interventions to an individual, group, or population aged 21 and above, to enhance safety, health and wellness, chronic condition management, and occupational performance [B.3.6].
15. Demonstrate ability to select and deliver interventions that are actual occupations or occupation-centered, therapeutic, and/or supportive in nature (may include virtual) [B.3.6] and demonstrate ability to collaborate in the development of intervention plans and strategies that are client-centered, culturally-relevant, and reflective of current evidence-based practice [B.3.5].
16. Demonstrate understanding and ability to perform aspects of the OT process, including collaboration with an OT in the development of occupation-based (or occupation-centered) interventions [B.3.5], monitoring, re-assessment, and modifying interventions [B.3.7], and assessing, grading, and possibly modifying the ways in which adults and older adult clients specifically perform occupations [B.3.8].
17. Design and implement occupation-based interventions designed to help adult/older adult clients establish, restore, and modify performance skills deficits [B.3.9].
18. Implement a plan for discharge [B.3.10] with demonstrated understanding of referrals [B.3.17] in collaboration with an interdisciplinary team (IDT) using principles of intra-/interpersonal team dynamics, professionalism and professional reasoning, leadership, advocacy, care coordination, consultation, and effective communication [B.2.11, B.3.2; B.3.21; B.3.22; B.4.2; B.4.6].
19. Demonstrate understanding of OT’s role in the teaching-learning and health literacy process and design an activity and training [B.3.19] to instruct an adult, an older adult (65 plus), a frail elder, and caregivers regarding safety and ways to improve occupational performance and independence during: community mobility [B.3.11]; functional mobility [B.3.12]; using assistive technology and adaptive devices [B.3.15]; and orthoses/prosthetic devices [B.3.16]. Demonstrate principles of instructional design [B.2.12], safety [B.2.8] and professional reasoning [B.3.2] during educational instruction.
20. Demonstrate activity analysis understanding in areas of occupation, performance skills, performance patterns, context, and adult/older adult client factors [B.2.7].
21. Demonstrate understanding regarding treatment interventions that address dysphagia and disorders of feeding and eating in an adult/older adult population, including training and education for caregivers [B.3.13] and ways in which client and contextual factors will differ in this population vs. In pediatrics.
22. Demonstrate basic understanding of the safe and effective application of superficial thermal agents, deep thermal agents, electrotherapeutic agents, and mechanical devices as a preparatory measure to improve occupational performance within an adult/older adult population (must include indications, contraindications, and precautions) [B.3.14].
23. Demonstrate knowledge regarding various reimbursement systems, coding and billing procedures of treatment, and documentation basics within various settings when treating this population with attention paid to unique reimbursement structures (i.e., Medicare and Medicare replacement plans, etc.) [B.4.3].
24. Demonstrate understanding of contextual factors and policy affecting OT service delivery and funding within an adult and older adult population [B.4.1]; explain the role of an OT practitioner as an advocate [B.4.2] and research ways to become involved and/or participate in advocacy efforts [B.4.2].
25. Apply and analyze the role of sociocultural, socioeconomic, and diversity, equity, and inclusion factors, as well as lifestyles in contemporary society to meet the needs of older persons, groups, and within this population [B.1.2].
26. Demonstrate knowledge of the social determinants of health for adults and older adults, groups, and within this population with or at risk for disabilities and chronic health conditions and distinguishes the epidemiological factors that impact the public health and welfare of populations [B.1.3].
27. Demonstrate understanding regarding the need for OT services within a community program to support occupational performance in adults and older persons, groups, and/or within this population; demonstrate ability to participate in an evolving service delivery model [B.4.7].
28. Demonstrate knowledge of technology used in adult/older adult OT practice [B.3.18] with attention paid to strengths and barriers regarding the use of technology within this population (i.e., memory, concentration difficulties; vision impairment, etc.).
COURSE CONTENT: Topical areas of study include - COURSE CONTENT: Topical areas of study include the following:
Various lifespan conditions common in an adult/older populations covered; will include various medical, physical, cognitive, and neurological impairments, including, but not limited to:
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Systematic (i.e., rheumatoid arthritis, cancer, kidney disease, etc.).
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Conditions (i.e., pain) that can be classified in multiple ways (i.e., acute, subacute, or chronic);
Will include conditions:
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Influence on the health and wellness of clients, caregivers, society, and the economy- in USA & globally.
Other:
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Treatment strategies (pharmacological, holistic, chemo/radiation, etc.) with considerations for frail elderly.
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Treatment plan development (screen, assessment, occupational profile interventions, discharge, etc.)
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Healthcare Team Collaboration (i.e., hospital professionals for acute, social work for mental health, PT for outpatient, hospice, etc.)
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Impact to areas due to motor and process skills dysfunction like cognitive-perceptual functioning, sensory processing, and neuromusculoskeletal dysfunction (tremors, tardive dyskinesia, peripheral neuropathy, etc.).
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Focus on evidence-based interventions utilized to decrease occupational performance challenges due to disrupted client factors associated with impaired motor and process skills like cognitive-perceptual functioning, sensory processing, and neuromusculoskeletal dysfunction.
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Adaptation/compensation/remediation/rehabilitation
Students will practice home-based, inpatient-based, outpatient-based, and facility-based interventions used by OTAs including assessment, planning, treatment implementation, and service discontinuation, with a focus on the use of meaningful occupation and client performance contexts and patterns.
Occupation-based and occupation-centered interventions will be practiced. Will include overview and use of the following skills:
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Practice, Performance, and Personal Skills required in treatment & delivery of OT services, including intra-/interprofessionalism, collaboration, care and discharge planning, referrals, and establishing client boundaries.
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Therapeutics-used within the treatment & delivery of OT services (i.e., therapeutic use of self, therapeutic activities, therapeutic exercise, manual/therapeutic modalities and agents, therapeutic exercise/stretching).
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Technical skills regarding tech/tools used in practice of OT (assessment; treatment such as training and fitting of adaptive/medical equipment, orthotics/prosthetics, etc.).
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Clinical skills as part of “clinical excellence” -will include personal and communication skills, etc. important in adult/older adult treatment (i.e., respect for elders, last name use only, formal language and behavior only, etc.) in which settings, which treatment populations; contraindications; scope defined.
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Advocacy: Students will advocate for OT in a service-learning activity/project; patient/family advocacy. Current health provision issues/advocacy efforts discussed.
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Professional reasoning skills
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Research skills for activities
Other:
Will research and explores topics on patient rights, treatment implications, and relevant research.
Will discuss and review current health care provision issues, including inclusivity, cultural, and social factors and influences.
Will explore leadership, patient and family advocacy, and health and wellness promotion unique to an adult/older adult population.
Will review performance and practice skills within the limitations of the scope of practice, basic principles of authority and responsibility, supervisory processes, collaboration, intra- and interprofessionalism, and technical skills with competency.
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