Hello Joan:

It's funny how things sometimes fall into place. Just today, I evaluated
an  older  adult  living  in  an  ALF.  The  referral was secondary to a
doctor's  report  of  bilateral  rotator  cuff injuries. Notice that the
referral wasn't for difficulty bathing, eating, dressing, etc.

Anyway,  in  talking  with  the client we identified obvious limitations
with ROM and she reported quite a bit of pain. BUT, she also stated that
she  had difficulty obtaining clothes from the closet and reaching items
on  the  dining  room  table.  So,  like  you  said, in listening to the
patient, she identified occupational deficits. But, here's the confusing
part.

If  the  goal  is  occupation,  then  I  only  need  recommend  a higher
chair/lower  dining  table  and  that  she  place her clothes on a lower
shelf.  Thus,  her occupational performance is restored. Obviously, such
recommendations   are   not  warranted  but  isn't  this  what  you  are
saying?

Instead,  shouldn't  I  address the cause of her occupational limitation
which  of  course  are  biomechanical  in  nature.  But  addressing  her
biomechanical problems so that she might better complete her occupations
is  no different than what a PT or in the case you gave, an RT might do.
They might not call them occupations but that isn't the point.

It  seems  that looking at these situations kind of leaves OT stuck in a
vise.  We say we are about occupation but when the rubber hits the road,
we are only about occupation as an ancillary byproduct of our therapy.

Ron

----- Original Message -----
From: Joan Riches <[EMAIL PROTECTED]>
Sent: Wednesday, April 26, 2006
To:   [email protected] <[email protected]>
Subj: [OTlist] Occupation

JR> Do  you see your clients in their homes? Most people will tell their
JR> troubles  to  an  empathetic  listener  and even if the problem is a
JR> 'medical'  one  the  'troubles'  will  include  the  things they are
JR> prevented from doing.



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