Week 7 Physical Rehabilitation Final Presnetation Copy

8/12/2019 Week 7 Physical Rehabilitation Final Presnetation Copy

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Curtin School of Occupational Therapy and Social Work

OT 242/ OT 542

Physical Rehabilitation:

Pallative Care and OT

John Harmsen with thanks to Sharon Keesing





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Lecture Unit Outcome

Unit Outcome 1 (from your unit outline)

Assess the impact of known conditions on

occupational performance, CLO1, T4.





Dr Seuss for today from “Did I ever tell you

how lucky you are”





Common condition for OT’s working in

pallative careCancer

Disordered and uncontrolled growth of cells within an

organ or tissue.

Left untreated, they grow steadily and result in a mass,

tumour

Benign or malignant





What is cancer?

Malignant cells proliferate and sometimes spread to other

sites in the body (metastases)

May be treated and cured or progress to palliation





Types

Classified according to the tissues and cells where they

originate

Haematological cancers

Oncological cancers





Haematological cancers

Leukaemia

Lymphoma

Myeloma





Oncological cancers

Lung

Breast

Gastrointestinal

- bowel

- stomach

- liver

Prostate





Oncological cancers

Skin

- basal cell carcinoma

- squamous cell carcinoma

- melanoma

Gynaecological

Urinary

Brain





Oncological cancers

Testicular

Head and neck

Soft tissue, bone

Cancers from an unknown primary





Signs and symptoms

Many and varied

Silent





10 most commonly diagnosed cancers

Australian Institute of Health and Welfare, 2011





Treatment and side effects

Surgery

Radiotherapy

Chemotherapy

Hormone therapy

Steroids

Bone marrow transplant

Stem cell transplant





Treatment and side effects

Allied health

Alternative therapies

Complementary therapies

Supportive care





OT role

‘Enable the person to participate in

meaningful occupation and chosen

roles regardless of prognosis’.





Rehabilitation Stages (Dietz,1981)

Preventative – anticipation of potential disability tolessen severity

Restorative – return to pre-morbid status without

significant handicap Supportive – support through decline of progressive

but stabilised disease to remain as functional aspossible & retaining an element of choice & control

Palliative – assist in symptom control & in advancedstages preventing complications through positioning,pressure care & prevention of contractures.





Not restoration to a former condition & status but ‘ a

recomposition of life’ using the OT process to help to

build the client’s life to a manageable level

(Unknown Author and Source)

30.07.2010Footer text - slideshow title





Assessment

Consider the context

COPM

MBI, FIM

Specialised sensory/motor screening

Cognitive screening





Interventions

Person Environment Occupation





Occupation

How can I assist the person to carry out their chosen

activities within the limits of their illness?

How might this change over time/progression of

illness/treatment?





Functional Issues

Self maintenance – impaired independence in ADLs

Productivity – loss of role/ personal satisfaction

Leisure – Participation

Sensory skills – pressure problems, pain, shortness ofbreath, balance, co-ordination & safety

Cognitive – memory, concentration, problem solving,

coping

Inter-personal - communication / relationships

Intra-personal – Anxiety, depression, denial





Fatigue

‘A persistent, subjective sense

of tiredness related to cancer

that or cancer treatment that interferes with usual

functioning’ (Mock, et al 2004)

One of the most prevalent symptoms reported by people

with cancer

One of the most common side effects of chemotherapy





Management strategies

Medical review

Self monitoring

Energy conservation

Distraction

Stress management

Exercise

Nutrition

Sleep






Budgeting energy

(deposits V withdrawals)

Activity records

Prioritise

Plan

Positioning

Pacing





Lymphoedema

www.jacksonvillelymphcl

inic.com






pain and swelling, infection

ROM

strain and muscles and joints

function

Education






Compression garments

Self management strategies

Complex lymphatic bandaging

-massage

bandaging





Stress and Anxiety

Normal sensation and response

Only a problem when it interferes with our

ability to function on a day to day basis

For people with cancer,

anxiety is a real threat (terminal illness)






Many and varied

Relaxation techniques

Problem solving strategies

Distraction (occupation?)

Cognitive approaches





Pressure care and comfort

Pain and other symptoms will impact person

Positioning, transfers, mobility, ADL/IADL, leisure,

productive roles

Provision of equipment and environmental modifications

Occupat ion





Palliative care

Prognosis and illness trajectories

Access and referral

A good death

Carers





Role of carers

Impact on lives of carers, may experience their own

occupational disruption

Value of contributions largely unrecognised

Significant part of rehab process





Support and Resources

Cancer Council (Australia)

- Breast Cancer support

- Prostate Cancer support

Health Department

- WA Cancer and palliative care network





Taking care of yourself





Acknowledgements

Kellie Blyth, Senior Occupational Therapist

SCGH

Hilary Palladino, Senior Occupational Therapist, SCGH

Sharon Keesing, Curtin University School of OT and SW





Resources

http://www.dyingmatters.org/

http://www.cancer.org.au/home.htm

http://www.palliativecare.org.au/











References

Australian Institute of Health and Welfare (2011) . The 10 most commonly

diagnosed cancers in Australia, 2007; The 10 most common causes of death

from cancer in Australia, 2007 Retrieved from: http://www.aihw.gov.au/cancer/

Dietz, J. H. (1981). Rehabilitation Oncology . New York: John Wiley

Mock, V (2003). Cancer related fatigue. In Evidence based cancer care and

prevention. Given, C, Given, B, champion, V, Kozachik, S & DeVoss, D. (Eds).

New York, Springer.

http://www.aihw.gov.au/cancer/

http://www.aihw.gov.au/cancer/

Week 7 Physical Rehabilitation Final Presnetation Copy

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