I do not think an occupation-based approach to evaluation, treatment and outcomes limits the practice of OT.? I only think giving up on UE treatment in hand clinics and with stroke patients would debilitate the field of OT.? I have not disagreed on very many of your specific case studies that you have provided in which you have DC'd a patient from OT.? I would have probably done the same thing.? I primarily work in an acute rehab unit, and taking an occupation based approach is the only way to go when the patient's goal is to make it back home.? I can totally see your point of view when trying to totally get away from UE treatment based on a?large sample of rehab hospital/nursing home therapists who provide only UE "treatment" to pass time without any purpose or meaning.?I strongly agree that OT would be much more of a?solidified profession if all of the OTs?in?acute rehab, home health, and?nursing homes would take an occupation based approach. ?I do not think this should ruin the reputation of all of the hard working OTs in hand therapy and neuro clinics who provide a critical service to patient's with UE dysfunction.? I continue to believe that these therapists are OTs and they are providing OT services that impact the patient's personal occupations.
I hope there is a solution?for all of the therapists whom give us OTs a poor reputation.? I have worked with individuals like this and they more often than not are oblivous to the fact that what they are doing is not really OT or therapy at all for that matter.? Somtimes a simple talking to works, sometimes it doesn't.? I think one step we can take is to try to be a mentor for individuals whom are stuck in an OT rut.?Another step that I think would be of value would be more continuuing education involving OT and occupation.? There are so many courses out their taught by PT focusing on body functions/structures, it is to no wonder that?therapists are focusing primarily on these issues.? I think we need more on occupation, practical solutions for impairments from top notch green thumb therapists.?Perhaps with a?major push in this we would see a "trickle down effect" in the quality of care. ?Ron have you ever thought about taking your act on the road and teaching on the continuuing ed circuit? Chris Nahrwold MS, OTR -----Original Message----- From: Ron Carson <[EMAIL PROTECTED]> To: [email protected] Sent: Thu, 23 Oct 2008 7:16 pm Subject: [OTlist] Thoughts on Limiting Our Practice It's been suggested that a occupation-based approach to evaluation, treatment and outcomes limits the practice of OT. I want to suggest that such an approach does just the opposite. First, there is NO profession addressing occupation. There are some professions, namely PT, SLP, Aides, RN, OT, that address PARTS of occupation, but no profession sees the entire picture from start to finish. And because of this, many, many patients never truly achieve their highest potential! Second, facilitating occupation is excruciating difficult. But, because of this, it's wonderfully rewarding. Case in point, is "Martha". One of her goals is independently getting on/off the toilet. Over the course of her treatment, Martha has been able to transfer to/from the toilet. And she has even successfully used her OLD toilet. I say "old" because in an effort to make transfers easier, a higher toilet was installed. BUT, the new toilet has a different seat in which Martha sinks into. Thus, while she can easier sit on her new toilet, she can not TURN while sitting to allow her to grad installed hand rails. Thus, the new toilet seat doesn't work well. You know, who would think that the shape of a toilet seat is the difference between independence and dependence. So, the observation skills, problem solving, environmental awareness, biomechanics, and even common sense that goes into occupation-based practice is anything but limiting. And while occupation-based practice does exclude some practice areas, notably acute injury, there are many more areas and patients who benefit from these services. Sorry for typos/graphos; I'm typing about as fast as I'm thinking! 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]
