Thank you so much for your encouragement. Sometimes as a new COTA, I feel like I have limited power but it my short time working I have realized that I have more power than I initally thought to intervene and make the sessions more relevent to the individual. It is not easy in a SNF, I see 10 patients in 6 hours. One on one therapy is very hard to schedule. One patient of mine expressed an interest in learning how to use the internet. In her particular circumstances, I felt that this was a good idea. This was not anything listed in her short or long term goals by the OTR. I had to develope a relationship with her and find out what motivates her. I asked the OTR and she said it was fine. I am a little bit disheartened that the inital evals don't really indicate what the patients want as goals. It seems to be what the therapists think they need. I think it is up to me or whomever is the assigned therapist to pursue a holistic approach beyond what is written in the eval.
And yes...Dr's told him he would not live another 10 years..... -----Original Message----- From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on Behalf Of susanne Sent: Monday, July 13, 2009 15:48 To: OTlist@OTnow.com Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE Hi Diane! Me, I'm quite impressed with your work with your patient - you may not have conveyed to us all that you do and I guess this is because some of it happens "silently" - but you seem to have established a great working relationship with him. You've together found out a lot about his motivation. He actually is loosing weight - he keeps weights in his room - he wants to go on about his training, weight loss and independence. For a person whose problems stem from serious overweight this is really something!! So I hope you congratulate yourself about these achievements and don't start questioning everything you do as a result of our probing here. Consider the opposite: Him not being motivated to loose weight, work out, or much engage in changing his situation, the isolation included.... Even if you'd then succeed in some improved independence - ie from him learning some good ole OT tricks and lots of adaptive equipment and environment changes - my guess is he would soon either die from complications to his lifestyle, or suffer a very low quality of life. It's not that I disagree with what Ron and Chris said - it's just that there's more to it IMO - like establishing 'rapport' with patient, digging into motivation (like what actually 'moves' the patient), considering overall QOL etc. You seem to really have gone there, and I suspect this has guided your choice of intervention in more ways than meet the eye! Off my soap box for now:-) Warmly susanne, denmark PS: A few abbreviations I didn't understand: PN, therex, RW. Could you elaborate? -- 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
