I have been thinking about this discussion a great deal this week since Ron stirred the pot, yet again! You go Ron!
When it comes to exercises, I think that they definitely fall into the category of health management, and I DO write HEPs for people with UE deficits, and I do encourage exercises, and I certainly use therapeutic exercises in treatment--albiet, not the entire treatment session--because I always look at occupations as well However, I strongly feel that a healthy dose of exercise, particularly for people who got to our facility due to poor health maintenance and lifestyles in the first place, is very definitely part of purposeful engagement in their own health maintenance; teaching them about healthy lifestyles is also part of increasing health literacy. Medicare spends billions of dollars on remedies because our country has such low health literacy, with consequent high rates of stroke, diabetes, heart disease, etc. My father had an MVA and broke his neck when I was a year old,resulting in an incomplete C6-7 SCI: that was 39 years ago. He is now 71, and has NEVER MISSED doing one-and-a-half HOURS of exercises DAILY, regardless of the weather, where he is in the world, or how he feels that day. He walked with a cane for years and years, had multiple spinal fusions, botched carpal tunnel releases (from years of W/B on his wrists), and is now in a wheelchair. He can barely walk anymore, so he bought himself a peddle machine and straps his feet to it to still do his exercises. He is fully engaged in his own health maintenance and it is meaningful and purposeful to him--more than anything else, because he does not want to deteriorate--and he knows that if he stops, his functional mobility will decline along with his mood, engagement in daily life, etc. I can wax poetic about my father, he is an amazing man, but thinking about him makes me understand that exercises ARE important and can very well be justified and incorporated into occupational therapy treatment. It is often the rationale behind the treatment activities that we choose to use that is important to understand--is that not clinical reasoning? Hope everyone has a good weekend, Orli -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mary Alice Cafiero Sent: Friday, January 12, 2007 3:31 PM To: [email protected] Subject: [OTlist] Role of OT This discussion brings to mind a recent experience I had. I have recently moved from working full time in a pediatric hospital to working on my own in a variety of PRN contract positions in home health, SNF, and high end independent wheelchair evaluations for Medicare and Medicaid. Interesting stuff. I have been out of OT school since 1993 (scary that I am an OLD OT!!) and have pretty much practiced in all areas. I did a couple of days in a well-respected upscale nursing home with a high capacity rehab unit attached. They have a large full time therapy staff and a big patient population that actually goes home. It was a deal where I was just filling in for a few days so didn't really get to know the staff at all.....just came in, quickly got oriented to the paperwork and where to find things, and was turned loose with a patient list. I was horrified to see all the OTs and COTAs sitting in the gym watching their patients sit in little clusters doing arm bikes, pinching clothespins, etc. I didn't see any cones, but I'm sure they were lurking in a corner somewhere. With so little time and preparation coming in, it was very difficult not to get sucked in to just plopping my patients right down with the rest of them and letting the patients do their time and count their minutes. Instead, I spent a little time figuring out what each patient was planning on doing after d/c and what they actually liked to do with their time (how novel!). I actually incorporated that into treatment (again, such a rebel!) With one guy, who was returning to live alone, we did actually work on him showering by himself. I was chastised severely by one of the other OTs and by the rehab director (a PTA) because the said now nursing would expect for OT to help with all the showers for the rehab patients. It is just sad and frustrating that we seemed to be damned if we do and damned if we don't. How hard is it to incorporate function and a person's individual needs and goals into a treatment plan? It isn't that hard! AND it quickly shows how unique and wonderful OT can be. Now, I've had my little moment on the soap box. I will let someone else have a turn! Mary Alice, Texas -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************ ************** Enroll in Boston University's post-professional Master of Science for OTs Online. 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