I  would  like to invite all of us working in SNF's to stop using the
arc  and  the  pegs  for  one  week  and  see if other, more real-life
activities can be done; ie clean a table using the circular motion the
arc  would  promote, clean a window  instead; place family pictures on
the  wall of their room using painter's tape or push pins; label their
dresser  drawers  with  the  contents  to  replace  the  infamous peg 
motions;  forgive  me  for been so blunt but do WE in  our daily life 
EVER  sit  and  pull  pegs aimlessly for any lenght of time? If we are
playing  a board game...there is a real life purpose to it; if we need
to  strengthen  sorting  skills...sort  socks, clothes...If I were the
patient...I  would be insulted if a therapist comes to me, charging an
arm  and  a  leg for every 15 min of the encounter to have me do that!
Research  does  NOT  support  using  pegs and rom arc to automatically
improve  self care skills. Research does show that practicing the very
tasks  to  be  mastered  iimproves  performance  in  such task... This
discussion  takes  me  back  to my first years as OT in Phys Dys...the
DRG's and Care Maps...and need to show a physical meassure of progress
for  every skill tested...Very cool but not necessarily Occupationally
based .  Now,  2007 we have a lot more tools/ research/ information at
our disposal to use activities that are relevant to our clients...

 I  find  myself struggling to re-contextualized the most simple tasks
 at  the  SNf  to make it relevant...Not easy yet possible most of the
 time...anyways...forgive  me  if  coming  across  offensive...not  my
 intent.  Occupationa Therapy has the power to infuse relevance to the
 life of a patient...are we facilitators or inhibitors?



Carmen


From: "Charles Sullivan" <[EMAIL PROTECTED]>
Reply-To: [email protected]
To: OTlist <[email protected]>
Subject: Re: [OTlist] OTlist Digest, Vol 25, Issue 17
Date: Thu, 22 Feb 2007 16:48:43 -0500
>
>I  DO use shoulder arcs too.
>
>For the most part, every SNF I have worked in has at least one arc,
>the colored cones and peg boards. I agree they do look child like and
>could be designed differently, like black, red and silver or maybe one
>could purchase weighted disc's, cones or pegs. I sometimes use velcro
>wrist weights, or I have the Pt stand to do the activity, or place it
>on the floor to achieve and grade depending on their short or
>long term goals with B/UE-LE ROM/strength/ADL's etc. Because many
>facilities "Therapy Rooms" have limited space, budgets etc. they
>purchase and have their OT's use of them. Because these items are
>portable and light weight, I often work with Pt's in their rooms
>(bedridden)and I am better able to get them to achieve their UE/LE ADL
>goals: dressing, bathing and grooming, where otherwise my options to
>achieve them would be limited. This is not a perfect OT world we work
>in. I enjoy reading OTlist.
>
>Keep up the good work Ron!
>
>B Sullivan COTA/L
>
>
>
>
>
>
>
>--
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>
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