Ron,

The nursing services for home health made the eval. for IADL'S

I missed a question on the tinetti but approx 12/16.  She had the most
difficulities with closed eyes and when I challenged her balance.

I went through several IADL's I could think of, ie preparing meals, laundry,
house cleaning.  Her neighbor does her laundry and she is currently
preparing her own meals (simple things).

I haven't heard of the COPM but would would be interested in learning more.

Thank you for your comments Ron, I really appreciate it.  I will.  I would
appreciate any other comments you have.
----- Original Message ----- 
From: "Ron Carson" <[EMAIL PROTECTED]>
To: "Shellie" <[email protected]>
Sent: Thursday, April 14, 2005 5:03 PM
Subject: Re: [OTlist] Home Health Question


> Shellie: Most of my comments may come to late, but I suggest:
>
> 1. An eval of her LE strength
>
> 2.  A  quantitative  eval  of  her balance - it's hard to provide justify
> improvement in something that's a 'little off'.
>
> 3. YOU can do strengthening and balance training
>
> 4. I don't think there's any insurance company that will pay for someone
> to learn to plant flowers!
>
> 5.  Does  her  balance  affect her occupations? Does she have difficulty
> taking  care  of herself or being productive in her home? If so, is this
> because of balance or LE strength? If so, AND she wants to address these
> occupations, then you have your goals and treatment plan.
>
> 6. Have you done an occupational assessment, like the COPM?
>
> 7.  Finally,  if  your  nor  the  client can't identify any occupational
> goals,  then  there  may not be a role for OT. If this is the case, then
> don't see the client.
>
> 8. Who made the OT referral and why?
>
> Ron
>
> ===========> Original Message Follows ....
>
> On4/14/2005, Shellie, <[EMAIL PROTECTED]> said:
>
> > I just started back to work as an OT last month and finally got my
> > first evaluation.  I am still really rusty and don't know
> > reimbursement rules for home health.
>
> > I got an order to evaluate a 79 y/o for IADLS.  The lady has mostly
> > 5/5 strength on the right, 4+/5 on the left.  She is independent with
> > ALL her ADL'S.  Her balance was a little off and she reported several
> > falls.  I told her we could work on her balance while making a meal,
> > etc but she wasn't interested in that.  She wants to get out and plant
> > flowers.
>
> > I really struggled with this.  PT could do strengthening and
> > balance training.  I didn't think an insurance company would cover for
> > IADL'S without having more significant problems.
>
> > I just evaluated her and need to turn the paper work in tommorrow,
> > any suggestions would be greatly appreciated.  I wanted to ask my
> > supervisor but she is a PT and it would be nice to get an OT's view.
>
> > Shellie
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