Awesome responses! The examples listed are very helpful to hear and I love the goals and treatment plans mentioned. Reading this is so very helpful since I don't work with another OT and can't ask all the 'silly' questions I could in my internships. Being older than the typical newly graduated OT, I think I have a good handle on working on functional activities and esp. working on what is important to the patient (our evals don't even have leisure act. addressed and in the elderly I feel this needs to be addressed equally with dressing, etc.). I am still looking in my books and online almost every day to figure things out.
Thanks so much for your support! Rebecca, OTR/L Minneapolis MN Senior Care Center [EMAIL PROTECTED] wrote: Send OTlist mailing list submissions to [email protected] To subscribe or unsubscribe via the World Wide Web, visit http://otnow.com/mailman/listinfo/otlist_otnow.com or, via email, send a message with subject or body 'help' to [EMAIL PROTECTED] You can reach the person managing the list at [EMAIL PROTECTED] When replying, please edit your Subject line so it is more specific than "Re: Contents of OTlist digest..." Today's Topics: 1. don't tell me what NOT to do, tell me what TO do... (Rebecca Holloway) 2. Re: don't tell me what NOT to do, tell me what TO do... (Chris Smith) 3. Re: don't tell me what NOT to do, tell me what TO do... (Ron Carson) 4. Re: Shoulder Arc (Rob Koch) 5. Re: don't tell me what NOT to do, tell me what TO do... (Ron Carson) 6. Re: Shoulder Arc (Jessica R. Gross) 7. SAEBO (Pat) ---------------------------------------------------------------------- Message: 1 Date: Wed, 21 Feb 2007 17:16:36 -0800 (PST) From: Rebecca Holloway Subject: [OTlist] don't tell me what NOT to do, tell me what TO do... To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=iso-8859-1 Hello, I am an older, newish OT and I understand why using pegs, cones and loops are not functional activities. I have used peg boards before to play a solitaire type game when someone is standing statically and for a couple of low functioning dementia patients after falls injuring shoulders. For some reason these types of activities engage the dementia patients more than actual ADL or exercise. Anyway, I am sure I am not the only newish OT on this list and I would like to know suggestions of functional activities that can be performed instead of using the old methods that seem to be in every OT dept. I can surely think of some, but I think another opinion is helpful and may be helpful to more people than just myself. Rebecca, OTR/L Minneapolis MN --------------------------------- Need a quick answer? Get one in minutes from people who know. Ask your question on Yahoo! Answers. ------------------------------ Message: 2 Date: Wed, 21 Feb 2007 20:51:40 -0500 (EST) From: "Chris Smith" Subject: Re: [OTlist] don't tell me what NOT to do, tell me what TO do... To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset="us-ascii" Hi,I am an older OT--over 50 and have been practicing only five years in long term care after 5 years in the schools. You have to have the confidence to do what works for each individual pt. With dementia pts I'd say if pegs ingage them, then do pegs. You can do what ever you what with a pt while you are working on standing. I have people fold towels, laundry, take things out of the cupboard and rearrange it, sort silverware, sort cards, play cards with me or someone else, play a board game, plant flower bulbs, water plants, do simple crafts, do peg activities, do activities on an easel so it is vertical, play catch and yes--bat balloons. Everyone even people who want respond to anything else will smile and try to hit a red balloon.I also like throwing activities--bean bags filled with a pound of beans is a nice weight. I have purchased one pound bags of the cheapest beans from someplace like Aldi, put the bag they come in, inside a zip lock bag, fold it over and wrap duct tape around it and then put in another bag and wrap several lengths of colored electrical tape around it. Yes, I do sometimes use colored cones for reaching activities--also individual sized water bottles with the water still in are good--you can vary the grasp required by using different amounts of water in each bottle. Makes it more random--learned that in UE course. Pin clothes pins on someones slacks, shoes and have then reach over, remove them and reach up, across or whatever to put them back in a box. ALso if you have a washer/dryer or diswasher have pts load and unload. Have them wash the towels. Fix a hook or tension rod and have them put clothes on the hangers and hang and unhang them. Hope this helps Chris _______________________________________________ Join Excite! - http://www.excite.com The most personalized portal on the Web! ------------------------------ Message: 3 Date: Wed, 21 Feb 2007 20:56:30 -0500 From: Ron Carson Subject: Re: [OTlist] don't tell me what NOT to do, tell me what TO do... To: Rebecca Holloway Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=us-ascii Hello Rebecca: Thanks for "stepping up" and writing. Here's my "simple" approach to OT. Evaluate the patient to determine their "problems". Isolate the cause of the problems. Identify those problems having the greatest chance for correction. Once you determine that a problem can't be corrected, work on adaptation. If adaptation isn't successful, then discharge! As I said, it's simple but it's generally how I approach most of my therapy. Here's case in point. I evaluated a patient 3 weeks ago. She lives in an ALF. She has multiple orthopedic problems including: 1. Left torn rotator cuff - s/p three years 2. Right shoulder OA 3. Bi-lateral knee OA 4. Depressed mood. She currently depends on a manual w/c and mod assistance for her mobility related living skills. But, the manual w/c is not effective secondary to her ortho problems. OK, so, what and who cares, right! Well, during the eval she was able to identify that she wants to be able to eat without spilling her food/drink and she wants to be able to walk to her bathroom. So, I writ the plan of treatment, including goals of feeding herself without spilling and using a rolling walker to access her bathroom/dining room. So, off to work I go! My manual therapy has not been successful for remediating the patients right shoulder problems and she has not been able to tolerate using a walker to safely and effectively access her bathroom/dining room. I've attempted adapting her eating style but it has not been effective. I've recommended a referral to a ortho doctor to better isolate her shoulder dysfunction. Just today, I did a power wheel chair eval. She needs additional training before I can recommend the power w/c. If she is unable to safely use the w/c and the ortho report comes back negative, then I will d/c her. But, through ALL of this, the patient just told me yesterday that I had really helped her. I suspect that our relationship has been the biggest help! And, I NEVER underestimate the power of SELF to effect change in patients! OK, that was quickly written so disregard typos, OK? Does this help? Every patient is unique and different but the process is basically the same. I should also point out that about the same time I was seeing this patient, I got a referral for another patient down the hall. The patient's primary complaint was depressed mood and debilitation s/p a long hospital stay. Well, despite several visits with this lady (whom I'd previously seen), I was unable to establish treatment goals. So, I checked in on her every couple of days, but I did NOT pick her up as a patient. No goals = no therapy!! I don't know if any of this helps but for me, the MOST liberating thing that I discovered about being an OT is that I can actually address the most important things in my patient's lives!! Here's a word of caution. If you evaluate people with mobility problems, with very few exceptions, they will want you to address their mobility issues. Since I work alone, I don't worry about boundary issues with PT but I understand that most OT's work alongside PT and that PT addresses mobility. But, that does not mean that as an OT, you also can't address mobility. For example, my experience is that most PT's work primarily with gait. What you can do, is take patient's gait and apply to their daily lives. For example, just because a patient can walk across the gym, that doesn't mean that they can go into the bathroom, turn on the light, position themselves near the toilet, lower their pants, etc.... As an OT, you should make sure that client's are able to safely use their mobility aide to allow them to complete their daily living. If they can't (maybe because it's too big, or not sturdy enough), you can consult with the PT and say something like: "You know, that patient's doing well with that standard walker, but they are fatiguing too quickly while dressing. They will benefit from a rolling walker to reduce their fatigue." In this manner, OT and PT are truly working to betterment of the patient, and they are not duplicating services and stepping on each other's toes (at least, not too much) OK, I'm done! Ron ----- Original Message ----- From: Rebecca Holloway Sent: Wednesday, February 21, 2007 To: [email protected] Subj: [OTlist] don't tell me what NOT to do, tell me what TO do... RH> Hello, RH> I am an older, newish OT and I understand why using pegs, RH> cones and loops are not functional activities. RH> I have used peg boards before to play a solitaire type game RH> when someone is standing statically and for a couple of low RH> functioning dementia patients after falls injuring shoulders. For RH> some reason these types of activities engage the dementia patients RH> more than actual ADL or exercise. RH> Anyway, I am sure I am not the only newish OT on this list RH> and I would like to know suggestions of functional activities that RH> can be performed instead of using the old methods that seem to be RH> in every OT dept. I can surely think of some, but I think another RH> opinion is helpful and may be helpful to more people than just RH> myself. RH> Rebecca, OTR/L RH> Minneapolis MN RH> --------------------------------- RH> Need a quick answer? Get one in minutes from people who know. RH> Ask your question on Yahoo! Answers. ------------------------------ Message: 4 Date: Wed, 21 Feb 2007 17:58:00 -0800 (PST) From: Rob Koch Subject: Re: [OTlist] Shoulder Arc To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=iso-8859-1 I'm disappointed this enlightened group hasn't mentioned pegs! I love to watch veteran therapists use the shoulder arc and cones - it really make me holler out laughing. And it is a great opportunity to roast students when they reach for them. Once a therapist starts to feel guilty because he knows that using the shoulder arc really is a PATHETIC activity - he should immediately switch to having the patient hang a shower curtain. It's the same activity - but then the therapist can claim to be doing "FUNCTIONAL" or "OCCUPATIONAL BASED" treatment. It's just that easy!! Then start to think of things in life that are just like cones!! You will begin to evolve as a therapist - change the whole department - the whole facility - the whole world!! Rob Koch P.S. Don't get me started on those "new, special" - SAEBO BALLS - "the revolutionary commercial alternative to cones". I laugh every time I see someone with the SaeboFlex pick up one of those balls. --- Ron Carson wrote: > In my opinion, the shoulder arc is one of the > "dumbest" pieces of OT > equipment ever invented. I've heard more people > complain about that > thing! It's childish looking and for the most > part, it's not age > appropriate. I could see using it with kids as a > game, but to have an > adult patient push little plastic rings across a > plastic hoop is about > as related to occupation as having a person put > little plastic pegs in > a board! These things must have been "invented" > back in the era of > contrived activity, because for the most part > that's about all they > do! > > I have a very dear friend who is just going to > rehab secondary to a > broken hip. I hope that her OT doesn't have a > shoulder arc!!!!!!!!!!!! > > > ----- Original Message ----- > From: Orli Weisser-Pike > > Sent: Wednesday, February 21, 2007 > To: [email protected] > Subj: [OTlist] Shoulder Arc > > OWP> Can we stop complaining about what others > are doing and rather > OWP> try and set examples ourselves???? > > OWP> I DO use shoulder arcs, but it depends on > what I am trying to > OWP> achieve. I am very annoyed by these > postings that keep > OWP> criticizing "those other" OTs out there in the > ether. Grumble. It > OWP> is very easy to point fingers at our > fellows, but gosh, it is > OWP> really so much nicer to hear success stories. > > > > -- > 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. Gain the skills > and credentials to propel your career. > www.otdegree.com/otn > ************************************************************************************** > Need Functional Therapy Activities? http://hometown.aol.com/MrFunction ____________________________________________________________________________________ Finding fabulous fares is fun. Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains. http://farechase.yahoo.com/promo-generic-14795097 ------------------------------ Message: 5 Date: Wed, 21 Feb 2007 21:08:19 -0500 From: Ron Carson Subject: Re: [OTlist] don't tell me what NOT to do, tell me what TO do... To: Rebecca Holloway Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=us-ascii Rebecca, engaging patient's during the course of a treatment session may not be medically necessary therapy. If the therapy doesn't specifically address a goal and progress is being made towards the goal, then the "skill" of the therapy may be in question. Just something to consider... Ron ----- Original Message ----- From: Rebecca Holloway Sent: Wednesday, February 21, 2007 To: [email protected] Subj: [OTlist] don't tell me what NOT to do, tell me what TO do... RH> for some reason these types of activities engage the dementia RH> patients more than actual ADL or exercise. ------------------------------ Message: 6 Date: Thu, 22 Feb 2007 08:54:52 -0500 From: "Jessica R. Gross" Subject: Re: [OTlist] Shoulder Arc To: Message-ID: Content-Type: text/plain; charset="us-ascii" Rob- I am very curious about your experience with SAEBO as I have none. Please email me your thoughts: [EMAIL PROTECTED] Thanks Jess -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Rob Koch Sent: Wednesday, February 21, 2007 8:58 PM To: [email protected] Subject: Re: [OTlist] Shoulder Arc I'm disappointed this enlightened group hasn't mentioned pegs! I love to watch veteran therapists use the shoulder arc and cones - it really make me holler out laughing. And it is a great opportunity to roast students when they reach for them. Once a therapist starts to feel guilty because he knows that using the shoulder arc really is a PATHETIC activity - he should immediately switch to having the patient hang a shower curtain. It's the same activity - but then the therapist can claim to be doing "FUNCTIONAL" or "OCCUPATIONAL BASED" treatment. It's just that easy!! Then start to think of things in life that are just like cones!! You will begin to evolve as a therapist - change the whole department - the whole facility - the whole world!! Rob Koch P.S. Don't get me started on those "new, special" - SAEBO BALLS - "the revolutionary commercial alternative to cones". I laugh every time I see someone with the SaeboFlex pick up one of those balls. --- Ron Carson wrote: > In my opinion, the shoulder arc is one of the "dumbest" pieces of OT > equipment ever invented. I've heard more people complain about that > thing! It's childish looking and for the most part, it's not age > appropriate. I could see using it with kids as a game, but to have an > adult patient push little plastic rings across a plastic hoop is about > as related to occupation as having a person put little plastic pegs in > a board! These things must have been "invented" > back in the era of > contrived activity, because for the most part that's about all they > do! > > I have a very dear friend who is just going to rehab secondary to a > broken hip. I hope that her OT doesn't have a shoulder arc!!!!!!!!!!!! > > > ----- Original Message ----- > From: Orli Weisser-Pike > > Sent: Wednesday, February 21, 2007 > To: [email protected] > Subj: [OTlist] Shoulder Arc > > OWP> Can we stop complaining about what others > are doing and rather > OWP> try and set examples ourselves???? > > OWP> I DO use shoulder arcs, but it depends on > what I am trying to > OWP> achieve. I am very annoyed by these > postings that keep > OWP> criticizing "those other" OTs out there in the > ether. Grumble. It > OWP> is very easy to point fingers at our > fellows, but gosh, it is > OWP> really so much nicer to hear success stories. > > > > -- > 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. Gain the skills > and credentials to propel your career. > www.otdegree.com/otn > ************************************************************************ ************** > Need Functional Therapy Activities? http://hometown.aol.com/MrFunction ________________________________________________________________________ ____________ Finding fabulous fares is fun. Let Yahoo! FareChase search your favorite travel sites to find flight and hotel bargains. http://farechase.yahoo.com/promo-generic-14795097 -- 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. Gain the skills and credentials to propel your career. www.otdegree.com/otn ************************************************************************ ************** ------------------------------ Message: 7 Date: Thu, 22 Feb 2007 07:04:22 -0700 From: Pat Subject: [OTlist] SAEBO To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset="us-ascii"; format=flowed Please keep it on the list... I'm sure a lot of other people would be interested too! Pat At 06:54 AM 2/22/2007, you wrote: >Rob- >I am very curious about your experience with SAEBO as I have none. >Please email me your thoughts: [EMAIL PROTECTED] >Thanks >Jess > >-----Original Message----- >From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On >Behalf Of Rob Koch >Sent: Wednesday, February 21, 2007 8:58 PM >To: [email protected] >Subject: Re: [OTlist] Shoulder Arc > >I'm disappointed this enlightened group hasn't mentioned pegs! >I love to watch veteran therapists use the shoulder arc and cones - it >really make me holler out laughing. > And it is a great opportunity to roast students when they reach for >them. > >Once a therapist starts to feel guilty because he knows that using the >shoulder arc really is a PATHETIC activity - he should immediately >switch to having the patient hang a shower curtain. >It's the same activity - but then the therapist can claim to be doing === message truncated === --------------------------------- Get your own web address. Have a HUGE year through Yahoo! Small Business. -- 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. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
