Could she problem solve with you regarding what would be appropriate items to use as a stabilizer and those that would not? What is her goal? If her goal is to be able to complete mobility aspects of her ADL and IADL with improved confidence, safety and/or independence; you may be able to rationalize with her that she isn't meeting those goals presently with her current practice of grabbing and reaching out for things in her environment. In the end though, if the patient is satisfied with her current practice, you will be hard pressed to change this behavior. Jim Aguirre <[EMAIL PROTECTED]> wrote: Hi all. Here are my 2 cents...
Assuming she can learn new information, teaching her new startegies could work. You have a good opportunity for restoration/adaptation and compensatory approaches... If she can not learn, ( Allen levels 4 ish), adaptation of environment to elimminate hazards, changing the most prevalent tasks she falls during, to be done by/with someone else... signs posted by cupboards that she may want to reach for to remind of doing something safer...rearranging her closets to have things at a safer plane... pictures of her doing something safer to cue to imitate the action Share the rtesults... Carmen From: "Christi Vicino" Reply-To: OTlist@OTnow.com To: Subject: Re: [OTlist] Functional Mobility Training Date: Tue, 4 Sep 2007 12:09:59 -0700 >How to recover from a fall .... Once on the ground how do you proceed >to get up.... > > >Christi >-----Original Message----- >From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On >Behalf Of Ron Carson >Sent: Tuesday, September 04, 2007 11:26 AM >To: Christi Vicino >Subject: Re: [OTlist] Functional Mobility Training > >What is a fall recovery program?? > >----- Original Message ----- >From: Christi Vicino >Sent: Tuesday, September 04, 2007 >To: OTlist@OTnow.com >Subj: [OTlist] Functional Mobility Training > >CV> Hi Ron... > >CV> I know you have thought of everything...but I love throwing things >CV> around in hopes something will spark a thought that was not >covered.... > >CV> Since she is pretty with it... Have you considered a fall recovery >CV> program.... And slipping in a demonstration of you loosing your >CV> balance under a variety of circumstances...(including furniture >walking).... >CV> Sometimes seeing things in action can click.... And then have her >CV> interact and simulate similar circumstances with mats in place??? > > >CV> Christi Vicino > > >CV> -----Original Message----- >CV> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On >CV> Behalf Of Ron Carson >CV> Sent: Tuesday, September 04, 2007 9:49 AM >CV> To: Christi Vicino >CV> Subject: Re: [OTlist] Functional Mobility Training > >CV> Hello Christ: > >CV> I have explained these to her. I have pointed out to her when she >CV> loses balance because she reached for something. I have repeatedly > >CV> shown her how she may misreach for something (visual changes) or the > >CV> item may move or she will have a LOB, but she is adamant about >CV> holding on to objects when they are in reach. > >CV> This is a tough case! I love it!!! > >CV> ----- Original Message ----- >CV> From: Christi Vicino >CV> Sent: Tuesday, September 04, 2007 >CV> To: OTlist@OTnow.com >CV> Subj: [OTlist] Functional Mobility Training > >CV>> The things that she is grabbing hold of may not be stable enough to > >CV>> provide assist in sustaining her balance. > >CV>> She may not always make appropriate choices of what to grab onto >CV>> especially when a loss of balance occurs. > >CV>> "Furniture Walking" alters her center of gravity when ambulating >CV>> and > >CV>> does not encourage the muscles that need to be strengthened by >CV>> walking with the appropriate posture to strengthen and make her a >CV> safe walker. > > >CV>> Christi > >CV>> -----Original Message----- >CV>> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On > >CV>> Behalf Of Ron Carson >CV>> Sent: Tuesday, September 04, 2007 8:38 AM >CV>> To: OTlist >CV>> Subject: [OTlist] Functional Mobility Training > >CV>> Hello All: > >CV>> I've been working with a geriatric friend/patient who is asking > >CV>> me a question that I can not convincingly answer. > >CV>> This 90 y/o patient is about 6 years s/p CVA with residual >CV>> visual / balance deficits. She has fallen twice this year fracturin >CV> both hips. > >CV>> She previously walked without any AD put had difficulty with >CV> balance. >CV>> She is very determined to return to functional mobility with a >cane. > >CV>> She has progressed from a 4-wheel walker (which is unsafe because > >CV>> she used it incorrectly (very impulsive)) to a cane. But >CV>> needs additional mobility training. Here's the problem. > >CV>> When she walks, she continually grabs doorways, handles, cabinets, >CV> etc. >CV>> She does NOT need these but feels more stable with them. I have >CV>> stressed that she needs to be consistent with her mobility and >CV>> walk in the same manner. But she asks me "why not use them if they >CV> are there"? > >CV>> I need help trying to explain to her that it's best if she not >CV>> rely on cabinets, doorways, etc for mobility. But I can't provide a > >CV>> satisfactory answer as to why? > >CV>> Any suggestions? > >CV>> Thanks, > >CV>> Ron > >CV>> -- >CV>> "... as a profession that offers unique services that are ideally >CV>> suited to meet the health, participation, and quality of life >CV>> needs of people of all ages, occupational therapy is >CV>> well-positioned to succeed and flourish in the 21st century." [Fred > >CV>> Somers, AJOT, April, 2005, p. 127] > >CV>> "The part of convalescence that I found most profoundly >CV>> humiliating > >CV>> and depressing was [OT]... I was reduced to playing with >CV>> brightly > >CV>> colored plastic letters ... like a three-year-old..." [AJOT, >CV> April, 2005, p. >CV>> 231] > > >CV>> -- >CV>> Options? >CV>> www.otnow.com/mailman/options/otlist_otnow.com > >CV>> Archive? >CV>> www.mail-archive.com/otlist@otnow.com > >CV>> ******************************************************************* >CV>> * >CV>> **** >CV>> ************** >CV>> Enroll in Boston University's post-professional Master of Science >CV>> for OTs Online. Gain the skills and credentials to propel your >CV> career. >CV>> www.otdegree.com/otn >CV>> ******************************************************************* >CV>> * >CV>> **** >CV>> ************** > > >CV> -- >CV> Options? >CV> www.otnow.com/mailman/options/otlist_otnow.com > >CV> Archive? >CV> www.mail-archive.com/otlist@otnow.com > >CV> ******************************************************************** >CV> **** >CV> ************** >CV> Enroll in Boston University's post-professional Master of Science >CV> for OTs Online. Gain the skills and credentials to propel your >career. >CV> www.otdegree.com/otn >CV> ******************************************************************** >CV> **** >CV> ************** > > > >-- >Options? > www.otnow.com/mailman/options/otlist_otnow.com > >Archive? > www.mail-archive.com/otlist@otnow.com > >************************************************************************ >************** >Enroll in Boston University's post-professional Master of Science for >OTs Online. Gain the skills and credentials to propel your career. >www.otdegree.com/otn >************************************************************************ >************** > >-- >Options? > www.otnow.com/mailman/options/otlist_otnow.com > >Archive? > www.mail-archive.com/otlist@otnow.com > >************************************************************************************** >Enroll in Boston University's post-professional Master of Science for OTs >Online. Gain the skills and credentials to propel your career. >www.otdegree.com/otn >************************************************************************************** Get a FREE small business Web site and more from Microsoft® Office Live! -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn ************************************************************************************** --------------------------------- Yahoo! oneSearch: Finally, mobile search that gives answers, not web links. -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
