Hi Ron I've read Rob's post and agree for the most part. However he left out what does the client WANT to do? If ever there was a place for the COPM it is here. My mind is full of questions. What was her life before the injury? What does she miss most? Is the four adult household the previous norm or is it temporary? Is there someone at home with her or does she need to manage alone for part of the day? Not sure why Rob thinks there are no child care demands (the child's age perhaps). I like Rob's emphasis on analysing every task for simplicity and accessibility. Be aware that she is forming habits and routines that need to last her for many years. People with SCI age just like the rest of us so staying open to continuous adaptation is a good attitude to develop. Energy conservation is critical so available energy is focused on the most meaningful things. Down the road some thought then to how to manage if she gets the flu, is especially tired etc. Is employment or further education a possibility? Are there community resources? I'd be looking at the Canadian Paraplegic Association for support both physical and emotional. What about the social network? Is there someone with the skills to lower closet rods, install railings etc. What has been addressed in rehab? What were this couple's plans for their family? Were they planning more children? If no-one else is addressing issues of sexuality and family planning you need to be prepared to do this or refer. One of the most satisfying experiences I've ever had was a very similar situation helping my client to manage and enjoy pregnancy, birth and newborn care. She was already independent in her w/c when I met her. I really like your request for collaboration. It will be easier to focus when the questions are more specific.
A thought to end - Independence doesn't always mean doing everything yourself with no help. A critical part of independence is taking responsibility for your own activities, planning, supervising, negotiating and appreciating the assistance that others provide. Go for it, Ron. She's a lucky client. Joan -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson Sent: Friday, May 25, 2007 3:24 PM To: Ron Carson Subject: Re: [OTlist] OTnow Colloboration With Spinal Cord Injury Here are some specifics: 1. There is no insurance 2. The patient is young, late 20's, mid 30's 3. She lives with her husband, sister and her husband 4. She has a 4 y/o daughter 5. There is no primary care doctor; She typically uses the ER 6. We have just starting weaning her off her TLSO 7. She has a donated power w/c (reclining captain's back) 8. She has no pressure ulcers 9. She is able to sit without assistance and without her TLSO. But she has LOB with UE movement. But this will shortly correct with practice 10. She is undergoing a sacral nerve stimulator trial to hopefully d/c cathing and suppository/digital stimulation. It seems to be working OK 11. She has good UE strength 12. Initial goal is indpendent with transfers. Currently uses a sliding board with min - max assist depending on incline. I envision that she will be able to d/c sliding board and do her transfers w/o assistance. 13. I also think a long term goal is for her to get a ultralight-weight w/c. 14. She has a weight issue but she is struggling to find enough activity to off-set her caloric intake. 15. They have no computer so on-line resources are not possible at this time. OK, hit me with some transfer ideas!!! And any other suggestions. ----- Original Message ----- From: Ron Carson <[EMAIL PROTECTED]> Sent: Friday, May 25, 2007 To: [email protected] <[email protected]> Subj: [OTlist] OTnow Colloboration With Spinal Cord Injury RC> Hello All: RC> I recently agreed to treat a patient who suffered a T9-T10 SC injury RC> late last year. She has just been d/c to her home after several months RC> of rehab. While I have worked with SC injury patients, I do not consider RC> it a speciality. There are SO many issues to manage and address that it RC> can be a bit overwhelming. Given that I work alone, I don't have a RC> 'team' to bounce off ideas, so I'm hoping that OTnow members will be my RC> surrogate team? <smile> RC> I would like to give and receive advice on topics relating to this case. RC> Do you think this will work? Will people participate?? RC> Thanks, RC> 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 **************************************************************************** ********** No virus found in this incoming message. Checked by AVG Free Edition. Version: 7.5.472 / Virus Database: 269.8.0/818 - Release Date: 5/25/2007 12:32 PM No virus found in this outgoing message. Checked by AVG Free Edition. Version: 7.5.472 / Virus Database: 269.8.0/819 - Release Date: 5/26/2007 10:47 AM -- 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 **************************************************************************************
