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includes cultural, personal, temporal and virtual Beyond the physical and social environment conditions surrounding the client |
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civil rights law accessible environment policies on public service, employment and public accommodations |
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Omnibus Budget Reconciliation Act (OBRA) |
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restraints cannot be used without proper justification and documentation |
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children with disabilities are in least restrictive environment |
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Definition
Identify and Prioritize needs, goals, desires, problem areas establish abilities assess functional use of devices Identify device's availability, safety and cost Determine device's location/frequency of use Determine funding before showing client |
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client factors and contextual factors of environmental evaluation |
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Definition
sensory skills, visual-perceptual processing skills, musculoskeletal skills, neuromuscular skills, cognitive skills, psychosocial skills
Contextual include physical considerations and sociocultural considerations |
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Term
Home Evaluation General Consideration |
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Definition
type of dwelling Protection from weather Driveway Level Entrance and accessibility Stairs Railings Door sills Width of elevator, doorways, hallways, Opening of doorways Door handles Obstructions Pets Carpeting Electrical Cords Seating Light Switches Telephones Smoke Detectors Space heaters Emergency call system/exit plan |
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Interior railing 1 1/2" from wall Exterior - waist high or 34-38" Railing - 1 1/2 to 2 " in diamerity |
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Definition
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18" using walkers 26" using wheelchairs |
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Definition
Bed height, size, etc Accessibility to bed Clothes accessible Room for commode |
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Definition
Number of Location Width of doorway Type of bathing ability Grab bars, etc. availability to add Height of tub, sink, toilet Throw rug hand held shower, anti-scald |
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Definition
Meal prep devices Countertop Direction of opening for items Accessibility of food, pts, etc Fire extinguisher Anti scald |
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Falls Evaluation - Intrinsic Factors |
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Definition
Sensory changes: vision Vestibular Age related changes Pathological state Medications Delirium/dementia Anxiety/depression History of Fear of |
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Falls Evaluation - Extrinsic Factors |
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Definition
Floor Toys Pets Carpets Furniture Stairs Footware Poor lighting Poor threshold Extension cords Transfer techniques A/E No grab bars Soap issues Toilet seat hight Wet floor Low bcabinets Movable chairs Height of bed, Closets Wires and Clutter Chairs too high |
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Term
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Definition
Determine Functional problems Take away risk factors Improve functional mobility through tx. and interventions Provide Sensory compensation strategies Modify ADLs Adapt and Modify activities Teach energy conservation techniques Communicate w/ family and caregiver Modify environment to reduce falls Provide safety guidelines to follow Provide psychological support and specific interventions |
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Definition
Check for: Fall injury Head injury Spinal Cord injury Dissiness that may have preceded fall Provide reassurance Provide first aid Call emergency don't life pt. Solicit witness document incident Refer to fall prevention program |
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Term
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Definition
width 24 - 26 " rim to rim length 42 - 43 " |
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Term
Turning measurements for s/c |
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Definition
Clearance space of 60" x 60" |
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Maximum countertop height |
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Definition
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Definition
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Definition
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Term
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minimum of 36" wide non skid surface ratio of slope to rise 1:12 (for every 1" rise 12" of ramp needed) |
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Definition
29" - 36" high (32" is average) |
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curbs on ramps
landings on ramps |
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Definition
4" high
if ramp is too long requires a landing |
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Height for side reaching
w/ counter |
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Definition
48" high without obstruction
46" w/counter |
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Definition
minimum of 4' x 4' on landing |
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Definition
minimum of 4' x 8' on landing |
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Term
in front of a door off of a ramp |
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Definition
5' x 5' platform 12" before the door to allow door swing |
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Definition
sensory issues neuromuscular issues musculoskeletal cognition psychosocial Personal assessment Contextual assessments W/C characteristics needed Developmental Considerations Cultural and Social and Contextural considerations |
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Term
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Definition
Armrests - wraparound spacesaver saves wheelchair 1" space Legrests - elevating - edema Footplates Tires Casters - solid core best - locks avail. Frame - fixed - sports &older Weight Flexibility Anti-tippers seatbelts harnesses arm trough, lap board head supports brake extensions hillholder |
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Term
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Definition
Measure width across hips and add 2" for bariatric - measure at forward edge of seated position Depth - posterior portion to popliteal fossa (back of knee) and subtract 2 inches back height - based on ability, posture, needs, etc. - take measurement from seat surface (including cushion) to either: under scapula by 1-2" - mid scapula - or top of shoulder Seat height - knees and ankles should be positioned at 90 degrees, footrests 2" clearnace from floor standard - 19.5 hemi-height 17.5 super low 14.5 Armrest height - measure under elbow to cushioned seating (shoulders in neutral and elbows at 90 degrees) |
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Term
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Definition
hard tires, adjustable backrest, reclining wheelchair, power application |
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Term
Wheelchair mobility training |
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Definition
Assess Cognition Posture Pressure relief Purpose Time schedule & weight shifts propulsion Safety Manipulate parts Maneuver Negotiate Maintenance Developmental considerations Independence |
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Term
Goals of seating and positioning |
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Definition
provide stability control and comfort Promote Proximal Stability Decrease the risk of muscle contracture, deformity, decubiti Increase sitting tolerance and enrgy level Increase function Allow for pressure distribution and support Allow for proper positioning and correct alignment of trunk and extremities |
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