OK, my answer #2. I didn't read all the replies before responding last time. It's nice to see that many of us think similarly.
As far as treating due to back, hip, leg, etc pain, I do if it is limiting the patient's ADL or occupational performance. I don't treat the source of the pain directly. I treat the problem resulting from the pain whether it is through compensation, new methods, assistive equipment, etc. I don't think someone is excluded from "qualifying" for OT just because of the location of the pain. By the same token, I don't think they are "disqualified" from PT because the site of injury is upper extremity. I have had home health companies ask me before to ask more questions and "find" a reason to see the patient for OT. I don't think that is right. If the patient identifies a problem, the patient views it as limiting and it should be addressed if possible. I will sometimes ask follow-up questions or point out areas that appear to be a problem to see if they are an issue for the patient. If the patient is not bothered by something that I view as a deficit or issue, I don't feel that I should treat them for it because I can't make reasonable goals for treatment around an issue that the patient doesn't see as an issue. Make sense? One situation where I can see this playing out differently is with safety or judgement. The patient may not always recognize or acknowledge their deficit. They may still need OT intervention. Often though, it seems that the treatment is more toward family or caregiver education since it is often impossible to get a patient to acknowledge a safety issue that they don't want to admit. Mary Alice Mary Alice Cafiero [EMAIL PROTECTED] 972-757-3733 Fax 888-708-8683 This message, including any attachments, may include confidential, privileged and/or inside information. Any distribution or use of this communication by anyone other than the intended recipient(s) is strictly prohibited and may be unlawful. If you are not the recipient of this message, please notify the sender and permanently delete the message from your system. On Aug 26, 2008, at 5:25 PM, Ron Carson wrote: > When asked, the patient reported that she was able to do all her daily > living. Now, this brings up an interesting point. > > Obviously, the patient *is* limited by her pain. She does not use her > right arm in the same manner as if she didn't have pain. So, does this > "qualify" her for OT? If we use this approach, why doesn't OT treat > people who are limited by back, hip, leg or foot pain? > > On the other hand, the patient's concerns are ONLY related to her > pain, nothing else is of great importance. Since she does not have > perceived occupational deficits, does this "disqualify" her for OT? > > How hard should an OT dig to find occupational deficits? Isn't the > OT's job to help **the patient** identify and prioritize their > deficits? Obviously, this approach isn't effective with cognitively > impaired patients, but for patients who are able, shouldn't THEY > identify their occupational deficits, with the help of the OT? > > Ron > > ----- Original Message ----- > From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> > Sent: Tuesday, August 26, 2008 > To: [email protected] <[email protected]> > Subj: [OTlist] Would You Treat For Refer to PT? > > cac> Are you sure she can reach up into high cabinets in order to > cac> cook and clean with that right arm? Can she fasten her bra the > cac> way she used to with an internal rotation?approach in back or > cac> is?she resorting to compensation, but she would like to get back > cac> to her?prior method??I'm sure if you dig hard?enough you?will > cac> find some occupational dysfunction. If not I would defer to PT. > cac> ?As an OT it depends if you are comfortable and competent to > cac> treat shoulder dysfunction.? I have had two post professional OT > cac> courses on shoulder dysfunctiion, ?taught at a credited program > cac> of OT, so I have to answer yes to your question. > > > cac> -----Original Message----- > cac> From: Ron Carson <[EMAIL PROTECTED]> > cac> To: OTlist <[email protected]> > cac> Sent: Tue, 26 Aug 2008 3:15 pm > cac> Subject: [OTlist] Would You Treat For Refer to PT? > > > > cac> Received a new home health referral. Patient's diagnosis > is right > cac> shoulder pain. Patient presents with bicep tendon pain > during AROM, > cac> PROM and palpation. She lives alone and is independent with > all her > cac> daily living tasks. > > cac> I referred the patient to PT for the shoulder pain. Would > you, as an > cac> OT, treat this patient? > > cac> Thanks, > > cac> Ron > > > cac> -- > cac> Options? > cac> www.otnow.com/mailman/options/otlist_otnow.com > > cac> Archive? > cac> www.mail-archive.com/[email protected] > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
