The most prevalent occupational therapy interventions utilized in my fieldwork IIB have to be energy conservation, adaptive equipment. Many of the geriatric patients occupational therapists treat suffer from a variety of neurological disorders, general weakness, decreased strength and ROM which all impact occupational performance. The common denominator the patients share is typically fatigue.
The patients I interact with in the ICU's, neurological unit, ortho, observation and/or med surgery all have the above deficits in common. We are constantly assessing the need for AE and issuing the equipment. An occupational therapist and researcher by the name of Mathiowetz is on the forefront regarding energy conservation efficacy. He and a team of researchers implemented and energy conservation course for those suffering from fatigue with positive results. According to Mathiowetz et al., (2007), “fatigue is a “subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with the usual and desired activities.” Furthermore, Mathiowetz et al., (2007), “defines energy conservation principles as commonsense ideas to improve task efficiency and reduce energy expenditure during all occupational performance tasks.” Energy conservation is a prevalent intervention in the acute setting. We don't have time to apply modalities, perform massage or make splints. We have a short amount of time to educate patients on how to be safe with ADL's because they often discharge within 2-3 days depending upon diagnosis. Furthermore, according to Hagsten et al., (2004), “Patients who receive individualized training and adaptive equipment are able to complete self care tasks more efficiently than those who do not.” When treating clients in this setting (acute) with fatigue and comorbidities including decreased ROM and strength, providing adaptive equipment and accurate education is imperative.
Overall, energy conservation instruction and the issuance of assistive equipment is a huge part of acute intervention. Our plan of care also includes ideal positioning and HEP programs that promote function. It would be nice to implement more interventions, but as I stated, it can be difficult in the acute setting. A lot of our therapists work a day in outpatient to keep their skills including interventions relevant.
References
Hagsten, B., Svensson, O., &Gardulf, A. (2004). Early individualized postoperative
occupational therapy training in 100 patients improves ADL after hip fracture: A
randomized trial. AOTA Orthop Scand, 75(2), 177-183.
Mathiowetz, et al., (2007). One Year Follow up to a Randomized Controlled Trial of an Energy
Conservation Course for Persons with Multiple Sclerosis. International Journal of Rehabilitation
Research, 30: 305-313.