You're right -no one would pay you to teach her to plant flowers, BUT if
you can clearly document how her client factors, context, etc affect
performance skills, then describe how the task demands (versus naming the
actual activity) of the therapeutic occupation are remediating the
performance issues, you're set. This can only be done successfully when
the client has been assessed from a truly client centered model with tools
such as the COPM.
Terrianne
Ron Carson
<[EMAIL PROTECTED]
om> To
Sent by: Shellie <[email protected]>
[EMAIL PROTECTED] cc
now.com
Subject
Re: [OTlist] Home Health Question
04/14/2005 06:03
PM
Please respond to
[email protected]
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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