Ron- It would help to have more information about this scenario. When you say that the patient began receiving OT, I'm not clear on whether the OT comes to this daycare center, the patient is going to an outpatient program, or is receiving home care OT. You mention that the therapist gave the daycare staff what in essence sounds like a home exercise program - something that can be carried out by non-OT/non-professionals to reinforce goal achievement in between therapy sessions. Is the OT treating the patient directly, in addition to these recommendations made to the center? You also mention that you don't know what the reason for the referral is. I think that is an essential piece of information - how do you know what it is that the OT is trying to correct, if you don't know what the referral is about? You mention that this OTs approach is miles away from your approach, but actually, you are not actually treating her for whatever condition OT has been referred in on, ! rather, it sounds like you may be doing something more in line with the Well Elderly study, based on your comments about a group activity. All of this information would be essential, as would more information about what the OT's goals are, and what he/she is doing with the patient during direct treatment sessions, before it is possible to assess differences in approach. Ann
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