So the essentials for going home safely is what I gather
A) Dressing and bathing themselves. Not only should we OTs practice
these skills with possible compensation techniques and environmental
adaptation, we should also analyze what part of the activity is
difficult. For example a patient might have a significant balance
problem or decreased standing tolerance from immobility. This can
certainly be addressed in the gym through the practice of sit to
stands, dynamic balance challenges, functional ambulation (gathering
clothes from closet with a walker and possibly a walker tray or
basket), and reaching for clothes placed at low levels and high levels.
Think high repetiions to generalize learning.
B) Toilet transfers and toileting-Practie, practice practice. Even if
they do not have to go, practice. Find a strategy that works best for
them.Everyone is not the same, so experiment and if does not work out,
back to the drawing board
C) Kitchen mobility, dining room mobility, family room mobility, car
transfers--practice in multiple treatment environments and get the
patient talking about their situation at home so the situation can be
matched as best as possible
D) cooking-If you don't have a kitchen than simulate to the best of
your ability-transporting objects from point A to B with a rolling
walker and a walker tray, scooting objects on countertops without loss
of balance. Education about how to set up their ki
tchen at home for
optimized safety.
E) Make sure the patient and you talk through the above homemaking plan
if they think family or another agency will complete for them. Make
sure you know in detail the exact plan. If the story is gray you might
have to make a few phone calls and possibly get the social worker
involved to determine if the cost for an agency to complete the
homemaking is realistic for the patient.
-----Original Message-----
From: Miranda Hayek <mltaylo...@hotmail.com>
To: otlist@otnow.com
Sent: Wed, Jul 15, 2009 6:06 am
Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE
I guess I am not thinking of any specific patient at this point, it's
just nice to hear other peoples ideas for interventions. I know each
patient has their own goals, but the majority are hoping to return
home, be independent with ADL's and do as much home management tasks as
they can (but are willing to have family or community support services
to assist with laundry, vacuuming.). Basically they just want to go
home vs. nursing home! Sorry it's so fague, I am not thinking of
anything specific so I realize it's a hard question to answer!
To: OTlist@OTnow.com
Date: Tue, 14 Jul 2009 21:53:49 -0400
From: cmnahrw...@aol.com
Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE
Miranda,
What occupations does the patient desire to improve o
n?
Chris
-----Original Message-----
From: Miranda Hayek <mltaylo...@hotmail.com>
To: otlist@otnow.com
Sent: Tue, Jul 14, 2009 7:00 pm
Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE
I find the information being shared between Diane and others is
helpful. I too am new to the profession and feel that we learn
interventions/treatments on the job (my schooling taught me the
theory
of OT more than hands on!). At my job I learn from the other
therapists, and find our afternoon treatments involve dowel,
theraband
exercises. Morning treatments involve ADL's. (acute and skilled
hospital setting). We are also limited on our space for opportunities
for more home management or other activities. So was wondering if
anyone can provide some examples of treatments they do with their
patients. Generally my patients are in the hospital for TKA, THA, CVA
(mild-mod), deconditioned due to pneumonia, etc.
Thanks.
> From: spark...@rcn.com
> To: OTlist@OTnow.com
> Date: Mon, 13 Jul 2009 12:30:41 -0400
> Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE
>
>
> "My concern in this is that you ONLY mention and UE program. If
general
> conditioning prevented the patient from performing occupation, why
limit
> it only to the UE?"
>
>
> Being that I am new to this and
my employment forces
me to live in "UE
> therex" land....perhaps you could give me an indication as to what
I
can do
> with this person. Others more experienced than me in the dept go
with
the
> flow. He is 500 pounds...can now walk about 50ft with someone
following him
> in a W/C and he is able to stand aboout 2-3 min in a RW.
>
> I have done all ADL's..and although he is able to life weights in
all
planes
> he does not have the arm length to bipass his midsection to do LE
dresssing.
> He has serious LE PN issues so he cannot use a sock aid. he has
refused both
> a dressing stick and reacher.
>
> I have done transfers with him from W/C to bed, W/C to toilet, W/C
to
shower
> I have done standing tolerance...he likes to draw so I have him
stand
in
> front of a white boards and he draws murals for the department.
>
> He does W/C pushups.
>
> He lives alone, rarely ever left his home due to his weight,
microwaves all
> his meals, and lives on disbaility.
>
>
>
>
>
> -----Original Message-----
> From: otlist-boun...@otnow.com [mailto:otlist-boun...@otnow.com]on
> Behalf Of Ron Carson
> Sent: Sunday, July 12, 2009 22:08
> To: Diane Randall
> Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE
>
>
> My concern in20this is that you ONLY mention and UE program. If
general
> conditioning prevented the patient from performing occupation, why
limit
> it only
to the UE?
>
> For me, general phy-dys practitioner's focus on the UE while
> disregarding the rest of the body severely hampers our professional
> autonomy.
>
> We MUST break free from the mold of being UE therapists!
>
> Ron
>
> ----- Original Message -----
> From: Diane Randall <spark...@rcn.com>
> Sent: Sunday, July 12, 2009
> To: OTlist@OTnow.com <OTlist@OTnow.com>
> Subj: [OTlist] Why OT's Should NOT Focus on the UE
>
> DR> I see your point...I was mistaken if I implied in my very first
post
> that I
> DR> told the patient that he needed UE program in order to
transfer.
It was
> DR> justified to increase his overall conditioning. My inital
reason
for the
> DR> post was to point out that sometimes our patients assume the
things we
> do in
> DR> the gym are "therapy" and the functional ADL's are just extras
we
> do...which
> DR> of course is the very opposite.
>
>
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