Most OT clinicians use approaches that OT educators
consider more like [PT]... to treat the deficit rather than the whole
person. In the clinic, that is perfectly acceptable and understood by
other disciplines.
I find this to be often true in nursing homes. I supervise two COTAs at two nursing homes, and have for many years. I write both kinds of goals - my 700s/701s usually have 8 to 10 short term and 8 to 10 long term goals, including ADLs and UE function, and activity tolerance and patient education. I admit I kind of ignore the fact that my COTAs usually address mostly the UE goals and activity tolerance in treatments, and consider home health, where I actually treat patients rather than supervising, to be the better setting for OT. But recently, I changed nursing homes where I supervise and changed COTAs and I found that my new COTA actually does address many of the ADL goals that I write, and suggests extra ADL goals, which include ambulating, like ambulate safely from bed to toilet, perform toileting and clothing management, and return safely to bed with whatever assistance and than as LTG, independently. ( I know Ron has called ADLs the A word, but I find them to be important occupations for the frail elderly population, and anyway that is another conversation.) My new COTA spends most of her treatment time in the patients room and bathroom or in the dining room. She hardly ever uses the "Therapy room" which is equipped with mat table, parallel bars, and reductionist OT equipment like range bow and pegs. She does use the counter and sink in the therapy room and has done some cooking activities with a crock post especially for going home patients. I am impressed. For years, I have just not worried if the COTAs act like UE PTs, but it is refreshing to work with this COTA. I only wish I could switch them now since my reductionist COTA works at a nursing home that is equipped with a nice ADL apartment in the therapy room and my Occupation COTA works at a home with a crummy therapy room converted from a whirlpool room ( the whirlpool is still there in the way. But even if everone agreed to that it wouldn't work. The Occupation COTA already drives about 45 minutes to work and it would be 75 to the nursing home with the ADL apartment, although it would decrease the reductionist COTA's commute from 30 to 15 minutes if they switched. Plus the Occupation COTA and herf husband are building a log house after living in a trailer for 15 years so I don't think she would want to move. Blah blah I have gotten off topic, but anyway, theres my thoughts. -- Jody
