Plan
Previous Topic
Planning how to deliver rehabilitation interventions for ADLs follows the assessment and is based on the information gathered.
Recall the three steps outlined in the ‘Introduction to Rehabilitation’ and ‘Introduction to Self-Care’ modules for planning rehabilitation interventions:
- Set a rehabilitation goal
- Select the right intervention
- Support where needed with a referral to additional services
Do not forget the factors to consider when selecting the right self-care intervention and dosage.
Apply these factors to ADLs as shown below:
- Identify the ADLs that work for the person.
For example, asking a person who has difficulty with dressing to practice buttoning clothes may not work for that person if they do not have any or are not used to wearing clothes with buttons. Similarly, if the person has a habit of eating with their fingers, it will be more appropriate to practice eating with fingers instead of using cutlery.
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Identify the elements in the person’s environment that can be used or modified to improve ADLs
For example, the handle of a cup or spoon can be modified by wrapping a piece of bandage around it to improve grip for feeding. Also, if the person cannot afford or does not have access to incontinence pads or liners for bladder and bowel management, a cotton cloth can be washed and folded to use.
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Consider how to make assistive products available to the person
Find out if, for example, there are government or non-governmental funds to support rehabilitation services and the purchase of assistive products such as toilet and shower chairs.
Refer to the assistive products module for indications and how to select, fit and use these assistive products.
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Identify the right pharmacological agents, when relevant and if it is within your usual scope of practice.
Examples of pharmacological agents for ADLs include anticholinergics and laxatives for bowel and bladder difficulties.
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Consider how to fit the ADL interventions into the person’s schedule.
For example, if the person finds that practising bathing is best done in the evenings, it is best not to make a plan for practising in the mornings.
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Consider the most appropriate frequency and duration for carrying out the activities of daily living interventions.
Remember to:
- Find a quiet place to avoid distractions
- Involve caregivers or family members when appropriate
- Try to give education and advice using words that align with the person’s level of health literacy
Question
Remember Tevita?
Tevita has had an assessment for self-care difficulties and set goals for her rehabilitation. During the assessment, additional information was obtained by the health professional which included the fact that Tevita’s friend visits every afternoon for tea and to chat with her. There are also some government funds to cover some assistive products but a letter has to be written by the health professional. The health professional also noted that Tevita takes her bath in the mornings and the evenings, she loves to eat with only a spoon and her hands and because her hair is short, she only uses a comb and not a brush to tidy it.
Select all that apply.
- a. Work with Tevita to practice combing her hair every afternoon
- b. Involve Tevita’s friend in assisting her to take a bath during the afternoons when she visits
- c. Work with Tevita to practice eating with a spoon daily
- d. Ask Tevita not to bother brushing her hair since she is frail and her hands usually shake
- e. Write a letter for Tevita to access the funds for a shower chair
If you selected ‘a’, ’b’ and ‘d’ you are correct . Tevita’s daily schedule involves having her bath in the mornings and evenings while her friend visits in the afternoons for tea and chatting. It will therefore not be advisable to ask Tevita to take another bath in the afternoons. Tevita can be taught how to practice combing her hair but this can be done in the mornings or evenings and not the afternoon when she has a visitor.
