Absolutely agree. In my first job in the long term care the 'groups' had
been set up with OT and RT working together. This may have worked
previously with good collaboration between the disciplines but by that
time they had deteriorated to entertainment with very little planning
and no tracking of individual progress. Aides rushed around filling up
the group. When it was over the recreation staff took off and OT cleaned
up (vastly different requirements for payment etc. here). Over time we
took over some groups as specifically OT with patients assessed for
potential benefit and assigned and with drew our participation from the
others. In that particular setting at this time OT is essentially
individual with OT findings and suggestions shared with recreation staff
to enhance the quality of life for residents. It was necessary to
clarify our own professional goals and be clear about the purpose of OT
when declining participation in recreational activities.

Blessings, Joan
403 652 7928

-----Original Message-----
From: [email protected] [mailto:[email protected]] On
Behalf Of Ron Carson
Sent: July 24, 2009 6:09 AM
To: Sue Doyle
Subject: Re: [OTlist] Vision ~vs~ Reality

In  my  opinion,  the  VAST  majority  of  group  "therapy" isn't really
therapy.  It's  simply  a way for corporations and therapists to squeeze
more productivity and reimbursement out of Medicare. Additionally, in my
experience  most  group therapy done by OT is a total waste of patients'
time.  I can't tell you how many UE groups I've seen done by OT when the
absolute  last  thing  patient's  needed was UE strengthening. There are
certainly  times  when group THERAPY is indicated, but this NOT how it's
been traditionally done.

Ron

~~~
Ron Carson MHS, OT
www.OTnow.com

----- Original Message -----
From: Sue Doyle <[email protected]>
Sent: Thursday, July 23, 2009
To:   [email protected] <[email protected]>
Subj: [OTlist] Vision ~vs~ Reality


SD> In Inpatient Rehab you cannot see more than one patient as a time
SD> unless they are part of a group. If they are a group they have to
SD> have similar goals that are part of each patients individual plan
SD> that can be matched together. While there is no set limit on how
SD> much group therapy a patient can receive as a proportion of their
SD> therapy, Skilled nursing facilities are limited to 25% and it is
SD> recommended that rehab does not exceed this as well.

SD> While some of patient's goals often include being able to use their
SD> affected upper extremity one should really focus on the clients
SD> occupational goals. The problems generally start with the evaluation
SD> process. If you do not identify occupational issues and patient
SD> goals in your evaluation but identify upper extremity issues that is
SD> where you will focus your treatment. Has anyone used the "Cardinal
SD> Hill Occupational Framework documentation that identifies
SD> documentation that focuses on the occupational framework and hence
SD> helps to guide the clinical reasoning process to a more
occupationally focuses manner.

SD> This then means that generally the clinical setting needs to change
SD> particularly in rehab, so that the treatment media would need to be
SD> focused on various occupational options. I built boxes or kits with
SD> a variety of options that my clients expressed interest in. It is
SD> best to use the real objects and occupations. 

SD> Hope this helps some.
SD> Sue D 





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