A few years ago I had a client in the community who had Parkinson's. She had fallen and had negative x-rays. She was sent back home and her mobility and transfers declined to Max x2 or Dependent. Her physician had adjusted her medication but no relief from the pain and no improvement in movement.
Her 60+ husband was her primary caregiver. I called the community case manager and recommended that she call his physician to have her re-assessed. ( I also had him call, using the squeaky wheel principle and told him not to take no for an answer.) She was able to be seen that day and the new x-rays showed a pelvic fracture. She was able to stay in for follow up and rehab. Your client may have something more mysterious going on, or it may be the views they took or their interpretation was flawed. Perhaps it was not discernible from an x-ray. Just an idea. Greg -----Original Message----- From: Ron Carson [mailto:[EMAIL PROTECTED] Sent: Wednesday, December 17, 2003 8:01 AM To: [EMAIL PROTECTED] Subject: [OTnow] Help with Client Hello: I am working with a client who was diagnosed with Alzheimer's Disease approximately 7 years ago. She has shown a steady decline in occupational independence during the years but she has shown a significant decline in the past month. The family is 100% dedicated to keeping their mother at home. The family reports, that about three weeks ago, the client was walking in/out of the home with SBA. While outside, the client fell, apparently when striking at a caregiver. Since her fall, she has shown tremendous decline in her ability to walk, stand and transfer. Prior to the fall, the client would stand in the bathroom while the family cared for hygiene. To day, the client required max assist (X2) to stand. The possibility of a hip injury/fracture remains, but all orthopedic x-rays were negative. The questions I have are: 1. What are the likely causes of the client's recent decline: a. Normal progression of the disease b. Fear of falling/standing secondary to recent fall 2. Based on the above, or any other plausible explanations, what treatment approaches will best facilitate this client to be able to increase her participation in toileting and transfers. Thanks, Ron P.S. I am seeing the client today and Friday and plan to make a decision about which direction to take our remaining therapy. Should we continue working on remediation of underlying issues or begin adaptive strategies to decrease the family's burden and promote the client's safety _______________________________________________ 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] ================ _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
