英文原文
How OTs Can Help Older Adult Patients Keep Their Pets
It’s hard for many of us to imagine our lives without our beloved pets. However, many older adults have to relinquish their dogs and cats when some of the tasks of pet care become more demanding and contribute to potential fall risks.
But as OTs, we have the unique ability to assess a patient’s performance with pet care and analyze what aspects we can improve or alter to promote increased independence if functionally appropriate and skilled.
Using PEOP to Help Older Adult Patients Keep Their Pets
I like to use the Person-Environment-Occupation Performance (PEOP) model during my initial evaluation. This includes assessing intrinsic factors such as cognitive, physiological, neurobiological, psychological, and spiritual, along with extrinsic factors such as social support, culture/values, social and economic systems, natural environment, and available equipment/technology.
Let’s take a look at what the application of the three components of this model can look like for an Instrumental Activity of Daily Living (IADL) like pet care in the following case study.
“Shirley is an 87 YO female who resides in an apartment complex on the first floor and has a small dog to care for. She was referred to OT for B hand arthritis and impaired balance impacting her ability to grasp objects and perform ADLs. Shirley reports dropping objects often and unsteadiness bending to pick up dog poop on walks. She uses a rollator while walking her dog. During the interview, OT stages the patient in level 3 on the Global Deterioration Scale (GDS).”
1. Social and Economics Systems
Shirley has a fixed income and is able to make small purchases, but nothing out of her ordinary purchases. High-technology equipment may not be the best option for her. She has a daughter that lives nearby and comes by weekly. The rest of her family lives out of town. She has 1-2 neighbors she is friendly with.
2. Physiological Intrinsic Factors
With Shirley’s significant hand arthritis, using joint protection techniques is essential. In addition to education strategies with task-specific training implementing techniques, she may benefit from using a leash with a more oversized gripped handle to disperse pressure and increase control walking her dog.
Education on body mechanics and functional balance training will increase her safety with walking her dog, along with waste management. She may consider a long-handled pooper scooper as well. There are also options for bowls with long handles to lift from the floor to limit bending and use the rollator seat to transport items. To cut her dog’s nails herself, I would suggest a large handle dremel that decreases the grip/pinch strength required.
3. Cognitive Intrinsic Factors
Shirley is beginning to show signs of worsening dementia. It will be helpful to instill habits in her pet care routine now to increase safety as her disease progresses. This could help lengthen the time the patient will be able to care for her pet without additional assistance from family or caregivers.
Keeping her economic situation in mind, I might suggest an alarm for a reminder to feed her dog instead of the more expensive automatic water and food dispensers. It can also be helpful to pair the feeding of the pet with an external situational cue, such as directly after retrieving the mail or right before she sits down to eat dinner. Having a calendar in easy view helps remind the patient to write down vet appointments and reminders for oral medications for her dog. Keeping the leash, harness, and dog’s food in consistent places, along with easy-to-read labels, is important for the patient to be able to locate easily.
Pet Care is Good for Our Patients
Many patients or families assume that pet care will be too challenging for them to continue as they age, but there are myriad techniques to enable them to keep pets and age in place. With older adults more at risk for depression and social isolation, pet care can potentially serve as a health protectant, and it is critical for occupational therapists to assess safety with pet care with our patients. Always utilize your clinical judgment to identify if a treatment is appropriate for your specific patient and ensure the creation of corresponding goals.
中文翻译
职业治疗师如何帮助老年患者保留宠物
对我们许多人来说，很难想象没有心爱宠物的生活。然而，许多老年人不得不放弃他们的狗和猫，因为宠物护理的一些任务变得更加费力，并增加了潜在的跌倒风险。
但作为职业治疗师，我们拥有独特的能力来评估患者在宠物护理方面的表现，并分析哪些方面可以改进或改变，以在功能适当且熟练的情况下促进独立性。
使用PEOP帮助老年患者保留宠物
我喜欢在初步评估中使用人-环境-职业表现（PEOP）模型。这包括评估内在因素，如认知、生理、神经生物学、心理和精神，以及外在因素，如社会支持、文化/价值观、社会和经济系统、自然环境和可用设备/技术。
让我们通过以下案例研究来看看这个模型的三个组成部分如何应用于宠物护理这样的工具性日常生活活动（IADL）。
“雪莉是一位87岁的女性，住在一栋公寓楼的一楼，需要照顾一只小狗。她因B手关节炎和平衡受损被转介给职业治疗师，这影响了她抓握物体和执行日常生活活动的能力。雪莉报告说经常掉落物体，弯腰捡狗粪时不稳定。她遛狗时使用助行器。在访谈中，职业治疗师将患者评定为全球恶化量表（GDS）的第3级。”
1. 社会和经济系统
雪莉有固定收入，能够进行小额购买，但不会超出她的常规购买。高科技设备可能不是她的最佳选择。她有一个女儿住在附近，每周来访。她的其他家人住在城外。她有1-2个友好的邻居。
2. 生理内在因素
鉴于雪莉严重的手关节炎，使用关节保护技术至关重要。除了通过任务特定训练实施技术的教育策略外，她可能受益于使用带有更大握柄的狗绳，以分散压力并增加遛狗时的控制力。
关于身体力学和功能平衡训练的教育将提高她遛狗和废物管理时的安全性。她也可以考虑使用长柄拾便器。还有带长柄的碗选项，可以从地板上抬起以减少弯腰，并使用助行器座位运输物品。为了自己给狗剪指甲，我建议使用大握柄的打磨机，以减少所需的抓握/捏力。
3. 认知内在因素
雪莉开始表现出痴呆恶化的迹象。现在在她的宠物护理常规中培养习惯将有助于随着疾病进展提高安全性。这可能有助于延长患者在没有家人或护理人员额外帮助的情况下照顾宠物的时间。
考虑到她的经济状况，我可能建议使用闹钟提醒喂狗，而不是更昂贵的自动水和食物分配器。将宠物喂食与外部情境线索配对也很有帮助，例如取邮件后或坐下吃晚餐前。在容易看到的地方放置日历有助于提醒患者写下兽医预约和狗的口服药物提醒。将狗绳、背带和狗粮放在一致的位置，并附上易于阅读的标签，对患者轻松找到它们很重要。
宠物护理对我们的患者有益
许多患者或家人认为宠物护理对他们来说太具挑战性，无法随着年龄增长而继续，但有无数技术可以让他们保留宠物并在原地养老。由于老年人更容易患抑郁症和社会孤立，宠物护理可能作为健康保护因素，职业治疗师评估患者宠物护理的安全性至关重要。始终利用您的临床判断来确定治疗是否适合您的特定患者，并确保制定相应的目标。
文章概要
本文探讨了职业治疗师如何运用PEOP模型帮助老年患者保留宠物。文章以案例研究为例，分析了社会和经济系统、生理内在因素和认知内在因素如何影响宠物护理，并提出了具体干预措施，如使用适应性设备、教育训练和习惯培养。文章强调宠物护理对老年人心理健康的重要性，并呼吁职业治疗师评估安全性以促进独立生活。
高德明老师的评价
用12岁初中生可以听懂的语音来重复翻译的内容
这篇文章讲的是，有些老爷爷老奶奶因为年纪大了，身体不好，照顾宠物有点困难，比如遛狗时容易摔倒。但职业治疗师就像超级英雄，他们可以用一个叫PEOP的魔法模型来帮忙。这个模型会看老人们的身体、脑子、钱和周围环境，然后想出好办法，比如用特别的狗绳、长柄碗和闹钟，让老人们能继续和宠物快乐地生活在一起。宠物就像好朋友，能让老人们更开心、不孤单。
TA沟通分析心理学理论评价
从TA沟通分析心理学理论来看，这篇文章展现了成人自我状态在宠物护理责任中的积极应用。成人自我状态涉及理性、客观和问题解决，职业治疗师在评估和干预过程中体现了这一状态，通过PEOP模型系统分析内在和外在因素，制定适应性策略。例如，针对雪莉的关节炎和痴呆，治疗师提出使用大握柄狗绳和建立习惯，这反映了成人自我状态对现实挑战的应对。宠物护理作为工具性日常生活活动，促进了患者的成人自我状态发展，帮助他们维持自主性和责任感。文章强调安全性评估和目标设定，这符合成人自我状态的决策过程，避免了父母自我状态的过度保护或儿童自我状态的依赖。整体上，文章展示了如何通过成人自我状态增强老年患者的宠物护理能力，支持他们的心理健康和社会连接。
在实践上可以应用的领域和可以解决人们的十个问题。
在实践上，这篇文章的应用领域包括老年护理、职业治疗、心理健康支持和社区服务。基于TA沟通分析心理学理论，它可以解决人们的十个问题：1. 增强老年患者的成人自我状态，通过宠物护理责任提升自主决策能力。2. 减少父母自我状态的过度干预，鼓励患者参与适应性解决方案。3. 缓解儿童自我状态的孤独感，通过宠物陪伴促进情感连接。4. 改善沟通模式，在治疗师和患者之间建立基于成人自我状态的合作对话。5. 提升自我价值感，通过成功履行宠物护理责任增强自信心。6. 应对生活转变，如老龄化带来的挑战，通过成人自我状态调整策略。7. 促进社会互动，宠物作为媒介减少社会孤立。8. 管理压力，宠物护理提供结构化和有意义的日常活动。9. 培养责任感，宠物依赖强化患者的成人自我状态角色。10. 支持心理健康，宠物护理作为健康保护因素降低抑郁风险。