Occupational Therapy and Neurological Conditions

Jenny Preston, PhD, BSc (Hons), DipCOT is a Consultant Occupational Therapist within NHS Ayrshire & Arran, and Glasgow Caledonian University. She has over 30 years clinical experience working with people with a range of neurological conditions, and is currently Chair of the College of Occupational Therapists Specialist Section Neurological Practice.Judi Edmans, PhD, MPhil, DipCOT, FCOT is a Senior Research Fellow in the Division of Rehabilitation and Ageing at the University of Nottingham. She has been qualified for over 35 years, has worked mainly in stroke both in clinical practice and research and is the editor of the book Occupational Therapy and Stroke.

List of figures and tables, viii

List of contributors, x

Academic foreword, xi

Service user foreword, xii

Preface, xiii

Acknowledgements, xiv

1 Introduction, 1

1.1 Economic impact of long?]term neurological conditions, 1

1.2 Definition of long?]term neurological conditions, 2

1.3 International Classification of Functioning, Disability and Health, 2

1.4 Huntington's disease, 4

1.5 Motor neurone disease, 9

1.6 Multiple sclerosis, 13

1.7 Parkinson's, 18

1.8 Self?]evaluation questions, 22

References, 22

2 Delivering good quality, safe and effective care, 24

2.1 Introduction, 24

2.2 The strategic context, 24

2.3 Evidence?]based practice, 27

2.4 Clinical guidelines, 33

2.5 Practice guidance, 33

2.6 Client expertise in evidence?]based practice, 35

2.7 Quality improvement, 36

2.8 Health economic evaluation, 39

2.9 Professional standards of practice, 40

2.10 CPD and lifelong learning, 40

2.11 Self?]evaluation questions, 42

References, 43

3 Person?]centredness and long?]term neurological conditions, 46

3.1 Introduction, 46

3.2 Person?]centredness, 46

3.3 Client?]centred practice, 48

3.4 Self?]management, 55

3.5 Co-production, 57

3.6 Evaluating your practice, 58

3.7 Self-evaluation questions, 59

References, 60

4 Theoretical basis, 63

4.1 Introduction, 63

4.2 Definitions of occupational therapy, 63

4.3 Central philosophy of occupational therapy, 65

4.4 Core professional reasoning skills, 65

4.5 Conceptual models of occupational therapy practice, 69

4.6 Frames of reference, 78

4.7 Context?]dependent practice skills, 81

4.8 Self?]evaluation questions, 83

References, 83

5 Occupation and long?]term neurological conditions, 86

5.1 Introduction, 86

5.2 Defining occupation, 86

5.3 Occupational patterns, 87

5.4 Doing, being, becoming and belonging, 88

5.5 Occupational dysfunction, 93

5.6 Occupational adaptation, 96

5.7 Defining occupational goals, 98

5.8 Self?]evaluation questions, 99

References, 99

6 Identifying occupational performance enablers and deficits, 101

6.1 Introduction, 101

6.2 What is measurement?, 101

6.3 What are occupational therapy outcomes?, 102

6.4 Selecting the right measure, 103

6.5 Commonly used measures in neurological rehabilitation, 106

6.6 Disease?]specific measures, 111

6.7 Self?]evaluation questions, 118

References, 118

7 Occupational therapy intervention, 122

7.1 Introduction, 122

7.2 Activities of daily living, 123

7.3 Fatigue management, 124

7.4 Cognitive rehabilitation, 126

7.5 Anxiety management, 129

7.6 Falls management, 135

7.7 Pain management, 137

7.8 Managing tremor, 140

7.9 Sleep, 143

7.10 Sexual relationships and intimacy, 144

7.11 Self evaluation questions, 147

References, 147

8 Using technology to support participation, 150

8.1 Introduction, 150

8.2 Environmental characteristics and occupational performance, 150

8.3 Environmental adaptations, 151

8.4 Assistive technology, 152

8.5 Assistive devices, 152

8.6 Housing adaptations, 154

8.7 Seating and postural management, 156

8.8 Management of posture and positioning in sitting, 158

8.9 Management of posture and positioning in lying, 160

8.10 Splinting, 162

8.11 Electronic assistive technology, 163

8.12 Self?]evaluation questions, 168

References, 168

9 Living with a long?]term neurological condition, 171

9.1 Introduction, 171

9.2 Transitions theory, 171

9.3 Illness experiences, 172

9.4 Rehabilitation and recovery, 173

9.5 Lifespan transitions, 174

9.6 Social and cultural transitions, 175

9.7 Caregiving, 183

9.8 Psychosocial adjustment, 185

9.9 Self?]evaluation questions, 189

References, 189

10 Planning for the future, 194

10.1 Introduction, 194

10.2 Disease progression, 194

10.3 The nature of occupation in death and dying, 197

10.4 Facilitation of meaning, quality of life and well?]being, 198

10.5 Spirituality, 198

10.6 Therapeutic use of self, 199

10.7 Advance care planning, 200

10.8 Conclusion, 209

10.9 Self?]evaluation questions, 209

References, 210

Index, 212