Q: What is care planning?
A: Care planning is a means of assessing future care needs and associated costs to make informed decisions about the client's abilities and limitations after illness or injury. Care planning is not the application of generic formulas to a diagnostic category but rather a process of describing client-specific needs relative to activity limitation and participation restrictions across all facets of daily living.
Q: What is the role of occupational therapy in cost of care determination?
A: Occupational therapy science supports the development of a disability profile. The occupational therapy practitioner conducts a needs analysis by producing evidence using task analysis in assessing the client's activity limitations and performance restrictions. The care planning process includes assessment (e.g., observation, testing, outcomes), the analysis of impairment, a disability profile, a needs analysis and the determination of resources (e.g., assistive devices, community resources and chronic care therapeutic interventions).
Q: What are the domains of practice of the occupational therapy practitioner?
A: The established body of knowledge or expertise of the occupational therapy practitioner is analysis of the capacity of an individual to engage in required and desired life activities/occupations that have meaning for the individual. This encompasses basic personal care or activities of daily living (e.g., taking care of one's own body); effective living skills or instrumental activities of daily living (e.g., communication, taking care of others, mobility, financial management); rest and sleep; education; paid work and unpaid domestic work; and play, leisure and social participation.
Q: What is the purpose of a disability analysis and life care plan?
A: An understanding of the client's impairment and its lifelong impact on health and well-being is essential to care planning and includes a synthesis of medical, psychological and rehabilitation information. A disability profile provides evidence of limitations and restrictions that are linked to the medically diagnosed impairment or condition suffered by the individual. The disability analysis answers the following questions that inform the life care plan and resources needed to restore a person as near as possible to his or her without impairment lifestyle: How does an impairment affect the client's function now? What are the predicted future issues related to impairment and its limitations?
Q: What is the purpose of an assessment of functional capacity?
A: A functional capacity assessment or evaluation is only one part of the larger process in development of a disability profile that examines the physical aspects of disability limitations/restrictions. There are a number of guidelines for conducting a functional assessment/evaluation based on standards of practice.
Q: What approaches may be used in assessment of functional ability/capacity?
A: There are three primary approaches to functional capacity assessment/evaluation: use of a commercial system that has some degree of research into reliability and validity; use of a hybrid system where the clinician selects the equipment, tests and protocols from various sources to assemble a test system based on clinical experience and published findings regarding reliability and validity; and simulation of paid work activity demands and domestic work activity demands. A clinician may use a combination of these approaches according to the evaluee's occupations and life roles and responsibilities.
Q: How does the age of the individual direct the occupational therapy process?
A: Occupational therapy practitioners have the knowledge and skills in biological, physical, social and behavioural sciences to evaluate and intervene with individuals across the life course (American Occupational Therapy Association, 2011). Lifespan transitions influence engagement in occupation and participation in contexts. For example, newborns begin to develop basic skills such as feeding, childhood leads to development of identity, social skills, emotional well-being, adolescents develop prevocational pursuits, and adults expand life skills through vocational pursuits and establishing an independent home. The focus across these life stages is role competence or the ability to effectively meet the demands of the role in life (e.g., learning through play, formal education, job training and job acquisition).
Q: What is involved in the assessment of loss of housekeeping capacity?
A: Housekeeping or home management is a broad term that conjures different meanings, depending on the individual. In everyday use, the terms can refer to house cleaning tasks; meal planning and preparation; shopping; light household repairs; financial management; management of recycling and garbage; lawn and garden care, and snow removal; and vehicle maintenance (washing, vacuuming and repairs). How an impairment affects the individual varies, depending on his or her own pre- and post-impairment roles and those of the family.
Q: What is involved in the assessment of the capacity to return to paid work or sustain work?
A: For full-time workers, paid employment is the occupation they spend most of their time performing. Loss of ability to work is not only an economic hardship but can lead to a loss of self-esteem and a diminished sense of purpose. A Functional Capacity Evaluation (FCE) is an objective measure of an individual's level of function as it pertains to their ability to perform specific work tasks and be employable. The primary focus of an FCE is on physical function to perform job tasks. Individuals with a physical disability may also present with fatigue, sleep disturbance, limited function, evidence of depressive mood and chronic pain, all of which can have an outcome on employability regardless of measured physical capacity in a clinic setting. The occupational therapy practitioner develops an opinion of work capacity not only from physical assessments but through analysis of the fit between residual abilities, job demands (e.g., overall work tolerance), and work standards (e.g., attendance, productivity and safety).
A: Care planning is a means of assessing future care needs and associated costs to make informed decisions about the client's abilities and limitations after illness or injury. Care planning is not the application of generic formulas to a diagnostic category but rather a process of describing client-specific needs relative to activity limitation and participation restrictions across all facets of daily living.
Q: What is the role of occupational therapy in cost of care determination?
A: Occupational therapy science supports the development of a disability profile. The occupational therapy practitioner conducts a needs analysis by producing evidence using task analysis in assessing the client's activity limitations and performance restrictions. The care planning process includes assessment (e.g., observation, testing, outcomes), the analysis of impairment, a disability profile, a needs analysis and the determination of resources (e.g., assistive devices, community resources and chronic care therapeutic interventions).
Q: What are the domains of practice of the occupational therapy practitioner?
A: The established body of knowledge or expertise of the occupational therapy practitioner is analysis of the capacity of an individual to engage in required and desired life activities/occupations that have meaning for the individual. This encompasses basic personal care or activities of daily living (e.g., taking care of one's own body); effective living skills or instrumental activities of daily living (e.g., communication, taking care of others, mobility, financial management); rest and sleep; education; paid work and unpaid domestic work; and play, leisure and social participation.
Q: What is the purpose of a disability analysis and life care plan?
A: An understanding of the client's impairment and its lifelong impact on health and well-being is essential to care planning and includes a synthesis of medical, psychological and rehabilitation information. A disability profile provides evidence of limitations and restrictions that are linked to the medically diagnosed impairment or condition suffered by the individual. The disability analysis answers the following questions that inform the life care plan and resources needed to restore a person as near as possible to his or her without impairment lifestyle: How does an impairment affect the client's function now? What are the predicted future issues related to impairment and its limitations?
Q: What is the purpose of an assessment of functional capacity?
A: A functional capacity assessment or evaluation is only one part of the larger process in development of a disability profile that examines the physical aspects of disability limitations/restrictions. There are a number of guidelines for conducting a functional assessment/evaluation based on standards of practice.
Q: What approaches may be used in assessment of functional ability/capacity?
A: There are three primary approaches to functional capacity assessment/evaluation: use of a commercial system that has some degree of research into reliability and validity; use of a hybrid system where the clinician selects the equipment, tests and protocols from various sources to assemble a test system based on clinical experience and published findings regarding reliability and validity; and simulation of paid work activity demands and domestic work activity demands. A clinician may use a combination of these approaches according to the evaluee's occupations and life roles and responsibilities.
Q: How does the age of the individual direct the occupational therapy process?
A: Occupational therapy practitioners have the knowledge and skills in biological, physical, social and behavioural sciences to evaluate and intervene with individuals across the life course (American Occupational Therapy Association, 2011). Lifespan transitions influence engagement in occupation and participation in contexts. For example, newborns begin to develop basic skills such as feeding, childhood leads to development of identity, social skills, emotional well-being, adolescents develop prevocational pursuits, and adults expand life skills through vocational pursuits and establishing an independent home. The focus across these life stages is role competence or the ability to effectively meet the demands of the role in life (e.g., learning through play, formal education, job training and job acquisition).
Q: What is involved in the assessment of loss of housekeeping capacity?
A: Housekeeping or home management is a broad term that conjures different meanings, depending on the individual. In everyday use, the terms can refer to house cleaning tasks; meal planning and preparation; shopping; light household repairs; financial management; management of recycling and garbage; lawn and garden care, and snow removal; and vehicle maintenance (washing, vacuuming and repairs). How an impairment affects the individual varies, depending on his or her own pre- and post-impairment roles and those of the family.
Q: What is involved in the assessment of the capacity to return to paid work or sustain work?
A: For full-time workers, paid employment is the occupation they spend most of their time performing. Loss of ability to work is not only an economic hardship but can lead to a loss of self-esteem and a diminished sense of purpose. A Functional Capacity Evaluation (FCE) is an objective measure of an individual's level of function as it pertains to their ability to perform specific work tasks and be employable. The primary focus of an FCE is on physical function to perform job tasks. Individuals with a physical disability may also present with fatigue, sleep disturbance, limited function, evidence of depressive mood and chronic pain, all of which can have an outcome on employability regardless of measured physical capacity in a clinic setting. The occupational therapy practitioner develops an opinion of work capacity not only from physical assessments but through analysis of the fit between residual abilities, job demands (e.g., overall work tolerance), and work standards (e.g., attendance, productivity and safety).