Family health is the responsibility of a family health care team of professionals
Depending on the needs, this team includes family members and any or all of the following health care professionals; occupational therapists, physical therapists, social workers, speech therapists, recreational therapists, medical doctors, nutritionists, nurses and others specialists.
Professionals involved in these health care teams must be able to work collaboratively and with compassion for clients of all backgrounds, personalities, and ages. Patience, organizational ability, ingenuity, a sense of humor and creativity are necessary.
Each family health care team member evaluates the patient from the perspective of their own career specialty and then works together with the team to develop a treatment plan for the patient. It is the responsibility of all team members to advocate for the needs of their clients and family health.The occupational therapist (OT) evaluates, diagnoses, and implements treatment for people whose ability to perform activities of daily living is impaired by physical injury, illness, psychological disorder, congenital or developmental disability, or aging.
OT services include: the design, fabrication, and application of orthoses, such as hand splints; guidance in the selection and use of adaptive equipment; engagement in therapeutic, meaningful activities to enhance functional performance; vocational evaluation and training; and consultation concerning the adaptation of the physical environment for the handicapped.
The OT examines the social, psychological, and physical factors that can assist a person to become as independent as possible in performing meaningful activities at home, school or work environments. The OT teaches their client new ways of performing daily activities and how to use adaptive equipment such as reachers, visual aids, kitchen and bathroom aids (Norrgard, 2001).
The OT helps the patient regain the ability to do everyday tasks. This may be achieved by restoring old skills or teaching the patient new skills that adjust to disabilities using adaptive equipment, orthotics, and/or modification of the patient's environment (Gale, 1999)
Physical therapy (PT) is the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat, hydrotherapy, electrical stimulation, and light to assist in rehabilitation and in restoring function after an illness or injury (Mosby, 1998). The PT works with a client to improve mobility, relieve pain, and prevent or limit permanent physical disabilities in clients who have experienced an injury or disease process (Anderson and Malaski, 1999). The PT teaches clients how to use devices such as crutches, walkers, or grab bars and how to do special exercises (Norrgard 2001). Exercise is the most widely used and best-known type of PT. Depending on the patient's condition, exercises may be performed actively by the patient alone or assisted with the PT's help, or passively with the PT moving the patient's limbs (Gale, 1999)
The PT and OT often collaborate, providing assessment and treatment for functional limitations in a variety of client diagnoses. Depending on the setting, the individual therapist's training and specialty area may determine the differences between the profession's responsibilities. For example, in a pediatric setting, the PT may address gross motor evaluation while the OT may complete the fine motor evaluation although the OT is qualified to do both. Typically, the PT has limited involvement in assisting with the activities of daily living (Anderson and Malaski, 1999).
The speech therapist (ST) specializes in measuring and evaluating language abilities, auditory processes, speech production, treatments of children and adults with speech and language disorders, and research methods in the study of communication skills (Mosby, 1998).
The ST helps patients to correct speech disorders or restore speech. The ST assesses and treats clients with speech, language, communication, voice, or fluency dysfunction and clients with oral motor problems that pose difficulties in eating and swallowing (Anderson and Malaski, 1999).
To strengthen muscles, the patient may be asked to speak, smile, close the mouth, or perform tongue exercises. To remember the names of objects, increase vocabulary, practice reading, and communicate with others, picture cards of everyday objects and workbooks may be used. Computer software is available to improve speech, reading, recollection, and listening skills (Gale, 1999).
The ST and OT may collaborate to assess oral motor skills and level of cognition. During treatment sessions, the ST may address the client's comprehension of instructions as well as their responses to verbal directions while the OT engages the patient in functional purposeful activities that have meaning for the client and address their functional limitations (Anderson and Malaski, 1999)
The recreational therapist (RT) uses recreation or play as a healing methodology to provide treatment for the physical, mental, emotional, and social wellness of their clients (Anderson and Malaski, 1999). The RT uses games or other group activities as a way to modify maladaptive behavior, awaken social interests, or improve the ability to interact and function in socially acceptable ways (Mosby, 1998).
The RT assesses the patient's ability to function, develops a treatment plan, leads activities, and monitors progress as the plan is carried out. Apart from pleasure, these activities provide opportunities for exercise and social participation. Other goals for the activity might include relieving anxiety, building confidence, and promoting independence (Gamliel, 1985).
As with OTs, RTs share the understanding that ordinary activities can help a disabled or special needs person to improve or recover. (Gamliel, 1985) For example, the RT and OT may collaborate in their client going to a theater. The RT works with the client to plan the outing and address accessibility issues, while the OT may work with the client to address cognitive areas of money management as well as sequencing parts of the activity, such as transferring from a wheelchair to a theater seat (Anderson and Malaski, 1999).
The social worker (SW) deals with the social, emotional, and environmental problems associated with an illness or disability. A medical SW counsels patients and their families in a medical setting and helps them to access community resources and may coordinate the discharge plan. A psychiatric SW may specialize in counseling individuals and families in coping with social, emotional, or environmental problems pertaining to mental illness (Mosby, 1998).
The SW promotes human wellness and assists in meeting the basic needs of all individuals, with particular attention to those who are vulnerable, oppressed, or living in poverty. The OT and SW may collaborate on preparing a client's hospital discharge. The OT may complete a home evaluation before discharge from the hospital and identify deficits in the client's living environment that the SW may then address (Anderson and Malaski, 1999).
Nutritionists or registered dietitians (RD) provide dietary advice to help the patient recover from or avoid specific problems or diseases (Gale, 1999). The RD evaluates, prevents, and treats illness through the promotion of healthy eating habits. The RD may plan nutritional programs and supervise the preparation and serving of meals to clients. For example, under the guidance of a medical doctor (MD), the RD may prescribe a diet with reduced salts, fats, sugars, and proteins (Anderson and Malaski, 1999).
An RD and OT may collaborate to address feeding and eating problems, such as the types and consistency of foods that would be best to allow a client to feed themselves. The RD may educate the client on appropriate food selection and the OT would assist the client in preparation of the food in an independent manner (Anderson and Malaski, 1999).
The registered nurse (RN) provides care for clients who are ill or injured, promotes wellness, and assists clients in staying healthy. RNs address the physical, social, emotional, and mental needs of their clients. RNs observe their clients, assess their condition and treatment progress, record symptoms, administer medications and treatments, assist MDs and educate family regarding the client's medical condition and course of treatment (Anderson and Malaski, 1999).
Some of the RN's concerns are: limitations of the client's ability for self-care; impaired ability to perform basic functions such as sleeping and eating; impaired cognitive abilities; extra demands imposed by normal life-processes as birth, growth, or death; and difficulty in social relationships (Mosby, 1998).
The medical doctor (MD) plays a key role in developing and reviewing a health care program to ensure that the client's healthcare needs are being met. The MD contributes an understanding of the disease process and medical treatment for the patient's care. The MD can prescribe medicine, durable medical equipment, adaptive equipment, health care supplies, and the intervention of other allied health services.
The Medical Doctor collaborates in the prevention, diagnosis, treatment, and management of the client with other health care professionals, and may assume the responsibility of leading and coordinating the work of other team members. For example, the MD may order OT when the client needs to develop new skills to perform normal activities of daily living.
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