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Terapia Ocupaional poate reducesemnificativ cheltuielile serviciilor de

ngrijire pentru populaia n vrst

Zilele Medicale Felix, 2012

Studiul Colegiului Terapeuilor Ocupaionali dinMarea Britanie, realizat n 2010

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Dune Ana-MariaF.K.T, specializare n T.O.

Mirela BurlluF.K.T., specializare n T.O.

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Provocrile socio-economice ale Europei de astzi,

mbtrnirea demografic

sustenabilitate financiar a sistemelor de ngrijire i sntate

confer programelor de terapie ocupaional un loc esenial n

cadrul serviciilor medico-sociale oferite populaiei n vrst, n:

prevenirea cderilor

sigurana i independena casnic

sntate fizic i mental

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1. Terapia Ocupaional n prevenirea cderilor

(College of Occupational Therapists, UK, 2010)

Cderile reprezint principala cauz a fracturilor de old (90%) ide deces (70%) n rndul populaiei cu vrsta de peste 65 ani.

Costurile statului britanic n cazul fracturii de old cauzat decdere se ridic la 28.665 / persoan (Heywood i Turne, 2007).

Perspectiva T.O. n prevenirea eficient i cu succes a acestuifenomen socio-economic const n abordarea dinamicii

consecinelor cderii, care devin adeseori cauzele acesteia.

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inactivitate

Izolare;

plasare ninstituie /spitalizare

Cderea

Prescriereamedicaiei

psihoactive

pierdereaautonomieii ncrederii

n sine

frica decdere

complicaii

medicale,depresie i

anxietate

Berckman & Miller, 1991; Woodland & Hobson, 2003

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Programul de prevenie primar(Miller, 1988)

Educaia /

Consiliere

a familiei informaii cu privire la:

factorii de risc

strategiile de

prevenire

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Programul de prevenie secundar(Miller, 1988)

Evaluarea

factorilor

de riscvizita la domiciliu

evaluarea persoanei

evaluarea resurselor i a mediului

evaluarea necesitii achiziionriide dispozitive de asisten

management comportamental

direcionare - colaborare cu alteservicii de specialitate

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Programul de instituire a terapiei adaptativ -

compensatorii (Miller, 1988)

Condiiile riscante i obstacolele mediului fizic

dormitorulnlimeapatului, iluminatul

corect, covoarele

baianlimeatoaletei, bare de sprijin,

pavimente

accesibilizarea cilor

de acces

dipoziia mobilierului

folosirea materialeloranti-derapante

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Programul de instituire a terapiei adaptativ -

compensatorii (Miller, 1988)

Folosirea (in)adecvat a dispozitivelor de transfer i de mers

Echipamente defecte

nclmintea inadecvat

Educaia

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Concluzii:

Reducerea cu pn la 40% a cderilor n rndul populaiein vrst.

Adaptare major a locuinei este cu de 4,7 ori mairedus dect costurile de spitalizare a vrstnicului dup ofractur de old prin cdere.

Aplicarea mnerelor i barelor de sprijin n vedereareducerii cderilor + iluminarea holurilor, reduce cu

aproape 100 de ori riscul spitalizrii vrstnicului.

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2.Terapia Ocupaional n asigurarea independenei isiguranei la domiciliu a vrstnicului cu demen

Programul Independence at Home:

Adaptarea i transformarea locuinei ntr-un mediu mai sigur pentru cei ce olocuiesc, reduce n mod eficient riscurile i stressul ce nsoesc modificrilecomportamentale i funcionale din demen.

Informarea, educarea i colaborarea cu familia, folosind explicaii irecomandri simple i unice.

Dobndirea independenei n activitile de auto-ngrijire prin modificareacaracteristicilor fizice ale mediului.

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3. Terapia Ocupaional n promovarea sntii fizice

i mentale a vrstnicului

atenia

memoria i limbajul

concepte descriptive

categorizarea

rezolvarea-problemei

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relaxarea

memoria

abilitile de comunicare

atenia

limbajul

rezolvarea-problemei

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atenia

limbajul

abilitile de comunicare

atenia

memoria

comunicarea

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abiliti cognitive

interaciune social

abilitile de comunicare

Sortarea diverselor obiecte - haine, bijuterii, cri potale, reviste, articole deziar, etc. - se preteaz pentru persoanele cu abiliti cognitive diminuate.

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Concluzie:

Odat cu fenomenul de mbtrnire demografic la care asistm,

abordarea tradiional a vrstnicului n sistemul de ngrijire de tip

rezidenial i spitalicesc nu mai este valid, serviciile oferite ncomunitate devenind o necesitate evident, funcional i cost-

eficient n sprijinirea vieii independente i promovarea bunstrii

populaiei n vrst.

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Bibliografie Campbell et al (2005) Randomised controlled trial of prevention of falls in people aged > 75 with severe visual

impairment: the VIP trial. The British Medical Journal, 331(7520),817.

College of Occupational Therapists (2006) Falls management. London: COT.Ip et al (2004), Short-stay in-patient rehabilitation of elderly patients with chronic obstructive pulmonary disease:prospective study. Hong Kong Med J Vol10 No 5 October 2004.

Allen K and Glasby, J (2010) The billion dollar question: embedding prevention in older peoples services 10 highimpact changes. Birmingham: Health Services Management Centre, University of Birmingham.

College of Occupational Therapists (2009) Occupational therapy and equipment. How equipment can make your lifeeasier. London: COT.

College of Occupational Therapists (2008) The value of occupational therapy and its contribution to adult social serviceusers and their carers (Position Statement). London: COT.

Graff et al (2008) Community based occupational therapy for older people with dementia and their care givers: costeffectiveness study. British Medical Journal, 336 (7636): 134-138.

Heywood F and Turner L (2007) Better outcomes, lower costs: implications for health and social care budgets ofinvestment in housing adaptations, improvements and equipment: a review of the evidence. London: Stationery Office.

Laing and Buisson (2008) Care of elderly people: UK market survey 2008. London: Laing and Buisson.Littlechild R, Bowl R, Makta E (2010) An independence at home service: the potential and the pitfalls for occupationaltherapy services. British Journal of Occupational Therapy, 73(6), 242-250.

College of Occupational Therapists (2007) Activity provision: benchmarking good practice in care homes. London: COT.

College of Occupational Therapists (2008) Continue to have an active life as you get older. London: COT.

College of Occupational Therapists (2008) Health promotion in occupational therapy. London: COT

Jennifer Kay-Williams, MA, CCP-SLP. e-book: Activities for Geriatric Patients 2012www.advancewebcom/SPGeriatricblog

http://www.advancewebcom/SPGeriatricbloghttp://www.advancewebcom/SPGeriatricblog