I agree with Chris, I would take this patient and right all 4 goals. The only exception is i would state why i was going to decrease the pain or increase ROM. I would probably say something like: Pt. will increase active elbow extension to -20 degrees to allow for increased independence with upper body dressing or decrease reports or pain to increase functional performance with bilateral upper extremity tasks (grooming, bathing, dressing, etc.) Ron, you have now given us examples of 2 patients you would not treat, I too am wondering what kind of patient would you see?
Kari, MOT, OTR/L Hollywood, Florida --- On Sat, 8/30/08, [EMAIL PROTECTED] <[EMAIL PROTECTED]> wrote: From: [EMAIL PROTECTED] <[EMAIL PROTECTED]> Subject: Re: [OTlist] Elbow Break, Referral... To: OTlist@OTnow.com Date: Saturday, August 30, 2008, 5:21 PM 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 -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com