I have just read through the postings for the last couple of weeks and felt I needed to make some comments. I have worked in the USA but am currently practicing in New Zealand, so I do have an understanding of the issues American OTs face. On the issue about being UE therapists….. “the therapists complete UE exercise and group therapy all day long” my question is why are OTs doing exercise programmes for UE- that’s the PTs responsibility. I know I never did this in 71/2 yrs of practice in the USA. What happened to ADL retraining daily to increase activity tolerance, safety, functional balance/mobility/reach? ADL retraining can increase AROM by using occupation, which is more meaningful than exercise. Many of my patients made excuses to not to do PT but willingly engaged in ADLs with OT. As they increased strength and AROM etc they also had a visible outcome for their labours and could see how adaptation to previous patterns of movement or behaviour were acceptable to them and sped up their discharge home. I found FIM great for demonstrating positive outcomes for OT. On the issue about the CVA patient and the painful shoulder…. I always found that in this type of scenario my skills lay in helping the person adapt to a non-functional arm. To decrease pain I would use weight bearing activities ( ie ADLs contrived to accommodate a WB position for his UE and his LE ) and I would focus on increasing his independence in ADLs which would involve unconscious PROM for his UE also a way of decreasing pain. My goal would be independent bathing and dressing which would impact his sense of loss, and of being a burden, and restore some sense of self respect. On the issue of cones and pegs… When did OTs forget to explain their interventions and help carers understand that sometimes the things we do may look irrelevant but will help with the rehab process ultimately? I thought we were the experts at using therapeutic self, which also means developing the relationship with the client and the family so that understanding can underpin the hands on things we do. On the issue of refusing the UE referral….. Why? Have you forgotten how to take the patients daily occupations and analyse them so you can utilise the core performance components to formulate a programme of daily productive tasks to increase AROM, decrease pain and maintain/improve physical and mental function? UE vs LE….. I must have been really lucky but in the rehab hospital I worked in while in the States. OTs and PTs worked as a team, acknowledging each others strengths and reinforcing each others treatment plans. My PT often was aghast that I could get 90’ of knee flexion so soon after a TKA, when they were struggling. Little did they know about my challenge to my patients to wash and dry their feet within a week seated on a shower stool that got lower and lower everyday! And no, I did not use the same technique with my THAs. They were also challenged to gain increased AROM and strength by multiple sit to stands during their ADLs ( from an appropriate height stool, without using their hands ). Response to Brett 22/04/09 I have recently become very interested in the role of smoking cessation in healthcare and the role of OT in smoking cessation. I too would feel challenged by your dilemma, but I do not feel that I could assist with lighting his cigarettes. I would have thought that there would be a No Smoking rule in your facility, therefore any smoking would be done outside and thus this task would be the responsibility of whoever takes him outside. At the same time I would explain to him that I have no problem with him having nicotine but would prefer it was being delivered in a clean way ( patches, gum, lozenges etc ) rather than by smoking, which impacts those around him and we all know how dangerous secondhand smoke is, don’t we? So promote the clean delivery of nicotine, which he may be able to manage without help, thus making him less dependent! If you want further discussion about smoking cessation from an OT perspective write to me. And finally I’m assuming that there has been a discussion about a male doing bathing/dressing with a female and I would just like to say that I’m not a great fan of dry runs, especially if there are cognitive deficits as taking an activity out of context can lead to more probs down the track. But I have seen females initially scared of having a male OT/COTA doing ADLs be totally turned around because of the professional and competent manner in which my male colleagues conducted themselves. It does raise the issue that female OTs doing ADLs with men are also vulnerable. It would be interesting to research if there is a difference between male OTs and male nurses when undertaking these more sensitive areas of care. And finally, I am still thinking about the case with the lady who has Alzheimers and the femoral neck fracture! I will touch base with my colleague who works in the Mental Health for the Older Persons Service. > From: [email protected] > Subject: OTlist Digest, Vol 66, Issue 1 > To: [email protected] > Date: Wed, 13 May 2009 06:01:18 -0700 > > Send OTlist mailing list submissions to > [email protected] > > To subscribe or unsubscribe via the World Wide Web, visit > http://otnow.com/mailman/listinfo/otlist_otnow.com > or, via email, send a message with subject or body 'help' to > [email protected] > > You can reach the person managing the list at > [email protected] > > When replying, please edit your Subject line so it is more specific > than "Re: Contents of OTlist digest..." > > > Today's Topics: > > 1. Re: Breaking the Bonds of Upper Extremity OT; Is it even > (Johnson, Arley) > 2. Re: Breaking the Bonds of Upper Extremity OT; Is it even > ([email protected]) > 3. Re: promoting OT (susanne) > 4. My Next Goal is to walk... (Ron Carson) > 5. "Healing the Splintered Mind" (Ron Carson) > 6. Re: "Healing the Splintered Mind" ([email protected]) > 7. Positive comment of the day ([email protected]) > 8. 2nd Postive Comment of the Day (Ron Carson) > 9. Re: promoting OT (Alayna Adams) > 10. Marketing Flyers (Juan Turcios) > 11. Re: Marketing Flyers (Ron Carson) > > > ---------------------------------------------------------------------- > > Message: 1 > Date: Fri, 24 Apr 2009 21:17:32 -0400 > From: "Johnson, Arley" <[email protected]> > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > To: <[email protected]> > Message-ID: > <944d43ee89f5ac43bcfb4e8f63fb32bc03b87...@uphsmbx7.uphs.pennhealth.prv> > > Content-Type: text/plain; charset="iso-8859-1" > > > Having some experience with a RAC review a few years ago, they will go after > anything to deny payment. I don't know if CMS fixed their incentive loophole, > but they would get a percent of whatever amount they denied. If the facility > appealed the denials(80% turnover rate) and won, the RAC would still get paid > their cut. At the time, my OTs did plenty of UE ther ex (which I disliked, > but that's another convo) with the joint replacement patients, but the RAC > never mentioned that in our reason for denials. That leads me back to my > initial statement that they will hunt for anything in the chart to get a > denial. To expand, they were inconsistent with their reviews. One patient had > unstable hgb levels, UTI and newly diagnosed diabetes. They said she did not > demonstrate a need for 24 hr medical supervision,but yet they approved a > straight forward unilateral TKR with no acute illnesses. Go figure. > To conclude, we shouldn't get so bent on that one experience as the fall of > OT. :-) These reviewers aren't always the sharpest pencils in the bunch. > > > Arley Johnson, MS, OTR/L > Site Manager, Pennsylvania Hospital > Rehabilitation Services > > ________________________________ > > From: [email protected] on behalf of [email protected] > Sent: Fri 4/24/2009 5:04 PM > To: [email protected] > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it even > > > > PatJoan, > > I do not think you understand. Medicare (our government payor source > for the elderly)is now not allowing general debility patients into > acute rehab period. We used to have this 75% rule in which 75% of our > cases had to match a certain diagnois (stroke, spinal cord, etc), and > the other 25% could be whatever diagnosis. Now Medicare CMS is > auditing charts and making rehab facilities pay back millions of > dollars finding that the patients were not appropriate to be there. > Several cases she explained was that the OT did not have enough > documentation to support that they truly needed OT. Her claim was that > a general debility patient would not need OT for arm exercises. When a > person has 5/5 strength and the therapists complete UE exerise and > group therapy all day long that is totally inapproriate. We need to > complete ADLs during the first three days of their stay to document the > need for skilled OT and then actually work on those issues during their > stay to demonstrate improvement on the FIM. The funny thing is the > patients improve much faster when we take an occupational approach. It > is not rocket science. Bottom line is that patients need to get up of > the the wheelchair and get moving by engaging in their daily > occuapations in the way they plan on completing them at home. We OTs > need to speak up to the OTs who are screwing our profession up. I am > sure AOTA is aware of these issues because these Medicare RACK audits > is a hot topic in rehab right now. > > -----Original Message----- > From: Joan Riches <[email protected]> > To: [email protected] > Sent: Fri, 24 Apr 2009 2:32 pm > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > > > Have you reported this with names and details to AOTA for follow-up? > What was the result of the debate? Will this person continue the blanket > refusal of all OT? Targeted refusals of UE exercise without specific > rationale and a UE diagnosis might go a long way to changing practice. > I wonder how widespread this is in Canada. I did see it 25 years ago as > a student. It definitely does not happen in this area. All the OTs are > far too busy too waste time that way. > Joan Riches B.Sc.O.T., OT(C) > Specialist in Cognitive Disability > Riches Consulting > High River, Alberta, Canada > 403 652 7928 > > -----Original Message----- > From: [email protected] [mailto:[email protected]] On > Behalf Of [email protected] > Sent: April 23, 2009 8:12 PM > To: [email protected] > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > > > Listened to a medicare teleconference describing why CMS is denying > debility patients from acute rehab stays. When asked why this is so, > the medicare communicater stated that they did not have medical > necessity for occupational therapy. When debating this issue and how > occupational therapy works on a debility patient's occupations, the > communicator stated that she thought that all we did was UE exercise. > I guess from all of her chart audits she has concluded this over the > years. I am starting to slowly see Ron's point of view even clearer > now. I now am recognizing that this is more of a standard practice than > I thought. I think we really need to focus on occupations when the goal > is to get the patient home or to improve their quality of life. I > think it is ok to work on UE strength, fine motor control to an extent > especiallly when the imparment is effecting the individual on a > disability level, but the focus needs to be on the skills that will > allow the patient to go home safelyl. I believe that this move by > medicare CMS will slowly trickle down into other areas of our care. We > need to start now to force our other therapists to treat as > occupational therapists not cone and peg pushers. Managers need to > initiate policies that address these issues now, > > > No virus found in this outgoing message. > Checked by AVG - www.avg.com > Version: 8.0.238 / Virus Database: 270.12.4/2078 - Release Date: > 04/24/09 07:54:00 > > > > -- > 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] > > > > > The information contained in this e-mail message is intended only for the > personal and confidential use of the recipient(s) named above. If the reader > of this message is not the intended recipient or an agent responsible for > delivering it to the intended recipient, you are hereby notified that you > have received this document in error and that any review, dissemination, > distribution, or copying of this message is strictly prohibited. If you have > received this communication in error, please notify us immediately by e-mail, > and delete the original message. > > > > ------------------------------ > > Message: 2 > Date: Sat, 25 Apr 2009 13:28:55 -0400 > From: [email protected] > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii"; format=flowed > > Arley. > > Good points. Thanks for bringing me back to reality. > > -----Original Message----- > From: Johnson, Arley <[email protected]> > To: [email protected] > Sent: Fri, 24 Apr 2009 8:17 pm > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > > > Having some experience with a RAC review a few years ago, they will go > after anything to deny payment. I don't know if CMS fixed their > incentive loophole, but they would get a percent of whatever amount > they denied. If the facility appealed the denials(80% turnover rate) > and won, the RAC would still get paid their cut. At the time, my OTs > did plenty of UE ther ex (which I disliked, but that's another convo) > with the joint replacement patients, but the RAC never mentioned that > in our reason for denials. That leads me back to my initial statement > that they will hunt for anything in the chart to get a denial. To > expand, they were inconsistent with their reviews. One patient had > unstable hgb levels, UTI and newly diagnosed diabetes. They said she > did not demonstrate a need for 24 hr medical supervision,but yet they > approved a straight forward unilateral TKR with no acute illnesses. Go > figure. > To conclude, we shouldn't get so bent on that one experience as the > fall of OT. :-) These reviewers aren't always the sharpest pencils in > the bunch. > > > Arley Johnson, MS, OTR/L > Site Manager, Pennsylvania Hospital > Rehabilitation Services > > ________________________________ > > From: [email protected] on behalf of [email protected] > Sent: Fri 4/24/2009 5:04 PM > To: [email protected] > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > > > > PatJoan, > > I do not think you understand. Medicare (our government payor source > for the elderly)is now not allowing general debility patients into > acute rehab period. We used to have this 75% rule in which 75% of our > cases had to match a certain diagnois (stroke, spinal cord, etc), and > the other 25% could be whatever diagnosis. Now Medicare CMS is > auditing charts and making rehab facilities pay back millions of > dollars finding that the patients were not appropriate to be there. > Several cases she explained was that the OT did not have enough > documentation to support that they truly needed OT. Her claim was that > a general debility patient would not need OT for arm exercises. When a > person has 5/5 strength and the therapists complete UE exerise and > group therapy all day long that is totally inapproriate. We need to > complete ADLs during the first three days of their stay to document the > need for skilled OT and then actually work on those issues during their > stay to demonstrate improvement on the FIM. The funny thing is the > patients improve much faster when we take an occupational approach. It > is not rocket science. Bottom line is that patients need to get up of > the the wheelchair and get moving by engaging in their daily > occuapations in the way they plan on completing them at home. We OTs > need to speak up to the OTs who are screwing our profession up. I am > sure AOTA is aware of these issues because these Medicare RACK audits > is a hot topic in rehab right now. > > -----Original Message----- > From: Joan Riches <[email protected]> > To: [email protected] > Sent: Fri, 24 Apr 2009 2:32 pm > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > > > Have you reported this with names and details to AOTA for follow-up? > What was the result of the debate? Will this person continue the blanket > refusal of all OT? Targeted refusals of UE exercise without specific > rationale and a UE diagnosis might go a long way to changing practice. > I wonder how widespread this is in Canada. I did see it 25 years ago as > a student. It definitely does not happen in this area. All the OTs are > far too busy too waste time that way. > Joan Riches B.Sc.O.T., OT(C) > Specialist in Cognitive Disability > Riches Consulting > High River, Alberta, Canada > 403 652 7928 > > -----Original Message----- > From: [email protected] [mailto:[email protected]] On > Behalf Of [email protected] > Sent: April 23, 2009 8:12 PM > To: [email protected] > Subject: Re: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it > even > > > Listened to a medicare teleconference describing why CMS is denying > debility patients from acute rehab stays. When asked why this is so, > the medicare communicater stated that they did not have medical > necessity for occupational therapy. When debating this issue and how > occupational therapy works on a debility patient's occupations, the > communicator stated that she thought that all we did was UE exercise. > I guess from all of her chart audits she has concluded this over the > years. I am starting to slowly see Ron's point of view even clearer > now. I now am recognizing that this is more of a standard practice than > I thought. I think we really need to focus on occupations when the goal > is to get the patient home or to improve their quality of life. I > think it is ok to work on UE strength, fine motor control to an extent > especiallly when the imparment is effecting the individual on a > disability level, but the focus needs to be on the skills that will > allow the patient to go home safelyl. I believe that this move by > medicare CMS will slowly trickle down into other areas of our care. We > need to start now to force our other therapists to treat as > occupational therapists not cone and peg pushers. Managers need to > initiate policies that address these issues now, > > > No virus found in this outgoing message. > Checked by AVG - www.avg.com > Version: 8.0.238 / Virus Database: 270.12.4/2078 - Release Date: > 04/24/09 07:54:00 > > > > -- > 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] > > > > > The information contained in this e-mail message is intended only for > the personal and confidential use of the recipient(s) named above. If > the reader of this message is not the intended recipient or an agent > responsible for delivering it to the intended recipient, you are hereby > notified that you have received this document in error and that any > review, dissemination, distribution, or copying of this message is > strictly prohibited. If you have received this communication in error, > please notify us immediately by e-mail, and delete the original message. > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > > > > > ------------------------------ > > Message: 3 > Date: Sun, 26 Apr 2009 23:46:23 +0200 > From: "susanne" <[email protected]> > Subject: Re: [OTlist] promoting OT > To: <[email protected]> > Message-ID: <00d401c9c6b8$ca56fb70$fee15...@dell1> > > ---- Original Message ---- > From: "Alayna Adams" <[email protected]> > Sent: Monday, April 20, 2009 3:51 AM > > > Hi everyone,I am going to write a letter to the editor of my local > > newspaper to promote OT for OT month. I would appreciate any > > feedback. > > Hi Alayna! > > Kudos for that initiative - I feel much inspired! I also am grateful > for the chance to give feedback and so here are a few things that > caught my eye while reading. But please note that I'm a Danish OT, so > how I see OT may not apply where you are! > > >Sorry about the format being off. > > No problem - I take it the text begins here: > > > To celebrate > > Occupational Therapy (OT) month, I would like to inform our > > community on what OT is and how it benefits residents. OT is a type > > of rehabilitation that aims to help people with a physical, > > developmental, or cognitive disability.... > > *I'm not sure about OT being limited to treating people with > disabilities? People with, say, more temporary conditions may not > identify with this... > > .....increase independence with > > everyday occupations including but not limited to dressing, > > cooking, bathing and leisure. > > *I'd like to see a bit more included here - at least work, interests > and caregiving (of children and other family members). Maybe the place > to mention something about fulfilling one's roles? > > Occupational therapists work in > > hospitals, nursing homes, schools, rehabilitation facilities, > > mental health facilities and a variety of other settings with > > people of all ages and abilities. > > *The very important part of working with the patient/client in their > own home, workplace and community I'd like to see mentioned here. > > OT benefits patients and family > > members by improving their ability to take care of themselves and > > live more independently. OT treatment consists of adapting the > > environment and recommending equipment such as tub benches, > > reachers and magnifiers to enable a person to complete activities > > of daily living. > > *This looks like an exclusive statement to me? Maybe: One part of OT > treatment may consist of...... > > OT will work with patients to improve mobility, > > cognition, and activity tolerance to regain function in order to > > live as independently as possible > > *(I would add here:) "... and/or be able to do what is especially > meaningful for them." (This because to me living 'as independently as > possible' is not always the primary goal - think OT in hospice, or > with someone still needing 24/7 care or supervision.) > > > . Many of our elderly community > > members have received OT and are able to return home without > > services or significant help from family or caregivers. > > *Maybe elaborate a bit here: Home from where, after what? Also, I'd > say: "... without NEEDING services..." - otherwise it sounds kind of > scary:-) > > > Occupational Therapists can complete home evaluations and recommend > > adaptations as necessary. > > *I wonder if "home evaluations" may sound scary if you don't know what > it is. Like, is someone going to judge my home unsuitable...? Maybe > explain how a hospital OT may go along with you for a home visit > before you are discharged, and help you find out how to cope at home, > if adaptations and equipment could help etc. Maybe give an example? > > > OT will train and educate caregivers to > > enable them to help their loved ones live a life with dignity and > > independence. Infants and children are able to reach developmental > > milestones and perform better in school with the skilled treatment > > of OT..... > *(I'd love to see home and playground included here.) > .....People with a mental illness can learn new habits and roles > > to enable them to contribute to society. A teenager with a spinal > > cord injury could learn of adaptations to allow them to go to > > college and > > complete self care. Many people are unaware of what occupational > > therapy is because of the title. Occupation is what we do everyday > > of our lives, what makes our life meaningful to us. Occupational > > Therapy is a profession that can help people regain function to > > live life to the fullest. > > I especially liked this last paragraph, how you mentioned dignity, > contributing to society, and how you linked occupation and OT in the > end. In this context 'living life to the fullest' suddenly makes more > sense to me! I also liked how you built your letter to get around > different OT stuff to get to this point. > > Best of luck with your letter, > > warmly > > Susanne, Denmark > > > > > > ------------------------------ > > Message: 4 > Date: Mon, 27 Apr 2009 22:21:56 -0400 > From: Ron Carson <[email protected]> > Subject: [OTlist] My Next Goal is to walk... > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset=windows-1252 > > I just started working with a middle age woman with multiple problems > including history of CVA, kidney failure with multiple organ > transplants, IDDM. I just evaled her last week. In fact this patient is > horror story #933,533, which I earlier posted. > > This woman sort of has a disability mindset, so I've been working on > empowering and enabling occupations. Part of my approach today was > having the patient identify what the next day's treatment session would > be. I asked her to tell me in the morning what specifically she wanted > to work on. I suggested it could be anything like cooking, car > transfers, using the computer, etc. The bottom line was for HER to > decide the direction of the tx. The patient was previously active on the > computer so I asked her to e-mail me her input. > > This evening I got her message and here's what it says: > > "my next goal is to walk" > > So, what's a good UE therapist going to do with this goal? <LOL> > > Ron > > > > > ------------------------------ > > Message: 5 > Date: Mon, 27 Apr 2009 23:04:02 -0400 > From: Ron Carson <[email protected]> > Subject: [OTlist] "Healing the Splintered Mind" > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset=windows-1252 > > >From Advance for Directors in Rehabilitation, Vol 18, No.4 > > Here's a great quote from the article on page 33: > > "the role of a therapist must expand beyond traditional > objectives to a view that allows clients to return to community > ambulation and a satisfying, productive life. This requires a > thorough understanding of the 'whole person' - a patient with > unique physical, cognitive, emotional , social and spiritual > characteristics. A holistic treatment plan can address these > comprehensive issues and define primary roles for therapists > across disciplines." > > This is a great description of how OT should be. Too bad this is written > by a PT about PT! I left one word of out the quote's 1st line, it > actually reads: "the role of a PHYSICAL therapist..." > > Once again, as adult phys dys OT's are stuck in the STUPID role of being > "crappy upper extremity PT's", the PT's are starting to do what we > should already be doing! > > I sometimes think we are the dumbest profession on the face of the > earth. How did we ever make it this far? How and why are 1,000's of OT > standing around with their thumbs up their nose wasting money and time > doing non-necessary, non-skilled, UE exercises while patients can't get > from point A to point B to do the things they want? > > That slogan of "PT teaches you how to walk and OT teaches what to do > when you get there" is dumb. It's dumb because patients do not care what > they are going to do when they get there! They primarily care about > getting there! > > For a long time, I've said that OT should be the mobility experts and > the above quote is EXACTLY why. We, yes OT, is the best profession to > look at the multiple factors inhibiting and contributing to successful > engagement in mobility-related occupations. Why must PT see that > mobility is much more than gait but OT refuses to recognize that > occupation involves gait. > > Can I teach a person to get from point A to point B? Sure. Do I get > overly involved in the correct procedure of toe off, swing through, etc? > No. That's PT! Do, I worry about causing injury from improper gait? > Sure! Do I do stretching and LE exercises? Only to show the patient, the > rest I leave up to PT. > > See, I think PT needs to stay in their well-defined role of being > PHYSICAL therapists. They are the EXPERTS on physical dysfunction. > Strengthening, ROM, pain - these are PT's domain. On the other hand, > OT's domain is OCCUPATION. It's the doing of daily activity from going > pee to cooking a meal to driving a car. It's the rich world of making > our lives worth living. It's the utterly complex and at time > overwhelming treatment realm of physical, mental, emotional, social and > environmental all rolled up into one big ball of string! It's a > WONDERFUL place for and OT to call home! > > You know, OT needs to heal OUR splintered mind! > > Ron > > ~~~ > Ron Carson MHS, OT > www.OTnow.com > > > > > ------------------------------ > > Message: 6 > Date: Tue, 28 Apr 2009 16:59:25 -0400 > From: [email protected] > Subject: Re: [OTlist] "Healing the Splintered Mind" > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii" > > You go Ron! > > -----Original Message----- > From: Ron Carson <[email protected]> > To: [email protected] > Sent: Mon, 27 Apr 2009 10:04 pm > Subject: [OTlist] "Healing the Splintered Mind" > > >From Advance for Directors in Rehabilitation, Vol 18, No.4 > > Here's a great quote from the article on page 33: > > "the role of a therapist must expand beyond traditional > objectives to a view that allows clients to return to community > ambulation and a satisfying, productive life. This requires a > thorough understanding of the 'whole person' - a patient with > unique physical, cognitive, emotional , social and spiritual > characteristics. A holistic treatment plan can address these > comprehensive issues and define primary roles for therapists > across disciplines." > > This is a great description of how OT should be. Too bad this is written > by a PT about PT! I left one word of out the quote's 1st line, it > actually reads: "the role of a PHYSICAL therapist..." > > Once again, as adult phys dys OT's are stuck in the STUPID role of being > "crappy upper extremity PT's", the PT's are starting to do what we > should already be doing! > > I sometimes think we are the dumbest profession on the face of the > earth. How did we ever make it this far? How and why are 1,000's of OT > standing around with their thumbs up their nose wasting money and time > doing non-necessary, non-skilled, UE exercises while patients can't get > from point A to point B to do the things they want? > > That slogan of "PT teaches you how to walk and OT teaches what to do > when you get there" is dumb. It's dumb because patients do not care what > they are going to do when they get there! They primarily care about > getting there! > > For a long time, I've said that OT should be the mobility experts and > the above quote is EXACTLY why. We, yes OT, is the best profession to > look at the multiple factors inhibiting and contributing to successful > engagement in mobility-related occupations. Why must PT see that > mobility is much more than gait but OT refuses to recognize that > occupation involves gait. > > Can I teach a person to get from point A to point B? Sure. Do I get > overly involved in the correct procedure of toe off, swing through, etc? > No. That's PT! Do, I worry about causing injury from improper gait? > Sure! Do I do stretching and LE exercises? Only to show the patient, the > rest I leave up to PT. > > See, I think PT needs to stay in their well-defined role of being > PHYSICAL therapists. They are the EXPERTS on physical dysfunction. > Strengthening, ROM, pain - these are PT's domain. On the other hand, > OT's domain is OCCUPATION. It's the doing of daily activity from going > pee to cooking a meal to driving a car. It's the rich world of making > our lives worth living. It's the utterly complex and at time > overwhelming treatment realm of physical, mental, emotional, social and > environmental all rolled up into one big ball of string! It's a > WONDERFUL place for and OT to call home! > > You know, OT needs to heal OUR splintered mind! > > Ron > > ~~~ > Ron Carson MHS, OT > www.OTnow.com > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > > > > > ------------------------------ > > Message: 7 > Date: Tue, 28 Apr 2009 21:50:41 -0400 > From: [email protected] > Subject: [OTlist] Positive comment of the day > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset="us-ascii"; format=flowed > > Have a patient in rehab this week who has parkinson's disease and > suffered a fall while gathering a drink out of the fridge.. Yesterday > we made a list of all of the occupations he wants to be able to do in > order to make it home and to improve his quality of life again. So far > we have the basics like showering, dressing, laundry, loading the > dishwasher, and getting a drink out of the refridgerator. Well today > his wife came to therapy and was very happy to see her husband engaging > in such activity. She states that she now understands why his > depression has lifted a bit since yesterday. Very interesting comment. > Could it be the antidepressive drugs or the engagment in occupations > that give the patient hope to return to a regular life again? > Hopefully a combination of both. > > Chris Nahrwold MS, OTR > > > > > > > ------------------------------ > > Message: 8 > Date: Wed, 29 Apr 2009 08:23:48 -0400 > From: Ron Carson <[email protected]> > Subject: [OTlist] 2nd Postive Comment of the Day > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset=windows-1252 > > Following up on Chris' message, I also have a (+) comment! > > Through my private practice, I've been seeing a s/p CVA patient. She has > already been through home health, which was not very effective. The > primary problems are depression, lethargy, and visual > orientation/integration. > > After over 5 straight days of OT, the patient's granddaughter took the > patient to the grocery store to go shopping. This is the 1st time the > patient has done ANYTHING like this since her stroke. > > It is a great breakthrough for the patient and the family was very > ecstatic. To take off the old Memorex commercials, "Is it coincidence > or is it OT"? I don't know, but I like to think that OT played a large > part in enabling occupation. > > Ron > > > > > ------------------------------ > > Message: 9 > Date: Wed, 29 Apr 2009 19:10:56 -0700 (PDT) > From: Alayna Adams <[email protected]> > Subject: Re: [OTlist] promoting OT > To: [email protected] > Message-ID: <[email protected]> > Content-Type: text/plain; charset=iso-8859-1 > > Thank you very much for your feedback! I am still waiting to hear back from > the newspaper! > It hasn't been published yet. > Thanks again, > ? > Alayna > > --- On Sun, 4/26/09, susanne <[email protected]> wrote: > > From: susanne <[email protected]> > Subject: Re: [OTlist] promoting OT > To: [email protected] > Date: Sunday, April 26, 2009, 5:46 PM > > ---- Original Message ---- > From: "Alayna Adams" <[email protected]> > Sent: Monday, April 20, 2009 3:51 AM > > > Hi everyone,I am going to write a letter to the editor of my local > > newspaper to promote OT for OT month. I would appreciate any > > feedback. > > Hi Alayna! > > Kudos for that initiative - I feel much inspired! I also am grateful > for the chance to give feedback and so here are a few things that > caught my eye while reading. But please note that I'm a Danish OT, so > how I see OT may not apply where you are! > > >Sorry about the format being off. > > No problem - I take it the text begins here: > > > To celebrate > > Occupational Therapy (OT) month, I would like to inform our > > community on what OT is and how it benefits residents. OT is a type > > of rehabilitation that aims to help people with a physical, > > developmental, or cognitive disability.... > > *I'm not sure about OT being limited to treating people with > disabilities? People with, say, more temporary conditions may not > identify with this... > > .....increase independence with > > everyday occupations including but not limited to dressing, > > cooking, bathing and leisure. > > *I'd like to see a bit more included here - at least work, interests > and caregiving (of children and other family members). Maybe the place > to mention something about fulfilling one's roles? > > Occupational therapists work in > > hospitals, nursing homes, schools, rehabilitation facilities, > > mental health facilities and a variety of other settings with > > people of all ages and abilities. > > *The very important part of working with the patient/client in their > own home, workplace and community I'd like to see mentioned here. > > OT benefits patients and family > > members by improving their ability to take care of themselves and > > live more independently. OT treatment consists of adapting the > > environment and recommending equipment such as tub benches, > > reachers and magnifiers to enable a person to complete activities > > of daily living. > > *This looks like an exclusive statement to me? Maybe: One part of OT > treatment may consist of...... > > OT will work with patients to improve mobility, > > cognition, and activity tolerance to regain function in order to > > live as independently as possible > > *(I would add here:) "... and/or be able to do what is especially > meaningful for them." (This because to me living 'as independently as > possible' is not always the primary goal - think OT in hospice, or > with someone still needing 24/7 care or supervision.) > > > . Many of our elderly community > > members have received OT and are able to return home without > > services or significant help from family or caregivers. > > *Maybe elaborate a bit here: Home from where, after what? Also, I'd > say: "... without NEEDING services..." - otherwise it sounds kind of > scary:-) > > > Occupational Therapists can complete home evaluations and recommend > > adaptations as necessary. > > *I wonder if "home evaluations" may sound scary if you don't know > what > it is. Like, is someone going to judge my home unsuitable...? Maybe > explain how a hospital OT may go along with you for a home visit > before you are discharged, and help you find out how to cope at home, > if adaptations and equipment could help etc. Maybe give an example? > > > OT will train and educate caregivers to > > enable them to help their loved ones live a life with dignity and > > independence. Infants and children are able to reach developmental > > milestones and perform better in school with the skilled treatment > > of OT..... > *(I'd love to see home and playground included here.) > .....People with a mental illness can learn new habits and roles > > to enable them to contribute to society. A teenager with a spinal > > cord injury could learn of adaptations to allow them to go to > > college and > > complete self care. Many people are unaware of what occupational > > therapy is because of the title. Occupation is what we do everyday > > of our lives, what makes our life meaningful to us. Occupational > > Therapy is a profession that can help people regain function to > > live life to the fullest. > > I especially liked this last paragraph, how you mentioned dignity, > contributing to society, and how you linked occupation and OT in the > end. In this context 'living life to the fullest' suddenly makes more > sense to me! I also liked how you built your letter to get around > different OT stuff to get to this point. > > Best of luck with your letter, > > warmly > > Susanne, Denmark > > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > > > > > ------------------------------ > > Message: 10 > Date: Wed, 13 May 2009 08:17:10 -0400 > From: Juan Turcios <[email protected]> > Subject: [OTlist] Marketing Flyers > To: [email protected] > Message-ID: > <[email protected]> > Content-Type: text/plain; charset=ISO-8859-1 > > Hello everyone. I have a question for all OTs involved in OTPP. I have been > trying to get referrals from MD's in my area, but i am having a difficult > time. Ron, I know you told me so. I have been thinking lately to market the > program to the client themselves, like the drug companies do now a days. > Does anyone have any ideas on what I can say to the client themselves? I was > thinking of reasons why they would benefit from OT (e.g. decrease in fxl > status). Also once the client reaches out to me, will the MD be willing to > be involved in the plan? Any comments and ideas are greatly appreciated. > Thanks a lot, Juan > > > ------------------------------ > > Message: 11 > Date: Wed, 13 May 2009 09:00:47 -0400 > From: Ron Carson <[email protected]> > Subject: Re: [OTlist] Marketing Flyers > To: Juan Turcios <[email protected]> > Message-ID: <[email protected]> > Content-Type: text/plain; charset=windows-1252 > > Juan, my experience says that direct marketing to potential patients > will also yield few, if any, referrals. Patients, especially older > adults, expect the doctor to ORDER therapy. I know very few individuals > willing to start therapy without first going through the MD. > > I still have a website for my private practice. You MAY get some ideas > from it: www.hopetherapyservices.com. Also, if I can remember, I'll post > a copy of my brochure. > > On a good note, IF you can get any direct access patients, then I'm sure > that the majority of MD's will sign your plan of treatment, probably > without even reading it. > > Ron > > > > ----- Original Message ----- > From: Juan Turcios <[email protected]> > Sent: Wednesday, May 13, 2009 > To: [email protected] <[email protected]> > Subj: [OTlist] Marketing Flyers > > JT> Hello everyone. I have a question for all OTs involved in OTPP. I have > been > JT> trying to get referrals from MD's in my area, but i am having a difficult > JT> time. Ron, I know you told me so. I have been thinking lately to market > the > JT> program to the client themselves, like the drug companies do now a days. > JT> Does anyone have any ideas on what I can say to the client themselves? I > was > JT> thinking of reasons why they would benefit from OT (e.g. decrease in fxl > JT> status). Also once the client reaches out to me, will the MD be willing to > JT> be involved in the plan? Any comments and ideas are greatly appreciated. > JT> Thanks a lot, Juan > JT> -- > JT> Options? > JT> www.otnow.com/mailman/options/otlist_otnow.com > > JT> Archive? > JT> www.mail-archive.com/[email protected] > > > > > ------------------------------ > > -- > Unsubscribe? > [email protected] > > Change options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > > Help? > [email protected] > > > > End of OTlist Digest, Vol 66, Issue 1 > ************************************* _________________________________________________________________ Hotmail® goes with you. http://windowslive.com/Tutorial/Hotmail/Mobile?ocid=TXT_TAGLM_WL_HM_Tutorial_Mobile1_052009 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
