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