HOME ASSESSMENT TOOL

It has long been understood that physical features in the home can positively or negatively affect people’s ability to function safely and independently. 

Occupational Therapists work within the field of human medicine to assess the individual in the context of their own home, and with their own unique challenges. They specialise in finding solutions by either modifying the environment or the task. Pet owners are increasingly looking for ways to assist their pet to achieve a better quality of life into older age. Like humans, living into old age often means living with long term conditions, such as arthritis, that have a profound effect on mobility and comfort. 

CAM has recognised that there is a lot that the enlightened owner can do to reduce the cumulative effects of activities that are thought to compound ‘wear and tear’ on joints, (such as slipping on laminate floors), and making the dogs environment easier to negotiate thereby improving their quality of life. The authors have used the well respected human screening tool, the Home Fast (Home Falls and Accidents Screening Tool, (Mackenzie, British Journal of Occupational Therapy, 2000)) as a model to create a simple checklist for use by owners, therapists or veterinary nurses to consider what features in the home could be modified, to reduce the impact of arthritis on that individual dog’s function. 

The items for inclusion have been selected following a request to CAM’s Facebook followers to contribute from their own experience. A cohort of 29 respondents provided information from which the author extrapolated 17 questions that focused on activities of daily living that are closely aligned with the home environment. CAM intend to trial the tool, and then use a panel of experts to refine it. It is hoped that the final tool will contribute to assisting the multimodal management of canine arthritis.

Joint Protection

Joint protection is widely used in human medicine for the management of inflammatory joint disease. There are several components to a joint protection programme including use of proper joint mechanics and joint alignment, altering working methods, using assistive devices, modifying activities, pacing and modifying environments (Hammond, 2013)

Research has demonstrated that significant improvements in pain, disease status and functional ability are found in people who have attended a joint protection programme, and there is evidence that it can slow the progression of the effects of rheumatoid arthritis over and above the effects of drug therapy (Hammond and Freeman, 2001) Using techniques and equipment that spare joints from further trauma, joint protection seeks to reduce loading on articular cartilage and subchondral bone, strengthen muscle support and improve the shock absorbing capabilities of joints (Cordery and Rocchi, 1998). Other benefits include reducing pain during activities, helping to reduce deforming forces on joints, reducing fatigue and maintaining function ( Hammond, 2013)

The application of joint protection principles has not been researched in dogs with arthritis, however common sense would dictate that attempting to reduce repetitive, concussive or twisting forces on inflamed tissues may positively impact pain and disease progression in dogs with similar pathology. It is our hope that some of these practical suggestions will help to protect the joints of the dogs that we share our lives with

References

Cordery J, Rocchi M 1998 Joint protection and fatigue management. In: Melvin J, Jensen G. (eds.) Rheumatologic Rehabilitation Volume 1: Assessment and Management. American Occupational Therapy Association, Bethesda, MD.

A. Hammond, K. Freeman; One-year outcomes of a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis, Rheumatology, Volume 40, Issue 9, 1 September 2001, Pages 1044–1051, https://doi.org/10.1093/rheumatology/40.9.1044

Hammond A (2013) Chapter 8: Joint Protection. In L Goodacre and M MacArthur (Eds): Rheumatology Practice in Occupational Therapy: Lifestyle Management. Edition 1. (pages 111-132). Wiley-Blackwell, Chichester. ISBN: 9780470655160

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