discussion post
If an OT wants to evaluate the basic living skills and make living recommendations that promote safety for a patient with an acquired brain injury recently admitted to the hospital, which assessment tool would you recommend they use?
KELS
If an individual scored 20 out of 30 points on the Mini-mental what would their level of severity be? What would be the next step for the OT to take after determining the level of severity for this client?
mild cognitive impairment
Michelle is a 65-year-old retired medical assistant. She lives with her husband, Joe, of 40 years in a 2-story farmhouse in northeastern Montana. Recently, Michelle's husband has been nervous about how forgetful Michelle has been with daily tasks. She has been forgetting things such as turning off the stove after making a meal and leaving her curling iron on after getting ready in the mornings. Joe is starting to have safety concerns for his wife while he is gone during the day at his own job. Joe decides to make an appointment with Michelle's primary care physician to voice his concerns. During the appointment, a referral to occupational therapy is made for a mini-mental state examination (MMSE) to be taken on Michelle. During the assessment, the OT tallies a final score of 23 for Michelle. Based on the scoring results of the MMSE, what is the interpretation of Michelle's 23/30 points? A.) Normal B.) Severe Cognitive Impairment C.) Mild Cognitive Impairment D.) Decreased odds of Dementia
mild cognitive impairment - given documents
Carol is an 80-year-old woman who is living in a nursing home. Her caretakers have noticed that she is struggling with memory and has been having a few more behaviors at night. Her family has stated that dementia runs in their family. Which assessment would be appropriate to use for Carol? Mini-Mental PEDI COPM KELS
mini mental
John is a 53 year old man with a college education. Lately he has been having trouble remembering to do small tasks around the house such as turning the stove off and putting his dishes away. His wife has also noticed he has been getting lost and forgetting the routes to many familiar places. She worries about his memory. What assessment would be best for us to use to assess John's cognition and memory?
mini mental
The KELS evaluations tests 17 skills in 5 different domain areas. Which of the following is NOT included in the KELS domain? A) leisure participation B) employment C) self-care D) motor skills E) money management
motor skills
Brandi was admitted to your facility after a right sided stroke. To make a recommendation for Brandi's ability to return home, you use Section GG to determine her independence levels. For showering/bathing, Brandi was able to wash her legs, feet, torso, and left upper extremity. She needed assistance with washing her right upper extremity. What code would you use for Brandi's showering/bathing score?
partial/moderate assistance
Steve scored a 55 on the Barthel Index. What does this indicate? 0 to 15 - totally dependent 20 to 35 - very dependent 40 to 55 - partially dependent 60 to 75 - minimally dependent 80 to 100 - totally independent
partially dependent
If Robert is a 45-year-old male diagnosed with anxiety and panic disorder. Robert was evaluated by two OTs in the San Diego Area. Through interview format, the COPM was administered. He addressed 5 problem areas on the COPM in areas of personal care, household management, paid and unpaid work, quiet recreation, and socialization. In areas of Performance Robert scored himself as: personal care: 6 household management: 5 paid and unpaid work: 6 quiet recreation: 6 socialization: 4 In areas of Satisfaction rankings, Robert scored himself as: personal care: 4 household management: 3 paid and unpaid work: 5 quiet recreation: 4 socialization: 3 COPM - assessment PDF more-1.pdf Download COPM - assessment PDF more-1.pdf What was the average performance score? What was the average satisfaction score?
the average performance score was: 5.4 the average satisfaction core was: 3.8
An OT client mentioned she has been having problems with memory at work and at home. The OT decided to administer the SLUMS assessment. The client scored 18 on this examination. What does this score mean on the SLUMS assessment and what should the OT's next steps be regarding this client?
A score of 18 indicates that the client might have dementia. It does not matter whether she has a high school education or not as the criteria indicates dementia in either case. An OT should refer the client to a doctor or neurologist who can look at the client in more detail. The OT could help provide information on her possible diagnosis as well as provide some tips for helping her remember things.
You are an OT at an outpatient clinic; a 5-year-old child just got a referral as she struggles with self-care. You need to gather further information about what specific self-care tasks she is struggling with- What assessment tool would be the best to use?
ANSWER: PEDI would be the best assessment tool to use as the client is 5 years old. The PEDI is used for children 6 mo. to 7.5 years old. This assessment will help the OT learn what specific self-care tasks the client is struggling with.
You received an order for outpatient OT to assess fine motor skills with Sally. Upon health history and interview, parents have concerns with coloring and using a spoon and fork. Eval date is 9-3-2022 and the birth date is 04-30-2017. Because of her hand skills and fine motor difficulties, as well as her age, you choose to use the PEABODY DEVELOPMENTAL MOTOR SCALES 2nd edition (PDMS-2). What month would you start and what domain would you use?
Answer: Chronological age: 5 years 4 months 3 days = 64 months starting month You would use object manipulation and grasping because she is having issues with holding a crayon and probably a pencil and holding utensils. If she is having difficulty holding an item she will have difficulty manipulating items in her hand.
you are assessing a patient who suffered a mild stroke 3 weeks prior to the evaluation. After deciding to use the Stroke Quality of Life assessment tool (SSQOL), you have the patient complete all subcategories involved with the assessment. The patient receives a final score of 215. Using the SSQOL scale determine what this score means to the patient and to you as the therapist.
Answer: Due to the maximum score of the SSQOL assessment being 245 and the minimum score being 49, a score of 215 would indicate that the patient's overall quality of life is good. The higher they score the better their quality of life is considered compared to a lower score indicating their quality of life may be deteriorating.
John, a 70-year-old male is in inpatient rehab recovering from a stroke. He is eager to go home to his wife. The occupational therapist on John's team administered the Barthel Index. He can walk independently, but he uses a cane at all times. What would John score in mobility on the Barthel Index?
Answer: John's score is 15. He is independent in this category, and the cane has no effect on his scoring.
Larry is a 74 year old retired farmer and former veteran who finished high school but never went to college. He has noticed recently that he is getting lost on his way to the store and and has been making mathematical mistakes when paying the bills. His wife mentioned that she now drives him to appointments and takes care of the finances. She has found that he is often confused and needs prompting to carry out tasks he used to do on his own such as mowing the lawn. You decide to administer the SLUMS exam and Larry scores a 21. What does this score mean and what recommendations would you give Larry based on his score?
Answer: Larry's score of a 21 on the SLUMS exam puts him in the range for a possible mild neurocognitive disorder. Some appropriate recommendations for Larry would include further assessment, an in home evaluation, and a follow up with his general practitioner.
Sarah is a 10-year-old girl seen in outpatient OT. She is having problems brushing her teeth. What specific area of the COPM is she having problems with? What does this mean if she rated her performance as 2 and satisfaction as 1?
Answer: Sarah is having difficulties in the self-care section, specifically personal care occupations. She rated her performance as a 2 and satisfaction as a 1. Her performance means that she is not able to do this task very well. Her satisfaction means that she is not satisfied at all with how she is brushing her teeth.
Samantha is a three-year-old girl who has a diagnosis of down syndrome. Her chronological age is three years, one month, and one day. Her parents report that she struggles to feed herself, get dressed, and brush her hair and teeth. The occupational therapist interviews Samantha's mom and completes the self-care domain for the functional skills, caregiver assistance, and modifications portions of the PEDI assessment. Her raw score for the self-care functional skills section was 14. Using the age-appropriate chart, what is her normative standard score? Then, using the score profile, how many standard deviations above or below the mean is she? Score Chart and Score Profile Documents:
Answer: Using the correct age-appropriate chart (3 years - 3 years 5 months and 30 days), her normative standard score would be 15.8. After plotting this number on the score profile, she would be approximately 3.5 standard deviations below the mean of her peers in self-care functional skills.
Mr. Schmitt is a 63 year old male with a diagnosis of a Right CVA, you choose to use the Barthel Index to see what Mr. Schmitt can do in the domains of ADLs to establish a degree of independence from any help. After interviewing him and observing him, he scores a 45. What does a score of 45 mean?
Based on Mr. Schmitt's score of 45 on the Barthel index it does mean that he is partial dependent. This means he needs some assistance with some of the ADL tasks on the Barthel, but also has some level of independence.
Linda is 65 years old and feels as though she has lost some of her sense of purpose after going through chemotherapy treatments. Additionally, she's having a difficult time finding activities she enjoys as many she used to enjoy have now become occupational problems in her life. What assessment tool would you use to help increase her sense of purpose and find activities that are meaningful to her? Why would you use this tool? KELSCOPMPEDICMOP-E
COPM
Susan is a 36-year-old woman who is supported by her three kids and husband. She works as a dentist and often feels overwhelmed and stressed with her schedule as it is taking away from family time and overall time for herself. Susan has experienced an occpational imbalance within her roles and especially in the areas of self care, productivity, and leisure. What assessment would be appropriate to use for Susan? a) Slums b) COPM c) Mini Mental d) PEDI
COPM
Sally is 5 years 6 months old and currently attends Kindergarten. Sally's mom is seeking OT evaluation for Sally after her teacher noticed that Sally was struggling with her handwriting and falling down frequently, especially in gym class. Sally's mom has noticed that she seems to be uncoordinated at home, but was unsure if that was normal for her age. The doctor suggested an evaluation. Based on this information, which assessment tool would be the most appropriate for evaluating Sally? A. PEDI B. PDMS-II C. BOT-2 D. COPM
I would use the B) PDMS-II to assess both fine and gross motor skills of Sally, she is also still in the age range for this assessment to be used.
Bob is a 68-year-old man who recently got admitted to the hospital due to a fall. He hit his head during the fall so he is having issues with most of his occupations. Bob wants to return home but the therapist doesn't think his living environment would be the safest for him. What assessment would you use to help match Bob's environment in which success can be experienced, thereby increasing satisfaction, motivation, and a sense of independence?
KELS to evaluate Bob's independence and safety in his home environment especially if he would like to return home.
You are administering the SLUMS examination to Maggie, a 78 year old woman suspected to have dementia. You ask her question #5: You have $100 and you go to the store and buy a dozen apples for $3 and a tricycle for $20. How much did you spend? (1 point) How much do you have left? (2 points). Maggie answers $22 for "how much did you spend?" and answers $88 for "how much do you have left?" How would you score Maggie on this question? A) 1 out of 3 B) 2 out of 3 C) 1.5 out of 3 D) 3 out of 3
Rationale: A) 1 out of 3. Even though Maggie calculated "how much did you spend?" incorrectly, since she did the math "how much do you have left" properly. She scored 0 out of 1 points for "how much did you spend" and 1 out of 2 points for "how much do you have left".
Steve is a 56 year old male with a diagnosis of Motor Neuron disease. Steve lives with his wife, who is his primary caregiver. He was working as a mechanic until his diagnosis due to the rigidity and lack of control of his hands. He was referred to Occupational Therapy to become more independent in eating and looking for adaptive equipment to help with his daily activities. While administering the Barthel Index, Steve said he needs some help, but can do some things alone in the category of "Toilet Use". What score did he receive in this category? GIVEN HANDOUT
Score of 5
Brett is a 5-year-old boy in kindergarten who has limited functional abilities regarding self-care and ADL's. These include struggling with brushing his teeth, zipping his jackets/pants, and tying his shoes independently. What assessment tool would help assess self-care, mobility, and social function to measure the capability and performance of Brett?
The PEDI measures self care, mobility, and social function and is able to be used for children ages 6 months to 7.5 years old so this would be a good assessment to use with Brett.
What does the Pediatric Evaluation of Disability Inventory (PEDI) measure and what is the age range children have to fall into to use this assessment tool?
The PEDI measures self care, mobility, and social function. The age range that children have to fall into to use this assessment is 6 months to 7.5 years old.
Why would a therapist want to do multiple assessments for one child? For example, an interview based assessment like the PEDI alongside the BOT-2 which is action/observation based.
The answer would be to gain a full understanding of the child. There are strengths and weaknesses to an observation based assessment and interview based assessments so having both will give us a better picture of the child. Interviewing the parent might lead to some bias so having the proof that the child can or cant perform certain tasks is always beneficial.
Joe is a 64 year old male who presented with right sided paralysis. Joe explained that he struggles with things related to work/productivity, personality, language, and upper extremity functioning. Which assessment tool might assist the occupational therapist in learning more about Joe's self reported domains that impact his life?
The best assessment tool that would fit this case scenario is the Stroke Specific Quality of Life.
Brady is a 54-year-old man who was referred to start seeing OT based on the stroke he recently had. Brady was diagnosed with a left hemisphere stroke in the cerebrum. He lives with his wife and has two children who live in the same town as him. They visit him on a regular basis for family dinners. Brady was completely independent in all daily activities before his stroke. After Brady was referred to OT, the Stroke Specific Quality of Life assessment was given to him. These were his results in Language.... 1. Did you have trouble speaking? For example, get stuck, stutter, stammer, or slur your words? Score: 3 2. Did you have trouble speaking clearly enough to use the telephone? Score: 2 3. Did other people have trouble understanding what you said? Score: 2 4. Did you have a hard time finding the word you wanted to say? Score:2 5. Did you have to repeat yourself so others could understand you? Score:2 Based on the scoring above what would the average score be for the language category for Brady?
The correct answer is an average score of 2.2.
Lily receives nutrition by eating and drinking by mouth, as well as additional support through tube feeding due to a chronic condition. When eating by mouth, Lily requires help preparing her meal. Once it is in front of her, she can bring the food to her mouth and chew and swallow appropriately. How would you code Lily's admission performance for eating? a. Code 5, Set up or clean-up assistance b. Code 6, Independent c. Code 09, Not applicable d. Code 88, Not attempted due to medical concerns or safety Edited by Laura Krom on Dec 5 at 8:03pm
The correct answer is b. Code 6, Independent Eating by mouth can still be coded even if Lily uses a tube feeding some of the time. Eating does not take into account preparing food. She can independently bring food to her mouth, chew, and swallow, meaning she can do all the steps independently
Rachael is an 88-year-old female recently placed in a nursing home facility. A therapist is coming in to evaluate her. When she arrives she realizes that Rachael is receiving food through a g-tube. In regards to Section GG, how would the therapist code her performance for eating?
You would use code 88. Due to a medical condition, Rachael therapist would not attempt to feed Rachael orally.
What does the Barthel Index assess? What do the results of the Barthel Index indicate?
This assessment aims to show what the patient can do at the time. Assess 10 ADLs. The results of the Barthel are scored by points and that tells the level from totally dependent to independent. The scores range from 0-100 meaning if they score a 0 they are totally dependent and 100 means they are totally independent.
