Barb, I want to offer a suggestion. In my early days as an OT, I worked
in adult rehab. It was VERY faced paced and therapists generally had 2 -
3 patient's hour. In the beginning, I was stuck in the peg, cone, etc
routine, but one day I read a book that changed my practice.
I changed my practice pattern from UE/ADL to occupation-based treatment.
In this approach, a patients occupational needs/desires become the ONLY
reason for treatment. In the absence of occupational problems that are
improvable, there is no role for OT.
This approach 100% clarified my treatment for both myself and patients.
I no longer wondered what to do with patients. Suddenly, I began
stepping away from typical OT activity and began addressing patient's
most important needs. My treatment boundaries greatly expanded and I
began feeling much better about my treatments.
No longer did I do "contrived" OT treatment, instead I addressed the the
ACTUAL needs of the patients. Since you asked for concrete ideas here
they are:
1. Identify client's needs/desires
2. Identify why the can't do these things
3. Direct 100% of your treatment to:
a. Remediating underlying issues
b. Compensating for uncorrectable problems
c. Changing environments
Forget made up activities, forget games and other silly things. YOU CAN
DO THIS!
Ron
--
Ron Carson MHS, OT
www.OTnow.com
----- Original Message -----
From: [email protected] <[email protected]>
Sent: Friday, February 13, 2009
To: [email protected] <[email protected]>
Subj: [OTlist] The Saddest OT Statement I've Ever Heard
bcn> Thanks, Sue, for providing some specifics. I understand the need
bcn> for functional tx that is specific to the patient! I just need
bcn> some more specific, concrete ideas about how others do this in the
bcn> clinic environment. With productivity demands it is even difficult
bcn> for me to spend time in a patient's room alone with them. I seem
bcn> to be the ONLY OT in my department who takes the time to do ADLs with some
of my patients.
bcn> So I am looking for more concrete ideas and less philosophical
bcn> ranting. I do get that part. I know venting is necessary
bcn> sometimes, but I joined this list to get more specific ideas to
bcn> help with my tx planning and so that is why I asked the question.
bcn> Thanks,
bcn> Barb Howard COTA
bcn> ----- Original Message -----
bcn> From: "Sue Doyle" <[email protected]>
bcn> To: [email protected]
bcn> Sent: Friday, February 13, 2009 7:46:09 AM GMT -05:00 US/Canada Eastern
bcn> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard
bcn> I am the lead therapist in an inpatient rehab center. We focus on the
bcn> clients goals and predominantly use functional tasks. Even spent the
bcn> afternoon knitting and compiling emails with a patient. I have a
bcn> carburetor that I have had out several times for some of the men to
bcn> work on as their goal has been to go back to working on their car.
bcn> Sue D
>> From: [email protected]
>> To: [email protected]
>> Date: Thu, 12 Feb 2009 19:46:44 -0500
>> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard
>>
>> I do not have alot of experience yet ...I am still a student, but I have
>> been in places that simply sit patients up at tables and gave them something
>> to do that may or may not be functional for them specifically. For example,
>> a patient may get something out of cognitively out of sorting colored pegs
>> on a peg board but is has no meaning to their life. Our challenge as
>> professionals is to dig deeper and find something that we can do to reach
>> the same goal but make it applicable to the patients life. However, I
>> understand this has been all but impossible in many rehabs because of
>> productivity demands. I happen to be in a rehab setting that is more
>> flexible because the we smaller and it is acute rehab vs. SNF. I cannot
>> judge how other places are run, in fact, I do feel I am in a unique facility
>> and although I may never be employed there, I will take this experience with
>> me wherever I go. ADL's are the first priority and ususaly what the patients
>> say are goals for themselves but we can make meals, simulate homemaking
>> activites, and the list goes on..the point is that is has some functional
>> application to the patient...so it is always different and changing.
>>
>> -----Original Message-----
>> From: [email protected] [mailto:[email protected]]on
>> Behalf Of [email protected]
>> Sent: Thursday, February 12, 2009 19:06
>> To: [email protected]
>> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard
>>
>>
>>
>>
>> How about sharing some specifics - some typical tx sessions.
>>
>> When you say adult rehab, do you mean outpatient,..home health...?
>>
>>
>>
>> This is becoming a mantra - Productivity requirements impose cookie cutter
>> approaches.
>>
>> Therapists are caught in the middle and many give up swimming upstream. I
>> haven't given up, but
>>
>> I know I have to go elsewhere to accomplish this. I'd like to run my own
>> department someday, but
>>
>> I want to learn as much as I can specifically about functional treatment,
>> that is, in addition to doing ADLs
>>
>> with patients.
>>
>> Any info would be appreciated.
>>
>> Barb Howard, COTA
>>
>>
>>
>>
>> ----- Original Message -----
>> From: "Diane Randall" <[email protected]>
>> To: [email protected]
>> Sent: Thursday, February 12, 2009 6:31:35 PM GMT -05:00 US/Canada Eastern
>> Subject: Re: [OTlist] The Saddest OT Statement I've Ever Heard
>>
>> Wow..I am interning in adult rehab right now and UE therex is only used for
>> people who really need it. Been there six weeks and everything revolves
>> around function.
>>
>> -----Original Message-----
>> From: [email protected] [mailto:[email protected]]on
>> Behalf Of Ron Carson
>> Sent: Wednesday, February 11, 2009 18:40
>> To: [email protected]
>> Subject: [OTlist] The Saddest OT Statement I've Ever Heard
>>
>>
>> Today, I met a new PT assistant who was just starting with our home
>> health company. He was just finishing with a patient as I was starting
>> my evaluation. The PTA came from 20 years of geriatric rehab and rehab
>> experiences.
>>
>> About 1/2 through my eval he said to me, and I quote: "I'm not use to
>> OT's working on functional things". He went on to say that at his rehab
>> facility, the OT's mainly did UE exercises.
>>
>> "Living life to the fullest". What a crock!
>>
>> Ron
>>
>> --
>> Ron Carson MHS, OT
>> www.OTnow.com
>>
>>
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