" Ask yourself, are you doing something that an
aide could be doing? If so, then you are not doing therapy!"
Please explain... you are correct in that aides may not know the clinical
reasoning behind a therapy but the actual physical part of engaging in
theraputic activity with a patient can sometimes be done by an aide although
unethical...just saying it is physically possible.
-----Original Message-----
From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on
Behalf Of Ron Carson
Sent: Monday, July 13, 2009 09:25
To: cmnahrw...@aol.com
Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE
I will take Chris' suggestions a little further. If the patient wants to
bathe in the shower, you must 1st know the environment in which this
occurs.
Is it a roll-in shower, walk-in shower, tub w/ a shower, glass
doors, does it have a seat, how big is the shower, does it have
grab rails.
These environmental issues are VERY important to the goal of
showering.
Also, you must understand the persons physical, mental, cognitive and
social strengths and weakness.
IF showering is the goal, a skilled OT looks at all factors involved in
the process, identifies which are hindering success and then works on
overcoming these factors.
Also, if showering is the goal, it is NOT necessary to shower with the
patient during every treatment session. What IS important is identifying
barriers (and there are more than I listed) and then working on the most
significant problem(s). If LE strength is a KNOWN limitation, then make
the patient's muscles stronger. Personally, I don't do exercises. I tell
patient's that's PT's job. I am not well enough trained to identify and
treat SPECIFIC muscle weakness/imbalance. Instead, I ask patients to do
challenging physical activity.
The list of possible barriers is really endless. Two of the most common
barriers patient encounter are fear and lack of competency. In these
situations, a skilled OT can progress the patient by engaging them in
over-achieving activity. For example, if a patient wants to shower but
is afraid to step over a 4" threshold into their shower, set up a
clinical situation where the patient has a 5" threshold. Provide various
challenges (i.e. walker ~vs~ no walker, rail ~vs~ no rail). Practice,
practice, practice is what builds competency and decreases fear.
Remember, ALL therapy should require the skills of a therapist. I
frequently tell patients, I am not going to do "that" because it does
not require my skills. Ask yourself, are you doing something that an
aide could be doing? If so, then you are not doing therapy! If you are
sitting around bored to death, watching patients do exercise, you are
not doing therapy. If you are not challenging your patients beyond their
ability, you are not doing therapy. If patients are not progressing to
their goals, you are not doing therapy.
Therapy is a SKILL. If you are not applying skill, you are not doing
therapy!
Ron
~~~
Ron Carson MHS, OT
www.OTnow.com
----- Original Message -----
From: cmnahrw...@aol.com <cmnahrw...@aol.com>
Sent: Sunday, July 12, 2009
To: OTlist@OTnow.com <OTlist@OTnow.com>
Subj: [OTlist] Why OT's Should NOT Focus on the UE
cac> If you want to go by the book, then you have to key into the concept of
cac> task specific training. This is usually an easy concept for new
cac> clinicians. If you want to get better at walking go ahead and walk, if
cac> you want to get better at getting into a shower go ahead an get into a
cac> shower, if you want to get better at bathing and dressing go ahead and
cac> practice this as well.
cac> Hope this helps,
cac> Chris
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