You're right Brent. It's analogous to OT orders for splinting...its reductionist thinking.
Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Brent Cheyne Sent: Tuesday, September 09, 2008 3:47 PM To: otlist@otnow.com Subject: Re: [OTlist] OT role in ADL Linda, Ron and all, I work in SNF and the issue of ADL and showers comes up a lot. My thought is that ideed there are some patients that it is too soon to work on showers....so there should be no goal in the treatment plan for showering at that time. Sometimes basic grooming and washing and dressing are challenging and engaging enough to match the patients capability. Goals should be set for this type of activity. This is a clinical judgement. It is a matter of activity analysis and grading of activity which takes some critical thinking and logical progression. Eventually the goal of completing a shower with assistance would come as a progression and be an appropriate challange. If you take a patient and hose them down and scub them up and dry them off such that they are a passive receiver of the shower, it would be unethical to bill for therapy for that type of treatment and we couldn't call it occupation-based either. People don't improve function by being in the presence of occupation but by engaging in it. There is sucha a thing as too much too soon which is a big waste of therapy time. On the other hand just taking patients to the gym and randomly doing puzzles and playing cards isn't right either. WIth all due respect, I don't think blanket rule about "OT must bathe the patient once a week makes a lot of sense...a bit of rigid overkill" which implicates that there is no thought, or decision-making skills required to plan, analyze and progress the patient in logical and effective manner. In that case the therapist is not needed . But, believe me I do understand and relate to the frustration managers have with who don't seem to "get it" about occupation. Staff education, inservicing, skill building, mentoring, and team building are oftern required to keep a team fresh and dynamic and out of bad habits. Besides...its important to look at outcomes, if patients are progressing to the point where they can shower independently and go home....somebody must be doing something right..who are they and what are they doing? Eliminate those thiings that don't need doing. "There's a time for everything under the sun" It's a gradual and logiccal process. SIncerely, submitted wtih respect Brent Cheyne OTR/L -- 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
