Thanks for the feedback! I feel a little more confident in my OT skills after reading your suggestions as I do all of those things. I guess when I hear everyone talk so negatively about dowel exercises/theraband, and we do those with our patients, I felt maybe I wasn't doing enough. But I do address all those other areas in conjuction with my session of exercises for afternoon treatments!
Thanks again! > To: OTlist@OTnow.com > Date: Wed, 15 Jul 2009 19:08:46 -0400 > From: cmnahrw...@aol.com > Subject: Re: [OTlist] Why OT's Should NOT Focus on the UE > > 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. > > > > > > > > > -- > > > 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 > > > > _________________________________________________________________ > > Lauren found her dream laptop. Find the PC that’s right for you. > > http://www.microsoft.com/windows/choosepc/?ocid=ftp_val_wl_290 > > -- > > Options? > > www.otnow.com/mailman/options/otlist_otnow.com > > > > Archive? > > www.mail-archive.com/otlist@otnow.com > > =0 > > A > > > > > > -- > > Options? > > www.otnow.com/mailman/options/otlist_otnow.com > > > > Archive? > > www.mail-archive.com/otlist@otnow.com > > _________________________________________________________________ > Windows Live™: Keep your life in sync. > http://windowslive.com/explore?ocid=TXT_TAGLM_WL_BR_life_in_synch_062009 > -- > 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 _________________________________________________________________ Windows Live™: Keep your life in sync. http://windowslive.com/explore?ocid=TXT_TAGLM_WL_BR_life_in_synch_062009 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
