Your questions are good and actually are similar to ones I have had through
the years.  To me physical therapists....traditionally...and I acknowledge
that this is changing...might work on components needed to complete a task
ie. Strengthening specific leg muscles needed to walk....and might practice
walking and transfers out of context ie. Walking x number of feet with
support.  Occupational therapists...in best case scenario...see the entire
task process in context.  I call this a functional perspective.  For
example...my best friend broke her ankle and had it pinned on a Friday
night.  She was ill from the spinal and missed a few PT appointments.
Monday morning I called prior to picking her up.  I was to be her primary
assist at home, and I have chronic pain/fatigue.  I asked PT if she could
get out of the chair herself.  Yes.  Could she walk to and from the
bathroom.  Yes she can walk x number of feet.  I asked if I could count on
her being able to do this for the 11th time in a given day.  Hmmmm.....they
didn’t know.  Could she stand at the kitchen counter and prepare a meal.  I
would have to talk with OT about that.  I knew she hadn't had OT.  I could
picture her apartment and had already cleared pathways and arranged "work
areas" for her.  She is a large person and has numerous health problems.
She lives alone and is totally responsible for all aspects of her life.  An
accessible bathroom on first floor was great, but sleeping arrangements
needed to be made on this level.  As an OTR I ran through a mental list of
motivational level, experience, meaning attached to being dependent (and the
need to preserve our friendship above all), routine, essential tasks, how to
encourage as much independence as possible, durable medical equipment
available from local loan closet, preferences, health considerations
(shortness of breathe, high blood pressure, depression)...in a nutshell I
tried to take into account every little detail involved in her daily life
and recovery.  In a clinic setting, there is often no time to do this.  Good
OT's can get to the heart of the matter and prioritized factors.  For
instance there is no point in coming up with a picture perfect treatment
plan if the patient doesn't buy it or won't follow through with it.  Our
background in psychology, sociology, anatomy, physiology...etc. gives us a
rich resource pool for analyzing every aspect of a task.  We can help people
do the things they need or want to do ie. To be functional, to function, to
work on functioning better.  It gels for me this way at age 52 as an
intuitive thinker, wife, and mother.  My patients have included celebrities,
the homeless, and many profiles in between.  

There is more to be addressed, but I need to make supper now.  Will get back
to this when I have time.  

I would say that I have had many experiences being part of a team.  We
allowed each other to pursue our area of precise skill/interest within our
profession.  Soo....when someone entered the industrial rehab center with
psych issues they usually were headed my way.  When filling in on rehab in a
small hospital, if I was working with someone on feeding themselves and
noted weak trunk muscles I would mention it to PT.  They were better
equipped to work on that in this particular setting.  Speech worked on the
facial muscle control as that was not an area I was experienced in at all.
I worked on alerting and patterning as well as educating dietary, nursing,
and family on ways to focus the person's attention, provide utensils and
set-up to compensate for impairments, and initiate the feeding patterns if
they did not happen spontaneously. 

More later.
  
Deb

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Jimmie Arceneaux
Sent: Tuesday, March 08, 2005 1:45 PM
To: [email protected]
Subject: [OTlist] RE: [Outlist] Long Rant about OT


Deb,

Please take these questions not as a personal attack, but as an attempt to
explore the issue further.  I am not trying to hurt anyone's feelings, but I
don't want to be called a functional therapist.  I think the term is
ambiguous and sacrifices the founding principles of a profession for an easy
attempt at definition. 


Based on your previous post would you answer the following:  How then do you
differentiate your self from other rehab disciplines?  When a PT works on
the mechanics of gait is this not functional?  When an ST works on
swallowing is this not functional?  What makes OT a distinct profession in
your view? 


Jimmie

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
Deb
Sent: Tuesday, March 08, 2005 1:00 PM
To: [email protected]
Subject: RE: [OTlist] Long Rant about OT


I have wished that occupational therapy COULD be called functional therapy.
After over 25 years of practice this IS the term that means something to the
patients, physicians, other healthcare providers, employers, human service
agencies, and general public with whom I have been involved.  In a two part
television program that I helped make for our local community channel, the
public feedback supported this also.

Deb (Experience in nursing homes, a visiting nurse service, a community
support program, for profit and non-profit home health, day treatment,
establishment of an OT program in a half-way house, industrial
rehabilitation, in-patient rehab., and out-patient services in various
capacities including staff therapist and director (full, part-time, on-call,
fill-in in Arizona, Minnesota, and Wisconsin).  Also child of the 70's.

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Jimmie Arceneaux
Sent: Tuesday, March 08, 2005 8:05 AM
To: [email protected]
Subject: RE: [OTlist] Long Rant about OT


Hey Ron,

An equally long and possibly offensive rant:

I hate the term function!  What exactly does that denote?  You see a
multitude of people now harping on such terms as "functional ambulation",
"functional memory", functional mobility". functional range of motion, etc.
It is silly.  If there is such a thing as functional ambulation, would
someone care to take a stab at defining non-functional ambulation?






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