I presently work in long-term care and find myself writing similar goals for different patients. My concern in writing the goals comes from two persectives. First, (for the Medicare reviewers of our state) do the goals reflect the need for the skills of an occupational therapist? Within this I am cautious that I am able to document that the patient is benefiting from the skilled services of an occupational therapist, and that nursing is not documenting in a way that suggests that our skilled services are not "reasonable and necessary". Second, I keep the client-centered goals (those of the patient) in mind when generating goals, and would ammend a "standard" goal for one that meets the patient's identified needs. Here I feel that more grey areas come forth.
Unfortunately, but realistically, the patient does not always have full insight into their situation (ie, because of dementia and the like). Should a person's goals be "unrealistic" than I feel I must superscede their goal for one that may be more appropriate. It is here that I must always pause however. Though the individual may have poor judgement, within their personal goal lies a seed that may be useful within the course of treatment and should be sowed whenever possible. An example of this could be the following: Mrs. M.'s goal is that she wants to return home. She previously was living in an independent retirement community, but was failing to meet the cognitive demands of "independent" living. I believe that a return to "indepent" living may not be wise at this time due to poor judgement, memory and safety. I would try to determine in what ways Mrs. M. found purpose in her life in the previous living situation. To what "occupations" did she find meaning and commit time. This is not an easy line of inquiry, and I am always learning. But if we could find that Mrs. M. enjoyed the socialization at mealtime with a neighbor, or that she was active with a group, maybe we could find ways to make this occur in a more supportive environment. Please forgive my soapbox. FUNCTION pays the bills for occupational therapists, but it often does not adequately reflect one's qualilty of life. OTs need to be strong and secure in how they address function, but must move to better understand how occupation affects quality of life. It is our professions heritage, and I hope our future. Aaron Eakman ----- Original Message ----- From: "Ron Carson" <[EMAIL PROTECTED]> To: "Suzanne Martin" <[EMAIL PROTECTED]> Sent: Tuesday, March 26, 2002 8:05 PM Subject: Re: Prefabricated goals > Hello Suzanne: > > Formerly, I worked in acute care rehab and we used critical pathways for > nearly all our charting. While the pathways certainly had room and > designations for individualizing goals to clients' needs, it was a very rare > therapist who took the time to identify and chart these goals. JCAHO seemed > to love the pathways as long as they were signed and dated by therapists. > It's funny because accuracy of documentation was more relevant rather than > the authenticity of the goals. > > Ron > > ~~~~~~ > On Tuesday, March 26, 2002, [EMAIL PROTECTED] wrote: > > SM> The facility I work for just developed new eval forms for acute and SNF, > SM> including a prefabricated check off list of goals. Our boss let two OTs > SM> who are new to SNF and acute do this because the "write the same goals > SM> for everybody anyway". This is the second facility I have seen do > SM> this. I am the only one who believes that this is so incredibly > SM> unclient centered. Does anybody have experiece with forms like this? > SM> Would JACHO approve of this? I think this is taking the skill out of > SM> what we do. Please tell me I am not the only OT who LIKES to write > SM> individualized goals!! > > SM> > > > > > > > SM> MSN Photos is the easiest way to share and print your photos:Click Here > SM> *********��*********** > > SM> Unsubscribe? Send a message to [EMAIL PROTECTED] > > SM> In the message's *body*, put the following text: unsubscribe OTlist > > SM> ** List messages are archived at: > > SM> http://www.mail-archive.com/[email protected] > > SM> *********��*********** > > *********��*********** > > Unsubscribe? Send a message to [EMAIL PROTECTED] > > In the message's *body*, put the following text: unsubscribe OTlist > > ** List messages are archived at: > > http://www.mail-archive.com/[email protected] > > *********��*********** > *********��*********** Unsubscribe? Send a message to [EMAIL PROTECTED] In the message's *body*, put the following text: unsubscribe OTlist ** List messages are archived at: http://www.mail-archive.com/[email protected] *********��***********
