Someone said something about seeing the "whole" persons. While I think that the concept of being holistic or seeing the whole person are "nice", they are not truly possible. 1st off, we can only see what the patient reveals, which may or may not be their wholeness. None the less, I want to quickly write about a current patient that MAY represent trying to see the whole person.
This young woman has multiple medical issues, including CVA, IDDM, s/p kidney transplat w/ dialysis. When I first met her, she was essentially w/c bound. A few months later, in fact yesterday, she ambulated to the kitchen to get her OT a glass of water, and did a small load of laundry. PT has been involved in this case but only minimally. In fact, they were put on hold for two weeks and they currently see the patient 1x/week. OT is on the case 5x/week. >From the beginning, OT worked on following: 1. Standing, sit/stand, functional mobility w/ RW, cane and w/o an AD. 2. Bed mobility, bed transfers, toilet transfers, dressing, car transfers 3. Insulin injections (more verbal prompting than teaching), meal prep, laundry, etc. Yesterday, it was obivious that the patients dominant UE was limiting her occupation equally as much as her LE, balance, endurance, and fear. So, I asked the patient if she wanted me to address her arm dysfunction. She said yes. In the past, I told the patient, that her arm was not the greatest limitation to her goals. But, as her other body functions increase, her arm is becoming a limitation. All along, I have instructed the patient to use her affected arm and I even discussed CIMT that her caregiver could try. So, it's not that her arm has not be addressed, it just hasn't been a focus of treatment. But, starting next week, I think I will increase treatment on her extremity. Now, to me, this is the way OT should be. We should help patient's identify occupation goals, determine limiting factors, prioritize these factors, then get to work on correcting or working around these issues. To me, it makes no difference if it's a LE, UE, cognition, environment, adatipive device. If it's within my scope of practice, I try my hardest to address the issues preventing occupational success. To me, this is the best that I can do to treat the "whole person", whatever that is! <smile> Thanks, Ron ~~~ Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
