Hello Angela and All: I strongly agree with much of what you said. It seems that you take an "inclusive" rather than "exclusive" approach to neglect. And that's EXACTLY how I see OT's role.
In other words, people experiencing neglect should be treated by verbal/tactile cuing and environmental mods to promote increased attention during daily activity. This is what I call "inclusive" because the neglect treatment is included in the treatment. I do this sort of treatment ALL the time. In fact, I did it today with a patient who has right disregard/neglect. I am constantly giving verbal and tactile cues during his therapy. Whether is working on sit to stands, transfers, toileting/hygiene, etc. I am constantly cueing him to include his right side. It seems that either I expressed myself poorly or my words were misconstrued about OT's treating neglect. Thanks for writing... Ron ~~~ Ron Carson MHS, OT www.OTnow.com ----- Original Message ----- From: Angela King (ADHB) <[email protected]> Sent: Thursday, August 13, 2009 To: [email protected] <[email protected]> Subj: [OTlist] OTlist Digest, Vol 74, Issue 1 AKA> On this whole issue of the neglect thing I have a couple more things to AKA> add, because like Ron I have an opinion on just about everything (except AKA> the whole UE thing!!). AKA> Ron I understand where you are coming from in that neglect can be AKA> difficult to improve but in most clients some degree of improvement does AKA> occur. Yes a lot of that is down to spontaneous recovery but most of AKA> what improves post stroke is down to spontaneous recovery and it is our AKA> job as therapists to provide the correct stimulation to the brain during AKA> this time when it is trying to fix itself. If we neglect the neglect AKA> when the brain is geared up to heal then we are not maximising the AKA> improvements that can be made. Well that's what I tell myself anyway! AKA> Things like arranging the room so that a person must attend to that side AKA> is quick and easy and if it gives them 2% improvement that is a start. AKA> The significant other side of this is the education and compensation AKA> side of things. I have had clients with very bad neglect who through AKA> intensive training have learned to compensate for their neglect. I AKA> personally think that education is one of the best things we can do for AKA> our clients. I try and train my stroke clients to know what I know so AKA> that when they leave me they can be their own therapist. My clients AKA> probably know more about neuroplasticity and grading activities than AKA> many OT's! That way they can continue to improve if they are motivated AKA> to. I have an ex-client with a shocking neglect who uses a power AKA> wheelchair for mobility. She does crash into doorways occasionally when AKA> distracted but for the most part she is ok and has the freedom to get AKA> herself around (inside anyway)- all down to compensation. AKA> So even if someone months post stroke has an awful neglect and are not AKA> making spontaneous recovery I'd be teaching them how to compensate for AKA> it in daily life, because that is what we as OT's do! We don't give up AKA> on people with paraplegia because they don't walk again. AKA> Haha my opinion yet again. AKA> Angela King NZROT, Assessor AKA> Outpatients, Directions Appraisal Team - REHAB PLUS AKA> 54 Carrington Road AKA> Pt Chevalier, Auckland AKA> Auckland District Health Board AKA> ##################################################################################### AKA> Scanned by MailMarshal - Marshal8e6's comprehensive email content security solution. AKA> Download a free evaluation of MailMarshal at www.marshal.com AKA> ##################################################################################### AKA> -- AKA> Options? AKA> www.otnow.com/mailman/options/otlist_otnow.com AKA> Archive? AKA> www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
