In a message dated 8/7/2003 8:56:32 PM Eastern Standard Time, [EMAIL PROTECTED] writes:
Hello Joe:
I imagine that the number of PT's billing under self-care and community
re-entry is very small. But maybe you are correct.
Everything done to occupy ourselves is not occupation. Much of what we
do during our days/nights is not significant or personally meaningful.
****While a person would often not identify many of the things they do that occupy their daily lives as significant or personally meaningful, those same things may be the very activities that will determine whether someone can resume what they do consider significant/meaningful. I don't consider independently toileting as a supremely meaningful act in my life, but if I couldn't do it, I wouldn't be able to live alone, and that would greatly impact my current life roles. Same thing with dressing, bathing, household chores - I happen to HATE housekeeping, but I hate an invasion of my privacy more, so having to rely on another to perform those tasks for me would be financially and emotionally detrimental. To follow this through to your case approach below, if you were to use the COPM with me, it would not necessarily reveal the above, as I would probably spend more time telling you about the importance of my ability to care for and interact with my dogs as well as perform my job.
I whole-heartedly disagree that OT's are equally trained to handle
physical dysfunction. I how for a fact, that PT students at the
University that I previously taught at received much more advanced
training in physical dysfunction. I may be wrong, but I bet that the OT
and PT students on this list will confirm my statement. Also, OT's at my
previous place of employment are primarily trained in the upper
extremity, not the pelvis, spine or lower extremity. So, in my
experience, OT's are less trained in physical dysfunction than PT's and
especially in LE's. Which lends further stamina to my disagreeing with
Estelle B. about OT's treating the whole body.
*******The people treated in a physical dysfunction setting are not just orthopedic cases, which seem to be the ones you are focussing on in your comments above. People with neurologic disorders constitute a large percentage of the phy.dys. population. Those of us OTs out here treating them have not only as good an understanding and education in regard to the physical deficits resulting from a neurologic disorder, but also a superior knowledge of and education in the cognitive and psychosocial deficits that are just as much a part of this population's deficits. Even the orthopedic cases you seem to refer to experience occupational role disruption that benefits from the intervention of an OT, and our contribution is something that PTs are not as qualified to provide.
Ann
Ron
As for mock cases I can pretty much tell you how I will treat.
1. Use the OPPM (occupational perfomance process model) to guide
intervention, outcomes and treatment
2. Use the COPM as my outcome measure.
3. Accordingly, if the client doesn't have occupational issues, send
them to someone else.
Ron
