Deliver care


Four step process to providing rehabilitation care - Deliver care


Delivering IADL interventions to address personal and environmental factors

After a plan has been developed with the person, the rehabilitation interventions are then delivered. These interventions should be linked to the assessment findings and the plan. A person may not need all the suggested interventions listed below; only the interventions relevant to them should be provided. This is also not an exhaustive list of all the interventions that may be helpful to a person- it is also useful to problem solve with the person and find solutions with them.


Doing household chores

Personal

  1. Provide the person with training on how to practice components of the tasks for household chores such as cooking, cleaning, laundry, and gardening 
  2. Educate and advise the person on safety considerations (e.g. when using the stove) 
  3. Educate and advise the person on energy conservation (e.g. prioritizing, planning ahead, pacing themselves, and positioning) 
  4. Educate and advise the person on energy conservation and to modify certain household chores activities such as:

  • Prioritize, plan ahead and pace themselves
  • Rest between tasks, and break down large tasks into smaller steps 
  • Eliminate unnecessary tasks (such as drying dishes or ironing) 
  • Carry out tasks while seated when possible 
  • Alternate between heavy and light tasks 
  • Simplify meal preparation (e.g. using pre-cut or frozen meals, batch cooking and use of electric appliances) 
  • Use a meal delivery service if able 


Environmental

  1. Advise the person how they may adapt their environment, such as:

  • Relocate items for easy access 
  • Clearly label or mark items, such as food and ingredients, for a person with visual or cognitive impairment 
  • Improve lighting and use colour contrast (e.g. using a high visibility tape to mark steps in the house), for a person with visual impairment 
  • Remove trip hazards from around the house, such as loose rugs, clutter, or cords on the floor
  • Move heavy cooking objects by sliding them along tabletop, rather than picking them up, to avoid heavy lifting  

  1. Facilitate the provision and installation of assistive products, and provide training in their use. Common assistive products for household chores include:

  • Use long-handed reacher to minimize bending and reaching, such as when cleaning
  • One-handed cutting equipment 
  • Non-slip material to open jars  

 

Taking medication

Personal

  1. Provide the person with training on how to use memory strategies to recall when/which medication is to be taken 
  2. Provide the person with training on how to facilitate the administration of medication e.g. sitting upright with chin tuck for easy swallowing

Environmental

  1. Educate and advice the person to adapt the environment through activities such as:

  • Place pills where they are visible and accessible to reach to help the person remember to take them 
  • Make medication for those with visual impairment easily identifiable (e.g. clearly mark or label medication, place each medication in a different shaped container) 

  1. Facilitate the provision and installation of assistive products such as:

  • Alarms or reminders on mobile phone 
  • Simple memory supports 
  • Pill organizer 

 

Using telephone

Personal

  1. Work with the person on practicing

  • Dialing and answering the telephone  or sending a text message
  • typical greetings and conversation etiquette 

  1. Offer education and advice on how to use a telephone or mobile phone device 
  2. Educate and advise the person to modify certain activities surrounding using the telephone such as:

  • Use text messaging, rather than an audio call, for a person with a hearing or speech impairment 
  • Use speaker phone or headphones rather than holding the phone to the ear 

Environmental

  1. Advise the person on how to adapt the environment through activities such as:

  • Place a list of key phone numbers next to the telephone (e.g. number of family members, doctor, and emergency services) 
  • Use a phone that is easier to manipulate (e.g. use a phone with enlarged buttons, hands free or voice-activated phone) 

  1. Facilitate the provision and installation of assistive products such as:

  • Text telephone or telecommunication devices, for a person with a hearing or speech impairment 
  • Alarm signallers, for persons with vision impairment 
  • Smart phone with accessibility functions 


Managing personal finances

Personal

  1. Provide training for components of managing finances, e.g. in-hand manipulation of money and cards
  2. Educate and advise the person on:

  • bill reading and comprehension 

  1. Educate and advice the person to modify certain activities such as using computer banking and direct debits where possible to reduce the need to remember transactions and count money


Environmental

  1. Advise the person on how to adapt their environment through a basic written system to track spending
  2. Facilitate the provision and installation of assistive products such as:

  • Simple memory supports
  • Magnifiers 
  • Reading glasses 

 

Using transportation

Personal

  1. Provide training for the person on practicing:

  • steps in taking public transport 
  • identifying bus routes and times 

  1. Educate and advice the person to modify certain activities such as:

  • Use public transport at times when it is less busy 
  • Choose a route that has accessible stations 
  • Avoid driving at night or when it is raining 

 

Environmental

  1. Facilitate the provision and installation of assistive products such as:

  • White canes

 

Shopping

Personal

  1. Provide training for the person on practicing the steps of a purchase transaction
  2. Educate and advise the person to modify certain activities such as:

  • Write a shopping list, organized by aisle or section of the store 
  • Transport shopping items in a wheeled cart rather than basket 
  • Shop during quiet periods, to avoid crowds 
  • Use online shopping or shopping delivery services 

 

Environmental

  1. Facilitate the provision and installation of assistive products such as simple memory supports


 

Remember to follow the three steps of

    1. Explaining the intervention to the person
    2. Demonstrating the intervention and
    3. Letting the person practice the intervention in your presence to ensure safe home implementation


Note: 

Use the BORG scale to determine whether the practice is at an appropriate intensity




Question

Remember Tevita

Tevita using a wheeled cart

Tevita using a mobile phone with phone numbers at the back

The health professional worked with Tevita to develop a plan of rehabilitation interventions for her IADLs. In delivering the interventions, the health professional did the following:

  1. Educate and advice Tevita on energy conservation (e.g. using a wheeled cart during household chores)
  2. Provide training for the person on practicing steps in taking public transport 
  3. Place a list of key phone numbers next to the telephone (e.g. number of family members, doctor, and emergency services) 
  4. Provide training for the person on practicing sequence of tasks to dial and answer the telephone 

Three days later, Tevita returns and complains that she still cannot remember the items she needs to purchase and is unable to carry her shopping items.


  1. Why do you think Tevita is still unable to perform activities surrounding shopping?

The health professional did not include rehabilitation interventions for shopping into Tevita’s plan

  1. What specific interventions targeting Tevita’s complaints can be instituted to assist her engage in IADLs?

Educate and advice Tevita to modify her shopping activities such as:

  • Write a shopping list, organized by aisle or section of the store 
  • Transport shopping items in a shopping cart rather than a basket
  • Use online shopping or shopping delivery services 


Last modified: Thursday, 24 March 2022, 12:19 PM