Hi Ron! > > WOW!, you really provide a ton of information!! :-). Ummm, yes...I've been known to ramble on quite a bit :) > I am interested in all that you said but I am most interested in your > comments about Enabling Occupation. > Well, right now my experience on this acute unit is somewhat limited - as I'm filling in for another therapist and I've only been working for this service for 5 weeks or so, BUT - One of the routines this acute service had developed in relation to OT practice is - screen the client and then do an AM care assessment or a Kitchen assessment to determine if the client is safe to return home. Those are the two consults I seem to get most often and primarily because of the "acuteness" of the service and the fast discharge rate. And although there is nothing specifically wrong with doing an AM care assessment or kitchen assessment, it seems that the clients don't always understand 1) why they are doing it or 2) how this can benefit them - which in my opinion makes it difficult to collaborate with the client, identify what they feel the occupational performance issues are, or to obtain informed consent to participate in OT. I have been trying to use the COPM as a tool to identify the occupational performance issues with my client, and if I don't have the time or resources to address the issues, I try to find an alternate service that can ensure a continuum of care for the clients. In one situation the team firmly wanted an AM care assessment done - to "clear" the person to return home. Now the underlying "physical limitations" included shortness of breath, fatigue, and decreased range of motion in upper extremities. When I interviewed my client she didn't identify self care as an issue that was important to her - prior to coming to hospital she "got by" with the basics, and would limit her dressing to simple robes, etc. However, she desperately wanted to be able to pursue her lesiure activities again - cross word puzzles, tole painting, etc. So we identified the barriers to her performing these occupations - which included the SOB, decreased ROM, and fatigue. We discussed energy conservation techniques and came up with ideas so that she could conserve energy doing the "day to day" chores and would allow her to pursue the more meaningful occupations. To address her ability to function at home, we agreed that we would do an "AM care assessment" - as part of her routine in getting ready to come to the OT room to do tole painting. I assessed her ability to perform her self care, then when we headed over to the OT room we discussed methods of simplifting self care and we continued with problem solving in regard to tole painting - pacing, energy conservation techniques. In the end, she was satisfied with her OT intervention and was able to incorporate the methods learned into other occupations. The team was also satisfied because they had their "ok" for discharging the client. I guess on my part it's involved problem solving and creativity as well as educating the clinical staff with whom I work. We'll see how it goes :) Cherie ******************** Unsubscribe by sending a message to [EMAIL PROTECTED] In the message's body, put the following text: unsubscribe OTlist ------ OTnow messages are archived at: http://www.mail-archive.com/[email protected] (and) http://www.mail-archive.com/[email protected] ********rC***********
