Sounds like she might be back to her baseline with her ADL performance.? Her bi-lateral shoulder problem sounds like either severe arthritis or torn RTCs.? At her age surgery not?likely for the RT.? Is she ok with receiving assistance with bathing and dressing or is it a goal of hers to improve?? If it a goal for her to improve in ADL performance, I would attempt to teach her how to use adaptive equipment like a dressing stick to pull the shirt over her head so her arms would not have to go over 90 degrees.? I would also instruct the patient and family on heat and slow stretching so the limitation in her arms will not become worse and perhaps so she can lift her arms on a table or sink to slip on her shirt over her head and to groom/eat.? I just had a man in a similiar situation, but he was much younger.? The basic compensation techniques and exercises worked like a charm, and he was very happy about the progress, but he was very motivated to improve because his wife was unable to help him much.
Chris Nahrwold MS, OTR -----Original Message----- From: Ron Carson <[EMAIL PROTECTED]> To: [email protected] Sent: Fri, 17 Oct 2008 6:58 pm Subject: [OTlist] How Would YOU Treat This Patient? Did an eval today and wondering how other OT's might address the situation. 94 y/o female living with her 70 y/o daughter. Recent fall resulting in femur fracture. Ambulates with a rolling walker and supervision. Independent with toileting. Requires assistance with upper body dressing, independent with LE dressing. Requires assistance with bathing. Patient previously received assistance with bathing and dressing. Patient has pain 8/10 in right femur with weight bearing. She is unable to raise her bi-lateral shoulders past approximately 90 degree flexion/abduction. How would you treat this patient and WHY??? Thanks, Ron -- Ron Carson MHS, OT -- 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]
