Precisely!
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 Carmen Aguirre Sent: Monday, October 27, 2008 8:03 PM To: otlist@otnow.com Subject: Re: [OTlist] Best Practice I think the message here limits the power of task analysis and task equivalency. There a MANY times when a client will need physical agent modalities/ neuromuscular re-education, lymphedema treatment , etc to prepare a body segment to perform then or later, a desired occupation. The role of OT is important to id. those components that would facilitate the occupational outcome. I would not ID those physical agent modalities, refer my patient to PT, wait until I'm told "they are ready" and then work with my patient on the occupation. It is a segmented approach and unnecessary in my opinion. We are competent to see the process from beginning to end. Carmen ---------------------------------------- > Date: Sun, 5 Oct 2008 20:17:43 -0400 > From: [EMAIL PROTECTED] > To: OTlist@OTnow.com > Subject: [OTlist] Best Practice > > I just posted the following on AOTA's Phy-Dys list serve and wanted to > get OTnow.com readers' opinion. As usual, it's lengthy: > > ###################### START ############################## > > I have always believe that OT intervention and goals must be a > straight and direct line. In other words, what OT does MUST have a > DIRECT effect on the patient's occupational deficits. To accomplish > this intervention, I've sort of developed an "outline" which is > primarily based on the Canadian Model of Occupational Performance. > What follows is a simplified model which helps establish the DIRECT > LINE between goals and treatment: > > 1. Help the patient figure out what they want or need to do > (i.e. occupation) > > 2. Figure out what is keeping the patient from doing their > identified occupations: > > a. Environmental > b. Cognition > c. Physical > d. Social > e. Emotional > 1. Fear > 2. Motivation > > 3. Prioritize the above into those things that can be changed > and THEN GET BUSY CHANGING THEM! Don't waste therapist or > patient time addressing those issues which can not be changed. > > Now this is simple and incomplete, but it works because outcomes and > treatment focus on occupation. Recently, it's been suggested, both on > this list and in print, that quality OT must include occupation into > treatment sessions. I do not feel that such an approach is mandated by > AOTA's Framework, not is it always appropriate. > > Here are several passages from the OT Framework, Rev 2 collaborating > this concept: > > {EVALUATION} > > Occupation-based activity analysis places the person [client] > in the foreground. It takes into account the particular > person's [client's] interests, goals, abilities, and contexts, > as well as the demands of the activity itself. These > considerations shape the practitioner's efforts to help > the...person [client] reach his/her goals through carefully > designed evaluation and intervention. (Crepeau, 2003, p. 193) > (P. 651) > > Analyzing occupational performance requires an understanding > of the complex and dynamic interaction among performance > skills, performance patterns, contexts and environments, > activity demands, and client factors. (P. 651) > > {INTERVENTION} > > The intervention process consists of the skilled actions taken > by occupational therapy practitioners in collaboration with > the client to facilitate engagement in occupation related to > health and participation. (P. 652) > > The intervention focus is on modifying the > environment/contexts and activity demands or patterns, > promoting health, establishing or restoring and maintaining > occupational performance, and preventing further disability > and occupational performance problems. (P. 652) > > Intervention implementation is the process of putting the plan > into action. It involves the skilled process of altering > factors in the client, activity, and context and environment > for the purpose of effecting positive change in the client's > desired engagement in occupation, health, and participation. > (P. 656) > > Nothing in these passages suggests that occupation (or more often > contrived occupation) must or should be a part of each and every > treatment session. What does stand out is the concept that OT is about > occupation as an outcome and as a measure. If an OT's therapy is > DIRECTLY connected to a SPECIFIC occupational goal, then I believe > that quality occupational therapy is being performed. Remember, > quality OT is not about what's being done, it's WHY! > > Why are you doing e-stim? Why are you ambulating with your patients? > Why are you stacking cones? Is it so the patient will regain function? > Is it so the patient can move their arm with less pain so that they > can get dressed? Or is it because the treatments are DIRECTLY > addressing a SPECIFIC barrier to a SPECIFIC occupation? If it's > anything but the later, I suggest that something other than > best-practice is being applied to your patients. > > Sincerely and Respectfully, > > Ron > > -- > Ron Carson MHS, OT > www.OTnow.com > > ############################# END ############################### > > > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/otlist@otnow.com _________________________________________________________________ Want to read Hotmail messages in Outlook? 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