Ron,
I disagree. We are not at different ends of the spectrum. I think we
have different ways of expressing the same desire to keep occupation the
central tenet of OT. However, I still think you are trying to "burn
both ends of the candle" by not admitting in order to establish baseline
occupational performance one must establish baseline "human" deficit.
We are limited creatures, who depend on these bodies that are decaying
(some more rapidly than others) to successfully engage in the things
(occupations) that are meaningful to us. Your own case history reveals
this. You do a great job of establishing in a snap shot where the
deficits are:
Martha: A Case Study
History:
90 y/o female
s/p CVA (approximately 10 years) with mild residual affects
Generalized weakness
Decreased endurance
Diffuse pattern of extremity pain
HTTN
Severe anxiety
Evaluation:
Decreased strength in bi-lateral LE
Pain in right LE, secondary to "injury" while standing from
toilet
Decreased endurance
Dependent for most ADL's.
Requires mod - max assist with transfers
Non-ambulatory
Prior Level of Function:
Previously ambulated with RW, short distances
Transferred independently
The only occupation mentioned (toileting)is in relation to pain. Your
goals reflect occupational performance areas but your eval does not.
Why?
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
-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
Behalf Of Ron Carson
Sent: Saturday, October 11, 2008 6:49 AM
To: Neal Luther
Subject: Re: [OTlist] Best Practice
Hello Neal:
I do not feel that I'm splitting hairs at all. What you and I are
saying are at two ends of the spectrum. We are describing totally
different theoretical approaches to treatment. Using IADL's to
remediate balance is nothing unique to our profession. And, I think
this type of approach leads some OT's to do pretty silly stuff like
cones, shoulder arc, pegs, balloons, laundry, washing windows, etc.
What I'm arguing is that OT's role should not be remediating
underlying issues, other profession's do that. Instead, our primary
role, and distinction is remediating occupational issues.
Ron
--
Ron Carson MHS, OT
----- Original Message -----
From: Neal Luther <[EMAIL PROTECTED]>
Sent: Friday, October 10, 2008
To: OTlist@OTnow.com <OTlist@OTnow.com>
Subj: [OTlist] Best Practice
NL> Ron,
NL> Your splitting hairs.
NL> I put IADL/balance in the context of treating an ortho pt. (TKR).
NL> Respectfully,
NL> Neal C. Luther,OTR/L
NL> Rehab Program Coordinator
NL> Advanced Home Care
NL> 1-336-878-8824 xt 3205
NL> [EMAIL PROTECTED]
NL> Home Care is our Business...Caring is our Specialty
NL> -----Original Message-----
NL> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
NL> Behalf Of Ron Carson
NL> Sent: Thursday, October 09, 2008 9:36 PM
NL> To: Neal Luther
NL> Subject: Re: [OTlist] Best Practice
NL> Neal, it seems that we look at things differently:
NL> You say:
NL> "we do higher level IADL tasks ... usually to work on
the
NL> dynamics of balance"
NL> I look at it this way:
NL> I do higher level tasks so the patient can learn to do
these
NL> tasks independently <and>
NL> I work on the dynamics of balance so the patient can do
higher
NL> level tasks
NL> Also, for me, I know if interventions are successful if the
patient
NL> has improved occupational performance. Lastly, In my opinion,
OT's
NL> role is not PREPARING the patient for return to activity,
it's
NL> RETURNING them to activity.
NL> Does any of this make sense or is it just "rubbish" <smile>
NL> Ron
NL> --
NL> Ron Carson MHS, OT
NL> ----- Original Message -----
NL> From: Neal Luther <[EMAIL PROTECTED]>
NL> Sent: Thursday, October 09, 2008
NL> To: OTlist@OTnow.com <OTlist@OTnow.com>
NL> Subj: [OTlist] Best Practice
NL>> Simple. If we don't know that our interventions are successful we
NL> dare
NL>> not make claims on occupational performance. It's akin to
NL> performing
NL>> PROM on someone in a coma (which can be a good thing) and when they
NL> come
NL>> out of the coma claiming our intervention as the reason they are
NL> able
NL>> feed themselves now. Another example would be in orthopedics. Why
NL> do
NL>> we do higher level IADL tasks. In my experience, it is usually to
NL> work
NL>> on the dynamics of balance (especially with TKR's). If I do not
NL> know
NL>> the effects of single leg stance on the joint and whether that pt.
NL> Is
NL>> ready (usually in consult with PT) then I can't plan occupational
NL> tasks
NL>> accordingly. And if this is not addressed then I have not done my
NL> job to
NL>> prepare that pt. For return to meaningful activity.
NL>> Neal C. Luther,OTR/L
NL>> Rehab Program Coordinator
NL>> Advanced Home Care
NL>> 1-336-878-8824 xt 3205
NL>> [EMAIL PROTECTED]
NL>> Home Care is our Business...Caring is our Specialty
NL>> The information contained in this electronic document from
NL>> Advanced Home Care is privileged and confidential information
NL>> intended for the sole use of [EMAIL PROTECTED] If the reader of
NL>> this communication is not the intended recipient, or the employee
NL>> or agent responsible for delivering it to the intended recipient,
NL>> you are hereby notified that any dissemination, distribution or
NL>> copying of this communication is strictly prohibited. If you have
NL>> received this communication in error, please immediately notify
NL>> the person listed above and discard the original.-----Original
NL> Message-----
NL>> From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On
NL>> Behalf Of Ron Carson
NL>> Sent: Wednesday, October 08, 2008 9:13 PM
NL>> To: Neal Luther
NL>> Subject: Re: [OTlist] Best Practice
NL>> Why?
NL>> Ron
NL>> --
NL>> Ron Carson MHS, OT
NL>> ----- Original Message -----
NL>> From: Neal Luther <[EMAIL PROTECTED]>
NL>> Sent: Wednesday, October 08, 2008
NL>> To: OTlist@OTnow.com <OTlist@OTnow.com>
NL>> Subj: [OTlist] Best Practice
NL>>> Also, I think we have to measure success at both levels --the
NL>>> treated area and occupational performance.
NL> --
NL> Options?
NL> www.otnow.com/mailman/options/otlist_otnow.com
NL> Archive?
NL> 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
