Hello Jimmie: I haven't yet read the article but did want to comment about something that I heard yesterday.
My wife (who's on this list) and I went on an OT marketing call to an ALF. Normally I do these by myself but my wife knows the ALF so she decided to attend. As I was talking to the ALF owner, I noticed a person doing a hand massage on a resident. Well, come to find out, the person doing the massage is a COTA and was seeing one of the residents for therapy. And if it isn't strange enough having two OT's at a facility at the same time, the COTA worked for my major competitor - very strange!! Because of some billing questions the ALF asked the COTA to join our conversation. As usual, explaining the difference between OT and PT became a prominent part of the conversation. The COTA explained OT as: "focusing on the UE" while PT "focuses on the LE." I just about fell out of my seat, because the COTA had previously explained that OT works on the whole body. How confusing is that!!! Ron ----- Original Message ----- From: Jimmie Arceneaux <[EMAIL PROTECTED]> Sent: Friday, July 01, 2005 To: [email protected] <[email protected]> Subj: [OTlist] "It's A Matter of Strength" JA> Hello, JA> OK, has anyone else read the article titled, "it's A Matter of JA> Strength: Optimizing Functional Independence" in the June 27 JA> edition of Advance for OTs? I cannot for the life of me understand JA> why OTs pigeon hole themselves into the upper extremity thing all JA> the time. The article mentions that OTs do upper extremity JA> strengthening or exercise close to 10 times by my reckoning. This JA> is along with many other unfathomable comments. JA> One quote, "For the geriatric population, upper extremity JA> strength plays a key role in maintaining independence." I suppose JA> strength in the rest of the body has no bearing on independence. JA> Why make a statement like that? JA> Another quote, "In addition, the age-related decline in muscle JA> mass that leads to decreasing upper body strength and endurance JA> often creates difficulties for older people. Without the strength JA> required to perform basic activities of daily living (ADL), many JA> older people become frustrated, eat less, lose self esteem, reduce JA> their socialization, and limit or stop participation in other JA> formerly enjoyable activities." It seems like a chicken before the JA> egg scenario! I feel that the decline in strength is secondary to JA> the occupational dysfunction and that progressing limitation in JA> occupational capabilities and participation in daily occupations JA> leads to many secondary issues including decreased JA> strength/endurance. Although, I can see where their coming from, it JA> would be a clearer example of OT to use a differnet approach (i.e. JA> one focusing on the occupational task and using engagement in JA> purposeful activtiy as a primary means for intervention). JA> They go on to mention regarding observation of inability to JA> transfer, push up from a chair, mobilize around the facility, JA> support their weight and maneuver with a walker and relate this to JA> identify a patient in need of upper extremity strengthening. Did I JA> miss something? Wouldn't the above items more denote an individual JA> in need of lower extremity strengthening? Regardless, why don't JA> they explore the occupational limitations associated with all of the JA> above limitations and focus their interventions appropriately. If a JA> patient is having difficulty as noted above, they would probably JA> have difficulty with self care, productivity and leisure interests. JA> Will upper extremity strengthening ameliorate the occupational JA> issues? If you were to take a biomechanical approach, why wouldn't JA> you prescribe lower extremity strengthening for this type of patient? JA> The most blatant statement reads, "..what sets occupational JA> therapy apart from other therapy disciplines is the focus on tasks JA> and goals that relate to functional activities." It would come as a JA> surprise to most PTs that they don't focus on tasks and goals that JA> relate to function. I really don't believe this is what makes OT a JA> distinct profession. JA> They finish with a statement about getting out the "message" JA> about signs of declining strength and endurance. I would rather JA> they not get that message out...Thank you very much. JA> Jimmie Arceneaux, LOTR JA> Metro Preferred Home Care JA> 3501 N. Causeway Blvd., Ste 200 JA> Metairie, LA 70002 JA> 504-838-7080 JA> Fax 504-833-9309 JA> *** NOTICE--The attached communication contains privileged and JA> confidential information. If you are not the intended recipient, DO JA> NOT read, copy, or disseminate this communication. Non-intended JA> recipients are hereby placed on notice that any unauthorized JA> disclosure, duplication, distribution, or taking of any action in JA> reliance on the contents of these materials is expressly prohibited. JA> If you have received this communication in error, please delete this JA> information in its entirety and contact the Amedisys Privacy Hotline JA> at 1-866-518-6684. Also, please immediately notify the sender via JA> e-mail that you have received this communication in error. *** JA> -- JA> Unsubscribe? JA> [EMAIL PROTECTED] JA> Change options? JA> www.otnow.com/mailman/options/otlist_otnow.com JA> Archive? JA> www.mail-archive.com/[email protected] JA> Help? 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