dont we all David A. Lehman, PhD, PT Associate Professor Tennessee State University Department of Physical Therapy 3500 John A. Merritt Blvd. Nashville, TN 37209 615-963-5946 [EMAIL PROTECTED]
-----Original Message----- From: Ron Carson [mailto:[EMAIL PROTECTED] Sent: Wednesday, December 17, 2003 9:08 AM To: Lehman, David Subject: Re[4]: [OTnow] Help with Client I think I need help!! ======================================================= On Wednesday, December 17, 2003, @ 9:59 AM, you wrote: LD> So, what do you think? LD> David A. Lehman, PhD, PT LD> Associate Professor LD> Tennessee State University LD> Department of Physical Therapy LD> 3500 John A. Merritt Blvd. LD> Nashville, TN 37209 LD> 615-963-5946 LD> [EMAIL PROTECTED] LD> -----Original Message----- LD> From: Ron Carson [mailto:[EMAIL PROTECTED] LD> Sent: Wednesday, December 17, 2003 8:29 AM LD> To: Lehman, David LD> Subject: Re[2]: [OTnow] Help with Client LD> Hello David; LD> I agree with your observations that it is unlikely that the disease itself LD> would lead to such immediate changes. I also believe that people with any LD> type of disease( physical, mental or environmental) are more susceptible to LD> stress and that stress can magnify their symptoms. LD> Regarding your physical trauma question... The family states that there was LD> no bruising or any other signs of trauma. The ONLY medication she is on is LD> something to stimulate her appetite. And, she has been on this meds, at the LD> same dose, for an extended period of time LD> Ron LD> ======================================================= LD> On Wednesday, December 17, 2003, @ 9:15 AM, you wrote: LD>> Wow....I have seen such things before in people with progressive LD>> neuro disease.....it is hard to pin it on progression per say, because LD>> it seems unlikely that there would be an immediate and drastic decline LD>> overnight....question: was there any physical trauma (i.e. fracture or LD>> anything that required medication or surgical intervention)? It could LD>> be the medication. Also, my belief is that sometimes trauma causes a LD>> stress to the system that then "causes" a more rapid decline....it has LD>> been hypothesized that numerous neurodegenerative diseases respond to LD>> stress. LD>> David A. Lehman, PhD, PT LD>> Associate Professor LD>> Tennessee State University LD>> Department of Physical Therapy LD>> 3500 John A. Merritt Blvd. LD>> Nashville, TN 37209 LD>> 615-963-5946 LD>> [EMAIL PROTECTED] LD>> -----Original Message----- LD>> From: Ron Carson [mailto:[EMAIL PROTECTED] LD>> Sent: Wednesday, December 17, 2003 8:01 AM LD>> To: [EMAIL PROTECTED] LD>> Subject: [OTnow] Help with Client LD>> Hello: LD>> I am working with a client who was diagnosed with Alzheimer's Disease LD>> approximately 7 years ago. She has shown a steady decline in occupational LD>> independence during the years but she has shown a significant decline in the LD>> past month. LD>> The family is 100% dedicated to keeping their mother at home. LD>> The family reports, that about three weeks ago, the client was walking LD>> in/out of the home with SBA. While outside, the client fell, apparently when LD>> striking at a caregiver. Since her fall, she has shown tremendous decline in LD>> her ability to walk, stand and transfer. Prior to the fall, the client would LD>> stand in the bathroom while the family cared for hygiene. To day, the client LD>> required max assist (X2) to stand. The possibility of a hip injury/fracture LD>> remains, but all orthopedic x-rays were negative. LD>> The questions I have are: LD>> 1. What are the likely causes of the client's recent decline: LD>> a. Normal progression of the disease LD>> b. Fear of falling/standing secondary to recent fall LD>> 2. Based on the above, or any other plausible explanations, what treatment LD>> approaches will best facilitate this client to be able to increase her LD>> participation in toileting and transfers. LD>> Thanks, LD>> Ron LD>> P.S. I am seeing the client today and Friday and plan to make a decision LD>> about which direction to take our remaining therapy. Should we continue LD>> working on remediation of underlying issues or begin adaptive strategies to LD>> decrease the family's burden and promote the client's safety LD>> _______________________________________________ LD>> To unsubscribe, visit: LD>> http://otnow.com/mailman/listinfo/otlist_otnow.com LD>> The OTnow Mail Archive: LD>> www.mail-archive.com/[EMAIL PROTECTED] LD>> =============================================== LD>> _______________________________________________ LD>> To unsubscribe, visit: LD>> http://otnow.com/mailman/listinfo/otlist_otnow.com LD>> The OTnow Mail Archive: LD>> www.mail-archive.com/[EMAIL PROTECTED] LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] LD> =============================================== LD> _______________________________________________ LD> To unsubscribe, visit: LD> http://otnow.com/mailman/listinfo/otlist_otnow.com LD> The OTnow Mail Archive: LD> www.mail-archive.com/[EMAIL PROTECTED] _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] =============================================== _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ==============================================
