I would write all 4 goals.? Why in the world would you not take this patient?? 
"I shouldn't have taken it but I did."? What patient's do you take?

Chris Nahrwold MS, OTR
St. John's Hospital
Anderson, Indiana


-----Original Message-----
From: Ron Carson <[EMAIL PROTECTED]>
To: OTlist <OTlist@OTnow.com>
Sent: Sat, 30 Aug 2008 2:48 pm
Subject: [OTlist] Elbow Break, Referral...



Received  a  new referral for a elbow fracture. I shouldn't have taken
it but I did.

And  here  is  the  dilemma  facing our profession. The patient is 95,
previously living independently. Fractured elbow in a fall. Now living
with  daughter.  She  is  in a large amount of pain. Obviously, she is
dependent  for  most of her occupations. She currently uses a cane but
is not safe.

The  patient's  immediate concerns are her elbow. When pressed, she of
course wants to go back home, but that is not an immediate goal.

So what do I write for goals? For example should I write:

        Patient will self-report pain as 3 out of 10

        Patient's will increase active elbow extension to -20 degrees


These  goals seem to direct the patients and doctor's concerns but are
not occupationally oriented. So, should I write:


        Patient will safely and independently dress lower body

        Patient  will safely and independently ambulate to the bathroom
        using the least restrictive mobility aid

I like these goals but they don't address the immediate concerns.

Ron
-- 
Ron Carson MHS, OT


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