Thanks Joan. Interesting reference and something worth considering for
my NEXT patient. Unfortunately, I need "help" NOW!! <smile>

Ron
--
Ron Carson MHS, OT

----- Original Message -----
From: Joan Riches <[email protected]>
Sent: Saturday, December 13, 2008
To:   [email protected] <[email protected]>
Subj: [OTlist] Help with Treatment Plan???

JR> Hi Ron
JR> The thing is you can make a big difference for this lady and for the
JR> staff who work with her. The ACLS screening tool does not go as low as
JR> she seems to be and all these questions help to identify her level in
JR> order to create an effective plan for staff. One final one is Does she
JR> pick up and manipulate objects other than for eating? 
JR> The reference that I have found most useful in all cases of problematic
JR> behaviour is
JR> A Cognitive Link: Managing Problematic Bodily Behavior by Delaune
JR> Pollard
JR> Available from Selectone Rehab www.selectonerehab.com and from S&S. I
JR> wrote the foreword for this so I am understandably biased but for
JR> practical understandable help I don't think it can be beaten. 

JR> Joan Riches B.Sc.O.T., OT(C)
JR> Specialist in Cognitive Disability
JR> Riches Consulting
JR> High River, Alberta, Canada
JR> 403 652 7928
JR>  

JR> -----Original Message-----
JR> From: [email protected] [mailto:[email protected]] On
JR> Behalf Of Ron Carson
JR> Sent: December 13, 2008 5:20 PM
JR> To: Joan Riches
JR> Subject: Re: [OTlist] Help with Treatment Plan???


JR> Wow  Joan,  that's  a lot of questions. <smile> Truth be known, I only
JR> spent  about  45 minutes with this patient and she was new at the ALF.
JR> There  just  isn't much information to go on which is a big part of my
JR> problem.  Maybe  I  need  to  go  back  before  I generate a treatment
JR> plan???

JR> CGA- Min A is: contact guard assist and minimum assist.

JR> Ron
JR> --
JR> Ron Carson MHS, OT

JR> ----- Original Message -----
JR> From: Joan Riches <[email protected]>
JR> Sent: Saturday, December 13, 2008
JR> To:   [email protected] <[email protected]>
JR> Subj: [OTlist] Help with Treatment Plan???

JR>> Ron
JR>> This can be a tough one.
JR>> What is CGA - Min A?
JR>> To start with you can assess her gathering all the information you
JR> can.
JR>> What does independent in eating mean - does she use cutlery? What
JR> type
JR>> of diet is she on? Is all her food in bite size pieces that do not
JR> need
JR>> to be cut? Does she eat her food without needing to be cued?
JR>> Is her speech in Spanish any more complex than her speech in
JR> English?
JR>> Does she grab people and things and 'refuse' to let go?
JR>> Has she been 'taken down' due to combative behaviour?
JR>> If not, how is she being managed?
JR>> Are there any staff members with whom she is not combative?
JR>> At what points in the day or during what activities is she
JR> combative?
JR>> Are there complaints that she has voided urine in inappropriate
JR>> containers? 
JR>> Is she being restrained?
JR>> What are the characteristics of her combative behaviour? Does she
JR> punch,
JR>> kick, bite, spit etc. Is there a consistent pattern? 
JR>> Might the attitude and caution with which she is approached be
JR> perceived
JR>> by her as threatening?
JR>> Under what circumstances is she settled and content?
JR>> Is her behaviour both negative and positive being tracked and
JR> charted?
JR>> I suspect she is somewhere in Allen cognitive level 2 with cognitive
JR>> ability analogous to 9 - 23 months, probably nearer to the top of
JR> that
JR>> range.


JR>> Joan Riches B.Sc.O.T., OT(C)
JR>> Specialist in Cognitive Disability
JR>> Riches Consulting
JR>> High River, Alberta, Canada
JR>> 403 652 7928
JR>>  
JR>> -----Original Message-----
JR>> From: [email protected] [mailto:[email protected]] On
JR>> Behalf Of Ron Carson
JR>> Sent: December 12, 2008 6:06 PM
JR>> To: [email protected]
JR>> Subject: [OTlist] Help with Treatment Plan???


JR>> Evaled  a  new patient who was just transferred to an Alzheimer's
JR> ALF.
JR>> The  patient  spoke primarily in Spanish but also in some English.
JR> She
JR>> was  very  non-cooperative and was physically combative with ALF
JR> staff
JR>> and myself.

JR>> The  staff  says she is dependent for all ADL's except eating and
JR> that
JR>> she ambulates with CGA - Min A.

JR>> What can I do with this patient?

JR>> Ron



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