Occupational therapy (ET) depends on the self-help skills, and improve fine motor coordination of muscles and joints especially the upper extremities. In contrast to the physical therapy that focuses on muscle strength and joint range of motion, the ET focused on activities of daily living (ADL), because they are important for independent living. On basic ADL (h d.. Between surfaces such as bed, chair, bath or shower reciprocate) include eating, dressing, bathing, personal hygiene, toileting and position change. Using machines and devices requires more complex cognitive functions. These include the preparation of meals, telephone communication, written assignments or operating the computer, household finances, storage and daily drug regimens, cleaning, laundry, grocery shopping and other errands, transport pedestrians and public transport; as well as the steering of a vehicle or bicycle. Driving is particularly complex and requires the integration of visual, physical and cognitive tasks. Clarification ET can be initiated when a doctor writes a referral for rehabilitation. The transfer should be detailed, including a brief history of the problem (eg. As the type and duration of the illness or injury) as well as a definition of the goals of therapy (eg. As training complex ADL). Lists of occupational therapists can from the health insurance of the patient, the local hospital, the phone book, professional organizations or, for the United States, can be obtained on this website: American Occupational Therapy Association. Patients are limitations that require intervention and strengths that can be used to compensate for weaknesses investigated. With limitations, there may be restrictions on motor function, sensation, perception or psychosocial functioning. Doctors hold which activities patients need help: z. As work, leisure, social activities, learning. Patients may need help in a general activity (eg. B. Social Affairs) or a specific activity (eg. As church attendance), or they must be motivated to tackle an activity. Therapists can use certain tools for this clarification. One of the many functional evaluation tool is described in directive for activities of daily living by Katz. The patients are questioned about their social and family roles, their habits and social networks. The availability of resources (eg. As offers the community and service providers, private companion) should be investigated. Directive for activities of daily living after Katz activity item result Eating Eating unaided 2 Needs assistance only when cutting meat or the bread Grease 1 Needs assistance or food to be fed intravenously 0 dressing Hol t to clothes and pulls them without the help of 2 Requires the shoe tying aid 1 Needs assistance Bring clothes or getting dressed or remain completely or partially undressed 0 washing (washing at the sink or with the washcloth, bath, shower) Washes without help 2 needs help only when Waschein a specific body part (eg. As the back) 1 Requires when washing aid in more than one part of the body or he washes not 0 Transfer Moving in and out of bed and into the chair without help (may use cane or walker) 2 Requires help in movement in and out of bed or on the chair one comes not only from the bed 0 Toilet goes into the bathroom, used the toilet, dressing himself from pulling himself back on and returns without help – possibly using a cane or a walker; can bedpan or urinal at night alone use 2 Needs assistance toileting, cleaning, the retightening when returning 1 Do not go to the toilet to empty the bladder or intestine 0 continence controlled bladder and bowel complete (without occasional accidents ) 2 loses occasional control of bladder and bowel 1 Needs help in the control of bladder or bowel, requires the use of a catheter or is incontinent 0 Amended by Katz S, Downs TD, Cash HR, et al: Progress in the development of the index of ADL. Gerontologist 10: 20-30, 1970. With the approval of the Gerontological Society of America. Occupational therapists can investigate dangers and recommendations on the safety issue (eg. As removing carpets, more light in the hallway and kitchen, the dislodgement of a bedside table within reach of the bed which comprises applying a photo of a door also the home of the patient for better recognition of her room). Also detecting whether driving is a risk or whether driving lessons are needed is easier for the occupational therapists with specialized trainers. An advice for older drivers and their caregivers on how to deal with changes in driving abilities is also sometimes necessary. Interventions ET may consist of a consultant or frequent sessions of varying intensity. Therapy sessions can be held in different environments: In acute care, rehabilitation, outpatient care, day care, in placement in long term care facilities develop at home (as part of home care) in the old people’s home life care or assisted living occupational therapists an individual program for patients to improve their motor, cognitive, communicative and interactive skills. The goal is not only to help the patient to cope with ADL, but also exercise their favorite leisure activities and to promote social inclusion and participation and to maintain. Prior to the development of a program a therapist observes the patient in the activities of daily life, to see what the patient needs to run it safely and successfully. Therapist can then recommend maladaptive pattern options to eliminate or reduce and develop movements that promote the function and health. Specific practically oriented exercises are also suggested. Therapists emphasize that the exercises must be practiced and motivate their patients to this by reminding them that they are there to be active again at home and in society. Patients are taught creative ways to facilitate social activities (eg. As how to get without a car in museums or in the church, such as hearing aids or other assistive devices are used and how they can travel safely). Therapist can suggest new activities (eg. As volunteering in schools, kindergartens and hospitals). Patients are mediated strategies to compensate for their limitations (z. B. working in the garden to sit). The therapist can identify various tools that can help the patient in many activities of daily living (auxiliary equipment). Most occupational therapists will be able to choose requires adapted wheelchairs for their patients and to ensure the exercising of the region of the upper limb amputees. You can build individual tools and adapt to prevent contractures or for treatment of other functional deficits. Auxiliary equipment problem device balance or weak legs handles on the side and back of the bathtub or the toilet inability to stand for a long time, because of weakness or dizziness shower chairs balance problems or difficulties in the bathtub and get out again, because of pain or weakness in the legs bath benches Difficulty in getting toilet seats and seat leg increases (which is the seat of the chair increases) Weak handle tableware, shoehorn and other tools with large handles specially prepared for tremor Heavy eating utensils, cups with lids pivotable spoon coordination problems plate edge and rubber grips (for slipping to ) prevent difficulty in grasping or limited movement Grippers, pick up objects from the ground or can pick from a shelf Hand Tools problems with spring-loaded or electronic controls limited motion or coordination devices, electrical devices (eg. one as lamps, radios, fans) with the sound of the voice on or off paralysis of the arms or legs or other disorders that the function severely restrict computerized equipment blurred vision Larger keys on the phone and books in large print or audio books hearing loss phones and doorbells that is a flashing light appears when they ring difficulties with memory Automatic dialing on a phone, device, people remember ih to take re drug, as well as devices that record and play messages can recall (memories, instructions, lists) and in due course.