So you measure knee ROM? If so, you are by far and exception to the rule.
Ron -- Ron Carson MHS, OT ----- Original Message ----- From: L Sloan <[EMAIL PROTECTED]> Sent: Sunday, August 31, 2008 To: [email protected] <[email protected]> Subj: [OTlist] Elbow Break, Referral... LS> actually Ron....I do document limitations with lower extremity LS> ROM especially of the knees if it affects self-care.... LS> Lisa LS> ----- Original Message ---- LS> From: Ron Carson <[EMAIL PROTECTED]> LS> To: L Sloan <[email protected]> LS> Sent: Sunday, August 31, 2008 7:04:12 AM LS> Subject: Re: [OTlist] Elbow Break, Referral... LS> Hello Lisa: LS> Why take measurements if they aren't part of the goal? I do document LS> when a patient has limited ROM, but I don't measure it. LS> Don't you measure ROM when a patient has a lower extremity impairment LS> affecting function? Why not???? LS> Ron LS> -- LS> Ron Carson MHS, OT LS> ----- Original Message ----- LS> From: L Sloan <[EMAIL PROTECTED]> LS> Sent: Saturday, August 30, 2008 LS> To: [email protected] <[email protected]> LS> Subj: [OTlist] Elbow Break, Referral... LS>> Ron...did i understand you to say you don't take ROM LS>> measurements...why not???? I do take measurements or approximate LS>> on every patient with Upper extremity impairment affecting their function???? Lisa LS>> ----- Original Message ---- LS>> From: Ron Carson <[EMAIL PROTECTED]> LS>> To: Kari Rogozinski <[email protected]> LS>> Sent: Saturday, August 30, 2008 7:54:38 PM LS>> Subject: Re: [OTlist] Elbow Break, Referral... LS>> Call me think-headed, but I don't see how those goals are any LS>> different than PT. When I read the goals I see the primary focus on LS>> decreasing pain and increasing ROM and the "functional" stuff is just LS>> thrown in. And that's primarily what PT does. LS>> OT knows there's a lot more to dressing than just physical LS>> dysfunction.. There's the environment, cognition, motivation, family LS>> issues, etc. With your goals, what happens if ROM is increase so LS>> the patient SHOULD be able to dress but they still can't because the LS>> family doesn't feel they are safe? According to your goals, the LS>> patient is d/c. Either that or you'll need some new goals! LS>> I will also suggest that goals should not be written unless it has LS>> been assessed. In other words, I don't write ROM goals, because I LS>> don't take ROM measurements. I do assess occupation and those are the LS>> goals that I write. LS>> Again, what the therapists assess should be the goals. And conversely, LS>> if it's not assessed then it shouldn't be a goal. Also, goals must be LS>> measurable and progress must be made. How can a therapist measure LS>> progress towards a goal that is not initially measured? And, what LS>> measure is going to be used? I will say the "increase functional LS>> performance with bilateral UE tasks" is not exactly a measurable goal? LS>> Now, if you assessed that the patient required mod assist to donn LS>> her bra and the goal was "Pt will independently donn/doff bra", then LS>> that's an OT assessment and goal. However, can you see this ladies LS>> face when I ask her about how much assistance she need to put on her LS>> bra, or pull up her underwear? She's going to think I'm nuts because LS>> she wants me to fix her arm, not worry about teaching her to get LS>> dressed! LS>> Gosh, I hate long messages..... LS>> <Sorry for typos/graphos> LS>> Ron LS>> -- LS>> Ron Carson MHS, OT LS>> ----- Original Message ----- LS>> From: Kari Rogozinski <[EMAIL PROTECTED]> LS>> Sent: Saturday, August 30, 2008 LS>> To: [email protected] <[email protected]> LS>> Subj: [OTlist] Elbow Break, Referral... KR>>> I agree with Chris, I would take this patient and right all 4 KR>>> goals.. The only exception is i would state why i was going to KR>>> decrease the pain or increase ROM. I would probably say something KR>>> like: Pt. will increase active elbow extension to -20 degrees to KR>>> allow for increased independence with upper body dressing or KR>>> decrease reports or pain to increase functional performance with KR>>> bilateral upper extremity tasks (grooming, bathing, dressing, etc.) KR>>> KR>>> Ron, you have now given us examples of 2 patients you would not KR>>> treat, I too am wondering what kind of patient would you see? KR>>> KR>>> KR>>> Kari, MOT, OTR/L KR>>> Hollywood, Florida KR>>> --- On Sat, 8/30/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote: KR>>> From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> KR>>> Subject: Re: [OTlist] Elbow Break, Referral... KR>>> To: [email protected] KR>>> Date: Saturday, August 30, 2008, 5:21 PM KR>>> I would write all 4 goals.? Why in the world would you not take this patient?? KR>>> "I shouldn't have taken it but I did."? What patient's do you KR>>> take? KR>>> Chris Nahrwold MS, OTR KR>>> St. John's Hospital KR>>> Anderson, Indiana KR>>> -----Original Message----- KR>>> From: Ron Carson <[EMAIL PROTECTED]> KR>>> To: OTlist <[email protected]> KR>>> Sent: Sat, 30 Aug 2008 2:48 pm KR>>> Subject: [OTlist] Elbow Break, Referral... KR>>> Received a new referral for a elbow fracture. I shouldn't have taken KR>>> it but I did. KR>>> And here is the dilemma facing our profession. The patient is 95, KR>>> previously living independently. Fractured elbow in a fall. Now living KR>>> with daughter. She is in a large amount of pain. Obviously, she is KR>>> dependent for most of her occupations. She currently uses a cane but KR>>> is not safe. KR>>> The patient's immediate concerns are her elbow. When pressed, she of KR>>> course wants to go back home, but that is not an immediate goal. KR>>> So what do I write for goals? For example should I write: KR>>> Patient will self-report pain as 3 out of 10 KR>>> Patient's will increase active elbow extension to -20 degrees KR>>> These goals seem to direct the patients and doctor's concerns but are KR>>> not occupationally oriented. So, should I write: KR>>> Patient will safely and independently dress lower body KR>>> Patient will safely and independently ambulate to the bathroom KR>>> using the least restrictive mobility aid KR>>> I like these goals but they don't address the immediate concerns. KR>>> Ron KR>>> -- KR>>> Ron Carson MHS, OT KR>>> -- KR>>> Options? KR>>> www.otnow.com/mailman/options/otlist_otnow.com KR>>> Archive? KR>>> www.mail-archive.com/[email protected] KR>>> -- KR>>> Options? KR>>> www.otnow.com/mailman/options/otlist_otnow.com KR>>> Archive? KR>>> www.mail-archive.com/[email protected] KR>>> LS>> -- LS>> Options? LS>> www.otnow.com/mailman/options/otlist_otnow.com LS>> Archive? LS>> www.mail-archive.com/[EMAIL PROTECTED] LS>> LS> -- LS> Options? LS> www.otnow.com/mailman/options/otlist_otnow.com LS> Archive? LS> www.mail-archive.com/[email protected] LS> -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
