My first home health eval is a clear cut example of how being focused on
occupation makes it very easy to identify patients who need OT services.

This  patient  was  status post CVA. He also experienced a gout flare up
over  most  of  his joints. He had decreased vision and residual pain in
most  of his joints, especially his bi-lateral elbows. By his report, he
required assistance with ALL daily living occupations.

During  the  eval, it was clear that the patient was focused on only one
thing,  reducing  his  pain.  Even  though  he  required assistance with
living, his focus remained on resolving the source of his assistance.

Interestingly,  the  more  I pushed to fully understand why this man was
unable  to  better  care  for  himself the more frustrated he became. In
fact, he point blank told me, "I can't talk with you".

In  the  end,  I  offered the patient a choice to use my services but he
denied wanting them. And I agreed that there was no role for OT.

I  have  always  maintained  that  in  the  absence  of  CLEARLY defined
occupational  deficits,  OT  has  no role. And this is an example of how
that works.

On an unrelated side note, a PTA showed up about 15 minutes into my eval
and sort of took over things. I just sort of worked around him to finish
up  my  stuff,  but he had a well defined and much appreciated role with
the  patient.  But, this guy was over the top with his dress. He came in
with scrubs, a long white coat and a stethoscope around his neck. He had
the  doctor  look  down  to a "T". He was very doctor looking and doctor
acting. I think in this case, the patient appreciated the PTA's approach
better than my more casual approach. It was a great start to my day!!

Ron


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