I understand the flaccid hemiparesis, I was thinking more toward a resident with advanced dementia or Alzheimer's who have the physical ability to do it but not the mental.  Am I making sense?  Say you have a resident with dementia and with their PROM they do not have any limits nor do they have any contractures, but due to their limited cognitive ability they are unable to assist with adl's.  How would you code this scenario?
Michelle
----- Original Message -----
Sent: Friday, May 07, 2004 7:49 PM
Subject: Re: ROM vs Voluntary movement

Section G4 is measuring Functional Limitations in Range of Motion.  A resident who was not able to move his joint--required passive range of motion--would be coded as a limitation in range of motion.  Look at the example on the top of page 3-111. In the example, the resident has flaccid hemiparesis.  The example codes the resident with Limitation on one side of the body. 
The intent of the question is not to determine if it is possible to move the joint through the full range of motion, it is to identify limitations that interferes with daily functioning particularly with activities of daily living, or places the resident at risk of injury.
----- Original Message -----
Sent: Thursday, May 06, 2004 8:29 AM
Subject: ROM vs Voluntary movement

I keep getting confused on this point.  In the manual it keeps refering to active assistive ROM.  What if you have a patient that requires PROM and has no limits with that.  Since it is not active assistive would they decreased ROM?  I have to inservice on documentation and this is always a grey area for me.  I thought it means that if they have ROM with PROM you wouldn't code for decreased ROM.  Help, please.
Michelle
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Thank You.
 
Michelle Witges

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