Hello Veronica: I am seeing the patient! However, I am struggling to understand if I should be seeing the patient because she doesn't identify any occupational goals. I used to tell students, if there no occupational goals identified, then there's no role for OT. The goals with the client are mobility related like: "Client will safely ambulate to bathroom using appropriate mobility aid". I am comfortable with the goal IF the client identified the deficit. But she didn't, I did! I know that in some cases, clients are cognitively unable to identify goals, but such is not the case with this client.
What I am asking is more of a philosophical rather than practical question. Of course, the client needs therapy and of course, OT can treat the client but based on our treatment philosophy of being client-centered and addressing occupation, my question is SHOULD I be seeing her? Ron ===========> Original Message Follows .... On5/5/2005, Veronica, <[EMAIL PROTECTED]> said: V> That's a tough one! Are there any other professionals involved? V> Can her balance difficulties be addressed by someone else? She can't V> be left like that! some education is required re falls prevention! V> Are there any falls groups that she can join? Maybe it's an V> educational thing where she doesn't understand the relevance of OT to V> her situation and a falls prevention group may help educate her about V> how OT can help. Anyway, if she is not identifying any Occupational V> dysfunction areas as something that needs to be addressed OT cannot V> really be justified at present (or that's my opinion anyway), maybe V> she needs a bit of time to see what areas she is struggling with. V> A useful tool that I was recently shown (to use in Paeds but I V> think it is applicable accross the board) involves the client writing V> up a log of activities that they do daily. From getting up in the V> morning, brushing their teeth, walking to the bathroom, etc. and then V> using that with the COPM to identify degrees of satisfaction with V> tasks. It helped the client understand what was ment by OP tasks. V> In addition there is a standardized assessment (for Paeds not adult V> services - don't know if there's anything similar for adult services) V> called the PACS (Paediatric Activity Card Sort) that uses photos to V> help the child to identify what activities are more challenging. V> Hope this helps! V> Veronica V> Ron Carson <[EMAIL PROTECTED]> wrote: V> If we see a client that has physical dysfunction but *they* do not V> identify occupational dysfunction, is there a role for OT? Case in V> point: V> A client has a recent fall history. During the eval, the client scores V> very low on the Berg Balance test (indicative of increased fall risk). V> However, the client reports no difficulty using ambulating in her room V> or going to the dining room in her ALF. In other words, despite her V> fall, she does not readily feel she had difficulty with mobility related V> occupations. V> Now, I could probably pry it out of her that she has difficulty with V> going to/from the bathroom because she in fact fell coming back from the V> bathroom. But the *client* only sees that balance is her problem, not V> the balance-related activity. V> So, what to do? The client doesn't see occupation as the problem, she V> sees balance as the problem. V> Maybe I have analysis paralysis!! V> Ron V> -- V> Unsubscribe? V> [EMAIL PROTECTED] V> Change options? V> www.otnow.com/mailman/options/otlist_otnow.com V> Archive? V> www.mail-archive.com/[email protected] V> Help? V> [EMAIL PROTECTED] V> --------------------------------- V> Yahoo! Messenger - want a free & easy way to contact your friends online? -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
