INTERVENTIONS
Home Modification
A large amount of our time is spent inside our homes, so ensuring that they are accessible to us is essential. After injury, there may be aspects of the home that previously were fine, now present an issue. This is where the intervention of home modification comes into practice. Home modification involves an occupational therapist entering a home and helping the client modify it so that it accommodates their impairments. The goal of home modification is to prevent the home from disabling the client. Home modifications are unique to the individualized needs of the client. Home medications can include swapping a bathtub for a curdles shower to accommodate for a wheelchair, or even much more simple changes like removing a rug that could be a tripping hazard for someone with a high falls risk.
In order to carry out home modifications, the OT must be competent in problem solving and be aware of what current home modifications are available for different impairments. The OT should have good rapport with the client so that they can openly discuss their needs. OTs in this role might also help with funding and finding resources for the client. Home modification is a great tool to have because it emphasizes change in the environment, not the person. It helps drive home that sometimes disability is created by our surroundings, it does not live within ourselves. Although home modifications are typically thought of as needed after some sort of physical injury, determinants can come from any of the other drawers; home modification ties together many aspects of a clients life.
Some commonly needed modifications include:
bathroom grab bars near the toilet and in the shower or the tub;
railings on both sides of a stairway, if possible;
widening of door frames for greater access to common areas such as bathrooms kitchens,
and bedrooms; and
repair and removal of structural barriers such as inadequate flooring, uneven transitions
between flooring surface, and other non-structural barriers such as furniture.
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Adjusting and Adapting Computer Workstations
A properly adjusted workstation allows for the client to adopt a natural and comfortable posture. Refer to the attacked Ergonomics Checklist for more information.
Driving
From the driving assessment findings, the occupational therapist may recommend interventions and training to help facilitate access to the vehicle, driving or delay driving cessation, further assessment to clarify the level of risk and ability to drive or to continue driving, or driving cessation.
Depending on qualifications, OTs can intervene by:
Educating the client and or family (Generalist)
Provide domain specific training ( Generalist & Advanced)
Prescribe access/ transfer equipment (Generalist & Advanced)
Prescribe adaptive equipment ( Advanced & Advanced Specialist)
Referrals to Community Services & Supports
For older adults and other clients with disabilities, they may experience issues related to community mobility and transportation and cooking meals or grocery shopping. A significant challenge or barrier is that some home supports are not publicly-funded. There, an intervention can be providing clients with lists or information of appropriate services in the community or directly helping them to access these services to help them function better in the community. Meal delivery services such as meals on wheels can be suggested to clients who are having difficulty with cooking meals. If clients are having difficulty with getting groceries, I could provide them with a list of numbers and resources they could contact to have this service provided to them. These are definitely services that I would recommend to future clients. One of the main community supports and services that can be used as an environmental intervention for clients living in Kingston is getting them registered with the Kingston Access Bus (KAB). This is a bus service for individuals living with a disability that can pick individuals up from their place of living or desired location and drop them off in order to facilitate participation in the community. The bus can be used for transportation to appointments, running errands, or going where they need to in the community and is much more cost efficient than a taxi service. The application form needs to be filled out by a health professional, and OTs are qualified to do this. As an OT in future practice I would use this intervention and refer future clients to the access bus if they were having difficulties with community mobility or transportation. There are a few disadvantages of the access bus however, as there is very specific criteria that individuals have to meet to qualify for the access bus and due to a high volume of users, the bus has to be scheduled far in advance at times.