UE treatment

[mr silva]

I know this question will drive Ron nuts, but I'm requesting help from those OTs who treat UEs.   I work in home care and currently have an 80 y.o. patient with a recent (2 weeks) torn rotator cuff from a fall.  Due to his age and cardiac status, he will not have this tear surgically repaired.  It was just diagnosed this week, although I certainly suspected this diagnosis since I met this patient a week ago.  He is currently homebound, possibly for 2 weeks, due to his pain level - I will then refer him to outpatient.    Current status - AROM - maybe 20 degrees flexion.  PROM - difficult to fully ascertain due to pain but I can get around 45 degrees flexion and he has minimal rotation.  AROM elbow flexion is only to 45 degrees due to pain.  His pain level is severe - 8/10.  Please advise on appropriate treatment.   Ron, I am a well-seasoned OT.  I certainly embrace and utilize an occupation-based approach with all my patients and certainly hope you will give me and all the other OTs who prescribe to this listing the respect that we deserve.  It is clear that you feel you are the only one to practice pure OT, and that you envision yourself as the ultimate OT; however, believe it or not, there are many of us out there who are also competent, and leave our patients more capable (physically, emotionally, psychologically) of living the life they want and fulfilling their roles/occupations.  I have found your postings over the past few months to be very condenscending to other OTs and have been personally insulted by you a number of times, in spite of the fact that this is my first posting to the list and that you have never written to me directly. Donna