Hello Ron, I'm not sure I completely follow. If you are saying the point is occupational goal setting--I could not agree more. The exception I take is that many times we are reduced to glorified "shower attendants" in the name of occupation. More specifically, I have never had a pt. that had xfers as a goal. I may have influenced their opinion to that end but, they have never initially volunteered BADL type goals. As has been discussed before, most people "just want be a able to walk again". The problem, as we know, is we stand on the other side of the "river bank" with our pt's and we are trying to help them "build a bridge" to the other side. In my best moments of task analysis there are many types of "bridges"...some more precarious than others. Sometimes you "walk" over and sometimes you build in rest breaks. What's my point? Yes, functional I with the "necessities" of life are a part of occupational performance (BADL), but it is not the "end" for our pt's. For example, the xfers you mentioned before, they should be viewed in my opinion as the bridge to the greater goal/question of "what does the pt. want/need to be able to do once they are in?". The same is true at the other end of the spectrum of performance (modalities--->decreased pain/increased AROM--->increased functional I).
Rambling? Yeah...but look at the metaphors! Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Ron Carson Sent: Saturday, September 06, 2008 8:23 AM To: Neal Luther Subject: Re: [OTlist] Advance for OT Article: Point #3 Hello Neal: If OT's would adopt occupational goals then patients would be d/c when those goals are achieved. For example, if the goal is: "By d/c, patient will safely and independently transfer to/from car" Once the goal is best achieved the patient is discharged. Of course, patients have multiple goals but the concept is the same. Just last week, I evaluated a patient with total hip replacement. The evaluation resulted in 5 goals (in abbreviated format): 1. In/out shower 2. In/out of car 3. On/off toilet 4. Simple meal prep 5. Lower body dressing Using the above approach, it's easy to tell when the goal(s) are achieved. If additional goals are not established, the patient is discharged. Also, this approach empowers the patient because they generate their own goals. I strongly believe that my job is NOT making goals, but facilitating the patient to achieve them. Of course, there are exceptions. Ron -- Ron Carson MHS, OT ----- Original Message ----- From: Neal Luther <[EMAIL PROTECTED]> Sent: Friday, September 05, 2008 To: [email protected] <[email protected]> Subj: [OTlist] Advance for OT Article: Point #3 NL> Arley NL> I could not agree more! You are making some of the same points NL> that I believe Dr. Sorenesen has made recently with regard to EI NL> (quite a broohaha). We simply don't know how/when to D/C I NL> believe in part because we have not established plans of care NL> based on sound clinical reasoning. We confuse altruism with NL> therapeutic intervention (give a man a fish vs. teach a man to NL> fish). This results in treating everyone and everything and if NL> done so long enough even the smallest changes/improvements are NL> claimed to be as result of treatment. My two cents. NL> Neal C. Luther,OTR/L NL> Rehab Program Coordinator NL> Advanced Home Care NL> 1-336-878-8824 xt 3205 NL> [EMAIL PROTECTED] NL> Home Care is our Business...Caring is our Specialty -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
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