Re: Establishes Own Goals

[Delores234]

Follow the RAI manual, allow the resident to organize their own activities or set their own pace.  It is my experience that this type of resident is usually a problem for the facility.

They do not want to fit into the facility routine, they want care to fit into their routine.  And why not?  Doesn't the MDS ask us to assess for the residents customary routine?  I am not a morning person, if you schedule my PT in the morning I will probably do half as well as after lunch.  And forget PT and OT in the morning, I would throw them out of my room.

When I dislocated my elbow I scheduled my OT appointments after lunch--did great!  In the morning I moped around.  Did my exercises before I went to bed.

We document food preferences, why not document therapy preferences, pain medication preferences, ADL activity preferences etc.  Or would that be in conflict with "Facility Policies, rules, physical layout, etc."  Reference RAI manual page C28.

How would you feel if you knew you were going to receive therapy each day but you never knew when it would be?  Wouldn't that make you unsettled?  Maybe the resident would like to put on make up, comb her hair.  Perhaps she has a routine of a BM after breakfast, not PT.

I interviewed one resident who was refusing PT and the client was going to deny Medicare Part A benefits.  She said it was because they came too early and she was not dressed and it was cold in the therapy room in the morning--Good enough for me, schedule her in the late morning or after you heat up the room and she is dressed. 


Delores

Just curious......when this triggers, how does everyone care plan to this?
Our social services who code this area don't want to care plan to it under
psychosocial. Any ideas?

Delores L. Galias, RN, RHIT

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