Just responding to Ron's message about the patient who "felt helped" even though standardized testing measures indicated otherwise. I agree with whomever recently stated on this listserv, "Never underestimate the power of therapeutic use of self." While there is no CPT code to bill for this phenomenon, I believe that it's very relevant to our practice. As we move closer to outcome-based reimbursement in home health, the pressure will become even greater to document measurable, functional gains for our therapeutic efforts. I believe that embracing this phenomenon may actually facilitate progress, and thus increase measurable functional gains. Guess we'll see........ Bill Maloney, OTR
----- Original Message ---- From: "[EMAIL PROTECTED]" <[EMAIL PROTECTED]> To: [email protected] Sent: Tuesday, February 27, 2007 2:00:06 PM Subject: OTlist Digest, Vol 25, Issue 23 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. Re: Saebo (Carmen Aguirre) 2. Re: Sh arcs (Carmen Aguirre) 3. A Positive Report - I think? (Ron Carson) 4. Re: Saebo (Rob Koch) ---------------------------------------------------------------------- Message: 1 Date: Mon, 26 Feb 2007 18:02:22 -0500 From: "Carmen Aguirre" <[EMAIL PROTECTED]> Subject: Re: [OTlist] Saebo To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=us-ascii It is a spint used with people with hemiplegic/hemiparetic arms. It provides e-stim and to the digits/hands to move in a fuctional pattern to grasp objects. Just to a google search and you will see more about it. Carmen From: Ron Carson <[EMAIL PROTECTED]> Reply-To: [email protected] To: [email protected] Subject: [OTlist] Saebo Date: Fri, 23 Feb 2007 17:57:07 -0500 >What the heck is a Saebo? > >Ron ------------------------------ Message: 2 Date: Mon, 26 Feb 2007 19:21:29 -0500 From: "Carmen Aguirre" <[EMAIL PROTECTED]> Subject: Re: [OTlist] Sh arcs To: OTlist <[email protected]> Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=ISO-8859-15 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 > > > > > > > >-- >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 >************************************************************************************** Find what you need at prices you?ll love. Compare products and save at MSN? Shopping. ------------------------------ Message: 3 Date: Mon, 26 Feb 2007 20:08:10 -0500 From: Ron Carson <[EMAIL PROTECTED]> Subject: [OTlist] A Positive Report - I think? To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=ISO-8859-15 Today I d/c a patient who really didn't show much progress towards her goals. I previously sent a message as sort of a case study. I used two standardized measures, the Geriatric Depression Rating Scale and the COPM. Unbelievably, her discharge GDRS score showed a substantial increase in depression and her COPM scores are as follows: (Performance/Satisfaction) Initial Discharge Ambulate to bathroom with walker: 5/3 8/8 Feed Self without spilling food: 10/5 3/1 So, despite these meager outcomes, the patient was adamant that I had helped her. I wanted to pursue the situation but opted to just let it lie. But, I can't help but wonder why someone who didn't make much measurable progress felt that they had been helped. As you may suspect, I have a theory... Somewhere in my "travels", I came across the following statement: ===================================================================== "Often what appears to make a difference is the sense that we ?matter? to someone else in a genuine way. Good therapy is part of the general human condition to be connected and to matter." SOURCE: Tryssenaar, J. (1997). Clinical Interpretation of ?Understanding Professional Behavior: Experiences of Occupational Therapy Students inn Mental Health Settings?. AJOT 51(8). " ====================================================================== This patient lives in an ALF, her daughter visits regularly, but I can't help wondering if somehow my therapy, just being there, made enough of a difference in this sweet woman's life that she felt helped! It's these type of phenomena that make the profession of OT such as sweet, intriguing and perplexing profession. Ron ------------------------------ Message: 4 Date: Mon, 26 Feb 2007 17:15:44 -0800 (PST) From: Rob Koch <[EMAIL PROTECTED]> Subject: Re: [OTlist] Saebo To: [email protected] Message-ID: <[EMAIL PROTECTED]> Content-Type: text/plain; charset=iso-8859-1 Neither the SaeboFlex or SaeboStretch use e-stim. That is very incorrect - it is a mechanical dynamic hand splint. The "splint" that incorporates e-stim is the Bioness system. It is a very different product although the goals of both systems are similar Rob --- Carmen Aguirre <[EMAIL PROTECTED]> wrote: > It is a spint used with people with > hemiplegic/hemiparetic arms. It > provides e-stim and to the digits/hands to move in a > fuctional pattern > to grasp objects. Just to a google search and you > will see more about > it. > > Carmen > > > From: Ron Carson <[EMAIL PROTECTED]> > Reply-To: [email protected] > To: [email protected] > Subject: [OTlist] Saebo > Date: Fri, 23 Feb 2007 17:57:07 -0500 > >What the heck is a Saebo? > > > >Ron > > > > -- > 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 ____________________________________________________________________________________ Looking for earth-friendly autos? Browse Top Cars by "Green Rating" at Yahoo! Autos' Green Center. http://autos.yahoo.com/green_center/ ------------------------------ -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED] End of OTlist Digest, Vol 25, Issue 23 ************************************** -- 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 **************************************************************************************
