Question

Identify and discuss the complementary roles of the OTR and the OTA and the use of therapeutic reasoning in addressing client goals.

Answer 1

Ans) Although the AOTA guidelines are clear that the OT is ultimately in charge of assessing and interpreting the results, the OTA does have a role in contributing to the evaluation process by gathering assessment data and providing observations to the OT for interpretation.

- When evaluating for fall risk according to the AGS/BGS guidelines, the OT should perform the assessments addressing gait and balance, while either the OT or OTA can obtain the client’s fall history, medication information, and history of relevant risk factors.

- Upon gathering all the information from the evaluations, the OT and OTA can collaborate with the client to discuss possible interventions that address specific fall risks, including referral to other qualified professionals. When planning interventions, the OT has overall responsibility for intervention implementation, but the OTA is responsible for collaborating with the OT, the client, and any family members in implementation.

- Occupational therapy’s role in fall prevention is multi-factorial and includes physical interventions, environmental modifications, and behavioral adaptations. According to the AGS/BGS Guidelines, these should include adaptating or modifying the home environment to mitigate identified hazards and facilitate greater participation in daily activities, exercise (particularly balance, strength, and gait training), and promotion of the safe performance of daily activities.

- Either occupational therapy practitioner can carry out these interventions after the OT has determined the client goals and the intervention plan. The OTA may select and modify the therapeutic activities as long as they are within the client’s goals. The OT is responsible for supervising the OTA and conducting regular meetings to reevaluate treatment and guide the client’s treatment.

- The OT must measure and interpret outcomes according to preselected assessments to determine when the client is ready for discharge. The OTA may provide the client with appropriate materials and resources (such as referral to community programs) for post-discharge support from treatment.

- The OT and OTA work together with the client, family, and other health care professionals to prevent falls in those at risk. By working within the AGS/BGS Guidelines, occupational therapy practitioners can provide the client with the most up-to-date, evidenced-based intervention available to prevent further falls from impeding the client’s chosen occupations.