Hello Ed:
Thanks for your words. I wish to raise a point to something you wrote.
When working in acute care rehab, I believe I helped many clients increase
their mobility. How?? Through engaging the client in occupations such as
cooking, dressing, bathing, toileting, house work, etc. When appropriate,
(which was most of the time) I always suggest that clients try doing their
occupations from a standing versus a sitting position. Or I explained that
walking around the gym in PT is beneficial but its not quite the same as
trying to safely maneuver from a W/C to a toilet. So, when I worked with
clients during morning ADL's, if they were using an assistive device in PT
(regardless of whether they required CGA or Max A) I always brought the
device to the client's room. Or, if they demonstrated difficulty with the
device they used, I would try something differen.
To be honest, sometimes I would start clients on their occupational
independence by working in a safer environment such as parallel bars. Seems
like the safety allows both the client and therapist to be more aggressive
in overcoming fear of falling and of failure. As soon as the client
comfortably displayed basic skills, however, we immediately began practicing
in the real world using the assistive device that they used in PT. Although,
I was sometimes the first discipline to have clients use assistive devices
for occupational mobility.
I guess my point in all of this is that I never relegated mobility to PT. I
consider them to be the gait 'experts' but in my world, clients don't need
expert gait to get from point A to point B. Often, they need faith,
confidence, motivation, need, adaptation, and successful experiences to
increase both their desire and ability. It always drove me crazy when
clients were having difficulty doing self-care primarily because of mobility
but their OT only worked on upper extremity deficits. I am willing to bet
that had the therapist asked, the client would say that they really want to
be able to walk which translates to they want to dress standing up, they
want to get into their shower/bathtub, they want to stand up to pee (if they
are a male), they want to cook standing up. And the list goes on forever.
I guess this is one reason why I think OT is shooting itself in the foot by
trying to be UE experts. If clients have both UE and LE involvement, I bet
most would rather increase their LE function. Why, because loss of UE
function is more easily compensated for than loss of LE function. In other
words, someone can be dressed by an aide but the aide can't walk for them.
Time to go to work but I look forward to responses from readers.
Ron
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On 9/10/2001, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote:
[cut]
Oac> Often, I find myself differentiating between OT and PT services to clients
Oac> and family. Unfortunately, the persons I talk to tend to hit the "delete"
Oac> button in their brains when the word occupation is mentioned. It is mundane
Oac> and does not seem to be as exciting or technical as counting to ten with
Oac> ankle weights or applying a tens unit. Most clients and family admit that
Oac> performing routine occupations is important but..."can my mom walk?" Making
Oac> the connection of mobility with meaningful occupation is difficult to explain
Oac> to someone who just wants mom to walk. And everyone knows that is PT!!
Oac> However, when my message does get through, I usually end up with a very
Oac> strong proponent for OT, which makes my efforts worthwhile. It's a great
Oac> feling.
Oac> Thanks,
Oac> Ed Myers, OTR/L
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