Folding towels is not an occupation, it's an activity. IF a patient TRULY, and I mean truly, had a goal of doing laundry and for some reason they could not fold towels and by folding towels, the OT was addressing the underlying medical, social, environmental barriers, then folding towels would be a fine activity. In fact, Susan transferred laundry from the washer to the dryer. Why? Because laundry was one of her occupations and is something she will need/want to do as she get's better. Plus, it worked on the numerous underlying issues which impairs many of Susan's other occupations.
When I first started working on occupation after I read "Enabling Occupation: An Occupational Therapy Perspective". This book outlines my treatment philosophy an goes hand and hand with the COPM. So, I started administering the COPM. This assessment helped me identify patient's most needed goals. It was my job to identify the problems impeding their goals. Once I had painted the "portrait", I started addressing the problems. The 1st thing I found is that patients are mostly interested in mobility issues. The primary goals were almost always mobility related. Patients want to be able to walk to the kitchen and cook, they want to walk to the toilet and poop. They want to stand at the sink. They want to stand up and walk to do their occupations in as normal a fashion as possible. So, I got busy helping people be more mobile. If they couldn't sit, I worked on sitting. If they couldn't stand, I worked on standing. If they couldn't walk, I worked on mobility. I almost never did pure exercises. Instead, I engaged patients to their maximum potential and beyond in the necessary components of the desired occupation which was missing in the patient. I also found out about their homes. I had people bring in measurements. I found out if they had steps. I learned about the bathroom and the layout of the shower. I simulated these home environments in the rehab gym. If someone had 3 steps into theirs house, we went to the stairs of the hospital. If someone had a 6 inch threshold to get into their shower, we practiced stepping over bolsters of the same height. If they had a tub, I explained tub transfer benches and we practiced. And these are just the things I did in the gym. I did car transfers in the parking lot, I had patient get their own trays and go through the food line in the hospital. If patient's needed and wanted to cook at home (very few), we did cooking. I had patients engaging all sorts of daily occupation. BUT ONLY BECAUSE it was THEIR goal. I hate the idea of OT having patient's washing windows because there's some magical therapeutic power in the fact that it "meaningful". Hooey!, that's what I say! The list was endless. I was never at a loss of what to do. Sometimes, I didn't know HOW to do something but I always knew what to do. And that was very different. Before the COPM, I had no REAL idea what patient's wanted. I don't know, does that help? ----- Original Message ----- From: Miranda Hayek <[email protected]> Sent: Thursday, July 23, 2009 To: [email protected] <[email protected]> Subj: [OTlist] Vision ~vs~ Reality MH> Ron can you provide some examples of how you made it work in the MH> in-patient rehab setting. You mentioned that you would see 2-3 MH> people at a time, how did you work with each of them on their own occupations? MH> MH> Also, why is a cooking group, folding towels, not good occupations to work on? MH> Thanks, MH> ~ Miranda ~ -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
