Hi Ron I'm fascinated as usual. 
Who rated the performance in self feeding? I can't imagine a client rating
performance 10 when she is not satisfied. Is there pain? Is she dissatisfied
with the way she holds her cutlery? What?
As far as the COPM scores are concerned I think they are valuable for her
and for you in monitoring progress. They are also outcome measures to
demonstrate effective treatment. As a valid self report they may be
unconsciously contaminated if the client knows what you are hoping for and I
presume the treatment plan incorporating goals is established
collaboratively with the client. You have not included timeliness in the
suggested mobility goal. When she gets to the dining room is she in any
shape to enjoy her meals? or too tired from the effort?

Other questions that spring to mind
Are there other issues around meal time such as the setting for meals? food
quality? companions?
What does she do the rest of the time?
What is her cognitive level? Is it reduced by depression?
Independently getting to the dining room is often a strong facility
expectation. Is it, in fact, the best use of available energy in terms of
quality of life?  
In terms of her living situation what are the barriers to the best quality
of life given her medical condition? Can any of them be ameliorated?
Somehow I am picturing her as quite a neat lady. Someone I would like to
meet.
Best wishes to you both for a fruitful collaboration, Joan

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf
Of Ron Carson
Sent: Wednesday, January 31, 2007 11:12 AM
To: [email protected]
Subject: [OTlist] COPM Scores as the Goal?

Hello All:

I  just  evaluated  a patient with multiple medical issues. As part of
the  eval,  I  administered the COPM. The patient scores indicate that
she  is dissatisfied with her mobility and self-feeding. She has joint
ROM issues and pain secondary to RA and is mildly depressed because of
her living situation. Here COPM scores are:

                Performance     Satisfaction

Mobility            5                 3
Feeding            10                 5


So here's my question.

When drafting the patient's plan of treatment what becomes the goals;

1. Improving the COPM performance and satisfaction scores

                                 <or>

2. Improving the patient's actual mobility and self-feeding.

To  put it another way, if we take the mobility issue, should the goal
read:

1. Patient's COPM mobility scores will improve to 8 and 10

                                 <or>

1. Patient will safely and independtly ambulate to/from her ALF dining
room using a 4-wheel rolling walker.

I  like  the  concept  of using the COPM scores but I can only imagine
what  an  MD  thinks  when  he reads this stuff. I don't send them the
actual COPM, only my plan of treatment.


Ron

-- 
Ron Carson MHS, OTR/L
www.OTnow.com


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