Activities of daily living

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Activities of daily living:

Activities of daily living Presented by : vinod BPT 4 th year Amity physiotherapy college Roll no : 0071052607

Definition :

Definition ADL are tasks of self maintenance , mobility , communication and home management that enable to achieve personal independence in his environment 1 May 2012 2

Introduction :

Introduction Attention to self-care and daily living skills, serves three purposes: it increases your ability to perform these activities, provides overall muscle toning and increases your range of motion. 1 May 2012 3

PowerPoint Presentation:

ADL are usually taught in the following manner Any given activity is broken down into its simplest components Patient perform these specific motion in the form of graded exercises These activity itself is practised in a real life situation 1 May 2012 4

Purpose :

Purpose ADL evaluations help practitioners determine how independent patients are and what skills they can accomplish on their own how independent each individual can become after intervention by a health professional The purpose of an ADL program is to train to optimally perform with the limit of physical disabilies 1 May 2012 5

Goal :

Goal The goal of practitioners performing ADL evaluations is to help patients become as independent as possible, using appropriate adaptations if needed 1 May 2012 6

Description:

Description Many ADL indexes such as the Katz Index and the Barthel Index are typically use to evaluate patients on their self-care skills and rate each individual according to how functional they are Scoring is based on how independently a task can be performed and whether supervision or assistance is needed in performing the task. 1 May 2012 7

Basic ADL :

Basic ADL Basic activities of daily living are those skills needed in typical daily self care consist of bathing, dressing, feeding, and toileting etc 1 May 2012 8

Instrumental ADL:

Instrumental ADL Instrumental activities of daily living refer to skills beyond basic self care that evaluate how individuals function within their homes, workplaces, and social environments Instrumental ADLs may include typical domestic tasks, such as driving, cleaning, cooking, and shopping, as well as other less physically demanding tasks such as operating electronic appliances and handling budgets 1 May 2012 9

PowerPoint Presentation:

In the work environment, an ADL evaluation assesses the qualities necessary to perform a job, such as strength, endurance, manual dexterity, and pain management . 1 May 2012 10

Complications:

Complications Returning a client to full meaningful function can be problematic for individuals physical and occupation therapists are trained to evaluate not only the physical disability or dysfunction of an individual, but also the person's mental health and well-being 1 May 2012 11

ADL GROUPING:

ADL GROUPING Bed side activities Wheelchair activities Self care activities Miscellaneous hand activities Ambulation Elevation Travelling management of environment control devices communication 1 May 2012 12

Activity Grading:

Activity Grading Independent Need assistance Needs to lifted to perform the activity Dependent Activity contraindicated 1 May 2012 13

FIM Scale:

FIM Scale 7 Independent 6 Modified Independent 5 Supervision/Set-up 4 Minimal Assistance 3 Moderate Assistance 2 Maximal Assistance 1 Total Assistance 1 May 2012 14

Bedside Activities:

Bedside Activities Changing position: rolling , moving to the sitting position Maintaining the sitting balance while moving the trunk and arm in all direction Covering oneself with bed sheet Reaching out to the side table and manipulating object 1 May 2012 15

Wheelchair Activities:

Wheelchair Activities Wheelchair transfer to bed , chair , bathtub or toilet Wheelchair management Maintenance of wheelchair 1 May 2012 16

Personal Care:

Personal Care Self care activities Personal hygiene Personal image Attending to toilet need Dressing activities Eating activities 1 May 2012 17

Miscellaneous Hand Activities:

Miscellaneous Hand Activities Handling the telephone , signal buttons , coin Using eyeglasses , watch , light etc from various position Fine motor skill 1 May 2012 18

Ambulation :

Ambulation With in the home Out of door on different ground surfaces 1 May 2012 19

Elevation Activities:

Elevation Activities Standing up and sitting down from wheelchair, bed ,toilet seat or car Climbing activities – staircase ,steps 1 May 2012 20

Travelling :

Travelling Learning to drive and maintain a two wheeler or car, use of garage, and practice to get in and out of the vehicle Use of public transportation like a taxi or bus 1 May 2012 21

Environmental Control System:

Environmental Control System ECU is defined as , a mean to purposefully manipulate and interact with the environment by alternately accessing one or more electrical devices via switches ,voice activation ,remote control ,computer interface and other technologic adaptations The purpose of the ECU is to maximize functional ability and independence 1 May 2012 22

Communication :

Communication The ability to write, operate a personal computer, read ,type or use the telephone , a tape recorder , or special communication device 1 May 2012 23

Transfers :

Transfers Tub or shower Toilet Wheelchair Bed and chair Ambulation Car 1 May 2012 24

ADL Training:

ADL Training The training program may be graded by beginning with a few simple tasks and gradually increasing their number and complexity The method of teaching must be tailored to suit each patients learning style and ability Before beginning training in any ADL the therapist must begin by providing adequate space and arrange equipment Architectural barriers must be removed Performance is modified and corrected as needed 1 May 2012 25

Minimum Criteria for dressing training:

Minimum Criteria for dressing training Upper limb: The neck has to be stable on the shoulder girdle The muscle strength should be 3/5 or 4/5 The ROM of shoulder must be at 0-90º of flexion / abduction 0-30º of Medial/lateral rotation 15-140º of elbow flexion Sitting balance with or without support in bed and wheelchair 1 May 2012 26

PowerPoint Presentation:

Lower limb Muscle strength 3/5 to 4/5 in upper limb The extent of movement at the knee and hip must permit the person to sit with leg fully stretched and reach out of his calf Body control 1 May 2012 27

Problems encountered during ADL training:

Problems encountered during ADL training Breathing ability Pressure sore Non cooperation of patient Pain in neck or trunk that persist when attempting training 1 May 2012 28

Type of clothing recommended :

Type of clothing recommended Clothing should be loose fitting Zipper or velcro fastener are preferred to buttons Socks without elastic cuffs should be used Shoes should be carefully selected so as to provide foot stability during patient transfer 1 May 2012 29

Environmental Adaptation:

Environmental Adaptation 1 May 2012 30

Hygiene and Grooming :

Hygiene and Grooming A brush with grip is used for bathing A long handled bath brush A position adjustable hair dryer A long handled toothbrush , lipstick or razor Dressing sticks to enable the person to pull on clothes 1 May 2012 31

Communication and environmental hardware adaptation:

Communication and environmental hardware adaptation Adaptation to the computer and keyboard Telephones should be placed within easy reach Built up pens and pencils with easier grip Electric feather touch typewriters and modified keyboards 1 May 2012 32

PowerPoint Presentation:

1 May 2012 33

Mobility and Transfer:

Mobility and Transfer Modified wheelchairs Gutter crutches Enlarged grips for crutches A raised toilet seat Walker or crutches with padded grips 1 May 2012 34

Some Home Management :

Some Home Management Store frequently used items on the lower shelves of the cabinet Use a high stool Use a reacher to get items lower kitchen counters for easier access to wheelchair-bound individuals Stabilize mixing bowls and dishes Use lightweight utensils 1 May 2012 35

Health care team roles:

Health care team roles Physical therapists and occupational therapists are the two primary disciplines most qualified to assess ADL function and recommend the appropriate intervention and modifications in one's home and work environment 1 May 2012 36

Reference :

Reference Textbook of rehabilitation by “sunder” Physical rehabilitation assessment and rehabilitation by “sullivan” Google search 1 May 2012 37

PowerPoint Presentation:

THANK YOU

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