Hello, As a new OTA/L a week into my first job in a SNF, I have become well acquainted with the UE focus of OT. But, I think the most frustrating part of the process is not some much the interventions but the fact that so many of my patients have really no "occupation" to look forward to when discharged from rehab. It is no wonder we may be tempted to stick with just UE exercises. ( besides ADL's we do in rooms)
Question...tell me about a typical day you spend at home? Replies (paraphrased) Patient A- "I just watch Soaps..my daughter does everything (cooking, cleaning)" Patient B- "I have not worked since I gained weight...have not left the house except to come here for 2 weeks...thank god for disability." Patient C- "I don't want therapy and you can't make me go". patient D- " The nurses do everything for me...why should I dress myself" How can we motivate patients to value "occupation" when thier goals are to just get strong enough to go back to their lives which in many cases is totally dependent on others. Even simple ADL's do not seem to be a goal of some patients? I also see in some ways why UE has become so popular in SNF's....it's easy, it looks productive, and it can be done simultaneously with others. Productivity expectations have created UE ther-ex focused treatment. It is almost impossible to individualize OT treatment when you have 5-6 or more patients seeking your attention all at one time. In addition , I have noticed PT/OT /Speech seem to be in melting pot of therapy. I see speech do cognitive activities I learned in school. Sometimes the only difference you can really tell between an OT and PT in the gym setting is where they focus patient work (above or below the belt) HH is a little different..I would expect a HH agency to value occupation. I mean...it is one on one therapy for gods sakes. So much can be done in that setting. I would be frustrated too. We have to make a commitment to see UE ther-ex as a means to an end. Strength to transfer to a toilet independently-standing tolerance to create a simple meal in the kitchen from a recipe chosen by the patient). But is should never be the "only" focus or we have essentially become PT's..we all need to educate our patients about what we do...and sadly other professionals around us. -----Original Message----- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on Behalf Of Ron Carson Sent: Tuesday, June 30, 2009 20:28 To: OTlist@OTnow.com Subject: [OTlist] Just About To Give UP............ I am just about at the end of a very long road of trying to change my profession. No one seems to value occupation as an outcome. I refuse to see patient's with the purpose of improving UE function so my HH agency just calls other OT's who will. PT's don't appreciate occupation but it encroaches on their treatment. My agency is clueless about occupation and has no reason to learn about it. I so value what I do and I believe that most of my patient's do as well. Most of them can not articulate occupation or occupational therapy but they do know that I'm there to teach them two things: 1. How to take care of themselves 2. How to be productive I almost cried when I left my agency's staff meeting today. EVERTHING is about PT, PT, PT, and how wonderful they are. There must be like 15 PT's while there is only 3 OT's. It's really a sad state of affairs. I am tired of going from "hero to zero". Hero with patients and zero with my agency and other therapists. The other day a nurse with 24 years experience told a patient that OT was about small muscles and PT was about gait and large muscle groups. I promptly called the nurse and explained that OT is about occupation - i.e. take care of yourself and being productive. She said, that she didn't know and that even after all these years she really has no idea what OT does. She suggested that I call my agency and do an inservice. Now can you even imagine that a home health agency needs an inservice on the role of OT!! Sad state of affairs. Am I the ONLY OT who experiences and feel these emotions??????????????? Gosh, I hope not. But then on the other hand, maybe it's just me. Maybe I just refuse to accept the way things are. Maybe I'm just a self-centered egotist who is totally clueless about OT. I truly, truly don't understand WHY "things" are the way they are. And more importantly, what can be done, if anything, to change the direction of UE physical dysfunction OT. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
