Occupational Therapy and Neurological Conditions

While diagnosis with a neurological condition may not be life-threatening, it can have significant impact on everyday life and on participation in activities. Occupational therapists must be able to fully consider the physical, cognitive, emotional, psychological and behavioural problems which may occur as a consequence of a neurological disorder, and understand the impact of diagnosis from a person-centred perspective. Occupational Therapy and Neurological Conditions incorporates theoretical, clinical and research evidence to support occupational therapists in the management of people with neurological conditions.

• Covers the key symptoms of neurological conditions and the biological basis of these within the ICF framework
• Provides an overview of therapy and management for all neurological conditions
• Includes key occupational therapy theory
• Case studies root concepts in real-life practice
• End-of-chapter self-evaluation questions help test understanding

Occupational Therapy and Neurological Conditions is the ideal resource to support students, newly-qualified practitioners, and occupational therapists looking for an overview or introduction to this key area of 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 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

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