In SNFs, here NC, a huge issue by the regulators are items that could be considered restrictive vs. items for positioning. Regulators want to know that wheelchair straps or tabletops are used for positioning and not to keep a person strapped in their wheelchair so they can't get out of the chair and fall. This is just one example. Devices can not be used for staff convenience.
At my facility we can not say that an alarm or bedstrap is used for safety reasons- that is considered staff convenience and the device is being substituted for close supervision. I had to recruit the assistance of other OT's and Cota's for this information because my primary job is at a facility for sever/profound DD. (we have similar issues, regulations are not all the same). Hospice wanted the rules from an SNF perspective because they do much work with the SNF's. I agree with you about OT being underutilized in Hospice and I do think it has a lot to do with money. On the other hand, Hospice was a tremendous support to my family so I have a hard time criticizing them too much. -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of Ron Carson Sent: Thursday, December 06, 2001 7:15 PM To: Joanne Seng Subject: Re[2]: Hospice and OT (long) Hello Joanne: Thanks for your candid message. I think you highlight a 'big' problem with OT in hospice. We (OT's) know what we can do, but convincing hospices to buy into our contribution seems to be the problem. Undoubtedly, many hospices (as business) must be concerned about bottom-line profits. Do you think this is where the hang-up lies? By the way, will you please explain the term, "restrictiveness"? Thanks again, Ron ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ On 12/6/2001, Joanne Seng <[EMAIL PROTECTED]> wrote: JS> I served Hospice on a contractual basis for a few years and received very JS> few referrals. I did inservice the Hospice staff on OT's role with Hospice, JS> focusing on support, adaptive devices and compensatory techniques. However, JS> the Hospice staff seemed primarily interested in the issue of JS> restrictiveness vs. positioning and safety in wheel chairs, seats and beds. JS> I still did not receive very many referrals after the inservice. The county JS> that I worked with only saw clients who were in the very end stages of their JS> illness. JS> On a personal note, my mother had a terminal illness four years ago. She was JS> very much in denial about her brain tumor and felt she would find cure. Mom JS> also would not accept Hospice because she was going to find a cure for this. JS> As an OT, it became my role to approach her about the need for a wheelchair JS> and shower chair and feeding equipment. It was extremely difficult because JS> the need for these equipment was a concrete indication of the progression of JS> her tumor; however she wanted to stay as independent as possible for as long JS> as possible. So, I was allowed to borrow equipment from my job and keep her JS> going as much as possible. She was not interested in her usual occupations JS> other than basic self care at this point. JS> This whole experience tuned me into the interpersonal family struggles that JS> occur when a loved one is in denial about their condition and such things JS> like the dignity of being able to feed ones self versus being fed by someone JS> else and so forth....Joanne JS> -----Original Message----- JS> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]]On Behalf Of JS> [EMAIL PROTECTED] JS> Sent: Wednesday, December 05, 2001 9:38 AM JS> To: [EMAIL PROTECTED] JS> Subject: Re: Hospice and OT JS> I have almost no experience in hospice, but have two OT friends that JS> do...from what I know they do, in addition to how I practice OT, I would JS> say that the role of the OT in this setting should be to enable occupation. JS> I know that sounds ridiculously simple, but if the clients are truly JS> recieving OT, they should be getting the benefit of a therapist who can JS> help them determine which occupations are pertinent to the quality of their JS> daily life in this last stage (i.e., using the COPM), with a care plan JS> that reflects how those occupations can be achieved. JS> This isn't to say that positioning, splinting, etc are not a part of the JS> plan; if they enable the client to engage in occupations, then they are a JS> necessary intervention. I think in the area of hospice we also have to JS> remember that a persons occupational sphere is shrinking, and that a JS> meaningful occupation may be as simple as being able to sit up each day JS> for 30 minutes when the children come home from school, etc. JS> Also, and this is the beauty of the COPM, the family's needs can be JS> considered too. And of course environmental assessment and JS> recommendations, in addition to family/caregiver education are a given. JS> I would love to hear what others are thinking... JS> *********��*********** JS> Unsubscribe? Send a message to [EMAIL PROTECTED] JS> In the message's *body*, put the following text: JS> unsubscribe OTlist JS> List messages are archived at: JS> http://www.mail-archive.com/[email protected] JS> *********��*********** JS> *********��*********** JS> Unsubscribe? Send a message to [EMAIL PROTECTED] JS> In the message's *body*, put the following text: JS> unsubscribe OTlist JS> List messages are archived at: JS> http://www.mail-archive.com/[email protected] JS> *********��*********** *********��*********** Unsubscribe? Send a message to [EMAIL PROTECTED] In the message's *body*, put the following text: unsubscribe OTlist List messages are archived at: http://www.mail-archive.com/[email protected] *********��*********** *********��*********** Unsubscribe? 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