If I use the COPM  goal I would add a descriptive performance to it...Pt 
mobility scores will improve from 8 to 10  in order to ambulate to DR with FWW 
with no Loss of balance and no c/o fatigue.

If I use the second goal, I would specify the safetly part... with one rest 
period per energy savings educat, or with no LOB, or..with no cues for scanning 
hallway for obstacles, ...you get my drift...

I hope this helps...






Carmen


From: "Joan Riches" <[EMAIL PROTECTED]>
Reply-To: [email protected]
To: <[email protected]>
Subject: Re: [OTlist] COPM Scores as the Goal?
Date: Wed, 31 Jan 2007 15:06:27 -0700
>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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