Environmental Modifications to Facilitate Safety and Function at Home. Annette Lavezza OTR/L Team Leader Johns Hopkins Hospital

Transcription

1 Environmental Modifications to Facilitate Safety and Function at Home Annette Lavezza OTR/L Team Leader Johns Hopkins Hospital

2 Active Types of Interventions Systems and solutions that require learning new information in order to operate Examples: Microwaves; remote controls

3 Passive Types of Interventions Changes that alter the environment without requiring any learning Examples: automatic lights

4 Kitchen Access to glass and raw foods in refrigerator Install a latch to prevent access unless living alone

5 Remove clutter from counters If possible periodically check the perishable supplies for freshness Do not store cleaning and food supplies close together and always store cleaning supplies in original bottles

6 Stove Use Replace with microwave Stove Top Fire Stopper Disconnect or turn off at circuit breaker

7 Microwave Closely evaluate the complexity of the oven Minimize buttons; mark buttons with numbers Begin training early prior to it being unsafe to use the stove Purchase dishes and containers that are microwave safe and remove others

8 Bathroom Scald Burns: occur when water is above 120 degrees Anti scald devices Easily secures onto existing faucets Adjusts flow of water for hot water surges Lower water heater temperature Overflowing water Automatic shut off faucets Community Occupational Therapists and Associates, Safety Assessment of Function and the Environment for Rehabilitation

9 Entering and exiting the shower Grab bars positioned for a natural reach MUST be installed into wall studs Towel racks are NOT grab bars Standing from a toilet seat Place an over the commode raised seat with arms

10 Place non skid aids in the bottom of the tub Ensure that any rug has secure backing

11 Living Room/Family Room Unattached rugs Double sided rug tape Remove small scatter rugs

12 Medication Inaccurate administration or missing doses Automatic dispenser with alarms Most useful are systems that alarm and then dispense medication Always have a family member fill Ensure the device is lockable Check the volume and length of the alarm

13 Limit access to the original over the counter bottles and prescriptions Place locks on medicine cabinets Only store medication in one location

14 Wandering Door alarms Lock door with device that is easily removed but requires new learning Only an option if they live with a person capable of removing during a fire

15 Motion detectors with remote alarms or verbal feedback Alarms that sound when someone stands from a chair Register with Safe Return through the Alzheimer s s Association

16 Fall Risk Remove all unattached rugs Thresholds are most dangerous; label with bright tape to cue Bed and chair alarm pads Remove unnecessary clutter Community Occupational Therapists and Associates, Safety Assessment of Function and the Environment for Rehabilitation.

17 Miscellaneous Inability to dial telephone One button dialing with picture labels Unable to operate TV remote Tape all buttons except channel up Purchase device with only a few buttons Remove candles Ensure smoke detectors are active Notify local fire department Purchase automatic shut off appliances Community Occupational Therapists and Associates, Safety Assessment of Function and the Environment for Rehabilitation

18 Driving American Medical Association s s Guidelines for Assessing and Counseling the Older Driver. assn.org/ama/pub/category/10791.html

19 Self Assessment Sample questions Getting lost Others are worried about my driving Cars appear out of nowhere Others drive too fast/honk at me Feeling tired after driving Being stopped by the police recently Dislikes night driving, busy intersections, left hand turns Recent near misses assn.org/ama1/pub/upload/mm/433/appendixb.pdf

20 Questions for Caregivers Does your loved one Fails to yield right of way Fails to obey lights and stop signs Drive too slowly or quickly Gets lost Trouble staying in the lane Slow reactions Poor decisions related to driving Tickets/near misses/fender benders Comments from other assn.org/ama1/pub/upload/mm/433/appendixb.pdf

21 Strategies Talk to your loved one in a non threatening and safe environment Determine alternate modes of transportation Encourage them to make an appointment with their physician and discuss driving Call in advance to alert the physician Ask them to take a formal driving assessment with a driving rehabilitation specialist assn.org/ama1/pub/upload/mm/433/appendixb.pdf

22 Driving Programs in Maryland Doctors Community Hospital 8118 Good Luck Road Lanham, Maryland Dana Nixon, OTR/L, DRS (phone) OT Department (fax) Rehabilitation of Frederick 85 Thomas Johnson Court, Suite C Frederick, Maryland Tim Jones, OTR/L, CDRS (301) (phone/fax) (304) (cell phone) ottjones1@yahoo.com Good Samaritan Hospital 5601 Loch Raven Blvd. Baltimore, Maryland Karen Amoyal,, DRS (443) (phone) (410) (fax) karen.amoyal@medstar.net National Rehabilitation Hospital 2 Irving Street, NW Washington, DC (van in addition to car) Glen Digman,, OTR/L, CDRS (202) (phone) (202) (phone) Ken Byers, OTR/L202) , byersken@hotmail.com

23 Adventist Rehabilitation Hospital of MD 9909 Medical Center Drive Rockville MD Jennifer Milsovic,, OTR/L (questions regarding driving program) (to schedule a driving evaluation) Sheila J. Jackson, C.D.R.S. Certified Driver Rehab Specialist 50 Irving St. NW Washington, DC (202) ext sheila.jackson@va.gov Workforce and Technology Center 2301 Argonne Drive Baltimore, Maryland (van and car) For scheduling: Dan Dubay (410) (phone) John Arthur, DRS (410) (phone) Art Kleiman,, DRS (410) (phone) F.O.F. Occupational Therapy Services, LL Focus on Function 1700 Reisterstown Road, Suite 217 Pikesville MD Kim High, OTR/L, DRS phone fax

24 Resources

25 References American Medical Association s s Guidelines for Assessing ancd Counseling the Older Driver. assn.org Community Occupational Therapists and Associates. Safety Assessment of Function and the Environment for Rehabilitation

26 Contact Information Annette Lavezza OTR/L Acute Care Services Team Leader 600 North Wolfe Street Meyer Baltimore MD