Right Ron The dentist is a person with a profession who has a specialised expertise just like us. The dentist looks at a toothache with dentist eyes. The occupational deficit is implicit in the dental problem but it is not her expertise to address it - just as (unlike the OT/PT confusion) it is not part of our expertise to address the toothache per se. Part of our problem is that occupation is present in EVERYTHING that anyone does. Our special expertise is that we see that. I am remembering my own frustration when in Home Care I kept walking into situations where VERY OBVIOUS simple things were working against the client or compromising safety. Finally I realised that those things were not obvious to either the nurse or the client. It took OT eyes to see them and make them explicit and that is why I was there. Value your OT eyes. They are special. They are what make us specialists in occupation. They have become so much a part of us that we take them for granted. There is a problem our profession has that many others do not have. Many people can do their own OT interventions. You have described a lot of them. We do go to the dentist so we can eat corn on the cob. We've unconsciously done the assessment and identified the component that needs to be addressed. Then we name the component as the problem in order to access the specialty that can address it. The difference between us and the dentist is that dentistry is not embedded in all of life. The people who need us are those whose unconscious assessments are incomplete; for whom return to 'normal' is compromised by factors they do not have the expertise to consider; or whose present distress can be alleviated by practical means while natural or medical healing takes place. Quote from Michael "When given the choice of brushing their teeth standing at the sink (or) performing resistive standing exercises in parallel bars in most cases pt choose the exercises." I would too. I want to get my mouth feeling fresh and it's easier and more satisfying to do with the environmental modifications of sitting down with a glass and kidney basin. Struggling to do it standing at the sink compromises my occupational goal of a clean mouth and makes me feel inadequate. I'd sooner work on the standing separately in a social atmosphere where it is the prime concern. Someone (like us) needs to notice when I can stand well enough to use standing to support teeth brushing and encourage it. At that point standing ceases to be an occupation that requires my full attention and becomes a component to support dental hygiene. As I recover, dental hygiene will cease to be an occupation and become a component as well. This is called client centred practice. It's about not confusing our goals with the client's and then getting frustrated because we think our goals are more important. Lots of people will progress to standing at the sink on their own. We can help them by noticing and making the progress explicit since most of them will be focusing on the things they still cannot do 'nornally'. Wow has this discussion ever taken off. It's hard to keep up. Such a joy to have a place to struggle with these questions and others to 'listen ' with OT ears. Sorry if I'm pontificating. It's exciting to be so stimulated. Joan Riches
> -----Original Message----- > From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf > Of Ron Carson > Sent: Thursday, April 27, 2006 5:19 AM > To: Carmen Aguirre > Subject: Re: [OTlist] Occupation > > Carmen, it seems like a dentist is the same as an OT! > > ----- Original Message ----- > From: Carmen Aguirre <[EMAIL PROTECTED]> > Sent: Thursday, April 27, 2006 > To: [email protected] <[email protected]> > Subj: [OTlist] Occupation > > CA> Isn't the occupational relevance implied in the visit to the > CA> dentist?. I obviously can not eat because when I do, It > CA> hurts...therefore, I go to the dentist to get rid of the pain...I > CA> already know how to eat ...If all my teeth have to come out...the > CA> dentists comes up with compensatory appliances to help me perform > CA> the function of eating... > CA> I see the OT to help me use my hand in a coordinated manner so > CA> I can write...I know how to do it if I could make my fingers > CA> work...The limitation is the contracted hand or hyper/hypo-tonicity, > CA> etc; yet the implication of why I want it corrected is there... > CA> keep it coming! > CA> Carmen > CA> ----- Original Message ----- > CA> From: Ron Carson<mailto:[EMAIL PROTECTED]> > CA> To: Carmen Aguirre<mailto:[email protected]> > CA> Sent: Wednesday, April 26, 2006 6:00 PM > CA> Subject: Re: [OTlist] Occupation > > > CA> Yes, we see a dentist because of the toothache, not so we can eat corn > CA> on the cob! We call the electrician because we have an electrical short, > CA> not so we can watch TV. We take our care to a mechanic because it's > CA> broken, not so we can drive to a movie. > > CA> We call an OT because because we can't wash our feet.... > > CA> Now, who thinks of OT like that?? NO ONE, well almost no one! > > CA> About the only time that I hear mention of OT (keep in mind that I work > CA> in an outpatient private practice setting) is for fine motor, UE, and > CA> cognition. Once, I had a referral from a chiropractor to do a home > CA> safety assessment for his Dad, also a chiropractor. But by far, OT is > CA> normally referred to for anything OTHER than occupation. And that's a > CA> problem! > > CA> In my opinion, we MUST: > > CA> 1. Change our message > > CA> 2. Change our delivery > > CA> 3. Or a combination of the two > > CA> ----- Original Message ----- > CA> From: Carmen Aguirre > CA> <[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]>> > CA> Sent: Wednesday, April 26, 2006 > CA> To: [email protected]<mailto:[email protected]> > CA> <[email protected]<mailto:[email protected]>> > CA> Subj: [OTlist] Occupation > > CA> CA> Ron... > CA> CA> When we get sick, have a tooth ache, bleeding, etc we seek a > CA> CA> doctor to stop/cure/remediate the cause in order to restore "normal" > CA> CA> life (occupation). Why would it be different for patients who need > CA> CA> our services...I truly don't see the dis-articulation. Help? > CA> CA> Carmen > CA> CA> ----- Original Message ----- > CA> CA> From: Ron > CA> Carson<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]>> > CA> CA> To: > CA> > [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED] > r.com<mailto:[EMAIL PROTECTED]>> > CA> CA> Sent: Wednesday, April 26, 2006 11:17 AM > CA> CA> Subject: Re: [OTlist] Occupation > > > CA> CA> Yes, I agree 100% with your statement. BUT most patients that I see > are > CA> CA> not at the point of compensation. And besides, I don't think that > CA> CA> compensation is really a big part of medicine. I just can't see me going > CA> CA> to a doctor and saying; > > CA> CA> " If you have any patients who can't use their arms, hands, legs, > CA> CA> etc. then send them to me so I can teach them how to > compensate" > > CA> CA> Maybe this SHOULD be the role of OT but it is one role that in my > CA> CA> opinion is not highly promoted, practiced or warranted for many of our > CA> CA> patients. > > CA> CA> Ron > > CA> CA> ----- Original Message ----- > CA> CA> From: > CA> > [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED] > r.com<mailto:[EMAIL PROTECTED]>> > CA> CA> > CA> > <[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED] > rr.com<mailto:[EMAIL PROTECTED]>>> > CA> CA> Sent: Wednesday, April 26, 2006 > CA> CA> To: > CA> > [email protected]<mailto:[email protected]<mailto:[email protected]<mailt > o:[email protected]>> > CA> CA> > CA> > <[email protected]<mailto:[email protected]<mailto:[email protected]<mai > lto:[email protected]>>> > CA> CA> Subj: [OTlist] Occupation > > CA> CA> Enrc> Ok - I understand what you're saying, but let's just say that it > was > CA> CA> Enrc> not possible that this person receive a lens replacement and > everything > CA> CA> Enrc> did not get better and the problem could not be fixed. In this > case, > CA> CA> Enrc> occupation and compensation WOULD come to the forefront, > no? > > CA> CA> Enrc> ----- Original Message ----- > CA> CA> Enrc> From: Ron Carson > CA> CA> > CA> > <[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED] > com<mailto:[EMAIL PROTECTED]>>> > CA> CA> Enrc> Date: Wednesday, April 26, 2006 7:34 am > CA> CA> Enrc> Subject: [OTlist] Occupation > CA> CA> Enrc> To: > CA> > [email protected]<mailto:[email protected]<mailto:[email protected]<mailt > o:[email protected]>> > > CA> CA> >> Hello All: > CA> CA> >> > CA> CA> >> Recently Biraj pointed out that I: > CA> CA> >> > CA> CA> >> > always championed and advocated, very strongly I might > CA> CA> >> add,> occupation-based practice but now it seems [I am] > CA> CA> >> extremely> disappointed of anything the term has to do with in the > CA> CA> >> OT profession. > CA> CA> >> > CA> CA> >> Biraj is correct about my past vocalizations but today I don't > CA> CA> >> feel that > CA> CA> >> I am disappointed about occupation. I still feel the same > CA> CA> >> aboutoccupation but I think that I am becoming a bit jaded > CA> CA> >> at trying to > CA> CA> >> integrate occupation into my private practice. You see, > CA> CA> >> occupation is > CA> CA> >> important, it's important to ALL of us, but what I am > CA> CA> >> discovering is > CA> CA> >> that treating occupational deficits does not fit well with my > CA> CA> >> clientsbecause clients don't consider occupational deficits to be > CA> CA> >> the problem. > CA> CA> >> Here's a non-OT story to make my point. > CA> CA> >> > CA> CA> >> Recently, someone I know was diagnosed with cataracts. The > CA> CA> >> cataractsaffected his vision to the point that modifications were > CA> CA> >> needed to read, > CA> CA> >> work and play. Now, what do you think this person saw as the > CA> CA> >> problem;cataracts or occupations. Obviously, the impact on his > CA> CA> >> occupation is > CA> CA> >> what brought the cataracts to the forefront and motivated him to > CA> CA> >> seek a > CA> CA> >> lens replacement, but cataracts are the problem, not the > CA> CA> >> loss of > CA> CA> >> occupation. So, the person received a lens replacement and > CA> CA> >> everything is > CA> CA> >> getting better. Well, how does this 'story' apply to OT. > CA> CA> >> > CA> CA> >> Simple, our clients are seeking answers to problems. They want > CA> CA> >> theseproblems fixed. But the problems are not occupation, the > CA> CA> >> problems are > CA> CA> >> things like weakness, loss of balance, developmental delay, > CA> CA> >> depression,etc. Clients see these 'components' as the problem and > CA> CA> >> this is what they > CA> CA> >> expect their therapist to address. This is the way the entire > CA> CA> >> world of > CA> CA> >> medicine works and for OT to be any different just doesn't work. > CA> CA> >> > CA> CA> >> What I think needs to be done is for our patients to recognize > CA> CA> >> loss of > CA> CA> >> occupation as the primary problem. Then, they recognize the need > CA> CA> >> for an > CA> CA> >> occupational therapist. And as far as I can tell, the ONLY way > CA> CA> >> that this > CA> CA> >> is going to happen on a large scale is for AOTA to put > CA> CA> >> together a > CA> CA> >> NATIONAL ad campaign directed at educating people about > CA> CA> >> occupation and > CA> CA> >> thus occupational therapy. > CA> CA> >> > CA> CA> >> Finally, there are settings were occupation is the concern but > CA> CA> >> about the > CA> CA> >> only one that I know of is long-term mental health. And > CA> CA> >> given that > CA> CA> >> therapeutic occupation is rooted in mental health, this makes > CA> CA> >> perfectsense. But for the majority of OT's working in the US, > CA> CA> >> I think that > CA> CA> >> trying to integrate occupation as our main form and outcome is > CA> CA> >> a lost > CA> CA> >> battle, unless patients are EDUCATED, INTEGRATE and > CA> CA> >> EXPERIENCEoccupation-based therapy. > CA> CA> >> > CA> CA> >> Ron > CA> CA> >> > CA> CA> >> > CA> CA> >> > CA> CA> >> > CA> CA> >> -- > CA> CA> >> Unsubscribe? > CA> CA> >> > CA> CA> > CA> [EMAIL PROTECTED]<mailto:OTlist- > [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:OTlist- > [EMAIL PROTECTED]>> > CA> CA> >> > CA> CA> >> Change options? > CA> CA> >> > CA> CA> > CA> > www.otnow.com/mailman/options/otlist_otnow.com<http://www.otnow.com/mailman > /options/otlist_otnow.com<http://www.otnow.com/mailman/options/otlist_otnow. com > <http://www.otnow.com/mailman/options/otlist_otnow.com>> > CA> CA> >> > CA> CA> >> Archive? > CA> CA> >> > CA> CA> > CA> www.mail-archive.com/[email protected]<http://www.mail- > archive.com/[email protected]<http://www.mail- > archive.com/[email protected]<http://www.mail-archive.com/[email protected]>> > CA> CA> >> > CA> CA> >> Help? > CA> CA> >> > CA> > [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:hel > [EMAIL PROTECTED]>> > CA> CA> >> > > > > CA> CA> -- > CA> CA> Unsubscribe? > CA> CA> > CA> CA> > CA> [EMAIL PROTECTED]<mailto:OTlist- > [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:OTlist- > [EMAIL PROTECTED]>> > > CA> CA> Change options? > CA> CA> > CA> CA> > CA> > www.otnow.com/mailman/options/otlist_otnow.com<http://www.otnow.com/mailman > /options/otlist_otnow.com<http://www.otnow.com/mailman/options/otlist_otnow. com > <http://www.otnow.com/mailman/options/otlist_otnow.com>> > > CA> CA> Archive? > CA> CA> > CA> CA> > CA> www.mail-archive.com/[email protected]<http://www.mail- > archive.com/[email protected]<http://www.mail- > archive.com/[email protected]<http://www.mail-archive.com/[email protected]>> > > CA> CA> Help? > CA> CA> > CA> > [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]<mailto:hel > [EMAIL PROTECTED]>> > > > CA> -- > CA> Unsubscribe? > CA> > CA> [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]> > > CA> Change options? > CA> > CA> > www.otnow.com/mailman/options/otlist_otnow.com<http://www.otnow.com/mailman > /options/otlist_otnow.com> > > CA> Archive? > CA> > CA> www.mail-archive.com/[email protected]<http://www.mail- > archive.com/[email protected]> > > CA> Help? > CA> [EMAIL PROTECTED]<mailto:[EMAIL PROTECTED]> > > > -- > Unsubscribe? > [EMAIL PROTECTED] > > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > Help? > [EMAIL PROTECTED] > > -- > No virus found in this incoming message. > Checked by AVG Free Edition. > Version: 7.1.385 / Virus Database: 268.5.0/325 - Release Date: 4/26/2006 > -- No virus found in this outgoing message. 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